Booked Surgery for 9 July - questions!

Fibre Addict Joined : 03 Jul 2008 Posts : 14

Hello all,

Thank you so much for such great support pages. It has been a wealth of information for me in deciding to have LIS surgery next Wednesday here in Sydney, Australia.

I have a few questions though that I am hoping you all might be able to answer which may give me encouragement, or at least a better idea for what I am in for Wink

Firstly, from all my reading, it seems that a lot of you have had very large fissures combined with the spasms. I must say I have never experienced the spasm pains that some talk of; is the spasm directly related to the size or depth of the fissure? I have had the fissure for well over a year now, on and off, most pain presents when I have a bowel movement and varies from no pain after to slight pain for a couple of hours or so if I clench. I keep a great diet and use stool softners, but just can't get the bugger to close fully! My main issue is that even with small soft movements, it is very difficult to poo! I would say that from my reading of your experiences, I have a mild chronic fissure?

Finally, does anyone know if the size of the fissure relates to the healing time of the LIS? What I mean is, the LIS (from my understanding - you may clarify this for me!) is a cut made to the size of the fissure - meaning the bigger the fissure, the bigger the LIS cut? I would assume then that the bigger fissure, bigger LIS cut would mean more healing time?

Thanks so much for the pages..

Keyzer

Subject: Re: Booked Surgery for 9 July - questions! July 3rd 2008, 12:43 am

hmmm...that's a good question that i don't think has been asked here....

i know your fissurectomy is dependent on the size of the fissure - ie, how much they cut out depends on how big the fissure is.

but for an LIS, i wonder if they just need to get enough muscle below and not necessarily it have to be the size of the fissure?

let's see what the other boardies have to say.....
_________________
the marathon is on oct 26....just right around the corner.......

yikes!

Fibre Addict Joined : 03 Jul 2008 Posts : 14

Thanks Happyass - Yeah I've been searching for these answers for a while.

My surgeon did mentioned something about limiting the size of the cut to the "height" of the fissure (of this I am unsure what he could mean) - he mentioned that this limits rates of incontinence (by far my LARGEST fear for the LIS). He said he would take a look at scar tissue and remove if needed to promote healing.

Basically - his words - I use a blade to make an incision next to and up to the height of the fissure, then twist the blade to cut the internal muscles, thus relaxing the sphincter.

Not word for word, but pretty close Wink

Subject: Re: Booked Surgery for 9 July - questions! July 3rd 2008, 1:39 am

Hello Keyzer. I just had LIS, Fissurectomy and Hemmiectomy 15 days ago. My understanding is the fissurectomy was necessary because of the fibrosed (scar tissue) nature of my chronic fissures edges to promote healing. From what I also understand the cut is usually made along the fissure to relax the area from spasms (they may be occuring without you feeling pain) to prevent the cycle of retearing that occures with spasms.

As far as healing goes it varies among individuals and the many issues that are different person to person. My research indicates the better your circulation the better the healing process. Some, but certainly not all the factors include, exercise and smoking which can inhibit circulation. I also believe that your state of mind can contribute to the process.

For a detailed history of my surgery and recovery you can check out my thread "countdown to surgery". Welcome to the Board and Good Luck! D

Fibre Addict Joined : 03 Jul 2008 Posts : 14

Hi Badass..

Thanks for the post - I am glad that your story is one of success. In particular because you are a golfer; I actually had to beg my surgeon to fit me in earlier, as the first round of the club championships is on 10 days after my op. I guess that is the healing time I am hoping for - whilst not back to 100%, I am hoping that I can at least get around the course! I exercise 4-5 times a week, am lean, and don't smoke. I also have no other anal related complaints.

I am still interested in my original questions though - about limiting the size of the cut to the "height" of the fissure?

Keyzer

Subject: Re: Booked Surgery for 9 July - questions! July 3rd 2008, 5:59 am

Dear Kyzer
Welcome to this wonderful forum Smile

So sorry to hear about your suffering , soon to be a distant memory i am sure Smile

I dont have any advice to offer as i have not had the surgery,
but wanted to wish you well for the 9th, i hope the procedure goes smoothly and that you have a speedy recovery sunny

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Thank goodness for the good souls that make life better !

VIP Joined : 23 Apr 2008 Posts : 803 Mood : good

Kyzer,

Good luck with the surgery and please provide feedback so that we can all learn from your experience!

Subject: Re: Booked Surgery for 9 July - questions! July 3rd 2008, 9:32 am

Good luck keyzer!

Keep us posted and let us know how it goes! I am sure you will be pain free soon!

