Hey Adam - you'll be just fine! Don't worry about the first BM and taking painkillers with some restoralax if you need it. I really don't think you'll find bms too painful. Just please don't be afraid to take something for pain if you need it. We can help with advice about avoiding constipation.
I'm so glad you saw dr Rudd. He has a good reputation. I saw doctor dr McKenna at the downtown clinic. He is a jacka$$. He goes on anti-anal-sex rants and is brutal with his patients. Another boardie here, redcharger, also had bad experiences with him. I'm so happy you got the best surgeon at Rudd. We will be here to help as you heal.

Dawn, I'm sure I had a fissure in the beginning, and possibly still have it now, but is probably 90% healed. BecUse my bowel movements on pain scale from 1-10 started at 9, and this morning it was at 2. Also, the afterwards pain also was getting better day by day. But the fact is I have truly been taking it sooo easy on it. When I had to sit, I either sat with just my thigh on the seat, or driving, I'd put a sweater under my thighs, and use my legs to lift my bottom off the seat for the whole ride. Because even though the bm and post bm pain were getting better, I was still unable to sit because I felt the weird feeling there as I did on the day of the shattered
glass bm day. Sitting was the only thing that was not getting better at all.
And I don't have any rx pain meds Dawn. And I don't know what they are. Are they good? I don't think I'll need the pain meds as the doctor said "You should be able to go back to work in a couple days". So it may hurt tomorrow after my bm, but hopefully isn't too bad.
Hopetoheal, I think I may have seen Dr. Mckenna. He was about 5'10-6', grey hair and beard and a little husky? We acknowledged eachother in the hall, and seemed nice for that, but from experience a friendly acknowledgement means nothing about how a person really is. I explained to Dr. Rudd that I had anal sex for the first time 3 weeks ago, and a week after that is when the pain started. He only had a problem that enough lubricant wasn't used, that's why these things happen. But I honestly will not have it again after trying it. It doesn't feel right to me, and just look at how it so easily took away so far a month of my life, work, and 20 pounds off of my weight, probably 10 pounds of it was weeks of hard-earned muscle going to the gym 6 times a week. Now I haven't been to the gym ince then, and who knows when I'll be able to back at full-stride. And when I do go, people will see me probably 30-40 pounds lighter, and everyone will want to know what happened.
But i still do respect the people girls and guys who enjoy the anal sex, humans all have different interests just as I did to try it. I just think there should be public service announcements during the superbowl to use lube lol

Hey Adam,
A RX means prescription pain meds. I'm kind of worried about you not having any once the numbness wear off. Don't worry about anything over the counter constipating you if you don't have prescription pain meds. Heavy pain killers such as vicodin are the constipating ones.

Hey Adam - dr McKenna is bald with no beard and walks with a bit of a limp sometimes. Definitely stay away from him! I'm so glad dr Rudd is more enlightened. You're right there should be announcements about not skimping on the lube! Lol
after my LIS McKenna told me I diidnt need pain killers, but the nurse got a script for Percocet for me. I was glad i it for the first two days. I still had some left over that I used for the first three days after the fistulotomy. Maybe you can call your gp and tell him that you had surgery and maybe he can fax a script to a nearby pharmacy for you (if your doc knows you well, and knows you aren't very mobile, he might do it for you. Some pharmacies also deliver. Just a suggestion - you might not need them. :)
I definitely think surgeons seriously underestimate recovery time quite significantly. A few days to me is total bunk. At least a week is required, IMO, and two weeks is better. You're not likely to be healed for 6 to 8 weeks, even if you're feeling better and I really think those first few weeks are pretty critical to healing and avoiding complications. I really hope you are able to take some time off to look after yourself.
I also hope you have a good sleep and a good days tomorrow :) big hugs to you!

"Hey Adam - dr McKenna is bald with no beard and walks with a bit of a limp sometimes" - don't forget the hook and the eye-patch :)
Well Adam, you're a hero: to do that under just a local, in 15 minutes is, for me, nothing short of a miracle. My surgery (fissurectomy + botox) took 1.5 hours. There is NO WAY I would have done it under a local, not necessarily because of the pain, but the psychological stress.
As for the advice about the area, it seems a little weird to me, but maybe it's correct as you had a different surgery. For me it was: showers only with lukewarm water, painkillers daily (actually told 3x daily but I take just one), miralax/movicol daily, no soap, no baths, no poking at the area myself.
Anyway, good going and hope you get well soon!

I do have tylenol 3's from a year and a half ago when i broke my ankle. Are those okay? Strong enough? Constipating?
Yes I did tell my boss that I need the rest of this month off, so hopefully it heals well enough by then. I'm going to tough out this first bm this morning (hasn't come yet). And see how bad the pain is, if it's a little bad, I will go to my doctor for some pain meds and stool softeners even though i really don't want to.
Thanks dexterdude, and i definitely think our surgeries were much different. The doctor told me to USE soap to clean it.
Lastly, I'm going to explain what my wound looks like, so if you don't want to read, then there's nothing left in this post for you, no offense! I just don't want to disgust or scare anyone.
So the wound is like this: at 12 o'clock of my anal hole, that's where the tic tac sized abcess WAS. That looks like it was cut out and now there is a dark purplish wound about the size of a coffee bean. When I spread my bottom cheeks far enough, the wound opens, and it looks like it goes pretty deep. Some skin around my anus hole at 6 and 9 o'clock look a bit swollen but it just looks more like the skin there has shifted due to the surgery. That's all ao far! I'm not getting too much pus or blood. Less than a teaspoon of both together over-night.

