So here are the questions that I am taking with me to the CRS on my pre-op visit in a week - if you could think of other questions to include, please advise:
1. With the LIS you will perform, will you do an open or closed LIS? After doing further research it appears that the closed LIS is less invasive, does not require stitches, and has an improved recovery rate than open LIS. Can you please explain?
2. With the skin tag removal, will this require stitches?
3. What type of sedation will be used for these procedures?
4. Will there be any effects from any of the injection sites in the anus area post-op, such as swelling areas that are similar to little lumps? Will these areas have discharges?
5. After the anoscopies, do you anticipate that there would be a need for a fissurectomy?
6. During the procedure, if you end up seeing that the fissure has too much scar tissue, will you decide to perform a fissurectomy? How will that affect recovery?
7. Based on having smooth stools now and not anticipating changing my diet regimen, currently I do not take any stool softners or fiber additives, do you still recommend to add these a week before pre-op?
8. I know that there is no way to eliminate the possibility of infection and/or abscesses post-procedure, but can you please help me devise a plan to do my best to avoid this situation? Will you send me home with antibiotics and/or antibiotic ointment to apply to the area(s)?
9. With regards to post-procedure, can we please set up a pain management plan? I would like to request a prescription for Percocet (or Vicodine) (please advise which is perceived better) and Valium. Can you please issue me the prescription for these so that I can have these medications ready upon arrival at home or will you have them ready for me as I leave the surgical center? Can ibuprofen or acetomenophine be taken in addition to these?
10. In preparation for surgery, does the butt and anus area get shaved?
11. Can I continue to take magnesium tablets post-surgery in order to help muscle relaxation?
12. Please instruct in cleaning management of the skin tag wound and the LIS incision sites post-procedure. Is it advisable to still blow dry butt after shower? Are there any moisterizers - such as Palmers Cocoa Butter - or Aloe Vera or Vitamin E or Jojoba Oil that can be added after cleaning?
13. Will there be any "packing" included in the anus post-procedure that I should be aware of? How does this help and when/how does one go about removing it?
14. How many incision sites will there be with regards to the LIS?
15. Similar to the question about lumps/swelling at the injection sites, what is to be expected at the site of these incisions?
16. How important will it be to soak (I heard that it was unadvisable to soak in warm/hot water post-procedure)?
17. How can I insure that the anus is clean post-BM if there is no opportunity to shower/bath?
18. Post-procedure, how long is it recommended to avoid sitting on butt? Post-procedure, is it recommended to walk and if so, how long?
19. What is ideal post-procedure to increase/insure that blood flow is optimal to the fissure and area?
20. Based on the removal of skin tag and LIS, what is the expected recovery time? What is expected in terms of healing and the trauma to the tissues down there?

Great questions, Happy!
I took a list of questions with me and my husband read them from my tablet. I was a little embarrassed and told him that was enough before he was through and the CRS said- no that she loved to answer all of them and they were very good questions.
I think you will be over prepared for the procedure and will do fine with these questions. I can't think of anything you haven't come up with myself. Good Luck!

Ummm, you are having LIS, G?????

Kim wrote:Ummm, you are having LIS, G?????

yes, Kim, it is very life altering experience when you are reunited with your fissure! damn.
but mostly important, i guess it had to happen so that i could finally get to a CRS to verify and make sure that Laverne and Shirley indeed was a skin tag and not some ominous growth gone crazy, like a tumor or something. that skin tag was freaking me out as it had been growing steadily since 2008 and well, it spooked me!
as you know, i returned to school, and this semester taking cal 3 and linear algebra with a very "lost her enthusiasm for teaching" professor, it was super stressful and i had lots of constipation this semester. it was about four weeks ago that i must had retore because i had been doing so good since 2008. anyway, i also re-awakened horrific pains and it was taking a mental and emotional toll on me again.
so what do i have to lose?
unfortunately too ever since the anoscopies from last monday have still left me very sore and tender.
it makes me wonder what crappy shape i will be in post-procedure. but as long as the pay off is successful with the removal of the skin tag and the fissure healed, i am hopeful.
i am not even scared anymore of the LIS. it's mostly the removal of the skin tag but luckily there have been some skin tag free members recently on the board too. so i have lots to be positive about!
i hope you are doing well and i miss you and lots of other boardies when we were all starting out here around 06-07.
stay warm & big hugs,
g.

