Surgery Recovery Diary

Triple Whammy - LIS, Fissurectomy & Hemmorhoidectomy

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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Surgery Recovery Diary

Postby tight80 » 12 Oct 2019, 17:46

Hi everyone,

I had my surgery and wanted to post my experience and progress over the next few weeks. The recovery posts on this board really helped me to weigh my options and ultimately make the decision to move ahead with the surgery so I hope that my posts are helpful to others, as well. I'm very thankful for this awesome community. Even though many of us are struggling, the positivity and encouragement here is wonderful and I'm so appreciative of it.

Surgery Day 0:
I must admit that I was very nervous and still a bit in disbelief that I had signed myself up for this. My fissure wasn't causing me that much pain and I was operating around 70-80% on most days so I really felt like this was more of an elective surgery than a necessary one. It is very hard to want to pull the trigger on surgery when you feel good, so my advice is to keep a pain journal so you can refer to that. It helped me get to get there.

The bowel prep the night before wasn't that bad, but I was the last surgery of the day so being thirsty all day was the worst of it. The nurses were great and so was my anesthesiologist. They used deep sedation versus general so I didn't feel that bad when I woke up. One thing to note - I thought I was going in just for LIS and noticed that the surgery center had me sign off on LIS, Fissurectomy and Hemmorhoidectomy. I asked my surgeon about it and he said that sometimes these additional procedures are needed and he makes that call when you're on the table. Part of me was frustrated because I hadn't mentally prepared myself for the possibility of this... but part of me is glad I didn't know because I ended up needing all three procedures and may not have actually gone through with it if I had known ahead of time. So just be prepared that you may end up having more work done than was expected... and that's ok.

I woke up from surgery and my pain was almost immediately at a level 2/3 so the nurse advised me to take a Norco. Now this was my first experience with opioids so I didn't know what it would be like... but I was very pleased that it brought the pain down within a half an hour. My surgeon came in and told me that LIS went well, he had found a fissure that needed fissurectomy and he also took care of cauterizing some internal hemms. He said that my internal sphincter was so tight (even under anesthesia) that he had to stretch me just to be able to complete the procedure. This probably explains why I haven't been able to fart for over a year and can only pass pencil thin loose stools. Wouldn't it be nice if this was actually the cause of my IBS-D? CRS said that sometimes the body adapts to accommodate the tight sphincter so I'm keeping my fingers crossed that my stomach and bowel issues also improve after I heal from this procedure.

The car ride home wasn't that bad. I got home and situated and quickly realized that I wasn't going to have the easy recovery that many of the LIS surgery folks had... and I was grateful that both my mom and boyfriend would be tag teaming on care taking. If you end up getting the triple whammy - have someone stay with you the first few days. Best decision ever. I didn't think I would need help and boy did I ever. My pain level hovered around a 6 / 7 most of Surgery Day. Norco really helped but it makes you really weak and out of it. They told me bed rest for two days so I followed orders and took a second Norco around 9pm and tried to drift off for some sleep. My stomach was churning and growling and I could feel myself letting out little farts. Now this my sound scary to some, but to me who hasn't been able to pass gas easily in years... this was the most exciting thing ever! Made it all worth it to me ;)

Now the not so fun part: Woke up at 3AM to take my third Norco and within 30 minutes of taking it my heart was beating out of my chest and I started to develop mild skin hives. It was scary because the heart wouldn't stop racing. We had pretty much packed up for a trip to emergency when the heartbeat resolved and I got back in bed. Very scary.

So all in all Surgery Day was successful with a few minor bumps.
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Re: Surgery Recovery Diary

Postby patience_and_healing » 13 Oct 2019, 09:50

Wow that's a lot things you had done in one day. Wishing you a speedy recovery! And there are other painkillers you can take if the Norco is causing an allergic reaction. Definitely don't try taking it again if it caused hives once.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter
9/19: Trigger point injections and pudendal nerve block
Currently in pelvic physical therapy
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Re: Surgery Recovery Diary

Postby Tatie » 13 Oct 2019, 18:56

Tight80,

I hope you recover quickly ! Sending healing vibes your way.
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Re: Surgery Recovery Diary

Postby tight80 » 14 Oct 2019, 19:42

Thank you for the good thoughts Patience_and_Healing and Tatie!

DAY 1 AFTER SURGERY: THE WORST DAY
After the bad reaction to Norco I needed a new script but my CRS was in surgery until late in the day so I ended up soldiering through with no meds. I was at a pain level 10+. Got a script for Tramadol and it barely took the edge off... plus it trashed my stomach so I gave up on pain meds completely. They just don't agree with me.

