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Bowel Disorders Message Board


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This thread is a continuation of Parts 1-5, for those having had (or are considering having) sphincteroplasty and related surgeries.
Hello.....
I am new to this message board and sure wish i would have found it before I had surgery! To have such support from others is such a great thing. I thought I was the only woman that had these issues. I can relate to so many of you. The accidents, the urgency etc....I also have IBS so sometimes that made it even worse. Got to the point where I would really have to watch my diet, especially when traveling.

When delivering my first child, 27 years ago, I tore into my rectum...pretty bad but they stitched me up the best they could. Over the years and 2 children more....things really started to get worse. I couldn't take it anymore so I asked my Dr what could be done. He referred me to a specialist. She took tests and confirmed that over 50% of my muscles were gone and I didn't have any space between my vagina & rectum. So I scheduled surgery for Sept of this year. Surgery went very well....had no complications what so ever. I went back to work within 1 1/2 weeks. I was very fortunate!
I have had my final checkup and said I could resume to normal activites.

I did want to mention to anyone using the guaze squares......I used the square cotton cosmetic squares instead. I found they were alot more comfortable and cheaper! I was instructed to use a hemmoriod cream along with the cotton squares.

Thank you for all the advice.
Have a great day!!
MKD, I'm glad you found us! Please stay tuned so you can give advice and support to others (i.e. subscribe to the thread under "Thread Tools"). Gosh, I'm so glad you healed so well and quickly! Your success can give hope. I too was torn many years ago during childbirth and have IBS also. My surgery was in May, and my wound didn't open as others' have. Did you just have the sphincteroplasty, or rectocele repair as well? I'd guess from your post you've at least skimmed parts 4-5 of this thread... there is lots of good info there.

Mary
YAY! I am so happy I found you! What a blessing this message board is!

I am having an overlapping sphincteroplasty in 6 weeks. I have 2 toddlers at home and just moved to a new town in which I know no one except my husband. Our family and friends are all a minimum of 2 hours away. I really want to plan this right- and be well educated.

I realize that so many of the women posting had it much worse than I do- all kinds of "plastys"- mine is [U]just the sphincteroplasty[/U], so....

Can anyone tell me:
1. how long you were hospitalized
2. how long you were on prescription pain meds
3. what to watch out for
4. what you wish they told you
5. what you think about my colon-rectal surgeon saying that some people go home the same day

I read through the hundreds of posts on other threads...SO helpful!!!! I was just sometimes unsure as to what to expect with the sphincteroplasty, because as I said, so many women had much more complicated surgeries.

(I realized after my 4th degree tear during childbirth that I didn't have to suffer alone. I found a message board on another site that discussed it, and it really helped me get through some tough times, as you all understand. )

Thank you SO MUCH for anything you share and for taking the time to be on this site!

:D--JESSICA
Hi everyone! I'm so glad to have found this board. I have read through so many posts.

My name is Lisa. I am 27 and have a 15 month old son. When I gave birth to my son I had 4th degree tearing because my son's head came out but he got stuck and the doctor just went up and grabbed him out. I first found out I had a problem when I couldn't control my first BM after childbirth. I had a scheduled visit with the OB a week later and when I told him he acted as if this was unheard of. Having never been told the severity of my tearing I had to do much research online to confirm this was not normal. Things have gotten alot better since childbirth and I only have leakage now after BM. I have been a single mother since my son was born so this has been extremely hard for me to deal with both emotionally and physically.
I have seen a colorectal surgeon and had many tests done. I was told I need sphicteroplasty.
I have a defect anteriorly. My external anal squeeze pressure is extremely abnormal. I have a 24mm in diameter defect in the internal sphincter with a larger defect with the external sphincter. My rectal wall only measures 6mm thick.
Due to insurance reasons I am scheduled for a consultation with anouther surgeon on January 10 and plan to schedule my surgery for March.

