Not offered any alternative options by specialist. :(

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Not offered any alternative options by specialist. :(

Postby jay2502 » 15 Jan 2014, 12:53

hi.

i have been suffering from anal discomfort for what feels like forever now !
i have been back and forth to the rectal specialist.

first i was given GTN, but it made very little difference, and at my next appointment i was offered Analheal 2%, i would say this has improved my condition, but its very on and off, like one good day, one bad day and so on.
the appointment after that i was again told to persevere with the Analheal Neozem so i got another tube, and he said to me if at my the next appointment i have not healed then i need to consider surgery, or just ''live with it''.
the only surgery he mentioned was LIS, and he tried to put me clean off it at the same time. saying how i could be made incontinent etc etc.
the problem is, i have quite bad anxiety, and at the moment there is absolutely NO WAY i will allow them to 'put me to sleep' to perform the operation. do you really need to be put to sleep for such a procedure anyway?

he was quite specific and he didnt mention fissurectomy or botox at all. why ? do some hospitals not do the botox option?

im at the end of my tether now.
i wouldnt say im as bad as alot of people on the forum, i dont bleed. but it is extremely uncomfortable and enough to put me in a bad mood!

its like i have one tear about 1cm above the anal opening, sometimes it feels like its healed, and sometimes u can tell its ripped and it really hurts !
and it also hurts all around my anus, like very sore and red. :oops:

any help appreciated :thanx:
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Re: Not offered any alternative options by specialist. :(

Postby suzyljank » 15 Jan 2014, 13:32

You don't need to be put to sleep. The surgery can be performed using a spinal. I had a spinal for both of my surgeries. As far as options offered by your doctor LIS is the most popular way to treat an anal fissure but there are some people who can't have this done. There are other ways to treat a fissure such as fissurerectomy or a small advancement flap. You might benefit from a second opinion. Suzy
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Re: Not offered any alternative options by specialist. :(

Postby jay2502 » 15 Jan 2014, 14:39

suzyljank wrote:You don't need to be put to sleep. The surgery can be performed using a spinal. I had a spinal for both of my surgeries. As far as options offered by your doctor LIS is the most popular way to treat an anal fissure but there are some people who can't have this done. There are other ways to treat a fissure such as fissurerectomy or a small advancement flap. You might benefit from a second opinion. Suzy


Thanks for the reply, may I ask what a spinal is ? :confused:
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Re: Not offered any alternative options by specialist. :(

Postby suzyljank » 15 Jan 2014, 14:46

Hi, it's an injection that numbs you from the waist down.
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Re: Not offered any alternative options by specialist. :(

Postby Bettyblue » 17 Jan 2014, 14:54

The risk of incontinence for a LIS operation is very low. You have to do your research and find an experienced and good CRS that you can trust, because as my CRS told me " the most important thing for a LIS operation is your surgeon hands". I can not believe that your CRS told you to learn to live with that. There is not life that you can live with the kind of pain that a fissure brings. If I were you I will look for another doctor. In this forum you can have several post about the Botox option too. I had LIS 2 days ago and it was a piece of cake. I wish I would have done it early. I have had not pain at all, and haven't need until now any pain killer. The only thing I have is some soreness and irritation but compared with the pain I used to have. The soreness is like being in a party!
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Re: Not offered any alternative options by specialist. :(

Postby jay2502 » 17 Jan 2014, 19:01

Bettyblue wrote:The risk of incontinence for a LIS operation is very low. You have to do your research and find an experienced and good CRS that you can trust, because as my CRS told me " the most important thing for a LIS operation is your surgeon hands". I can not believe that your CRS told you to learn to live with that. There is not life that you can live with the kind of pain that a fissure brings. If I were you I will look for another doctor. In this forum you can have several post about the Botox option too. I had LIS 2 days ago and it was a piece of cake. I wish I would have done it early. I have had not pain at all, and haven't need until now any pain killer. The only thing I have is some soreness and irritation but compared with the pain I used to have. The soreness is like beiing in a party!


i take it 'CRS' is the surgeon/specialist.
how would one go about changing to someone else?
there is another hospital i could go to, would i need to get a referral there from my GP and start the whole process again ?

god i wish i could afford to go private ! :x
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Re: Not offered any alternative options by specialist. :(

Postby lefthanded » 18 Jan 2014, 05:00

It sounds like either you live in an area with not much of a choice of doctors, or that you have insurance that does not afford you choices. Can you tell us where you live and what kind of medical insurance you have, so maybe we can come up with some solutions that might better fit your situation?

