Thinking of LIS - your advice please!!

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Thinking of LIS - your advice please!!

Postby mashmetoo » 16 May 2011, 21:36

Hi everyone, I've been lurking on this forum for some time.
I wanted some feedback from the veteran LISers here. I had an anal fissure since the middle of 2007 (almost 4 years now). It is chronic, but it isn't that bad. I don't have pain sitting down, there's no spasms. The only issue for me is the periodic bleeding.
My chronic anal fissure has been a mixed blessing and curse for me. It forced me to eat a vegetarian diet for 3 years, but I also lost 30 pounds and could fit into all my high school clothes again - this and a lot of other health benefits of eating a healthy vegetarian meal. The curse of course, is the psychological trauma of seeing blood in your stool, and feeling the occasional sting as the fissure rips again... Basically, the fissure would heal for 2-5 months, but invariably, I would pass a very hard stool, and the fissure rips and bleeds - the cycle repeats over and over as it has for the past 4 years...
6 Months ago, around December 2010, the bleeding was REALLY bad. It was like a nosebleed, the paper swipes would be SOAKED in blood as would the toilet bowl. Bowel movements would sting, but the pain/discomfort was bearable, at most a 4-5/10 if I had to rank it. Anyways, I've seen THREE colorectal doctors and my family doc. All of them say that I do not need surgery (LIS), and that it's "not that bad". The last colorectal doc/surgeon I saw (in Dec 2010) told me to use Anurex - the cold therapy thing. But he did say that if this didn't work, he would perform the LIS surgery. But, I'm very concerned because his clinic is in Toronto, and they only use local anesthesia.. (Dr. Rudd if anyone's familiar with him...) So I wonder how much worse would the pain be if they only use local anesthesia?
This year, I was able go for 3 months without bleeding.. then it relapsed again in early May.. so, I'm thinking about surgery once again..
I'd really appreciate some feedback. I mean, I'd love to have this fissure business behind me forever and never see blood again... But at the same time, I've had FOUR doctors tell me that I don't need LIS surgery.. So I'm really confused as to what I should do...
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Re: Thinking of LIS - your advice please!!

Postby Elphie » 16 May 2011, 21:56

Well, recently hopetoheal went to the Rudd clinic in Toronto, her experience wasn't great, to say the least, but I am not a vet of LIS just had it almost three weeks ago and it gave me my life back. I had severe pain, bleeding for a year and chronic hemmeroids for many years before that. Please verify with them if you do get LIS that they knock you out! Poor hope was awake and PAINFULLY aware. The bottom line is, if the muscle is too tight, it won't let the fissure heal, but if you're not in too much pain, maybe Botox or ointments will help? I would NOT want to get LIS under local but if I couldn't live with the pain, I just might've! It's a hard choice to make I know but please read hopeto heal's story before you proceed, it might make you think twice about that clinic. Good luck hope you find your solution soon!
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Re: Thinking of LIS - your advice please!!

Postby Deleted User 579 » 17 May 2011, 06:05

hi mashmetoo - I had my LIS done at the Rudd Clinic (Dr. McKenna) and I would STRONGLY advise that you NOT get the procedure done there, especially if you are not in a lot of pain. If you've read my story, you will see why I say this!
It's too early for me to say yet whether or not th LIS worked for me, although I will say that the pain has diminished pretty dramatically. The local is VERY painful, and my surgeon didn't even sedate me. The Rudd docs have good reputations as surgeons, but they do not care much about pain-management and my surgeon was a pretty awful person. I was in a great deal of pain with my fissure and was not able to see a surgeon for 6 months to a year ... so I was pretty desparate. If you are not desparate (if you are not in pain), then I really, really, think you work with another surgeon, not with Rudd, and, if you do eventually need surgery, get it done in a hospital under general anesthesia.
I'm also puzzled about why the Rudd doc would give you anurex - did anybody give you nitro or diltiazem?
Please aggressively pursue options other than the Rudd Clinic! I hope you find a solution and relief very soon.
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Re: Thinking of LIS - your advice please!!

Postby mashmetoo » 17 May 2011, 09:16

Thanks for the reply Elphie and hopetoheal. I tried 0.2% nitro for a few weeks, I found out that I bled slightly more with the nitro, so I stopped using it 2 years ago. I had Dr. Rudd himself examine me, and he said I had anusitis - inflammation of the anal canal - that's why he told me to try the anurex.
Regarding the Rudd clinic, I understand you had Dr. Mckenna, did Dr. Rudd examine you at all? I was wondering if the bad experience was due to Mckenna exclusively? Would things be better with Dr. Rudd (the owner) himself, or would it be just as bad? On ratemd, Dr. Rudd averages 4.3/5 stars.. and the reviews are pretty good.
Also, the needles they gave you, are they "freezing needles", and what exactly is a freezing needle?
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Re: Thinking of LIS - your advice please!!

