Anal Fissure Support Forum

[98761234]

Quick intro - i've suffered with AF for years on and off. Prior to this last time it has been 'managed' through non-invasive treatment. First time GTN, second time Diltiazem and this time have been through GTN (horrible reaction vomitting / worst headache i've ever had) then Diltiazem but didn't seem to be working :-(



Met with the consultant 8 weeks ago and decided that if it wasn't working i would have investigative colonoscopy which i did and he said there was a fissure and banded some hems whilst there.
No improvement and i decided as it was starting to affect my daily life quite badly I would opt for surgery which was to be a fissurectomy / botox injection.
Looking back i entered surgery quite (very) naively. Surgery on Saturday 20th and according to the release notes I had 2 fissures. 1 at 12 o'clock which was superficial and 1 at 6 o'clock that was chronic. I also had a split in the internal sphincter which would have become a fistula without treatment. Sphincter was repaired and 6 o'clock fissure had an advancement flap created and botox injection and the 12 o'clock one had a fissurectomy / debridement.
I had asked the surgeon about recovery time and he said a few days initially when i think he thought it was a 'simple' debridement / botox injection.
I had the operation at 9am and felt pretty good initially (good old general!) and was back home at 4pm with codeine and lactulose by which time the general was definitely wearing off. The first 18 hours at home were horrific - pain was definitely not under control and was taking it minute by minute through the first night and just trying to talk myself out of a full melt down.
Sunday improved slightly but was very very sore with the dread that the lactulose and codeine were probably heading for a painful conclusion. Managed 2 very small BMs that day and they were 'fine'.
Monday i felt better again and tried reducing the codeine and managed to do 1500 steps in the evening (i'm a very fit 49 year old who typically does 1-2 hours exercise a day and 15,000 steps) and it felt like a marathon. Monday evening i felt the need for a 'proper' BM and unfortunately had to strain, blood and pain which turned into my typical AF symptom of a painful dull ache - i describe it as feeling of pressure, like there is a golf ball in there. No improvement for 6 hours so sleep was not great.
Tuesday woke up and spent the morning going through a cycle of having a relatively pain free at the time BMs followed by a shower....did this three times and the painful dull ache stayed for most of the morning / afternoon. Managed to get out in the afternoon / evening and do some more steps - up to 5000 on that day! Had a disturbed but 'OK' nights sleep and had no painkillers between 10pm and 7am.
Now Wednesday and feeling slightly better again but dreading the call of the BM which is no doubt coming.
I'm hopeful i am heading in the right direction but i do feel I should have done more research in what to expect for recovery, and i also feel my surgeon set my recovery expectations too high...changing the mindset from 'this will last for 3 days' to 'this could last for weeks' has been a hard one to do.

[Hazey123]

Gosh you’ve had a lot done!! I do wish surgeons would be more realistic about recovery times. A few days is literally laughable!! Even for a fissurectomy (which is still a lot to go through). I think you need to expect a few months of recovery at least and be very careful to baby the area as much as possible - keep up your miralax and avoid a hard BM at all costs while it heals. Keep walking that’s great but nothing too strenuous. I’m also an exercise addict and that has been the hardest part!! Good luck with your recovery.