Have been having acute fissure through whole my life. Had surgically removed hemorrhoids 20 years ago. Now I have chronic fissure that started last November. CRS prescribed verapamil cream and hydrocortisone acdetate 2.4% - Paramoxine HCI 1% cream. It closed fissure but within few days fissure came back due to a bad constipation.
Now I am scheduled to have LIS and fissurectomy within 2 weeks. Yes I am scared very much.
When I had surgery to remove hemorrhoid 20 years ago, the post op pain was so horrible. I still remember that one day after that surgery I pounded the wall with my head thinking I better die than enduring that much pain.
Anyway that experience 20 years ago, making me so scared now.
What am I expecting after surgery? How much pain am I expecting???

Hi Alpha! I am so sorry you are suffering so much! Everyone here understands the pain you are in. I've heard that a hemorrhoidectomy is the most painful surgery there is, so I definitely understand your worries. An LIS isn't anything near that kind of pain. I had my LIS, with skin tags removed 10 days ago and I am doing pretty good. I still have some pain, but nothing unbearable and it comes and goes. In fact, the first two days after surgery were the worst, pain-wise, but one percocet each day took care of it. After that, the pain was (and still is) less than before surgery. I didn't have a fissurectomy, though, which I hear is somewhat more painful than just the LIS, but still nowhere near the pain for a hemectomy.
There are many LIS stories on this forum, and many with fissurectomies too. I think you'll find that most of them are success stories and most do not involve nearly the pain you went through with hemorroid surgery. So, while I won't say there won't be any pain involved, I'm very sure that it wont't be anything like what you went through 20 years ago.
you should definitely ask your surgeon about that too. I think Rockpine recently had a fissurectomy and LIS, so you should read her story. Perhaps she and others will chime in as well.
I hope you feel a bit better about your upcoming surgery - there are many people on this forum who will share their experiences, offer excellent advice and provide encouragement, so it is good that you came here!

hopetoheal wrote:Hi Alpha! I am so sorry you are suffering so much! Everyone here understands the pain you are in. I've heard that a hemorrhoidectomy is the most painful surgery there is, so I definitely understand your worries. An LIS isn't anything near that kind of pain. I had my LIS, with skin tags removed 10 days ago and I am doing pretty good. I still have some pain, but nothing unbearable and it comes and goes. In fact, the first two days after surgery were the worst, pain-wise, but one percocet each day took care of it. After that, the pain was (and still is) less than before surgery. I didn't have a fissurectomy, though, which I hear is somewhat more painful than just the LIS, but still nowhere near the pain for a hemectomy.
There are many LIS stories on this forum, and many with fissurectomies too. I think you'll find that most of them are success stories and most do not involve nearly the pain you went through with hemorroid surgery. So, while I won't say there won't be any pain involved, I'm very sure that it wont't be anything like what you went through 20 years ago.
you should definitely ask your surgeon about that too. I think Rockpine recently had a fissurectomy and LIS, so you should read her story. Perhaps she and others will chime in as well.
I hope you feel a bit better about your upcoming surgery - there are many people on this forum who will share their experiences, offer excellent advice and provide encouragement, so it is good that you came here!

Thanks. Yes, fissurectomy is the part that I am worried because I heard that hurt a lot more than LIS.
Am I going to be able to walk around in my home or sit in front of computer to do some work from the next day of surgery?
I will be alone at home after surgery. (I sent my wife to her mother's home. I did not want to let her know about this embarrassing surgery.) So there will be no one who can help me or cook for me.

