Had LIS 5 Weeks Ago

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Had LIS 5 Weeks Ago

Postby queenofpain » 21 Nov 2011, 14:03

I haven't posted on this site in three and a half years! I didn't have a pc, and my login expired. I had trouble getting back on, and would visit the site merely to read periodically. At any rate, I learned so much from so many of you, and want now to share my LIS (at last) experience.
To recap, five years ago, I tried to lose 5 lbs. quickly by drinking Diet Coke, and eating one meal a day. I suffered a fissure, and all the nightmarish pain that goes with it. My first CRS insisted on treating me naturally with Metamucil, and other grain-based products. Even taken with lots of water, these products only made my stools very difficult to pass. Fortunately for this board, I learned about M.O.M. and Miralax, and have been on one or the other for the past few years. My CRS didn't like the idea, and dismissed me, saying he couldn't help me. I was shocked, my being quiet and respectful, and never having been dismissed by a doctor.
After some searching, I found another CRS who is part of a local research hospital. He is older, and I'm sure has done thousands of LISs. He understood right away about Metamucil, and put me on nitroglycerin, and later nifedipine. By the time I saw him, though, a year and a half or so had passed from when I first tore myself, and I was in much better shape pain-wise. I continued on these creams for the next few years. After having a second (September) bout with pain in this particular year (2011), I opted for LIS, and had the surgery in October. I will list some of my thoughts about the surgery below (pardon the randomness):
- The surgery was more painful than I thought. Aspects of it were worse than fissure pain. I was prescribed Norco, but it made me dizzy and nauseous. I asked for something to counteract the nausea, and they prescribed Zofran, which didn't work. I tried Tylenol 3, but that didn't help the pain much. I gave up, and rode the pain out for 10 days, when it finally broke. The only thing better about post-op pain is that it by 7:00 in the evening, the pain was tolerable, provided there were no recent bowel movements. Fissure pain, by contrast, has no rhyme or reason to it. It tends to be 24/7.
- During the next 11 days, the pain was very tolerable. I was riding high, feeling this fissure nightmare was coming to an end. At the end of this stretch, I must have had one bowel movement too many, and went into what felt like fissure-related or spasm pain. This lasted for at least 5 days, and was 24/7. When I had my post-op appointment at the end of this stretch (now 4 weeks after surgery), I was out of this period of pain. My CRS said it will take a while for the muscle to get out of spasm. He said my muscle was so tight (he remarked a few years ago that he had never seen anything like it, that I would end up having surgery some day, that even a child's scope wouldn't fit in me, nor could I even have a colonoscopy) that it'll take a while to normalize. After the exam (all along, he has only performed external exams on me - he said most of what they need to see is on the outside- THANK GOD), he seemed very pleased with the tension of the muscle, and seemed confident that it would right itself eventually.
- I found it important to have a stool softener regimen going before surgery. You don't want to deal with difficult-to-pass stools at this time. He prescribed Colace for me after the surgery, but I asked whether I could stay on M.O.M. He said one or the other is fine. I continue to stick with M.O.M., and plan to transition to Miralax, and then off of that someday (hopefully). It's important you know how your body reacts to different softeners, and to be confident things will be soft post-surgery.
- After a good week this past week, I experienced some knife-like pains (I've had this periodically over the years) while walking, and then went back into fissure/spasm pain this weekend, in which I remain.
- I continue to take sitz baths (three per day), and they have provided the most comfort, especially after bowel movements.
Here are my questions:
1) Did anyone have fissure/spasm pain back and forth like me following surgery? I'm a little discouraged, wondering if he cut enough, given the degree of spasm my muscle was in. He's had tons of experience (was department chair, too), but I'm sure this is a guessing game for them.
2) The CRS said my problem was never an open fissure (my fissures - 2 - were healed - all he saw was scar tissue), but the spasm. Why would there be pain with the spasm if the fissures are healed? Were they possibly not healed on some deep level? I mean, my muscle was in spasm for years before I tore myself, yet there was no pain. I had constant watery bowel movements from an irritable colon, and the sphincter shrunk and spasmed. I would expect with healed fissures, then, there would be no pain, even with spasm. Unless scar tissue plus spasm causes pain.
3) Is Lecia still on this site? I'm just wondering because she was so helpful to us, and I hope she's out of pain.
Thanks for listening to my trajectory.
queenofpain
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Re: Had LIS 5 Weeks Ago

Postby Guest » 21 Nov 2011, 14:37

Hi Queen,
Welcome back :) I have been on this for over about a year and a 1/2 and haven't seen Lecia post. She seemed so sweet and helpful.
I will try and answer what I know from my experience with LIS a little over a year ago, and hopefully others can add.
I did have post-op spasms and also had feared my surgery didn't work and the cut wasn't enough. It's a scary feeling to think you bit the bullet, had surgery for nothing! I did call my CRS right away and was prescribed Valium. I believe it was enough for 2 weeks. I was told that it's not uncommon at all to get post-op spasms. The valium worked beautifully for me and I had no problems with spasms since.
I don't know if you remember Fissy, but she had post-op spasms and took the valium also. She also got great relief. Some of the other boardies had the spasms also and were able to get them to settle with the baths.
Hopefully some of the others can join in and help with some of your other questions as I have no idea...
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Re: Had LIS 5 Weeks Ago