I finally got the courage to get a mirror and check things out and oh my... black and blue bruising, 3 hemms swollen to the size of grapes and clamp marks. Not a pretty scene. Discharge has been mostly light pinkish / brownish and boy does it smell like death. I also saw some yellow discharge on Surgery Day & Day 1.

Had my first 2 BMs today. Good news is they didn't hurt. My usual BM is pretty loose so perhaps that is why, but I'm happy to report that they were pain free!

DAY 2 AFTER SURGERY: BIG IMPROVEMENT
The hemm swelling has decreased over 50% and the pain is now almost manageable without meds so I continue to soldier on med free. If I had the chance to do it all over I would have chosen to use Extra Strength Tylenol and skipped trying the narcotics.

I realized that the main source of my pain were actually two little external stitches just next to the opening. I had a follow up call with my CRS and he said that was the site where he went in for the LIS surgery. Better healing rates doing the operation that way. He assured me that the smell and two types of discharge were normal and that it should all taper off around day 10.

I had 5 BMs today... seems like I have to go every time I have a meal or a snack... curious if that happened to anyone else early on? All of the BMs were pain free except for one which felt like it tore something a little.

DAY 3 AFTER SURGERY:
Pain level is still the same around a 4/5, but discharge has decreased in volume. The smell is still there, though. Had 4 BMs which were mostly pain free and I finally made it from the bed to the couch. Boyfriend and mom have been superstars - cooking me oatmeal, chicken, rice and veggies and taking such good care of me. I feel so blessed.

DAY 4 AFTER SURGERY:
Pain level is still the same around a 4/5, and discharge continues to decrease, but jeez that dang smell can clear a room. Did anyone else have this and how long does it last? I really hope that CRS is right that it will get better in another week or so.

BMs decreased to only 2 today - both pain free. They are still liquid (IBS for the win) so I'm hoping my system bounces back from the pain med debacle soon. I can't really sit yet. I have adapted a half lie down/half sit position for the time being. How long did it take until you all could sit normally again? I'd love to get some work done from home tomorrow.
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Re: Surgery Recovery Diary

Postby Tatie » 15 Oct 2019, 08:00

Tight80,

Bummer that you didn't tolerate the medications well but it's great news that you are improving everyday! As for sitting it took about a week for me to be able to sit comfortably for short periods and a few weeks for longer periods. I did not have a bad smell from my wound but I did not have as much work as you did and if your CRS says it's normal than I wouldn't worry about it.

Are you taking a lot of sitz baths ? I took several everyday and put a small amount of sea salt every time. I would rinse the area with warm water from my shower head then do a sitz bath ( I usually changed the water during once or twice) and I repeated this probably every couple of hours for the first week. I used a clean dry towel to gently pat dry after every bath. It was great for pain relief and it kept the area free of infection.
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Re: Surgery Recovery Diary

Postby tight80 » 15 Oct 2019, 14:58

Thanks Tatie!

Yes, I am taking about 5 sitz baths per day. Making sure to keep the surgical stitches clean while they are healing these first few weeks to avoid infection.

The drainage increased today... ugh. I'd say that has been the most frustrating part so far. I will be a much happier person when the drainage stops. Doc said it should only last about 10 days so I'm counting down the minutes. Did you deal with any drainage?

I was able to sit for 15 minutes today and enjoy my lunch. That was awesome! I'm back in my half sit/half lie down position and getting a little work done now.

I had such major improvement between day 1 after surgery and day 2 and things have pretty much plateaued since for days 3, 4 & 5... really hoping another big push of improvement happens soon. Fingers and toes crossed. I can't imagine going back to work in this state... I'm actually researching mini travel bidets on amazon right now lol.

Thank you for your comments, well wishes and for sharing your experience. It has been very helpful... and hopeful :)
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Re: Surgery Recovery Diary

Postby Tatie » 16 Oct 2019, 05:46

Tight80,

If I recall correctly I felt the "plateau" feeling you are mentioning and it does get better ! By three weeks I was back to work full-time so hang in there ! It takes a few weeks to really feel better.

I did not have any drainage? I had a closed LIS ( I think you did as well?...) therefore I did not have an incision inside ...only outside at the 9 o'clock area. The incision dried up quit quickly and the only other incision I had was a skin tag removal at 12 o'clock and honestly that bothered me the most. It was angry for ten days or so but never enough to take anything more than tylenol...I just lived with the pain. My doctor has asked me everytime i see him if i have any drainage so I know it's common...hang in there it will eventually subside. It's better your body rids itself of it than holds onto it.