I have read a few posts about bonding issues with one's child. I honestly thought I was alone with feeling like this. I too have at times had a hard time bonding with my son at the beginning. I had alot of guilt about it because I was the only parent there for him yet I was so devastated and almost regretted giving birth. I wasn't able to hold him for a couple months because I couldn't sit (I also broke my tailbone during labor). This has been an emotional roller coaster ride and I just pray that things will get better after I have surgery. The first surgeon I went to told me that if I get the surgery I would not be able to give birth vaginally ever again because the same thing would happen. I have come to terms with this and am definitly taking the advice.

I have been reading all the advice everyone has given and although I am scared to get the surgery I feel this board has encouraged me to make the right decision and that there is hope of feeling "normal" again.
Happy New Year!!

I had the overlapping sphincteroplasty surgery in September. Overall, I am really glad that I had the surgery. I still have some leakage after a BM....don't like that at all but is better than before. Hopefully as time goes on that will change. I have been doing Kegal exercises and that helps a bit....also helps that wonderful urine leakage that seems to happen. Oh, the joys of being a woman!!

I was in the hospital from Friday to Sunday. I think what hurt the most was that I had packing in my vagina and put pressure on my bottom. Packing was removed the next day. The actual pain from the surgery was alot less than the original tear. I was on pain med's until Saturday morning.....just Tylenol after that as needed. My stomach can't tolerate pain med's or antibotics very well so I ended up with some pretty loose stools the next day.(even with nothing in my system) I sure found out quickly what my new bottom could do....haha.
Like I said in previous post....I was very fortunate not to have any problems with my surgery. What I didn't realize was that when my Dr did the sphicter repair that it would change my bottom so much. I now have a "tween". That does take some getting used too.

Just don't strain too much when having a BM.....don't want to tear those stitches out. My Dr said I would have to relearn to use those muscles. I had to remember to relax and let my body do what it was supposed to do. I stuck with a liquid diet for the first 2 weeks after surgery and then slowly added regular food to my diet. Chicken worked the best and red meat was the worst. Just listen to your Dr and don't be afraid to ask lots of questions before & after surgery. Better to ask than to worry about it.

I do have a question regarding "intimacy". Did you find that the feelings before surgery are alot different after surgery? I am finding out that I have to relearn how things work. I am very fortunate to have a wonderful caring and patient partner that doesn't mind having to relearn these things. But it still can be frustrating at times.

Thanks to everyone!!
Hi everyone,

I started this thread last November, and I am glad that it is still helping so many others at this time. I think my whole life history is in threads 1-6 and also some other threads previous to these. I am regretfully letting you all know that I wish you all the best. I will not be able to check in very much from now on because I am trying to heal my 4 year old daughter that was just diagnosed with crohns disease. I have been doing a lot of research in that area as of lately. I hope everyone continues to recover and heal well. I am officially 1 year post op on January 18th and I am doing great. I fortunately, have absolutely no incontinence issues or smearing at all. I feel blessed to have met such wonderful and supportive people on this thread. I hope in the end, that my story can continue to be a source of strength and encouragement for others having to endure this. Right now, I am turning my focus to my little daughter who is not doing very well at the moment. If there is room on your prayer list--please add her, her name is Grace. Thanks again everyone.

Kelley
Kelley, you have helped so many of us. When I joined in May 2007, two days before my surgery, you and Jen helped me so much... and I've been a lurker and sometimes poster ever since. (Actually, didn't you start this in 2006?). I hope some of the others of the past year will step up and give the women advice and hope now that you and I are doing quite well and might not check in too often. I am so sorry to hear about Grace. I've not heard of Chron's at such an early age. But I know you can do your research and know where to go with this. And you are capable of such love, such caring, I know it will all work out. Certainly I will pray, hope, and send loving thoughts for Grace, you, and your family.

To the other recent posters who are facing surgery, I will reply soon... just wanted to get this {{{{{{{{{{hug}}}}}}}}} to Kelley ASAP.
Mary
Thanks Mary :)
Kelley,
I too want to give you a BIG HUG and also to your little Grace. I know that when you started this thread (why back when) I was the first to respond and have gone through the entire process with you. Having heard your story and going through the same thing, I honestly believe that having you as someone for me to talk to made me go through with this surgery, which I don't know if I would have if I hadn't found this board and you. I had my surgery in September, I am still trying to figure out my fiber intake as well as relearning how to work my bowels, but the surgery was a success and I am a much happier person because of it. It is quite a process, but knowing that I am not alone has helped more than you know. I honestly feel like I know you very well. Thanks for that...

