So I finally went ahead and scheduled an appointment with the out-of-state CRS that I've been emailing for the past few weeks. My appt. is scheduled for the Tuesday after Memorial Day so that my wife, daughter and I can drive to Dallas over the long weekend instead of having to fly. It will save hundreds of dollars on airfare and a rental car, so I hope it is worth it and I can handle the long drive. My wife will have to do the driving while I lye down on the seat. If the CRS still feels that LIS is recommended after the initial appt., he will most likely schedule surgery for the following day. I will plan to stay in Dallas for about 10 days post surgery and I really hope that I will be able to travel after 10 days. I am really on the fence about going through with this, because I have some major doubts about whether it will work for me and whether the recovery will be more difficult because of my underlying pelvic floor issues, but my fissure pain has been pretty bad the past few weeks and my bowel movements have been really difficult lately. It seems as though the muscles are in constant spasm and my rectum just will not open up properly to allow for an easy bowel movement. I really hope that this surgery will help to make my bm's much easier and with no straining. I think my expectations are so high that maybe I'm setting myself up to be disappointed.
Anyway, with all of these doubts and fear about the surgery, I may very well back out, but the thought that this surgery could give me at least some quality of life again, is something that I want so badly. I just fear that this surgery may not be quite as effective as I am hoping it will be.

Hi mm,
Congratulations on taking a first step!
It's totally understandable that you are having reservations in light of the pelvic floor dysfunction. I can only suggest taking it one small step at a time. You haven't completely committed yourself to anything yet, and haven't been seen by this new doctor yet, so it's all just one step at a time. Making a list of all your questions and getting a feel for your trust level in the doctor are the next steps.
In your case because you will be traveling it will be especially critical to have all the details about postoperative care and what to expect explained to you fully by your doctor. Also, do you have a doctor nearby at home you trust in case some kind of complication or something unexpected comes up?

i had a LIS done 1 wk back ..... and im feeling confident that things will work out.
certain things are expected like pain, soreness.... amount of laxative to be taken vs the bm consistency.
some blood and viscid discharge on ur post op dressing is expected... u can ask how much to expect.
most importantly try to relax, and get rid of the anxiousness... that helps most.
travelling after 10 days shud be ok given ur healing well and on painkillers. ask all questions u hav in mind from ur CRS.
all the best!!

As the day gets closer I am starting to wonder if I am doing the right thing with traveling out of state for LIS. I just wonder if I should try anything else before going to surgery or if I should wait until September when I can see a CRS at the local university hospital. I know I should just sick it up and stick to the plan but I hats the idea of.surgery and really hate the idea of surgery away from home without a local surgeon for follow up.

It's understandable to be nervous going into your procedure, that is normal. I was also nervous going into to my fissurectomy with Botox injection - wondering if I didn't exhaust all possible conservative treatments. As I expressed in my experience, it is totally up to your comfort level as to what you are happy and comfortable with doing. I knew that I wanted to exhaust all possible nonsurgical/conservative treatments before botox-fissurectomy, and definitely before LIS. Looking back, I wish I had for myself gotten a 2nd opinion sooner who would've added an additional measure. But, it may not have changed my ultimately needing the fissurectomy-botox in the end (or even from needing it twice). I definitely don't regret getting it done the 1st time as I was desparately in need to do something quick as I could not continue in the ongoing pain I was experiencing. I have read a lot of posts on this sight that many people who have gotten the LIS only regret not having gotten it done sooner (but I still wonder about the long term outcomes). For you, it sounds like you have already seen several professionals regarding yours and that perhaps the only alternative you could additionally exhaust before LIS is Botox? That is totally up to you, what you are comfortable with and happy with. It might help if you can decipher the source of your concern re: LIS - between normal pre-surgery jitters, valid concern-questions that can be addressed by the CRS, an inkling that there might be another option to attempt/exhaust before undergoing LIS. I would also be concerned with doing it far from home too, but it sounds like considering where you live and in the attempt to find a good CRS to treat you, that regardless of what procedure you get, you're not going to be able to really avoid that. I'm sorry if i'm not much help, bcz any time anyone is considering surgery - it is a big decision. But for me, it at least helps if I can decipher the source of my concerns and work back from there - and knowing I am someone who will go at great lengths to avoid permanent "cutting"/"damage" to a muscle - that has governed my decisions. Not to say that's better than going directly to LIS - bcz I may have been dealing with a longer road of pain/trial and error in the process. And if this 2nd Botox ultimately fails, then I might have to get LIS in the end anyway - but i've decided for myself, that if it comes to that, I will DEFINITELY have NO regrets or hesitations (if I should develop a complication/side effect/incontinence down the road) bcz I will know that I have truly exhausted all conservative approaches within my comfort zone. Good luck with your decision, can't go wrong with listening to your gut!

Sailorgal - thank you so much for your response. Everything you said makes perfect sense. My gut tells me that I desperately want to be out of pain, but sometimes being led by desperation can cause us to make bad decisions that are not well thought out. I guess that's why we need other people to help us see things more clearly, because when you're in pain day after day, you can't really think rationally. I feel like this is something that i should be able to deal with without the need for surgery, but my medical history would speak otherwise, since I've been dealing with this for over 6 years now. I've had periods of time where I would go a few years without a fissure, but then it comes back. This time seems much more difficult and I feel much more isolated because my regular CRS who treated the previous fissures has refused to schedule and appointment because I had been seeing other doctors for the same issues. I don't know if I would be able to find someone who could do botox out here and I'd love to try biofeedback, but with a fissure I don't know how that could be possible. My former CRS advised against LIS because he felt that with my pelvic floor issues and with the risk of incontinence, it wasn't a good option for me. Of course, he didn't offer anything else though. So, I still haven't cancelled my appt for next week, but I'm certainly considering it. Wondering if I should give myself a few more months to see if I can get this thing healed and then pursue biofeedback before deciding on surgery. If this doesn't heal and I can't do biofeedback, then I wouldn't have another choice I guess. Thanks again for the advice.

If it were me, I would at least go for the consultation. Tell yourself that you are not making any decisions regarding having LIS until after you have had the consultation. That will take some of the pressure off.