I doubt very much that you will be able to sit at your computer to work the day after surgery. Maybe you will be able to do that for short times a week or two weeks after the surgery. You will also likely find it difficult to do very much for the first week at least, like cook for yourself. So my advice is to arrange to be off work for at least a week, two or even three would be better. And, if you must look after yourself, then arrange to have meals that you only need to microwave or cook quickly. I didn't have a fissuerectomy and I could not have cooked for myself for the first week (well, maybe if I absolutely had to, I could have, but it would have been very difficult). My husband has been looking after me and it makes such a difference! The LIS and fissurectomy aren't as painful as hemorroid surgery, but it they aren't painless procedures either, so you should expect some pain for the first week or two at the very least. Some folks here even take a few months to really recover.
I am really sorry that you felt you had to send your wife away. I don't want to offend you, since I don't know your situation, but if the issue is only embarrassment, then I really think you might want to reconsider. My husband has been involved in all this from the beginning and he's been nothing by loving and helpful (we make some bum jokes, but only out of love). If my husband sent me away and went through such an ordeal without me to help him, I would be crying my eyes out. I never want my dear husband to be in pain and alone - I would want to take care of my darling! As a wife, there is nothing my husband would go through that I wouldn't want to be there to help him with. He never needs to be embarrassed with me - and I am not embarrassed to have my husband help me either.
If you are really uncomfortable having your wife help you, then maybe there is another family member who could help you for the first few days at least? I just really hope you don't have to go through this alone.

hopetoheal wrote:I doubt very much that you will be able to sit at your computer to work the day after surgery. Maybe you will be able to do that for short times a week or two weeks after the surgery. You will also likely find it difficult to do very much for the first week at least, like cook for yourself. So my advice is to arrange to be off work for at least a week, two or even three would be better. And, if you must look after yourself, then arrange to have meals that you only need to microwave or cook quickly. I didn't have a fissuerectomy and I could not have cooked for myself for the first week (well, maybe if I absolutely had to, I could have, but it would have been very difficult). My husband has been looking after me and it makes such a difference! The LIS and fissurectomy aren't as painful as hemorroid surgery, but it they aren't painless procedures either, so you should expect some pain for the first week or two at the very least. Some folks here even take a few months to really recover.
I am really sorry that you felt you had to send your wife away. I don't want to offend you, since I don't know your situation, but if the issue is only embarrassment, then I really think you might want to reconsider. My husband has been involved in all this from the beginning and he's been nothing by loving and helpful (we make some bum jokes, but only out of love). If my husband sent me away and went through such an ordeal without me to help him, I would be crying my eyes out. I never want my dear husband to be in pain and alone - I would want to take care of my darling! As a wife, there is nothing my husband would go through that I wouldn't want to be there to help him with. He never needs to be embarrassed with me - and I am not embarrassed to have my husband help me either.
If you are really uncomfortable having your wife help you, then maybe there is another family member who could help you for the first few days at least? I just really hope you don't have to go through this alone.

Thank you for all the kind words. About my wife, I know she will do all she can to help me to get through this. But I just don't want to let her know about this. (it's just too embarrassing. that's all to me) Also my wife is due for another baby this early July. So even if she is with me, I will be just another burden to her. She just can't take care of my son and me then take care of herself at this moment.
I have no family around where I live here so I have to do this alone.
Damn.. I miss my wife and son so much now.....

I see where you're coming from, Alpha. Congratulations on the approaching arrival of your baby!
I'm so sorry you have to face this alone. I definitely think you should plan some meals that are easy to prepare. And you might want to put together a list of things to have handy during recovery. A few things I can think of are:
Stool softener - mirilax is a very popular choice among the boardies here. You will want to keep stools very soft, so you should stock up if you don't already have some.
OTC pain meds - such as Ibuprofen or Tylenol (not codeine). You will likely be given painkillers by your surgeon, but they can be constipating, so you'll want to make sure you take stool softeners for sure. Many folks here go off the painkillers and switch to OTC pain meds within a few days (because the pain diminishes and we want to avoid constipation!)
A sitz bath and/or some kind of device (like a hand-held shower head) for rinsing the butt after BMs and/or for use during BMs. The butt will be very tender and a bit difficult to clean for a while, so many of us use a sitz bath for cleaning. I actually use a turkey baster to rinse while I'm going (some folks do the deed in a sitz bath because it's less painful that way).
Some people also use baby wipes (the gentlest kind with no alcohol) instead of toilet paper too. And definitely do NOT use soap to clean the butt!!!
Be sure to stock up on fissure-friendly food and you might also want to have some good movies handy too.
That's all I can think of right now ... but I'm sure others will chime in, and hopefully those with experience with fissurectomies will too.
I'm so sorry you are missing your wife and son right now. Hopefully, all this will be a distant memory very soon!