Postby queenofpain » 21 Nov 2011, 14:56

Thanks for the reply, Dawn. I'm just concerned because it seems like the surgery just put me back in the level of pain I had when I first experienced the fissure five years ago. When I opted for LIS, I truly had no fear about the surgical pain. I heard it was less or equal to fissure pain, and I figured it would end this nightmare. The CRS's nurse told me after the surgery (I called her about pain meds) the pain is very underrated. Prior to surgery, when I told her that I understand the pain from LIS is less than fissure pain, she looked at me, and said, "Really?" I guess she didn't want to frighten me. But others on here seem to do much better. I'm just concerned because I'm five weeks post-op tomorrow, and don't want a repeat of the years of fissure/spasm pain. I do hope Lecia is well.
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Re: Had LIS 5 Weeks Ago

Postby queenofpain » 21 Nov 2011, 15:10

Oh, my CRS suggested I apply one or other of the creams for a few weeks (nifedipine or nitroglycerin). I know some CRSs say 'no' to these post-op, but my CRS seems more laid back about things. He also said I could apply hydrocortisone cream or Desitin for post-op irritation. I'm just posting these ideas, so that people can see there are differences of opinion. But do what your doctor prescribes, or what's right for you.
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Re: Had LIS 5 Weeks Ago

Postby Guest » 21 Nov 2011, 15:41

I think many people are often relieved by the not having the shards of glass or spasms after LIS. I felt much better than I did with my fissure, but it was still very sore and bruised. I felt the spasms after about 8-9 days post-op pretty good though, but after the first dose of valium I was able to relax totally and have a good bm, and things pretty much went up hill week by week. I know that hasn't been the case for many others in here. Neuropathicguy comes to mind- as he said he felt worse after the surgery for quite sometime. He felt if he had had the surgery when his fissure was at it's worse that he may have felt differently, but before surgery it became manageable and wasn't causing really bad pain.
Steve and PaulsPain said it took quite awhile to get the spasms to settle after there surgeries. I believe Paul said a couple of months but both didn't take valium.
It's true all CRS seem to do things differently. I was told no ointments at all until I was 4 weeks post-op and then just vaseline. She thought the area needed to air. I did have the skin tag removed also...From my personal experience, I would never use Hydrocortisone on that area again. It thinned my skin out down there and made things worse when I had my fissure Image
I hope things settle for you soon! I hope Lecia is ok too. I read through her threads many times while laying in bed with my fissure. It was like reading a book with the last pages torn out. She seemed like a wonderful person. :)
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Re: Had LIS 5 Weeks Ago

Postby queenofpain » 21 Nov 2011, 15:51

Thanks, again, Dawn. Maybe I'll avoid hydrocortisone. I tend to be fearful of meds, anyway, and ride out pain. I'll take a look at Steve, PaulsPain, and Neuropathicguy. I had no pain for weeks prior to surgery, like some of the others, but decided on LIS because I felt I would never be able to get off Miralax or M.O.M. in my lifetime. That opening felt so small, and that area, so different, since the tear. Something needed to be done, and I had no fear about post-op pain or incontinence. I was just a little naive about the healing process. It's not like other surgeries (I had surgery on my finger and foot) where the healing trajectory is on an incline. At least, not for me.
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Re: Had LIS 5 Weeks Ago

Postby Guest » 21 Nov 2011, 18:41

Your welcome :)
Neuropathicguy (NG) gave a 1 year post-op update not too long ago. He really is very detailed with his post and had a way with explaining and covered all grounds. I think he said the same as you about being naive about the healing process and timelines. I often wonder if I hadn't imagined it to be so horrific if I would have felt the same about it "not being that bad". I was also in a lot of pain before my surgery.
It is a very slow process and I agree it's nothing like other surgeries. I've had a few and none can compare to butt surgery. I believe it was Fissulyna (fissy) who said she had read or been told by a doctor that it could take up to two years before that area is strong and feels as if a fissure never occurred. I had a scare recently that confirmed to me that I am still not completely out of the woods at 1 year.
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Re: Had LIS 5 Weeks Ago

Postby queenofpain » 22 Nov 2011, 10:21

Thanks again for all your insights, Dawn. I'm just so eager to get out of pain! I need to be functional at work. I must say, though, for the benefit of those considering surgery, I am glad I went through LIS despite my uneven healing trajectory, and present pain. Psychologically, at least, it helps to know that surgery is off my "to-do" list. Hopefully, I won't need more intervention with this sphincter being the way it is.
One other strange point of note for everyone. I've often found that sitz baths put my sphincter in spasm. I know that's counterintuitive. I continue to take them, but sometimes after a day of pain, with the pain subsiding by late evening, a sitz bath at that point puts me back in pain. This has happened time and time again. I don't know if it's from sitting on the hard surface of the bathtub, or gently and briefly washing the area, or the water is too warm (steaming), or just what. The other day, I was directing the water toward that area with my hand, and then experienced the shards of glass!
I just want to tell everyone considering surgery not to be dissuaded by my posts. Just try to do a little research on how you'll manage post-op pain (you might not have much at all - we're all different). I wish I knew which narcotic was least likely to cause nausea, and how to prevent it, if possible. Because I don't have answers, I choose pain over nausea. Just be proactive, and armed ahead of time. And, secondly, as I wrote before, get into a regimen before surgery that you know will produce soft stools. That area may be very tender, sore, and bruised after surgery.
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