My case: Will surgery help?

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 case: Will surgery help?

Postby Guest » 21 Sep 2011, 14:33

Just by way of a possible route. I have not had LIS but plenty of other surgery. Recently my CRS had scheduled LIS but as the time grew near I seemed to be improving. On the day I went to hospital I told my CRS that I was happy to have LIS but I was feeling better and did not want surgery if not required. He agreed to have a thorough look round while I was under in the theatre. He did just that; I came round a few minutes later no LIS as the examination show 'no active fissure'. There is no reason why you can't broker a similar arrangement yourself if you and your CRS are unsure.
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Re: My case: Will surgery help?

Postby yankees144 » 26 Sep 2011, 10:57

Jenny, I am still using the Hydrocortisone 2.5% now but that doesn't stop the stinging and throbbing pain - it only helps with the burn and itch. It's definitely better than nothing, but each case is different and I'm not sure if what works for me would work for someone else. All I know is that it's not good enough to get rid of the pain and it is not getting any closer to healing.
Update: My doctor called me back after having an ano-rectal manometry done and he said the results were normal. He suggested we do Botox and see how I respond, so I am scheduled to get that done October 3rd. He said LIS would not be recommended right now because of the results of the test, but Botox is safe enough to at least give a try. I will definitely keep everyone posted, especially for the people who have a similar situation to me or is considering Botox.
Wish me luck.
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Re: My case: Will surgery help?

Postby Guest » 26 Sep 2011, 20:32

Good Luck with your Botox Yankees144!
Please keep us posted.
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Re: My case: Will surgery help?

Postby dwarfs8 » 28 Sep 2011, 22:02

hmm... i don't think u shld use Hydrocortisone 2.5%, as it actually worsens my fissure (IMO) when my GP thought and insisted i have hemorrhoids ONLY, when i told him i felt sharp pain (i have a fissure and hemorrhoids actually).
Try aloe vera 100% gel, no alcohol or anything added. It's very good. I actually get myself to heal 90% from this thing. Try if it works for u too.
Also, sometimes, there can be recurrence from hemmies, i'm not sure did your CRS mentioned to u. BUT for me, at first i kept thinking why my fissure couldn't heal despite months of fissure diet and softeners and i'm still getting the pain (though not glass like sharp pain as with the fissure), THEN when my internal hemm starts prolapsing (i didn't know it's still there!), i realised the pain is coming from my hemm and not my fissures!
It totally sucks i know. Try aloe vera and vit c for healing if you are not into surgery now.
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Re: My case: Will surgery help?

Postby yankees144 » 05 Oct 2011, 12:54

So I had the botox and I wanted to update you on my status. I'll try to keep it short and simple:
I was sedated via IV sedation and was not awake for the injections. I do not know how much botox he gave me, but when I get the medical reports I will post that. When I woke up, there was 0 pain but I was given a local anesthetic so that likely explains it. I was able to take a 3 hour train ride home following the procedure and the pain wasn't too bad - it felt just a little sore from the injection sites (3-4 out of 10). The anesthesia made me extremely woozy and a bit disoriented though, so it's best to have someone with you.
I woke up the next day and there was no itching, no burning, and just some soreness. I also had a bad headache from the anesthesia - it felt like I had been up all night drinking. Small price to pay though.
Now for the first BM: I had been taking miralax and dulcolax for a few days as a preemptive strike against my first BM, so I was ready to go. I did not do this for my hemorrhoidectomy and it was the biggest mistake of my life. Anyway, I was prescribed percocet which I took 1 hour before my BM just in case it was going to hurt. I ABSOLUTELY RECOMMEND THE MIRALAX PRIOR TO THE SURGERY. I cannot stress that enough. My stool was soft and smooth and came out without much of a problem. It did hurt a little bit coming out, but not nearly as bad as I expected and it was not as bad as before the surgery (could have been the percocet's doing). I took care to wipe gently as well with tucks pads and 1 bit of dry toilet paper. No spasm, minimal pain. I was very optimistic.
Second day - it's itchy down there right now which has hurt my spirit a little bit and my anus hurts to the touch (4-5 out of 10 on pain scale). I'm frustrated about the itch because it was one of the things that was really bothering me and which drove me to get the surgery in the first place. I know that it's probably healing and will be there for a while, but it's still disheartening.
I have been taking the percocet to keep the pain at bay, although I think it wouldn't be that bad without it. I'm chugging miralax and colace to counteract the constipation so I'm not too worried about taking too much pain medication. I have not had a second BM yet though, although I do feel one coming. Sorry if that is graphic but I want to share my experience to those worried about the procedure.
Additional notes:
My diet has been limited, mostly fruit, oatmeal, and lean proteins. My goal is to have smooth and easy BMs that don't require a lot of wiping. So far so good.
I have stopped the other medications/creams - I am only taking the percocet, miralax, and colace. I'm debating on taking the hydrocortisone for the itch but have resisted so far since it inhibits healing.
I have not suffered any incontinence whatsoever. No accidental farts, leakage, stool, etc. It feels different down there, but I can control everything just fine. I have been avoiding gassy foods just in case though.
The doctor told me I can go back to regular activities: lifting weights, work, exercise, etc. but I have chosen to take a few days off of EVERYTHING and just lay around and heal. I think it's the way to go. I still get some fissure pain when I bend over so I want to make sure that everything heals the right way. I am not taking any chances.
I have been showering, but no warm baths as of yet. I want to do that today though and see if it helps.
I will continue to keep you posted on my recovery as things change. I'll keep a small log at the end of every post I make indicating how I feel about the surgery:
Satisfaction level so far: 7/10 (itchy, still a bit painful)
Pain: 3/10 (with percocet)
BM: Not too bad, but still hurts a bit.
Optimism: 6/10 (itchiness has discouraged me, still pain from BM)
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Re: My case: Will surgery help?