hopetoheal wrote:I see where you're coming from, Alpha. Congratulations on the approaching arrival of your baby!
I'm so sorry you have to face this alone. I definitely think you should plan some meals that are easy to prepare. And you might want to put together a list of things to have handy during recovery. A few things I can think of are:
Stool softener - mirilax is a very popular choice among the boardies here. You will want to keep stools very soft, so you should stock up if you don't already have some.
OTC pain meds - such as Ibuprofen or Tylenol (not codeine). You will likely be given painkillers by your surgeon, but they can be constipating, so you'll want to make sure you take stool softeners for sure. Many folks here go off the painkillers and switch to OTC pain meds within a few days (because the pain diminishes and we want to avoid constipation!)
A sitz bath and/or some kind of device (like a hand-held shower head) for rinsing the butt after BMs and/or for use during BMs. The butt will be very tender and a bit difficult to clean for a while, so many of us use a sitz bath for cleaning. I actually use a turkey baster to rinse while I'm going (some folks do the deed in a sitz bath because it's less painful that way).
Some people also use baby wipes (the gentlest kind with no alcohol) instead of toilet paper too. And definitely do NOT use soap to clean the butt!!!
Be sure to stock up on fissure-friendly food and you might also want to have some good movies handy too.
That's all I can think of right now ... but I'm sure others will chime in, and hopefully those with experience with fissurectomies will too.
I'm so sorry you are missing your wife and son right now. Hopefully, all this will be a distant memory very soon!

Thank you x 1000!!!
This is a really good information. I am really appreciated.
If you don't mind, I have few questions regarding this prep for the surgery.
I am thinking to take extra stool softner (docusate which worked well with me) 2 or 3 days before the surgery. So I never get constipated when I do the first BM after surgery and make it easier. Is this a good idea?
I am also thinking to use fleet enema, the day before surgery and in the morning of surgery. This is to lengthen the time go without BM after surgery as much as possible. I guess this will give more time to heal the wound. Right?
I am planning to get some vitamin-c supplements as my sister (a medical doctor) told me that vitamin-c promotes the healing of the cut.
Am I going to be able to watch TV and concentrate on it from the day after the surgery??? I guess its not possible due to pain???
What did you guys do while you guys were in the bed while recovering? I got an ipad for this so that I can surf the net while I am in the bed.
What dosage do you recommend with Ibuprofen or Tylenol????
Oh, do I need that diaper for adult? I already bought some (18 diapers) but I am not sure if I should buy more. As I will be totally alone, I can't go out and drive to get more diapers. So I should prepare enough. Do I need diapers? If so how many???
OK, I can steal some of my son's baby wipes. There are plenty so he wouldn't notice. That's no problem. :D
BTW, why you not recommend soap when cleaning? What's the best way to clean then????
Another thing. Miralax or Prune Juice? Which one should I use to prevent constipation for long term use? Any of these have any side effect? I googled about them and I did not find anything that suggests any bad side effect. But heard that prune juice has some very mild stimulative in it by nature. Are any of these OK to take for long period? like over an year?

