I wish I knew how to put all my emails in one place, so that you can follow my story. At any rate, i had planned to write after my six-month post-op appointment which was this past Monday (4-30-12). I had a lot of post-op pain until about the second week of December 2011. The past two months the pain has been minimal, and I was thinking I might be soon able to transition off M.O.M. to Miralax. The CRS said I don't need to see him anymore unless something happens, of course. Wouldn't you know it, a few hours after my appointment (he didn't do any exam), I went into pain (spasm, I assume) from a small, soft bowel movement, and have been in pain ever since. This is so frustrating. I always feel like I'm walking a tightrope, and am afraid to get off of M.O.M. The CRS told me that my fissures (2) were healed before surgery, and that the surgical site was healed by the end of last year. I still feel a lot of soreness after bowel movements, though, but he didn't think that was unusual, and could be expected up to 18 mos. post-op. As far as spasm, he assured me he cut as much as needed (I reminded him that he told me he never saw such a tight sphincter), and that my sphincter just needs to reconcile to the surgery. He has more than 40 years of experience, so I'm trying to trust him. I'm very careful with diet. I eat healthily, and drink lots of water. My stools are always very loose. I still take two sitz baths a day. I just have one question: Is there anyone who has had LIS who no longer has pain, and is functioning normally without over-the-counter stool softeners after a year or two after surgery?[i] I'm just wondering if there is any hope for a full recovery. Thanks.

I haven't have LIS yet, but I am very close to deciding to go forward with it, however, experiences such as this are what concern me and make me second guess my decision. When you read the literature on LIS and when you talk to the majority of surgeons who do the procedure, you hear that the typical recover time is about 4 weeks. My CRS told me that he does about 30 LIS surgeries per year and has been in practice for 25 years and has never seen a fissure not heal and has never seen a recurrence of fissures after LIS. He also stated that I should be back to functioning fairly normally within about a week or two at the most. Now, obviously if the surgery involves more than just LIS, such as a fissurectomy, hemorrhoid and/or skin tag removal, then the recovery will be significantly more complicated, but for a "simple" LIS, I have always heard that it is a very minor procedure as for are surgery goes, and that one should expect to begin feeling better fairly quickly after surgery. I guess everyone has a different experience, but it seems that 6 months is a very long time to still be in the "recovery" period. Do you mind me asking if you had just LIS or if you had other procedures along with LIS? It is good that your fissures are healed and that the surgical site is also healed though.

hi queenofpain,
yes there is hope of a full recovery.
will it be an easy road? no. maybe.
some days will be rough. some days will be disappointing. but most days will be promising, optimistic, and encouraging.
if you want to wean off MOM or Miralax, i highly recommend using the fiber capsules that Metamucil makes or a cheaper generic like Walgreen's or CVS's version. you take 5 capsules as needed - up to 3 times a day - to keep things smooth. since you have smoothness already, you probably only need to take the 5 capsules per day.
although i am about 1 year and 3 months out, i have made the metamucil capsules a staple in my diet.
around month 8 post LIS i had a really bad episode of constipation that i retore and i thought for sure it was sign of LIS #2 ahead. even though there was blood, pain, disappointment....it took about 2 weeks for things to be good. and every now and then i feel a little something but you know what, that little something is way better than anything i had the 8 years before LIS.
i have always been conservative in letting people know that healing will take up to a good year. there is a lot that goes into it. not only the surgical site, but mental, emotional - you name it, everything about the whole situation needs time to heal.
keep your chin up.
do what you need to do.
and expect to heal. just know that it will on your body's own time, not your time. work together with your body positively. don't let set backs get you down because you will allow yourself to be defeated and well, that sets off a lot of other processes in your body.
yes it may take a while to heal. give yourself a full year.
you're gonna be in a different place than where you are now.
take care.

Hi mm92599,
I, too, from reading the literature and learning of the exceptional success rate, thought that LIS would be a breeze compared to coping with a fissure. I was led to believe I would be able to return to work in three days, and only had to cope with pain for the first 24 to 48 hours. That's far from the case, at least from my experience. March and April were two relatively good months (although I still felt I was walking a tight rope, and the area continues to feel fragile), and now, I, mysteriously, have experineced seven days of pain from one very small, watery bm.
Is the surgery worth it? I still say, 'yes.' For one, there is hope. It seems I plateaued pre-surgery, and never returned to normal, still coping with periodic pain five years post-fissure. I actually had two fissures, which healed per the CRS, but I still would go into pain (spasm, as we're told). He said he never saw a sphincter that tight, and felt I would need surgery one day. So, after my last bout with pain in September 2011, I decided to get this done. I thought it was just something to check off my list, and I would be saying 'goodbye' to this pain business once for all.
No, I didn't have anything else done besides the LIS, and I've never been told that there were any other issues. There was no fissurectomy or anything. I would think the CRS would have checked the area during surgery to see what else was present. In fact, his nurse, told me during a phone call that he looked through the layers to see what was causing pain. Maybe that involves assessing the depth of the tear, but I don't know. He never did an internal exam in the office because he said I would never be able to tolerate it.
It's best to get a range of opinions on this board, and I'm glad you're doing that. The problem is that the area is deceptive. I was beginning to think I was possibly crossing the line of no return, having had two straight good months, only to have an inexplicable setback. This was the typcial pattern for me the last few years before surgery: long pain-free stretches, but then mysteriously and periodically crossing that line.
My CRS thinks that you have to be patient, and it can take 18 months to get over the pain (I think he randomly threw out a number). He said my fissures were healed pre-surgery, and the surgical site healed in six weeks. However, he explained, my sphincter still has to reconcile to the surgery.
I have no regrets about surgery. LIS is the gold standard treatment, and at least it gives hope where there previously was little.

Hi Happyass,
Thanks for the advice and encouragement. That's really all I need to hear, that things can take a year (even more). My CRS said if things are still problematic after 18 mos., maybe there's an issue. He said I can call at any time, but advises patience. He assured me he cut enough, and that's all I want to know. I was afraid he was too conservative.
I will stick with M.O.M. for now, and then try to wean to Miralax. I tried Metamucil and other grain-based products originally, and they made my stools very bulky and hard, even with drinking a lot of water, and adjusting the dose. It's a wonder I didn't tear that whole area apart :). I don't know if the capsules are any different, but I'm still very sore down there after going to the bathroom, and am terrified of Metamucil.
Thanks for your reply! Glad you are doing so well.