Hi all. new to forum advice would be great

[skip44]

Hi all,
great forum, nice not to feel to alone, i've had this for around 2 years but for the first 18 months i thought it was piles and it was bareable. Until about 4 months ago i was in excrutiating pain and i went to the docs. He diagnosed a fissure. I saw a specialist who implyed that because i have had it for a long time that surgery was best. But I tried the cream first, and for now touch wood the really bad pain has subsided but I still have bad days and it certainly hasn't gone. What is a seton drain? do you always have one? How long does the surgery take to heal? (im self employed so its difficult to take a long time off work?. sorry if its a lot of questions.

[Guest]

Hey Skip,
Welcome to the forum! Ask all the questions you need, that's what this forum is for

As far as I know a seton is for people who have fistulas(infection). I believe Paul( another boardie) has one.Hopefully others with the experience can explain more.
I recently had lis and to answer your question- No everyone doesn't get them with lis. It's only for people have have infection.
I had lis two weeks ago after having a fissure for 8 months. I'm so happy I did it! It has been nothing compared to the pain of a fissure. Most people will say to take a couple of weeks off work but everyone's experiences differ. For me, I was mostly sore but not in terrible pain for the first week, but could feel swelling if I walked too much. If I were you I'd take it really easy and do as little as possible for the first two weeks , not because you may not be able to do more but because it will give you the best shot at healing well. I definitely wouldn't do any heavy lifting or anything strenuous until your CRS say's your fissure is healed. The fissure will generally take 6-8 weeks to heal.

[NeuropathicGuy]

Hey there Skip,

Yep a seton (there are several different kinds) are used for fistulas. If you have an uncomplicated fissure, you don't need one.

What kind of cream did you try already? Generally fissures that haven't healed after a couple of months area indeed good candidates for surgery. A lot of us here have had surgery with good results. Most of us have also tried many other less invasive treatments.

I personally tried all three creams (nitroglycerin, nifedipine, diltiazem), got Botox injections, and finally ended up getting surgery (lateral internal sphincterotomy or LIS).

In all honesty, aside from surgery, I think the single most helpful thing I ever did for my fissure was take Miralax (a stool softener). It didn't cure the fissure for sure, but sure made it much more tolerable. That plus a largely veggie-based diet.

What kind of work do you do? Healing times after surgery differ quite a bit. Most people can return to somewhat normal activity after several weeks. Some sooner and some later. I was a very, very, VERY slow healer after surgery but do computer (software) work so I was able to work from home the entire time. I was physically out of the office for over a month but only missed 2 full days of work. If you do physical work then you might want to budget more time to be safe though.

[skip44]

Hey guys,

Thanks for the response, Its very good to hear some factual stuff as my specialist said 3 days recovery which i couldn't understand.

I used diltiazem cream but i'm not sure if it helped or if it was just the fact that I used it for 6 weeks that it got better anyway.
I am an electrician so its quite a physical role with power tools and stuff so the time off work is not great but on the other hand If I have to then so be it. I just dont know if I should carry on how I am in the hope it will go but im not confident. I can manage the pain now but it is a big drama, I used to be at work at 8 now I'm lucky if i'm there by 9. Should I carry on like this or take the plunge, also im due to go to New York at the end of Jan so If I did decide to have the op do I do it this month to try and recover in time or do I wait until I've been?

p.s. I'm very happy to hear you guys have come out the other side and are getting your lives back congrats

[Philber]

I used all the conventional treatments (diltiazem, high fiber diet, increased fluid intake, stool softeners, warm baths) for months, and although they helped with the pain and discomfort, it was still pretty unbearable.

Eventually, I had LIS and a hemmorhoidectomy, and the results were dramatic. The recovery was very painful and not something I recall fondly, but once I had recovered from the surgery (about two weeks), I was cured. I have no pain, no bleeding, no discomfort, and my life has returned to normal. Like you, I used to start my days early, but my butt problems prevented me from leaving the house. Now I am back to my normal routine.

