I've posted on here a couple of times awhile ago. I had LIS and a fissurectomy in April with a general surgeon. That DID NOT work and so I had just the LIS again in August with a CRS. Things were a little bit better after the second surgery but today I had two BM's and feel like I've ripped completely back open and the toilet was filled with blood. All I can do is sit here and sob. I'm only in pain when I go to the bathroom and I just feel sore down there the rest of the time. Here's the kicker. When I asked the general surgeon for my surgical report it said nothing about having an LIS done. It talked about the fissurectomy but that was it. Am I crazy to think that he never performed the LIS and I've really only had one done? If I have had two, will a CRS do a third LIS? I am losing my mind and am beyond frustrated and sad.

Hey Michelle, I've never had LIS so I can't help much there, sorry... But just curious, does your general surgeon recall doing LIS? If the surgical report doesn't mention it and you're still having problems then I don't think you're crazy at all for suspecting that he never did it. I'm sure some of the folks who are more familiar with LIS will chime in here shortly, please hang in there.

One person here had LIS 3 times--Fiss.

The general surgeon was very short with me each post-op visit I had with him. I asked him about the LIS and all he said was that my 2 fissures weren't that big so he hardly cut any muscle. Should you be able to see a scar if he did? My CRS couldn't find a scar from it so he cut me "again" on the left side.

cheryl - i think fissulyna only had 2 LIS..possibly one with fissurectomy?...not 100% sure on that though. she hasn't been around much anymore huh?
michelle - i've had 2 LIS and i have had drs suggest a 3rd as a last resort. i haven't had kids yet though so they'd be hesitant to do a 3rd due to the higher risk of incontinence. it sounds like you've only had 1 (especially if you're report doesn't say anything about it...) so you should be able to get another. but find a good dr and get a few opinions first. i jumped into my 2nd surgery about 12 weeks after my 1st and i totally regret not giving it more time. that was 2 1/2 years ago and i just didn't know as much then as i do now. it takes TIME.
a good CRS should be able to tell not only if you've had LIS (or more than 1) but also if it worked. if you're still super tight it probably didn't work or the dr probably didn't cut enough (i guess that's what happened to me).
are you taking miralax or any other softener? if not, you need to start! if you're only having pain during BM you're lucky! you just need to get your BMs super soft to cut down that pain and that's a huge part of the battle.
hang in there.

Michelle
Hi, I've had two LIS (August 2008 and February 2009). Still not healed but last 20 days have had much less pain than normal - not sure why less pain but am now on 0.5% nifedipine applied internally plus having a good period of soft BMs. Would a CRS do a third? I have just been referred to a new CRS after the first one said he cannot take it any further and it is beyond what he is comfortable with (which was good honest feedback) - the new CRS discussed doing a third LIS as one of several options but only after completing a number of diagnostics including an ultrasound and manometry. The first to see the effect of the earlier LIS's on the sphincter muscle structure and the second to see if the resting pressure of the muscle is normal or still very high. If very high (compared to the pop average - I did not have it done earlier for comparative purposes), then he may consider another LIS but if normal or low - definitely not because of the very high risk of incontinence. Interestingly, he could find no evidence of the first two LIS on the muscle - maybe they were very conservative and have healed over well? I should mention that other reasons (eg crohns) have been ruled out as factors preventing healing. If I was in your position I would be very hesitant about having more surgery until you (and your CRS) feel totally comfortable with that being the best option available - even if that means waiting a few months and trying nifedipine etc (if not already). Best wishes.
Charles

Thanks for all of your input. I am having a lot of pain down there and it feels as if I've never had surgery. I have an appointment with a gastroenterologist to talk about manometry and what can happen next. (I just moved to a new area and am already seeing him because I just had my gallbladder removed.) I have used the nifidipene .3% before but it didn't do anything. I still have some nitro cream left and am going to try that again. The gastro also prescribed diliatezam (sp?) but I haven't gotten that filled yet. I don't really want to have surgery again but I can't handle dealing with this all of the time. It is all consuming and after I go to the bathroom I just get depressed. The CRS that performed my surgery said if it didn't work he would consider a y-v anoplasty. Has anyone's doctor recommended that? I have read all of Kerr Bear's posts and I'm hoping that she is all better since she hasn't been on in awhile.

michelle - i think you're jumping the gun...you just had your second surgery in august? try to be patient and give it more time....a lot of people take months to heal, even years after surgery.

obviously it'd be your choice to have a 3rd surgery so soon, but i hope you continue with creams and diet and give that some time. i regret having so many surgeries because they didn't help me and also because i'll forever be dealing with the scar tissue that resulted. i wouldn't want anyone to be in the same situation.

Michelle - I haven't had surgery, but other things have definitely helped me avoid it. Please try taking a stool softener each day, and taking a laxative really, really helped me get on the path to healing. Have you tried any yet? The creams and ointments help with soothing irritation, but the laxative gets that muscle relaxed when pushing out a bm. And the softer the bm, the lesser the pain. Try a warm sitz bath after, drink lots of water, and try to avoid any foods that could irritate on the way out. I also have found that some daily exercise helps me - a 20 to 30 minute walk is great.
Hang in there. You're definitely in the right place for help.

hi michelle,
sorry you are having a challenging time now.
as juney stated, healing from an LIS generally takes 6-8 weeks just to make sure that the tissue is healing - not really indicative if you are pain free or 100% back to normal. that is expected about a year out.
i know you just recently had a set back with a BM and i hope that in a week or so, that you will recover from that.
i am not sure if you have modified your diet after the LIS - 2nd surgery - or if you are on what we call here 'AF diet' - but it is rather important to keep watch on what you eat after your surgery at least for the year following.
as a high anxiety person, i know that i would be nuts trying to figure out what is going on and sometimes it just makes me want to do something that really isn't in my best interest. so with that said, it sounds like you have some anxiety over your recent situation.
i am glad you are seeking out answers and alternatives. keep all of those in mind.
but also, give your body some time to allow the LIS you just had in August adjust for you.
you may want to see how you are doing in January just to give you some time to heal from the LIS and the recent retear.
good luck.