I too am afraid of incontinence, but that is because I had to have my entire colon and rectum removed and I have an ileal-anal reservoir called a j-pouch, attached right to the inner sphincter. Life is pretty much chronic loose and acidic stools without a colon. Even a tiny leak can cause horrible burns, which in turn cause spasms, which in turn aggravate the fissure. For that reason I hesitate to try surgery or botox, either one. The other reason is that I have had my fissures for almost 10 years now . . . and am not a great candidate for surgical success.
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Re: Not offered any alternative options by specialist. :(

Postby jay2502 » 18 Jan 2014, 05:36

lefthanded wrote:It sounds like either you live in an area with not much of a choice of doctors, or that you have insurance that does not afford you choices. Can you tell us where you live and what kind of medical insurance you have, so maybe we can come up with some solutions that might better fit your situation?

I too am afraid of incontinence, but that is because I had to have my entire colon and rectum removed and I have an ileal-anal reservoir called a j-pouch, attached right to the inner sphincter. Life is pretty much chronic loose and acidic stools without a colon. Even a tiny leak can cause horrible burns, which in turn cause spasms, which in turn aggravate the fissure. For that reason I hesitate to try surgery or botox, either one. The other reason is that I have had my fissures for almost 10 years now . . . and am not a great candidate for surgical success.


ok i have just noticed there are alot of americans on here.
im actually from England :lol:

we have NHS here, which is basically free healthcare, as its free you dont really get much options, you go where you are sent. though i can change to another hospital and surgeon so i think i will do that, as my current one really does not fill me with confidence at all, plus he is very young - lack of experience?
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Re: Not offered any alternative options by specialist. :(

Postby Bettyblue » 18 Jan 2014, 07:40

Let's see things in another light. Sorry, I was so upset for what your CRS ( Colo rectal surgeon) told you. Some CRS are real jerks but are very good surgeons, and that's what matter in the end. Also I have notice that every CRS has a different opinion about LIS. For example my CRS just shrugged at the mention of incontinence, but was more worried with infection, go figure. :roll: It is some times very confusing. Could you do some research and see if your surgeon has good reputation and experience? Maybe if you do some research before going to your GP for a referral you will know where he should send you?

I actually managed to heal my fissure, but it was a very slow process. I was declared officially healed in May 2012 by my CRS. But until August I really didn't feel completely cured ( meaning no pain at all). But even I was healed I always had an irritation and burning all the time. I never felt normal in my bum again. I decide to go for LIS because the fissure took over my life. Affected not only my social life but also my job.

LIS was a pice of cake for me, but every person is different and experience the LIS in a different way. My only advice is to look for an experienced surgeon that you feel you can trust.

I live in Spain and also have a public health care system .I had to go private because since I healed, they didn't considered I was a good candidate for a LIS. I needed to be bleeding and near death from the pain to have a referral. So I had to take all my savings and find myself a good CRS to do it. But I don't have any regrets. It was the best investment i could possible have done. So jay do your research or give it some time to the healing process. Do post some updates to know how Are you doing. Best of luck and take care.
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Re: Not offered any alternative options by specialist. :(

Postby dent1 » 18 Jan 2014, 14:55

Where are you in the UK and do you have any other issues linked to the fissure - such as constipation? Have you been prescribed any stool softners like movicol your GP can prescribe this?

I saw a surgeon in Bristol who did another type of surgery called a vy advancement flap and Botox for a chronic fissure which would not heal. The operation has helped me but I am staying on the movicol long term as the fissures come back if I stop it.
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