Hey Adam,
If they have codeine in them, then they can constipate, and you definitely need a stool softener because you don't want to get constipated! Some have taken stool softeners short term after surgery and stopped at about 6 weeks so if you have to take them, it's not like you will need them forever- if you don't usually constipate.
I can't believe you went through the night without pain meds!! I hope your 1st bm goes well. If it doesn't come today and since you are not taking stool softeners, you may need to take something because you can't risk constipation, Adam!:)
It's crazy the differences in CRS. I was told to not use soap and have heard others say the same thing. If possible, I would use a very mild soap there. Maybe a baby soap would be less harsh and may be something you could think about...
I never looked at my butt after surgery. You are brave! My husband was the butt inspector from day one,Lol
Hope things go well with your 1st bm. Try to relax as much as possible. Mine wasn't bad at all... Keep us posted :)

Hi Adam! I agree with Dawn that you will need a stool softener if you take the Tylenol 3s - anything with codeine will constipate. Also, if your meds are three years old, they may not be as effective anymore. Dawn's definitely right, you will want to keep those stools soft. Many of us find Restoralax/Miralax very effective. You can control the dosage and take more or less as you need it and many folks taper off a few months after surgery.
Your wound sounds like a fistulotomy wound! They tend to be quite wide because they have to heal from the inside out. I'm a bit concerned that my incision isn't healing quite properly, since I can still see a deep hole at the top of the long cut the surgeon made. But I guess I'll find out on Friday during my follow-up.
I hope you have as pain-free day as possible and that your first BM goes well! Remember to breathe and relax :D

Thanks Dawn I just had my bm a couple hours ago. It went great, the softest stool I had yet!! Maybe it seemed like the softest because the surgery already helped? However, I did see blood on my stools, not much, but the most I've seen. Little blood spots on the three pieces of large stools. Maybe 3-7 rice-sized blood spots on each stool. The doctor did say there will be some blood though.
To wipe, I used two 3-play kleenexes together, folded twice, so it was really like 24 ply lol. I dabbed some water on that with my hand and dabbed it and wiped away from the wound. I did that maybe 12 times very gently until there was little or almost no sign of stool. I then ju
Ped in the shower for maybe 15 minutes and rinsed, washed, and rinsed again 3 times as well as I could spreading my cheecks as much as possible and got right in there with the soapy wrag. I did it until I felt the wound was clean (no stinging pain).
I got out of the shower and dried it off a little with a wrag, but it did sting a bit like a cut, I hope that's normal. I took a look at it as usual and seen that there's a bit of white or dry skin around the wound, so I tried rubbing it off gently with a q-tip and did. It still felt a bit achey though, but the doc's instructions were, "If you washed it repeatedly and still hurts, get your spouse to dip a q-tip in hydrogen-peroxide, and apply it to the deepest part of the wound", so I used a mirror and did it myself just to be sure it was clean. It did not hurt at all.
In fact nothing hurts at all. I had maybe ten seconds of very mild burning but I think that's because of the cornstarched cottonball keeping it so dry right now. It still feels a bit achey but I'm not too worried because I can still walk. But right now I'm on my pile of pillows with my bottom higher than my heart to relieve the blood flow, and pain.
Thanks again Dawn, you got me off my lazy butt this morning when you reminded me to not constipate. The reason why I didn't have to go right away this morning as usual is prkbably because I only had two meals yesterday, as I was so busy, having the operation, getting other errands done, and cleaning my whole place especially the washroom and kitchen because I felt the bm's would paralyze me for a week. But all in all, I'm in bearable pain, and very happy about that :) Thanks again Dawn I hope I find a girl like you one day
Hopetoheal thanks goes out to you too :) I seen that the tylenol 3s I have contain 30 mg's of codeine, so right away I put them back at the back of the cupboard lol. Today I definitely don't need pain killers. I hope the next couple of days aren't too much worse than this. I also hope I'm cleaning it well and I think I did well my first time.
Hopetoheal, if you do feel a stinging pain coming from your incision wound it may be a bit dirty, if it does, just try to open the wound more to clean it better, and maybe try to open it more when drying it too, and dry it a bit longer than you usually do. But if it's just still deep, you're doing just fine. It's only been about a week right? My surgery wasn't that bad and I have little pain after the first day bm, so my situation may heal faster, and mine won't be "healed" until a month according to the crs, and that's probably the earliest it would heal, if I take good care of it. I don't even know if these wounds are supposed to close completely either especially in a month. So don't be worried at all hopetoheal, you're doing just fine. Any added stress will increase your blood flow which we all don't need the pain from
I feel so good right now. I have a little pain, but after this surgery I feel like I'm on the right path and almost there. I feel like going places and eating and working out and going to work. But even the crs told me I needed a few days off of work, so I will relax all day the next few days :) I'll probably go see some friends or famy tonight for maybe an hour but that's it - as long as the pain doesn't get worse, and I don't see how it logically can as it's almost 3 hours since my bm :)

Adam, I'm amazed how well you are doing. I can't believe you have had the first bm and no pain killers or stool softeners!
Since I had a whole different procedure than you, I can't really comment on after care, but with my experience any stool in the area would cause irritation and stinging. I took many baths but since you have been advised not too, I don't want to push that. Some here have used a product called balneol for cleaning the area after bm's, etc. It's specifically made for that from my understanding and I'm told that it works well....
Good Luck and may things continue to go well :)
I found this link. You may have already read it but thought it may be useful.
http://anal-fissure.org/t2465-fistulectomy-post-op-day-8#51710