Hi again Alpha! I’m glad you found my suggestions useful – I’ll try to answer your questions, but please remember that I’m going by my own experience, so please take my advice with a grain of salt!
I am thinking to take extra stool softner (docusate which worked well with me) 2 or 3 days before the surgery. So I never get constipated when I do the first BM after surgery and make it easier. Is this a good idea?
Many boardies here have been on stool softeners (mostly Miralax) full-time, so I imagine that it would fine for you to start the stool softeners before the surgery, as long as they don’t give you diarrhea or stools that are too loose and watery. And it would be a good idea to start them a few days before surgery so that your system is used to them. That said, it’s a good idea to call your doctor and ask about that.
I am also thinking to use fleet enema, the day before surgery and in the morning of surgery. This is to lengthen the time go without BM after surgery as much as possible. I guess this will give more time to heal the wound. Right?
Some folks here were given a fleet enema before their surgery, so that might be fine, although twice might be too much. Again, this is something you should clear with your surgeon. A fleet enema will likely only prevent a BM for one or two days (you probably don’t want to go without a BM much longer than that!), and that really isn’t enough time to affect healing, IMO. It will take your wounds weeks to months to heal. The LIS will only relax the sphincter muscle to eliminate the spasms that block the blood flow that prevents the healing of the fissure. An LIS, therefore, allows the fissure to heal naturally, without interference from a tight/spastic sphincter. The fissurectomy will be an open wound, so, again, things will take a while to heal. That’s why I don’t think that a few days BM-free will make that much of a difference. You may get an enema anyway – so you should double check with your doc. I think that the important thing is not preventing BMs, but rather keeping everything soft and coming out smoothly – here stool softeners are your best friends!
I am planning to get some vitamin-c supplements as my sister (a medical doctor) told me that vitamin-c promotes the healing of the cut.
Many boardies take vitamin supplements, including vit c, e, a and zinc (I’m actually taking those myself). Zinc is supposed to be very good for wound healing too. Just a note of caution – too much vit c can cause diarrhea and too much zinc might cause constipation, so don’t overdose on those ones! I think the best dosage may be associated with age, gender and weight, etc. Perhaps your sis can advise you here too.
Am I going to be able to watch TV and concentrate on it from the day after the surgery??? I guess its not possible due to pain???
The day after the surgery you are likely to be a bit dopey, especially if you are on painkillers. I had the tv on for company and for those times when I was conscious and needed some distraction. I was actually on painkillers for the first two days after my surgery, so I was sleeping quite a bit (which was lovely!). Since you are having a fissurectomy, I expect that you will be dopey from painkillers too for the first few days, but I don’t think the pain will be so bad that you won’t be able to watch some tv as a distraction. Try to sleep as much as you can.
BTW, stay on top of the pain – it is easier to prevent pain than it is to kill it once it sets in. So take the painkillers if you need them and dose up on stool softeners to prevent constipation. You may be able to replace the painkillers with OTC pain meds after a few days.
What did you guys do while you guys were in the bed while recovering? I got an ipad for this so that I can surf the net while I am in the bed.
I wish I had an ipad! I’m soooo jealous!!! I have my little laptop and have learned how to type lying down. You will really appreciate that wonderful toy while you recover! I mostly watched tv and movies. I could read novels after the first few days, but my attention span was very short (still is a bit). Mostly I tried to sleep as much as possible (sleep is a wonderful healer too). After that I spent a lot of time on this forum (I still do!)
What dosage do you recommend with Ibuprofen or Tylenol????
That’s a tough one. A lot depends on individual make-up. When things were really bad, I would take 2 Ibuprofen and a Robaxecet, which is a muscle relaxant. I love Robaxecet because it makes me drowsy and even puts me to sleep. I used it before and after my LIS because it would help minimize the spasms. For some people, the spasms stop immediately after the LIS, for others milder spasms linger a bit, which was the case for me – the muscle relaxant was a lifesaver. I usually only need one, sometimes two per day. BTW, Ibuprofen can thin the blood, so you might see more of it if you take that.
Oh, do I need that diaper for adult? I already bought some (18 diapers) but I am not sure if I should buy more. As I will be totally alone, I can't go out and drive to get more diapers. So I should prepare enough. Do I need diapers? If so how many???
I really don’t think you need a diaper! Full fecal incontinence – actually pooping in the pants – is incredibly rare (there isn’t a single case of it that I’ve found on this forum, and I’ve read just about every post here!). I prefer not to have anything on my butt just now.
But now that you mention it, there is something I forgot to mention for your list, and that is pads and panty-liners – sorry! I know guys aren’t big on feminine hygiene products (actually, gals aren’t either!), but they might come in handy, especially later. I recommend "Always" pads because they come in different absorbencies, and even the high absorbency ones are thin and comfortable. "Always" also has good panty-liners, which are much thinner than pads.
I suggest these because you will likely be leaking some blood and fluid for the first week or so. That’s common - just keep an eye on it. As long as it doesn’t smell too strong and doesn’t look like pus, you’re ok. But don’t be shy about calling your surgeon’s office if you have any questions about discharge because an infection is a possible complication and if it happens, you want to be on top of that asap.
I am actually walking around with no pants or underwear right now I put a clean sheet on the couch and put clean towels under my butt while I lie down and keep everything well ventilated :D
I have a stock-pile of clean sheets and towels so that I am using fresh ones every two days at least (I’m a bit compulsive about hygiene right now!)
OK, I can steal some of my son's baby wipes. There are plenty so he wouldn't notice. That's no problem.
Good job!
BTW, why you not recommend soap when cleaning? What's the best way to clean then????
Soap is a bad idea because it will dry and irritate the tissue. Most doctors I know say not to use soap on the anus or vagina because the tissue is too delicate – and besides, there are natural secretions that keep those areas clean and we shouldn’t mess with that too much. I think the best way to clean is to run water over your butt and take wet, soft baby wipes and gently dab your butt clean. Some folks also soak in the tub for about 20 minutes after a BM. I prefer a shower after a BM to let any leftover ‘matter’ wash away. I actually take about 4 quick showers a day to clean up the post-surgery discharge too. (Oh yeah, I also sanitized the heck out of my bathroom before my surgery and stockpiled clean towels too)
Another thing. Miralax or Prune Juice? Which one should I use to prevent constipation for long term use? Any of these have any side effect? I googled about them and I did not find anything that suggests any bad side effect. But heard that prune juice has some very mild stimulative in it by nature. Are any of these OK to take for long period? like over an year?
I think that is a personal choice. I could never get prune juice down (yuck!), so I don’t know much about it. Miralax seems to be the favourite here, but you should use whatever is best for you. The thing about Miralax is that it can take a few days to work, so you might want to overlap it as you taper off any other stool softener you are using. I think the advantage of Miralax and prune juice (over coalace, for example) is that they are both safe for long-term use. Many people here say their doctors say there is no problem using Miralax indefinitely; but if you want to go off it, taper off slowly.
Hmmm …. It think that’s about it. I hope this helps!

