Surgery on 6/10

Really scared, but out of options

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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Re: Surgery on 6/10

Postby StarrySky » 11 Jun 2020, 14:24

Had my first BM after surgery. It was pretty uneventful. Thankfully, not much pain except some burning from the incision site. It was pretty watery, though. I'm thinking I shouldn't be taking Colace since my BMs tend to be watery and soft anyway. I just wasn't sure since I know surgery meds can back you up. I'm going to try to eat my normal fiber-filled diet, although I will probably have smaller portions.

Feeling sore and burning a bit. Going to take a few sitz baths today and try to take it easy. I'm still fearful about all this. This whole fissure situation has caused me a lot of anxiety and depression, as I'm sure most everyone who has had fissures can relate to. I just hope this surgery works. My surgeon said my skin is very thin down there due to being through chemo last year. I hope that doesn't mean I won't heal. : ( It just makes me very scared. I want to get through this and heal for good!
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Re: Surgery on 6/10

Postby Pzgre » 11 Jun 2020, 15:25

I happy for you that you had a uneventful bowel movement!! I think you can cut back on colace since you eat a healthy diet. Make sure you are drinking lots of water. Stay positive, it will work!
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Re: Surgery on 6/10

Postby StarrySky » 15 Jun 2020, 13:50

Hi everyone,

Just wanted to post a quick update.

Doing very well! I am not totally pain-free, though, which is to be expected since it hasn't even been a week since my surgery. I can still feel (if that makes sense) the fissures there (they were cauterized, after all), but I don't get the awful, BURNING, debilitating spasms for hours after a BM anymore thanks to the LIS. The incision site is still a bit sore and itchy and the fissure sites seem to itch a bit when I do a BM.

My BMs have been very soft and almost totally pain-free (except for some mild soreness and stinging at the incision and fissure sites) at about a Type 6, which is usual for me. I hope that doesn't impede my healing since it's on the verge of diarrhea, but I'm not sure how to solve that issue. My CRS didn't seem to think it was a big deal and thought softer was better for healing. I'm getting conflicting information on that online. I eat a mostly plant-based diet, so it's obviously related to that. I stopped the Colace since I don't think I need it since I rarely ever get problems with constipation since I pretty much eat the same things every day and drink tons of water. I have no clue how to bulk up my stools without overdoing it. I've tried Metamucil in the past and it made my stools too huge, so I don't want that either! It's such a balancing act.

All in all, I am doing very well and hoping and praying for continued healing in the coming weeks. I am able to pretty much do everything I normally do, including taking walks, sitting (with breaks now and then), and working and going to the store. I'm still resting when I need it and getting plenty of sleep since that aids in healing. For pain medication, all I take is Tylenol now when I feel more soreness. I never had the need to take any narcotics, even right after surgery, which is a huge relief.

I hope I have more good news to post in the coming weeks. : ) Thanks so much for your support!
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Re: Surgery on 6/10

Postby chachacha » 15 Jun 2020, 13:59

Sounds like you're doing really, really well. Congrats!

On the bulking up front, could you try a much smaller dose of Metamucil? And one thing that thickens my stool up is rice. That might help you too. Keep up the great work!
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: Surgery on 6/10

Postby StarrySky » 15 Jun 2020, 14:52

Thanks, chachacha!

I will probably try a smaller dose of the Metamucil. For rice, do you suggest brown or white? I know white rice can be constipating. I used to eat a lot of brown rice in the past and I do think my stool was bulkier then. It's been a while since I used to eat rice, but I will try it!
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Re: Surgery on 6/10

Postby chachacha » 15 Jun 2020, 15:20

I believe that both firm things up, so eat whichever one you prefer. Good luck!
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: Surgery on 6/10

Postby StarrySky » 18 Jun 2020, 13:23

Just a small update:

Been feeling kind of bad the past day or so. The area seems more irritated and I still feel like I can feel my fissures sometimes. : ( I'm starting to get a bit discouraged. I know it's only been a week, but I can't help but worry sometimes. I just want to be pain-free!

My BMs have been fine (no pain), but afterward I seem to get some muscle spasms (and can feel the pain radiate down into my legs), which is similar to how it was before LIS and it seems to increase throughout the day. It's not quite the same as fissure pain, but it still hurts. Everything just feels sore and irritated. I had pelvic floor issues before all of this. Could those be exacerbated by the surgery?

Is it normal to have good and bad days after LIS? I was doing so well right after LIS and I'm just wondering why I'm getting shooting pains and soreness still. I worry that he made too conservative of a cut. : ( I just want to heal...
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Re: Surgery on 6/10

Postby StarrySky » 26 Jun 2020, 13:36

Update:

It's a little over 2 weeks since my operation and I'm not doing that well. I'm worried that the surgery was a failure. : ( I am still getting fissure pain and feel like I re-opened one of them (there was a minuscule drop of blood after my BM this morning). I don't get the spasms anymore due to the LIS, but I do still feel the fissures and I get random stabbing pains throughout the day, as well as muscle spasms in my legs (radiating pain). It really sucks and I'm starting to feel hopeless.

I don't know what to do. My CRS said the skin is thin down there, which makes it more difficult to heal. He thinks the thin skin is due to the chemo I had last year for breast cancer. He said there's nothing I can do about it but give it time. I'm so tired of waiting to heal. I am just losing my patience with all this! I am tired of being in pain!

I'm just wondering how I managed to heal the fissures last year right after I was done with chemo. You would think they would have trouble healing if my skin was really thinned by that. Does Crohn's disease or Ulcerative Colitis cause thin skin of the anus? Does loose stool? I know hydrocortisone can cause it, but I've never used that. Does lidocaine or any of the ointments for this cause the problem?

I would think my CRS would have given me a colonoscopy if he suspected that I had some underlying disease like Crohn's, but I have no symptoms of either (except looser stool) and I would think there would be signs of it when he examined me under anesthesia. I just have really loose stool ever since I stopped chemo last year (which gave me awful diarrhea almost all the time). I'm afraid to firm it up too much with more fiber because I worry if that will make things worse and rip me open even more.

I'm just at a loss right now and feeling really down. I just needed to vent. I don't have an appointment with my CRS until August, though. I just don't know what else to do and I hate feeling hopeless.
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Re: Surgery on 6/10

Postby chachacha » 26 Jun 2020, 16:03

It is still early days, but I'm sorry to hear that you're feeling hopeless.

The LIS doesn't prevent new fissures from forming, but does help them to heal faster and eliminates the horrendously painful spasms.

I can't help you with your medical questions about Crohn's and UC and also don't have an answer with regard to the lidocaine.

Please feel free to vent any time, and also try to keep your chin up, since it's not been very long since your surgery. There's still a good chance that things will improve soon.
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: Surgery on 6/10

Postby StarrySky » 26 Jun 2020, 18:57

Thanks, chachacha. I guess I will have to discuss this with my CRS. I am also worried he didn't cut enough muscle. Is that common? My CRS has 30+ years experience and this is his most common operation, so I find it hard to believe he wouldn't cut enough to allow my fissures to heal. I know some people got a second LIS, but I thought that was pretty rare.

I just want to be free of this problem once and for all. I've searched on this forum and nobody has a similar problem to me (thin skin in the area), so that makes this even more difficult since I feel so alone. I'm very depressed and just want to see a light at the end of the tunnel.
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