For little Grace, she is on my prayer list and I believe in my heart of hearts you will do whatever is possible to make sure she is just fine. You are in my thoughts and prayers always.
Mindy
Hi everyone, sorry that I've been MIA for the past few months. I've been busy with life and the holidays. I've been able to read some posts to keep up with everyone, but have not posted myself.

First, Kelley, thank you so very much for starting this wonderful board and for the wealth of knowledge, care, and support you have shared with every single person on this board. I know I speak for everyone when I say that you will be tremendously missed. But, more importantly, you need to devote your time and attention to your sweet daughter right now. She (and you) will be in my prayers.

I'm about 5 1/2 months into my recovery and I'm doing fairly well, but still having some issues with pain, scar tissue, and a few "structural" concerns. Sex is still very painful, but my husband is very understanding and patient. An unexpected perk (more for him) is that things are more "snug" since surgery. I'm guessing it's because they built up my perineum so much. Sorry if that is TMI! I go back to my surgeon on Friday, so I will address my concerns with him then. Over all, things are better than before surgery, but just not as great as I would like. Hopefully, time and more healing will improve most things.

Take care everyone and we'll miss you Kelley!

xoxo Elizabeth
I have to agree with everyone .....Thanks Kelley for starting this message board for others. I'm sure there are many others that can benefit from the past responses. I'll be thinking of your daughter too.

Elizabeth.....not too much information. At least not from my point of view. I'm sure all of us have had questions regarding those issues too. I know I have but didn't see much to answer my questions. I agree with you when you say things have "snugged" up. Yep, it is painful sometimes. Let us know how your Dr's appointment goes.

MK
Hi all,
Just found this site tonight and wanted to join in. I'm Susan and I had an overlapping anal sphinteroplasty on Dec 20 2007. So just a few weeks post op. I am still using 4x4s tucked in my rear to catch drainage, and have noticed some BM on them from time to time. Should the repair be effective right away or will it take some time? I have my next follow up on the 16th...so will ask Dr then, but thought i'd bring it up here as well.
I got the damage from a horrible 4th degree tear with the birth of my daughter 5 years ago.
Thanks so much.
Susan
Welcome Susan.....

Isn't it great that there are others out there to talk to with the same problems? I always felt so alone with no one to talk to about this....pretty embarrassing. Couldn't even talk to my spouse or my Mom. So I tried talking to other women but seemed to get negative responses...like what are you talking about? Or you are just going to have to put up with it...a sign of aging you know. Don't feel old! and certainly wasn't ready for diapers! I am glad that you have taken care of this so soon instead of waiting years. So overall, how did your surgery go?

I had the same problem with BM for awhile too....still have a little leakage but alot better than before. I think it will get better with time. Can anyone else help on that question? I am 3 1/2 mths in recovery. Did you try the cotton cosmetic squares yet? I still use them & Tronalane cream on occassion when bottom has been stressed. Lots of baths help too.

Have a great day!!
MK :)
Hi everyone, I've been really busy and apologize for not posting when I said I would. Some recent questions might be answered toward the end of "Sphincteroplasty Part 4" --- as I recall, several of us posted our "histories" there. I'm 8 moths post op and doing pretty well. Just learned I still have a "pocket" just inside the anus, though; that's the reason for some moist leaking after BM and even tiny bits of stool passing when least expected. But it's not full-on incontinence as before surgery. I'll probably go back to the surgeon when I come up for air and if bowel issues become a priority and start to rule my life again!

Yes, Susan, healing takes quite a long time. Leaking after a BM seems to be the norm in recovery (even without the "pocket"). My surgery-related leaking lasted about 4 months I think. It wasn't much but I did wear a mini-pad. The cotton/gauze bugged me because I had some irritation from an external yeast infection so I didn't use them often.

Don't get constipated! If you think you're susceptible to it, use Miralax or a stool softener. Increased fiber constipated me and it was horrible. For others fiber was a blessing. It's hard to find the right balance. MKD, is Tronalane cream an Rx? And do you apply it externally?

