by Lauren12 » 21 Sep 2012, 22:01
Why not ask your current CRS why the fissure was not detectable before, if it was caused by the surgery. He may have a satisfactory explanation which will reassure you. When I had the LIS surgery, the surgeon told me when visiting me on the ward afterwards that two new fissures had been caused by the surgery, one at the front and one at the back, but that these would now heal because of having had the LIS.
I also recall that I re-fissured frequently in the recovery period because the tissue is puffy and swollen then, making the anus tighter. These were minor fissures, but to me they felt very painful. Of course, I panicked, thinking the operation hadn't worked, and wondering why everyone else I read about had recovered in a few days or weeks. I really wish I could remember everything I learnt at the time - how long it takes scar tissue to settle down for instance. I remember the surgeon said that now I'd had the LIS, I wouldn't get any more major fissures and eventually, I wouldn't get any more minor ones either and this has proved to be the case.
I know what you mean about trying to find the poop that's just right! I feel like a scientist that's trying to come up with the perfect formula. The surgeon said that for me, the aim was to produce narrower but softer stools. It can't always be controlled of course, no matter how rigidly you stick to a good diet. For example dehydration in hot weather can make stools dryer. Most of the time it's fine. On the few days I can't go, I use a glycerin suppository. I was worried about becoming dependent on suppositories, or not being able to go the next day, but the CRS said I wouldn't become dependent, and again was right. When I used a glycerine suppository when I was still recovering however (this was 8 months after the operation!) whatever substance it contains irritated my anus for 48 hours and made me feel very down. Now that my anus is less sensitive, it doesn't do this.
I can understand your concerns about LIS. I think we all have those concerns pre-op. In fact having the procedure assists healing where chronic fissures or recurring fissures are concerned. It also has a very high success rate - somewhere in the region of 95%, if I recall the reading of research I did on line. Of course, I was worried I'd be amongst the 5%, but I think where it doesn't work it may be the person needs to return to have more of the muscle cut into.
I fully understand becoming over sensitive and crying so easily, having always been an optimist before. I did too. That's how this kind of condition can affect you. The CRS I saw had had similar problems himself in the past and said no one who hasn't experienced this sort of pain can understand. I felt so relieved to be understood as I always felt written off by the previous surgeon, as though I was complaining too much about a minor condition.
On the question of healing, I asked the same kind of questions as you. In 1998 at the age of 44, I had a haemorrhoidectomy and recovered just fine and reasonably quickly. No muscle spasms, no fissures from surgery (that I was aware of), no recurring fissures in the recovery period (so far as I was aware) and back to normality quite quickly. But in 2009 when the major fissure first occurred at the age of 55, it took months to heal and even once healed, I had pain from muscle spasm, and regular recurring minor fissures from a tight anus - and a pain cycle developed. I also took months to get back to normal after the LIS op to fix the condition. Why the difference, I don't know. The conditions and circumstances were not exactly identical maybe. It wasn't that I didn't heal readily from the LIS op, I did, the surgeon checked. It was that my anus didn't resolve back to normal for quite a while afterwards and its tightness caused minor fissures and because of the pain cycle, and such muscle spasms as it was able to produce post op with the degree of muscle tone it had left, even minor fissures caused me to experience a lot of pain. Someone who hadn't had these sorts of troubles with their anus probably wouldn't be bothered by a minor fissure.
It might be however, that you'd recover just fine from the LIS procedure, especially since you've been suffering a shorter time. I'd been in pain for almost two years before I had the procedure, and had had haemorrhoids banded and skin tags removed by the previous surgeon during that period, which upgraded the pain cycle by causing more pain. In all of the accounts I've read from people who've had the LIS operation, the vast majority have become pain free earlier than I did, and you may well be amongst them just on the basis of chance alone!
As for worries of incontinence, I think with a good surgeon you won't get this. I don't know what the prevalence of it is across all research. I think it means gas incontinence anyway, rather than poop incontinence. Shortly after the operation, I did think I was going to pass wind, and it turned out to be the other thing, but apparently that's common in the immediate aftermath of the operation. It's never happened again and I have no trouble with bowel control, even with a full bowel where i have to wait to get to a lavatory.
I don't have any experience of levator ani spasms I'm afraid so can't offer anything there. This is where the expertise of the surgeon comes in for both diagnosis and treatment. From talking to the CRS who cured me, I get the impression the anus is a complex area and even though he explained very well, I can't possibly understand on his level of knowledge. I could only keep pressing questions until I got some kind of reassuring answers. I used to go in with a prepared list of questions, and somehow we got through them all!
I'm sorry to have written so much, and know how difficult it can be with anal pain to sit and type, so don't feel pressured to respond. I really wish for you to get a cure soon, and maybe this next thing will be what you need. If you yourself have felt this was fissure related from the beginning, you may be accurate. I felt that, but the hospital I was going to prior to seeing the surgeon who fixed it, could never see any of these minor fissures, and just kept telling me I had a normal anus. The consultant there even referred to "idiopathic pain", that is pain arising from an unknown cause, which made me very distressed. Yet when I saw the new surgeon he could detect the minor fissures, see the anus spasming (which they couldn't seem able to) and knew exactly what the cause was and how to fix it!
Hugs and good wishes for the future.