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.