Jen

Subject: Re: Booked Surgery for 9 July - questions! July 3rd 2008, 2:25 pm

Hi Key : ) !!! Your doctor described the procedure exactly as mine except that my mentioned holding a finger inside the anus to feel exactly how much and when muscle relaxed after the initial cut. I had LIS and fissurectomy in December 2007 - healed in 9 weeks completely but re-injured area in mid April -although it can not even
be compared to the initial pain and spasming before the LIS. My CRS was too conservative and cut too little so my sphincter is too tight still. Closing of the fissure after the LIS goes pretty fast and pain is MUCH relieved immediately after the surgery. You will have to help your fissure heal by having sitz-baths and very good fissure friendly diet. Most of the fissures heal completely in 6-8 weeks , if you have fissurectomy too it takes up to 12 weeks. All in all, you have to be patient and take a good care of yourself to promote healing, but do not obsess about statistics regarding healing time - everybody is different ! I am sure that there are people that heal in 4 weeks as much as there are people that need 4 moths or longer.
Incontinence is very VERY rare, especially if you have good CRS. Ask him if he ever had a case - if he said no - you can relax really !!! Some people here had 2 or even 3 LIS procedures and are still fully continent - CRSs are very careful with that - none of them wants that liability ! It is even more rare with males than females - so if I were you , I would really not worry about that ; )
I wish my CRS cut it MORE LOL !

All the best and keep us posted !!!!

Fibre Addict Joined : 03 Jul 2008 Posts : 14

Hi all,

thank you so much for the kind words of support. I will take that with me into surgery.

I have to say, it sounds as though you have all had it FAR FAR FAR worse off than I have with dealing with this annoying condition! I can't imagine what some of you have been through - and am amazed that many hold off having the surgery. It actually makes me think I am being premature in my desire for the op.

As I mentioned, I have not had the spasms, painful to sit or any of those other related symptoms. My issue has been a tearing of one "larger" fissure and one "smaller" fissure from time to time - and if I pass any formed stool at all, it is that razor blade feeling that we all describe. This is followed by a few hours of stinging in the fissure site which tails off to no pain, but is followed the next few days by a tight sphincter and difficulty going to the toilet (the common cycle!). I have them under control at the moment, and hope that this will help with healing after the op.

For those that have had an LIS, do you think the surgical cut heals quickly? I do realise (we use s and not z in Aus Wink

) that the fissure site needs up to a year - but was wondering what healing time people experienced as to the actually LIS cut?

Subject: Re: Booked Surgery for 9 July - questions! July 3rd 2008, 8:52 pm

LIS cut was gone in 2 days for me !!!

Having a fissure for a year makes it very hard to heal on its own. I was warned by my CRS not to wait too long since scar tissue starts forming. I had it for 5 months and I already had some scar tissue ! Not only that, but other CRS told me that scar tissue can make one incontinent !!!!!! That definitely helped me to make fast decision and have it done rather sooner than later.

Best of luck !

Fibre Addict Joined : 03 Jul 2008 Posts : 14

Thanks so much for the replies!

Wow - so if the LIS cut can heal in two days (lets say 10 days or so even), what is the pain people are experiencing for weeks? Is this related to a the fissurectomy/fissures still causing pain?

To be more specific, I thought the weeks of pain people were experiencing was directly related to the surgery - the LIS cut of the muscle etc? But this seems not be the case, that it emanates from the fissures/fissurectomy which was obviously present before surgery?

Fibre Addict Joined : 03 Jul 2008 Posts : 14

Oh and one more question - is removing scar tissue the same as a fissurectomy?

Subject: Re: Booked Surgery for 9 July - questions! July 4th 2008, 12:40 am

The pain I felt after surgery was no way even close to the pain I had before the surgery. It was more like some dull pain on the side where incision was - probably muscle pain, again- nothing worth mentioning. Fissure site had some scratchy feeling and some burning - really again nothing even remotely as fissure pain. There was some swelling for couple of days and some mild bruising - I had LIS Dec. 20th and went celebrating New Years Eve and danced and eat normal food. As I said, my healing was fast, but I am still prone to injuries now that my sphincter regained most of it's
strength : ( ! 9 weeks post LIS I felt the best - my butt was almost like new.

Yes, fissurectomy is removal of scar tissue. They basically "shave
off" the edges of a fissure so they can adhere nicely together and
prevent formation of space beneath the surface of the fissure which than can lead to abscess formation.

Fibre Addict Joined : 03 Jul 2008 Posts : 14

Ok - that is very interesting. I would assume that there is some intense pain associated with the fissurectomy - I guess that could be a major issue!

Anyone else want to comment on the LIS cut itself VS the pain associated from fissures etc