Postby dwarfs8 » 05 Oct 2011, 18:15

Hi yankee, I so glad that u r getting better! Cont to do the warm baths, n whatever that soften ur stools. I feel that having soft stools are truly utmost important to heal these devils, be it fissures or piles. Cont to update us and give hope to us!
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Re: My case: Will surgery help?

Postby yankees144 » 10 Oct 2011, 09:03

So here is my 1 week update:
It's still pretty itchy down there and while it's better overall, it has gotten worse as compared to day 2 post-surgery. It seems to be worse in the morning when I wake up and gradually gets better during the day. It's the opposite of what used to happen before the surgery. I hope this means it's healing because I'm starting to lose hope.
Satisfaction level so far: 6/10 (still itchy)
Pain: 1/10 (occasionally hurts when seated for a long period)
BM: No pain, but causes itchiness
Optimism: 5/10 (itchiness has discouraged me)
I hope this is going to get better..
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Re: My case: Will surgery help?

Postby dwarfs8 » 10 Oct 2011, 18:54

Hi there, do check for lumps or pus, if no then the itchiness shld be sign of healing. Also do keep ur anus free of moisture, that can bring itchiness too.
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Re: My case: Will surgery help?

Postby yankees144 » 14 Oct 2011, 08:53

I am now 11 days out from my botox injection and only have bad news so far:
Today's BM must have been harder than usual and I felt the dreaded tear. This time there was a little bit of blood. I feel completely hopeless now, that's 2 weeks of healing that have been reversed in 5 minutes. And even the healing didn't feel like it was going well since it was constantly itchy and inflamed.
I have been doing my best to take dulcolax, miralax, and stool softener every day. I have done my best to eat better, get light exercise, and avoid long periods of sitting. And all of that went to waste. I'm going to call my doctor today and see if this is normal and if I'm going to recover from this. I just don't know how much more of this I can take... I thought this was done. I thought I was on the right path.
Satisfaction level so far: 3/10 (re-tear after BM)
Pain: 5/10 (more dull pain lately, itchy/stinging after today's BM)
BM: Re-tear
Optimism: 1/10
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Re: My case: Will surgery help?

Postby yankees144 » 25 Oct 2011, 13:08

Well I am now 3 weeks post op. I still feel a constant stinging, but it's not as bad. This is probably due to the setback I had last week with a bad re-tear. I am still taking stool softeners 2x a day and miralax 2x a day but I can't seem to pass BMs soft enough to not hurt or cause it to partially tear a little. I don't eat too much bulky food, mostly cereal, oatmeal, cold cuts, and a light dinner. Chocolate is my vice but I don't eat a ton of it.
Does anyone have any words of wisdom or comfort for me? Did my Botox fail? Is there anything else I can do to facilitate healing? I'm desperate and tired of feeling the stinging and burning.
I'm going to have a follow-up with my doctor soon and then I'm considering making a separate post with my medical records posted along with this day-to-day journal for all those considering what I have gone through. I hope I can help at least 1 person.
Satisfaction level so far: 3/10 (stinging and burning)
Pain: 3-4/10 (stinging and burning, some dull - mostly stings when I walk, sit, or bend/twist)
BM: Soft but still stings and partial re-tears occasionally
Optimism: 1/10
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