Dang that's a thorough list of questions :) I don't know your surgeon (obviously) but I think most of them like to go over the procedure "in their words" first. If yours is like that, I'd say to let him/her do so, and check off the questions (there will likely be many) that end up already covered in their standard spiel.
As for what else to add, I think you've actually got nearly everything and then some. If I had to add any, maybe it would be (1) whether you'll need to do an enema the day of the procedure (just for mental preparation purpose) and (2) whether any medications you're currently taking (assuming there are any) will need to be discontinued prior to the procedure. Include any supplements here because a good number of them cause reduce blood clotting and should be discontinued weeks beforehand. They'll give you a packet that covers a lot of stuff too. Oh, and most times, anesthesia can be discussed with the anesthesiologist, so if that's the case, make sure you ask your surgeon for info on which anesthesiologist or group they work with so you can contact them directly.
To that end, it may not be a bad idea to make sure you understand what other groups aside from the doctor will be involved in the surgery as well. Mostly for insurance purposes. For instance, your doctor may be part of your insurance network, but the anesthesiologist may or may not be, and the hospital (the majority of any surgery's cost is for ancillary services like facilities) may or may not be. The front desk or physician's assistant is probably the most appropriate place for stuff like this though.

I'm cursing, and really P.O.'d, it seems no good deeds go unpunished, after all you did for people here on this board and to have the %$$&*&$ thing return. I am swamped at work right now, but I will get back with you, Gareth...hugs and prayers for you!!!!!!!!!!!!!!

Happyass,
Will you be getting both- laverne and shirley removed?
I only had one skin tag removed. I was sore, but the fear of the procedure was much worse than the surgery itself.
Tabby's old post really inspired me. She stayed so calm and took everything one day at a time. I'm so grateful for the folks who posted their experiences and the support I got during my procedure. I just want you to know that I would do it all over again if I had too and I would be begging to do it faster than I did the first time around. It's not something I've enjoyed but it has definitely been easier than dealing with the fissure.
The worst thing about mine was I continued to have spasms for a short time until they gave me the valium. As soon as I got it, things went up-hill. If you have 2 skin tags removed at the same time with your LIS then I think that may increase your chances of some spasms, but the valium should take care of that. I've read of some who were given valium to take home after the procedure, I called the crs office and they called in my rx right away without any trouble. :)

One things for sure, you are going into your initial consultation much more prepared than I was!!!!!

And buddy, I can see why L&S are bugging you mentally, they should have been "reabsorbed" by now. Time for some answers!
And again, I wholly concur, the actual surgery is nothing to fear as long as you can get *something* for the pain immediately after the procedure...my arse felt like a bottle rocket had exploded inside but they took care of that. I guess your experience is going to vary depending on which type of LIS you wind up having(?)
Do you think your fissure is in the exact same spot as it was three or so years ago?
Yes, I think of you and all the other boardies all the time...I still check in on Cheryl and NG once every blue moon and pass out a few VIP awards....

@ dawn, Laverne and Shirley are one in the same, only representing one skin tag. it's almost like jekyll and hyde but i wanted a more funnier name....Laverne makes herself known when there is chaos down there; Shirley is the peaceful one.
Shirley has been keeping me company for a bit so that is good. I dread the days Laverne perks up and really kicks ass! LOL!
*
@ Kim. the CRS did say that the skin tag was big - but not huge - but yes, bigger, almost like 1/2 a rolley polley. anyway, her conclusion was that since the fissure was active that it was the body's way of trying to pacify the fissure and it has been trying to do that for awhile, hence it's size.
once she confirmed that it was nothing more than a skin tag trying to compensate for a fissure, then i was totally relieved, to the point where i had tears in my eyes.
it was soooo good to know that really that was all it was.
as i have said before, i always felt the skin tag and it's immediate surrounding side was the culprit to all my madness when it indeed was irritated.
i could care less if the skin tag is there if it was truly just a piece of flesh that did not attract pain or was easily disturbed. with that being said, i always had thought of what life would be like to have it removed.
but i too questioned why such insane pain. although i can tell you it was not like any horrific fissure pain i ever endured...it was quite different. i didn't experience the shards of glass or razor blades like i use to but more of a hot prodding and here and there acid burning sensations at the edges of the skin tag.
in any event, yes, i do believe my source of fissure 2.0 is right where fissure 1.0 was. it may be the case that somehow my body just dealt with it differently after the colonoscopy. i don't know.
oddly enough too, i don't think i even have spasms. LOL.
everything about me, including my ass, is just different than the normal human being! LOL.
yesterday i had ass pain - although not debilitating - still it was a very big distraction - i got home and played wii Just Dance and Just Dance 2 for like 1 hour and 30 minutes and my ass pain was gone!
for the rest of the day.

Happy,
Love your attitude. I always thought Laverne & Shirley were two hemmroids. You are so creative! I don't know what type of work you do, but you should do some writing! Good luck with your surgery! Your doctor will probably walk out when he sees that long list of questions you have!!