My story so far

Are you having, or have you had a Lateral Internal Sphincterotomy (LIS)? Please share your experiences here, or ask any questions.

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Re: My story so far

Postby dexterdude » 07 Aug 2011, 09:21

Checking in a 8 weeks post-op. I am not healed and not doing better either. Pain is still there and pretty bad without pain meds, feeling it all day, some bleeding during bms, the works. Also, I think the wound inside is not healed, as that's where the pain seems to come from as well as the discharge (which is also still there). On the outside I don't see any fissure or skin tag, but inside it's definitely there.
I have the appointment with the CRS next week, I'm curious what he proposes we do. I am totally fed up at this point and even worse is that I had some expectations the procedure would work, which it obviously hasn't.
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Re: My story so far

Postby val » 07 Aug 2011, 10:25

Sorry to hear that Dexter, you must be so fed up that it hasn't worked.
Do you think it may have healed wrongly - from outside inwards?
Glad you have a checkup next week, at least you can get some answers.
Hope things improve for you.
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Re: My story so far

Postby dexterdude » 07 Aug 2011, 11:26

To be honest I don't know if it's healing as supposed to or not. I know the wound is supposed to heal from the base up, which for the outside wound seems to be the case. However, since I can't see the inside one, I don't know how that is healing. But given I still have leakage I would think it's not healed/healing, just stagnating open somehow... :(
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Re: My story so far

Postby of all the places to hurt » 07 Aug 2011, 11:32

I hope you start feeling better really soon! Ah poor you! Don't give up! Be positive! were all here for you Image
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Re: My story so far

Postby Deleted User 579 » 07 Aug 2011, 12:27

Aww Dexterdude, this just sucks! I'm really sorry you're still suffering. I'm also curious about what your CRS will suggest that this point. There really has to be options at this point, especially since it sounds like you might be partly healed. I'm really glad you have an appointment for next week. I think you've been dealing with this for quite long enough! Image
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Re: My story so far

Postby dexterdude » 10 Aug 2011, 23:44

Saw the CRS. He said the wound is healing, but not healed yet. He also said the area is very tight, both the muscle and the "skin outside it". So at this point he suggested two things:
1. We wait 6 more weeks to see if it heals more. In this time try to bulk up the stools a bit so they stretch the area while it's healing, so it heals "stretched".
2. He talks about it to his boss (the chief surgeon) and comes back to me in a few days with options.
I of course asked him about doing LIS but he was again very reluctant and told me he wants to exhaust all other options before doing that.
At this point I'm a bit confused as 6 more weeks of pain is not a pretty thing to look forward to. Also, the fact that he suggested I bulk up the stools (by cutting gradually on the Movicol) scares me to no end.
Anyway, I'm now waiting for his feedback and I'll go from there I suppose...
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Re: My story so far

Postby Deleted User 579 » 11 Aug 2011, 08:19

Geez, Dexterdude - I'm so sorry you are still struggling with the ^%$ fissure! How frustrating to be almost healed but still in pain! Do you have the option of consulting with another CRS? I'm puzzled as to why your CRS is so reluctant to do an LIS. I understand that many surgeons are quite conservative, and that's a good thing, but, really, at some point they should seriously consider the surgery, IMO. Do you have the option of talking to the big chief yourself?
I really hope they get back to you with some serious options. I don't think the 'wait-and-see' approach is very effective with fissures, but that's just my opinion. I really hope you get some relief from this very soon!
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Re: My story so far

Postby val » 11 Aug 2011, 10:17

That sucks Dexter! 6 weeks of pain doesn't sound like fun at all.
I hope you can persuade someone to do something before 6 weeks.
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Re: My story so far

Postby dexterdude » 15 Aug 2011, 06:32

Hmm, have an appointment with the doc in a few days, but just had a call with him and he quickly told me he wants to do a manual dilation and also something like a LIS, but only for the skin, not the muscle, so just the skin is not that tight.
To be honest, in all my research I haven't heard of such a thing. I will for sure discuss more with him about it, but in the meantime, any thoughts about it?
Also, the dilation doesn't sound like fun and far as I read it's not that used anymore. But is it effective?...
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Re: My story so far

Postby Deleted User 579 » 15 Aug 2011, 07:08

Hey Dexterdude - I haven't heard of cutting the skin, but maybe that would help. Image
I have heard of the dilation procedure, though. It is an older procedure that surgeons had stopped using because it wasn't as effective as the LIS and had a higher rate of incontinence. However, milder versions of it seem to be used more these days because less violent dialation doesn't seem to have the same risks as earlier methods. I'm sure a few boardies here had it done. Genevieve, from Toronto, had an LIS and a small anal stretch after that. Her story is here:
http://anal-fissure.org/t45p30-genevieve#1005
I think the dilation helped her, but she still struggled with small fissures afterward. It’s not clear, though, if she possibly had another condition that caused her problems too.
I think you're definitely right to talk to him about this - especially abou the risks, and how many of these dilation procedures your doctor has done successfully. I also wonder if this cutting of the skin is like a mini fissurectomy? I also wonder why he isn't just going directly to an LIS. Would this procedure rule out an LIS in the future if dilation doesn't work. Yep... I'd have a lot of questions myself!
Please keep us posted. Maybe some folks who know more about it will chime in. Good luck with your appointment!
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