Postby Deleted User 579 » 17 May 2011, 09:45

hi again mashmetoo - I really can't say if things would go better with Dr. Rudd or not. I do think that a large part of my own bad experience had to do with Dr. McKenna being a j**kass. The needles I got were 'freezing needles'. I might have a low pain threshold (I don't know how people get botox injections without being knocked out!), but I found they hurt like a *&*%!. Another boardie (Genevieve) had her LIS done at Rudd. She got sedated and she still experienced quite a bit of pain with the needles. I seem to recall her saying that the pain from the needles didn't last very long. In my case I think part of the problem was that McKenna didn't sedate me and started on me before I was completely numb. So if you stay with Rudd, make sure he will sedate you! I'm sorry I can't be more helpful - I think it might make a difference to have a different surgeon at Rudd; but really, if I had a choice, I would rather have had the surgery at a hospital under general.
Did Dr. Rudd say anything about whether the anusitis would heal or if it's a permanent condition? Will it interfer with healing after an LIS?
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Re: Thinking of LIS - your advice please!!

Postby RedCharger » 17 May 2011, 14:57

I went to the Rudd Clinic yesterday for a examination. I have tremendous pain following a bowel movement that last 6-8 hours. My GP sent me to the Rudd clinic. I had a BM the morning before I headed down for my appointment. I almost cancelled because I was in too much pain to drive but I toughed it out in order to get this diagnosed and on a path to recovery. I was examined by Dr McKenna and after assuming the position he began to examine an already tender area. He asked his assistant for a small scope and shortly after that I thought I was going to pass out from the pain he was inflicting during his exam. I was screaming and sweating like crazy. He diagnosed me with a fissure and anusitis. He gave me a prescription for Diltiazem and told me to try that for 4-6 weeks and if it didn't help he would recommend surgery. He seemed very knowledgeable but I swear he got his training in the interrogation room at Guantanamo Bay detention camp because he had no remorse over the pain he was putting me through. If I do have to have surgury, he sure wouldn't be my choice to do it!
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Re: Thinking of LIS - your advice please!!

Postby Elphie » 17 May 2011, 15:28

Oh redcharger! Please read ALL hopetoheal's threads before you let this Dr McKenna near your butt again! I'm afraid for you, he did help hope but not without plenty of mental and physical torture first. I had to get aggressive with my doc before I got surgery but he knocked me out and gave me great pain meds after! For me, surgery was a breeze and my relief was immediate. No more burning! If you have the option, look for another doc or at least be firm that you want to be sedated before they stick those freezing needles in. I don't know your story, but if you've suffered like me, do the surgery. It's worth it. Just make sure it's on your terms, if I was hopetoheal, I don't know if I could ever go back...
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Re: Thinking of LIS - your advice please!!

Postby Deleted User 579 » 17 May 2011, 15:35

Redcharger - I'm so sorry you had that experience! you are definitely right that McKenna should work at gitmo - he has the perfect personality for a torturer. He refused to sedate me for my LIS (it's my understanding that the usual practice is to sedate the patient, but DEFINITELY confirm that!). I think you are absolultely right to avoid surgery with that guy. I'm not even going to see him for my follow-up. As I told mashmetoo, I really think that if you can, it is better to get the LIS done in a hospital where you can be knocked out. Even getting sedated, an LIS with only a local would be a rough go.
Where you really hollering? And did he tell you to be quiet? I was sure hollering when he was shoving needles in my ass and burning off the skin tags before I was numb - and he just told me to be quiet. Yep ... he's a sadistic SOB, so watch out!
I will say that I am doing better than I was before the surgery, so I do think that the surgery was a good call for me. But if you have any options at all, definitly avoid the torture I went through!
I am so sorry you are going through this. If you really must get any surgical procedure done at Rudd, absolutely demand to be sedated, like Elphie says.
I really hope you find relief very soon.
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Re: Thinking of LIS - your advice please!!

Postby RedCharger » 17 May 2011, 15:55

I was hollering...... His nurse tried to reassure me (blonde with a bit of an accent) but he seemed to not care and be on a mission. I don't think he is intentionally trying to inflict pain I just think he is such a dinosaur mabe in his day he would just give you a bullet or piece of wood to chomp down on. But seriously, I feel he has lost touch with the personal side of medicine. To him its routine, and ya we scream a little but he knows he isn't killing us. I think he is numb to the whole procedure since he has done it so many times. He looks too old to be doing this kind of treatment and he was limping around and couldn't stand long while I was with him. He should retire and give his bad hip and shaky hands a rest!
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Re: Thinking of LIS - your advice please!!

Postby Deleted User 579 » 17 May 2011, 16:30

it's funny you should say that! before I went into surgery, my husband offered to get me a bottle of whiskey and a piece of leather to chew on ... little did I know I would need them! I think you're right that this guy is really old school ... he is not accumstomed to patients asking questions or having a say in their treatment. I didn't see his hands shaking or I definitely would have run away there and then (well, hobbled, given the pain I was in!). But he did have to sit down mid-way through the procedure because his hips were bothering him. That was a very alarming thing to have happen during ass surgery, let me tell you!
I think you're right that he's just desensitized to the pain he causes - but that actually kinda pisses me off too because I was sure I wasn't the only patient who has ever hollered in his office, yet he got angry with me and blamed me for being in pain (I am a "nervous person").
Mashmetoo -- please beware. If the receptionist comes out and says "Dr McKenna will see you now" - RUN! And please definitely make sure that whoever deals with you respects you and shows some compassion!
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