So I would say that if your doc recommends the surgery, have the surgery done as soon as you can. It's no picnic, but living the way you are now is no fun either, and if it isn't getting better after a few months of conservative treatments, it probably isn't going to get better.

[Guest]

Skip, I'm Getting close to being 3 weeks post-op and I say go for it! I had lis, fissure cauterized and skin tag removed and I'm feeling great. So much better than having the fissure pain. You will be sore, just keep the high fiber diet, stool softeners(miralax is great) and take your baths and things will get better. I read in older threads where someone said count weeks , not days because it's like watching grass grow and I kept that in mind while recovering...
I say do it now and by January you will be a new man and actually enjoy your trip to New York.

Some people are slow healers, but many feel much , much better by 2 weeks. Phil had hemroidectomy( the worst) and LIS and healed in six weeks if I remember correctly. I think the key is keeping the good diet and keeping those bm's soft, plenty of laying around and doing nothing..

[skip44]

I guess i've got to make the decision its just hard when the pain at the moment is ok but its the amount of time and effort that you have to put in just to achieve it which is making me lean towards the surgery. I just hate operations especially the thought of this one, but thanks for your input people its a great help speaking to people who understand the trauma of this thing.

[NeuropathicGuy]

Hey Skip, if you're headed somewhere at the end of January, you should be good by then if you get the surgery in the next month or so IMO. The vast majority of people will be just fine by then. Even those of us who are slow healers will generally be travel-worthy in that timeframe.

Personally, I had LIS, then developed an abscess and had to have a second surgery 2 weeks after. Even after the 2 surgeries in 2 weeks, I would've been able to travel 2 months afterward, albeit with some discomfort (which wasn't nice but is nothing compared to having a fissure that's really acting up). I don't know what an electrician's schedule looks like, but would you get any extra time off during the holidays at all? If so that might be a good thing to consider. I'd think it would be best to play it safe and budget a couple weeks off minimum since your work is physical, and then play it by ear and see how it goes after that. Leave yourself some buffer time and hope you don't need it, that sort of thing.

[skip44]

Hey NeuropathicGuy

thanks, I was thinking if I do it by middle of december then like you say use the holiday period to recover. I'll take 2 weeks off before christmas then the week of holiday over christmas, that should also give me 6 weeks prior to travelling which i hope would be enough.
Now an abcess that sounds painful, why did that develop, how you doing now?

[Guest]

Hey Skip, I think 6 weeks will be plenty of time before traveling. As you can see , we all heal differently but many go back to work in 2 weeks. I'm 3 weeks post op and feel great.You just really have to stick with the diet and take your stool softeners , baths and rest to give yourself the best shot at healing well.

I think NG got his abcess from his lis surgery and it had to be drained 2 weeks later which is not really common, so don't let it scare you...

[Guest]

pss... I know the thought of this surgery is so scary. I was so scared the day of my lis that I could barely sign the papers( trembling) and crying... It is so fast and your butt will be so numb the first day, plus they give you great pain meds and when you do feel your butt again, it's kind of an achey, sore, not like fissure pain. Just be sure and do all the things you normally do to keep your poop soft.

[NeuropathicGuy]

Hey Skip,

Sorry for the late response. Yep I did get the abscess after LIS. Not sure why exactly, the area just gets dirty so it's always a bit of a risk. It's a rare complication though so it's unlikely you'll run into the same thing.

I think the timeline you laid out sounds reasonable. Maybe leave yourself a tiny bit of flex work-wise if possible, but unless anything unexpected happens, you shouldn't need it. 6 weeks before traveling would be fine for most folks, so I think you're pretty safe there.

I'm doing mostly okay now. Still some occasional very, very mild discomfort down there but I get about my business just fine and don't notice it very often at all. The first few months I had my fissure, I thought my life was over and now I barely remember those days (thankfully). LIS isn't a guaranteed cure for everyone, but in most cases it does do quite well.

[skip44]

Thanks again guys