Wow, hopetoheal, that's a lot of typing and I am so much grateful for all your help really.!!!
Now you mentioned about pad... Well, I've never had a chance to examine girl's pads or liner close. So don't know how it look like. :D
Do they cover the rectal area? I thought they cover only front part????
And those liner, can I use it with my boxy panties????
hummm.. what's the difference between pad and panty liners exactly????

No problem, Alpha!
Hmmm … yeah, if you’re a boxer man, than the pads and panty-liners might be a bit challenging because they need material to adhere to. Maybe you can grab a few briefs if you’ve got a chance.
Okay – pads vs panty-liners (apologies if there’s TMI here!). A pad is designed for full menstrual flow, so it is longer and thicker to catch and absorb a fair amount of blood. Panty-liners and smaller and thinner – they are designed to catch a smaller amounts of fluid (women like to use them for the last days of our periods, when there is only a little bit of blood or when there is discharge during other times of our cycle). Some Always pads have “wings”, which are designed to wrap around the sides of the undies so that blood doesn’t leak out the side. You might not want that, but you can also get Always with no wings. You can attach a pad or panty-liner pretty much anywhere on the underwear (or anywhere around the house, for that matter), so if you place them at the rear for your butt, no problem.
Here’s a website that describes the different products and lets you compare them - with visuals too!
http://www.always.com/products/compare.jsp
I recommend either “Long Super Ultra Thin”, "Regular Ultra Thins" or “Regular Maxi”, which are pads; I also recommend “Always Long”, which is a panty-liner.
Don’t get any that say “fresh” on the package – those ones are scented and so will have chemicals that you don’t want near delicate tissue (I have a real pet peeve about feminine products that are scented – they are harmful to women!).
I think you may find pads and/or liners more comfortable than diapers for catching any leakage after the surgery; but I also don’t want to insist that you get them because I don’t know how much discharge you will have or for how long and you might not need them. I probably would have needed a few panty-liners if I had to go out anywhere this last week.
I hope that helps. If nothing else, you’ll definitely impress the women in your life (It is so cool when men know about this kind of stuff!)