Hello This is Ravi and am back confused. I went to another surgeon ( Surgeon 2) today for a second opinion. He recommended that I dilute the nitroglycerine with an ointment he gave and try for 2 weeks. He said that the surgery would need me to take 1 week off from work with substantial pain during this time. The earlier surgeon ( Surgeon 12) I went to said that they do surgery on Thursday and I could go back to work on Monday.
The second surgeon talked with me for almost 30 minutes explaining fissure. He said that he could give me vicodin for pain relief but I will have to take it with a laxative. Surgeon 1 however had refused to give me any pain killers he said that if I need anything stronger than motrin I need surgery.
What do you think which surgeon seems to be right to you..
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Here is my first post on this site
Great to know about this group. Exactly what I was looking for. God bless the creator of this site.
I have had severe fissure pains for almost 7 months. I feel better for 3-4 days and then I am in terrible pain. I tried hydro cortisol supposotories, hot baths, Fiber changed diet etc. I also tried the 0.2 % nifediphene no relief.
My primary care phy prescribed 2% nitroglycerene. I applied 1/4th inch and got a throbbing headache and palpitations.
I have noticed that if I eat nuts, white bread then the next day I am definitely going to be in pain. I take stool softners every day for the last 3 months. The stool is soft but when I have a BM it wont come without a lot of straining. When this happens I know I am screwed. Few hours later the pain will begin and then I will get another BM after which it hurts like hell.
If I go to the gym and pick weights then I am sure to be in pain the next day.
Lately I have also been under a lot of stress. The days I am stressed then the fissure hurts like hell.
I am 32 years old and also am hyperthyroid. I have controlled my intake to 1800 calories no sugar and bad carbs, no coke etc. I am not overweight. I drink 2 litres of water every day.
Dr recommends surgery. I did some reserach about it and found that incontinence is a probable side effect. Based on this would you please recommed I go for surgery or not.

At the end of the day, its up to you whether you have the surgery or not. Personally, I think if you're in a lot of pain and you have a competent surgeon, then surgery is the best option. Especially if you have tried other methods and none work.

With regards to the pain after surgery, everyone is different but in my own experience, the pain gets better after 3 days, and depending on the work you do, you should be able to go back about a week or so afterwards, although its obviously better to be able to have a longer recovery time if at all possible.

Hope that helped!

the second surgeon seems to at least tell you upfront and not sugar coat things.
yes you should expect to be away from work at least one week, if not two.
also, healing from LIS will be a good 6-8 months and about 1 year to feel almost as normal as before.
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i just hope that you are seeing colon rectal surgeon specialists. not sure where you are writing from ravi.

Ravi -
I am not sure which one is better - ask yourself, Which one gave you the better vibes?
I think at least a week off for LIS is realistic. However, I have known a few people only took a couple days off. My CRS (who I totally love and pretty much believes anything this man tells me - He has never done me wrong!), told me he thought I could have LIS done on a Thursday and be back in school on a Monday. I think he bases the recovery time on your job, your age, your physical and mental health. But really, with all these factors, you can never tell what your recovery time will actually be until you are there. My first CRS (who I don't see anymore) told me at least a week for LIS.
I think you should try the nitro for a few weeks. I swear by that stuff. I have been using it for 3 months and "knock on wood" it works! My CRS told me to give it time, and he was right! Nitro has been a total life saver for me. I was on nifedipine for 6 weeks prior to the nitro and was ready to have LIS because it did not work at all. I am really happy I gave the nitro a chance.
Hope you feel better!
Jen

Thanks for all the replies. I am based in Northern Virginia Washington DC metro. I am seeing a colorectal surgeon. Both the surgeons are listed as Washington's top. The first one has been in the area for a while. My primary care physician (pcp)has a high regard form him Here is the web site http://www.fairfaxcolorectal.com/. The surgeon I am seeing is Dr Donald Colvin. I believe my pcp a lot and am tending towards the first one. Regardless I will give nitro another shot.

Ravi - with all of my experiences with CRSs - I would go with one who shows more compassion and understanding and patience - which is in your case CRS who talked to you for 30 min. Somebody who point blankly dismisses your pain and expects you to "jump around" in 5 days is totally off the mark. I had very fast course of healing - my incision was healed in 2 days (LIS), did not need any pain meds after surgery, but pain and bleeding are not the only indications of your readiness to go back to work full time. You have to be on very precise diet and have long sitz baths to help healing that area and for swelling to go down - I would take 2 weeks off the work if I were you to make sure I heal properly. One week minimum !!! The other very important fact about making a choice is competence of the CRS. You should ask both of them about THEIR personal success with LIS and if they ever had cases of incontinence and for how many years they are performing it. The answers should be :NEVER had a case of incontinence and having at least 15 years of practice.
Best of luck !

PS : I went on the link - maybe Dr. Colvin has that "upfront " attitude because he was trained and worked for long time in army hospitals and bases - maybe he has more gentle side "under that attitude" - LOL - Ravi - tough call buddy ; ). You have to follow your gut feeling and we actually never know what is in the stars anyway - so, yeah - best of luck ; ) - that is what one needs the most !!!!

Thanks.. I just got an appointment with Dr. Colvin now for Friday and am going to decide to do whatever I have to do then. My vibe says colvin because I am totally impressed by facility. When I had initially gone to him at that time he was compassionate and said 90% of the time the fissure should heal by itself. Only after 4 months of failed conservative methods he said dont suffer get LIS done. You will feel better after it and finally he said he will do surgery only if I think I have had enough of the pain. So I found him to be a nice guy.
On friday I will definitely ask how many surgeries he has done and how many led to incontinence.

ravi wrote:When I had initially gone to him at that time he was compassionate and said 90% of the time the fissure should heal by itself. Only after 4 months of failed conservative methods he said dont suffer get LIS done.

Ravi - My doc said this same thing! Its very encouraging, huh???
Good luck with your choice!

The one that tells you to try and heal it conservatively, but then says when you have had enough we'll do the LIS, is the one I would like. He's not interested in making money, but in seeing you heal in the best way.