It's my pleasure to share my experiences with others who are suffering from this painful condition. There is hope !:)
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Re: Surgery Recovery Diary

Postby tight80 » 16 Oct 2019, 15:27

Thank you for the info, Tatie. Really glad to hear that you were back to feeling good in three weeks. The drainage must be from the fissurectomy or hemmorhoidectomy then. It's lessened quite a bit today so I'm hopeful that it will be gone after a few more days. It's really the most uncomfortable part of healing for me so far. The surgical incision is right next to the left side of the opening at 9:00 and I have some very irritated / torn skin even closer in right next to the incision... so that area is constantly getting hit with the drainage which is both uncomfortable and quite painful. Part of me never wants to leave the bathtub. I believe that things will get so much better once the exterior wounds heal. I'm counting the minutes.
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Re: Surgery Recovery Diary

Postby tight80 » 16 Oct 2019, 15:46

DAY 5 AFTER SURGERY:
Not much to report. Took tons of sitz baths... I mean tons! It really does help soothe everything. Pain is hovering around a 4 and it's mostly the external incision and torn skin next to it that are causing the bulk of the pain. Drainage increased a little. Had 3 BMs - all soft and not painful.

DAY 6 AFTER SURGERY:
My overall pain increased today. But for some reason I can now sit for my meals without pain... go figure. Well I'm loving the fact that I can sit for short periods now. It's wonderful! The other good news is that my stomach finally healed from the surgery/pain med shock to the system. Very grateful to have an appetite again.

Got my billing done and have started to do a little work, too. Not quite ready for the hour long commute to my main client yet, so I'll probably take all of next week off, too. I feel very fortunate to have my own business and the ability to work at home when needed. It has made this recovery process much less stressful. I couldn't imagine going back to work after only 1 week. I'm just not functioning well enough yet. At 1 week post op I'm able to reheat food, but not cook for myself yet. I can sit upright for only about 15-20 minutes at a time. I'm still hitting the tub every few hours due to the drainage irritating the exterior wounds that are trying to heal. And a sneeze will still almost black me out. Yeah... not quite ready for the office yet.
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Re: Surgery Recovery Diary

Postby tight80 » 17 Oct 2019, 20:07

DAY 6 AFTER SURGERY (EVENING): A VERY SAD FIRST OUTING
Well, I didn't think I was ready for my first outing... but I didn't have a choice. My folks were out of town and their kitty (used to be my kitty in college) took a turn for the worst with her failing kidneys. It was time to let her go after almost 18 wonderful years of having her as part of our family. So my boyfriend drove me to pet emergency and we spent an hour visiting with her and we stayed with her and held her while she passed on. It was absolutely heartbreaking but I'm so glad I made the decision to leave my home to be with her. Rest in Peace, dearest Smudge.

I was on my feet or sitting (which I haven't done much of) for about 2 hours and it took a bit of a toll on my body. Discharge increased quite a bit and everything felt more swollen. But I survived and took a long sitz once we got home. BM was more difficult with the swelling, too.

DAY 7: MONKEY BUTT
A piece of advice - buy some Calmoseptine lotion before you have your surgery. I got hit with the monkey butt today. It's basically irritated skin from the constant wound drainage and cleaning. And all the Calmoseptine does is provide a protection barrier to help the skin heal. I wish I had started using the lotion before to avoid developing the rash... but oh well. Using it now is starting to help calm things down.
My incision site is still bothering me. Boyfriend took a picture of it and wow the camera tech has gotten good. The skin around the suture is still red and there's a very small black dot/bulge next to the stitch. There's also yellow drainage around the suture and I've developed a few skin bumps near it that are causing discomfort. I'm not terribly worried because the pain from the suture site has been improving each day... just very, very slowly. But to be safe I may send the photo to my CRS to see if my 1 week healing progression looks normal.
Overall pain is around a 3/4 today - mostly because of monkey butt and that pesky suture site. Drainage is back to minimal, but enough to be annoying and still irritate the skin. I have been wearing lite days pads which has made dealing with the drainage more manageable. Looking forward to the day it stops! Post op instructions say 10-14 days is average to have drainage. I'm praying for only 10 ;)
I made breakfast this morning with my boyfriend and was up on my feet a bit more today which felt good. Still having a BM after every meal and hoping that it drops back down to once daily sooner rather than later. What is interesting is that I don't feel the intense urge to go anymore when it's time. After surgery I now feel like my body has only two modes: empty or full. So when I feel that full feeling it's best to just sit on the toilet and every time I have a BM happens pretty easily. The ability to be able to pass gas again has already improved my stomach issues significantly. Fingers crossed that this continues and that my digestive system continues to feel better and better with each passing day.
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