Hey all - new member - 35 yrs old - struggled with a bad fissure this past year. Finally decided to get the surgery scheduled in a few weeks. I figured I would chronicle the adventure here
Few interesting things in my surgery -
1. I am not getting knocked out - decided to go with a spinal. I don't like getting knocked out and wanted to be concious for the procedure. It only takes about 30-45 minutes so will gut it out.
2. Besides the LIS I will be having both a fissurectomy and anoplasty - little more complicated then the usual LIS only but my Dr feels this gives me the better chance of long term full recovery without recurance.
3. Fissure is currently not hurting me - it has been off and on for a year. Some weeks it is fine. Other weeks it is agonizing. So not sure if the surgery will be easier since my fissure is not too painful right now or not.
Looking forward ot any feedback and I'll post my thoughts as well

Well congratulations on deciding to do the surgery. I just had it last month (minus your extra procedures) and it really wasnt that bad. I think it is well worth the effort and recovery. I have been fissure free ever since, and I am so glad that I finally decided to take the surgery route. My fissure had been bothering me for 4 years previously, but I thought it was hemorrhoids! It always helps to know what the real problem is!
Keep us updated, and welcome to the group!
kate

I think you're lucky to have a fissure that will give you a week off here and there. That seems to be pretty rare.
If you're healthy, you are doing the right thing, IMHO. Once you've had the beast for more than a year, and have tried everything...well, let me just say that surgery will give you your life back!
I'm not familiar with anoplasty...if you don't mind, could you tell us what is involved in that procedure?
Finally, you're brave doing the spinal thing. I considered it, but it was just too many needles and I heard it was painful when they first insert them. But your recovery should go much faster!
Kim

I would be interested in hearing more about the fissurectomy and anoplasty. I asked my doctor about fissurectomy last week but she didn't think it would be warranted in my case. What is anoplasty? Is that some kind of reconstruction? Are you in the US?
I am glad you aren't in miserable pain for the most part. It can really suck.
I asked my doctor if everyone seems to have the same amount of pain with a fissure and she said she has seen some people with a gaping fissure and they don't even notice it and others will have a papercut like fissure and be in agony.
I am just happy I am not in constant pain anymore. I still have my bad days like today but I have had some decent days where it doesn't hurt more than 4 or 5 hours. Yipee for me!!!
Anyway, welcome and feel free to ask any questions! I haven't had the surgery but we have some veterans here whose lives really have been restored by it!
Lecia

fletch, i hope you reconsider the spinal.
when i got my colonoscopy, they used VERSED and it was amazing. i was out but when i woke up, it was like i just woke up from rest. i didn't really feel like i was ever given anything.
i would do it again.
it would be interesting to know what your understanding of anoplasty is.

Sounds like I was given something similar to Versed (Midazolam) for my so-called hemorrhoidectomy "procedures" that were done here at my local hospital last August.
For longer, more intensive procedures, that may not be an option. When I inquired about the so-called "twilight" drugs for my LIS, I was told the entire area down there had to be completely anesthetized for up to 1.5 hours. Still, it couldn't hurt to ask...
Since Fletch is having three procedures at once, I'd bet the farm it's either GA or spinal, which were my only two options.
Unless Fletch has a very fast surgeon....
At least with the spinal, one is not running the chance of ischemia that is always present with general anesthesia. That was *my* biggest fear.

I still have my bad days like today but I have had some decent days where it doesn't hurt more than 4 or 5 hours. Yipee for me!!!

Gosh, Lecia...for the most part, 4-5 hours of fissure-fun occured on my *worst* days! My heart goes out to ya, gal!

Thanks for all the feedback!
I am getting the specifics on the procedure next week - but from what I remember from my Dr visit - the LIS only deals with the muscle while a fissurectomy actually cuts out and removes the fissure itself. Anoplasty is a small piece of skin they graft over the removed fissure area. Not sure if it is new or anything but my Dr is a specialist so maybe its somehting he does.
As for the GA vs spinal - it is still up for debate. Pain doesn't bother me so much - my problem is from the neck up in that regard! I get very nervous being knocked out - have this weird feeling that I won't wake up again - have had some minor heart issues and am concerned that there could be a problem with the GA - panic type of disorder I guess - nothing concrete to go on. My cardiologist says either is fine.
I am in the middle - on one hand I want to stay awake due to my issues - on the other I have heard that spinal is pretty painful - has just as many issues as GA - and also may need a cathater in my groin since you lose sensation (didn't know that until today) - so maybe GA is the way to go and if there's a problem at least I won't know what happened!
Thanks for all the comments - I'll keep this up to date. While my fissure has been friendly lately - it originally was torn to the muscle and agonizing so I know your pain! The nitro ointment plus milk of magnesia allowed me to heal to the point where I am not in agony but it is still on and off pain. Its no way to live for the next 50 years so might as well do it while I am young!

Yes, Fletch do keep us updated on things. I would be interested to hear more about what you learn about fissurectomy and anoplasty.
Gotta love that versed! Boy was that relaxing but it was used as a twilight drug during an epidural to help with my nerve pain.
I have had GA and I remember being afraid of not waking up and seeing my family and friends again. When I woke up I almost cried I was so relieved. It is kind of a creepy concept but I think for some things I would not want to be aware of the goings on. I had to have a catheter for GA but I don't know if that is routine. They had to remove one of my kidneys so it could have been related to it being a urological surgery.
I know with pain control during labor they use epidurals and occasionally that will lead to the use of a catheter if the bladder gets distended or the patient has problems emptying the bladder after delivery. The spinal medication goes into the dura so the effects will be more pronounced whereas the epidural is outside of the dural membrane.
I didn't have any discomfort when they did an epidural to help control the nerve pain. I think the key is getting a great anaestesiologist who has performed many and can get in and out.
I think if you talk to your doctor about your fears/concerns they may give you something to help you relax. When I had my wisdom teeth removed they gave me some valium. I didn't think it would do anything for me but by the time I was in the chair I didn't care what they did!
What part of the country are you in if you don't mind sharing. I just like to know what kinds of doctors and treatments are used regionally!
Take Care,
Lecia

I am in New Jersey
My Dr is a great surgeon but not involved with the spinal/GA - I have to deal with the hospital directly. I would love to just go twilight - like a colonoscopy - but think it has to be either a full GA or spinal.
I'm doing some more research on it and will make my decision soon - welcome all input of course!

Thanks for the info on the procedure, Lecia. Up 'til now, I had a pretty primtive/ignorant conception of the spinal procedure(s).
(what, with never having had a baby, or anything!)
Kim