There is still a tender spot at the perineum and intercourse is sometimes painful. I wish I could give more hope. Someone earlier mentioned olive oil, and I like K-Y Silk-E. Messy but far more comfortable. There definitely was a decrease in sensation for several months after surgery as the nerves and muscles "re-learned". And of course, fear of pain makes you tense up. Elizabeth and others, there is never TMI on this board!!! LOL if you can.

Lisa, you have done your homework and I think you saw another surgeon yesterday. Any news? I remember others talking about having more babies after surgery and perhaps you read those posts too.

Jessica, your surgery is coming up - did you get the answers you were seeking? MKD and others had some good info. I was in the hospital 5 days. Took Vicodin as needed for a week or so after (with stool softeners - those meds are constipating!). But DO take advantage of the morphine or other pain meds in the hospital!!! Be sure you don't lie on your back too much at first, turn over carefully, and don't sit directly on your bottom. It will take several months for you to heal completely, so go slow, take lots of warm baths, and get help at home for a month or so. You might not need it, but it's best to be prepared. You say you're just having the sphincteroplasty, but I'll bet there will be a perineum repair also as part of that, with some external stitches. Ask your Dr.

Mindy, glad to see you're still here... I know you have been through parts 1-2-3-4-5 and now 6... were you glad you waited 'till your boys were in school to have the surgery?

OK, this was long, and I'll probably not post for a while... lots of life stuff going on, and going on with life now that my surgery is ancient history. I wish you all the best, and please keep in touch with each other for support and hugs and prayers and whatever works. I know this board has been a blessing for me so keep it going!

Mary
Thanks for the information!!
Tronalane (older brand name) is an over the counter external cream that my Dr had me use after surgery.
I was also given instructions to use an enama (bag type with very soft pliable nozzle that I got at the hospital) every day for 4 weeks and then after that when needed to keep things going. It is very easy to get "clogged" up. There are days when I have to manually push on the outside to get things going. Do you think that there could be a pocket there? Or just muscles relearning? What are the signs of having a pocket? When I went in for my final checkup, she didn't say anything about a pocket. I'm still trying to find a good balance...I think that having IBS makes it a little more difficult. Coffee/cocoa is the morning does seem to help...maybe it's the warm liquid that gets things going.

Keep the great information coming!
There are days I also have to manually press on the outside to help the BM along (together with the usual toilet acrobatics) not sure if that's the pocket or just muscle sluggishness. Anyway, it works. Also coffee... like clockwork!
THANK YOU for having this information available for others! Honestly, I had no idea that anyone else was experiencing even similar things to my own experiences.

I had a 4th degree tear in 2002 with my first child. I was ill informed as to the extent of my injuries, and when I asked my Dr., I truly feel she wasn't forthcoming with information because she wanted to protect herself against a malpractice suit. (even though we had no intention of suing her) I went back a year after and complained of pain and incontinence, and was told that everything looked fine and there wasn't anything that could be done.

When I got pregnant with my 2nd child in 2006, I finally decided to switch to a new Dr. At my first appointment, she walked in and told me that my records had made for interesting reading ALL NIGHT the previous night. (I was impressed that she read them at all!!) Anyway, after a very eventful and totally unrelated 2nd birth in April 2007, (I ended up with 3 weeks of pre-term labor, and a 34 week preemie baby that spent 3 weeks in NICU) I asked my new Dr. what I could do, and she immediately referred me to a colorectal surgeon.

6 months post C-Section, they scheduled my surgery. The tests for determining the extent of my damage were less than fun. The defecogram was the least fun. I've been so impressed with all of the technical names that you ladies have regarding your various surgeries. I've just said the "bum surgery." But I ended up with a rectocele, a repair of the perineaum, (which was next to non existent), a repair of the anal muscle (also ripped to shreads), tightening of some of the muscles, and repair of the separating muscle wall. I'm sure you all have the technical names for these procedures. (Sorry that I don't know them!)

I had surgery on November 4th, 2007. It has not been a great experience. The Dr. told my husband post-op that it was even worse than he expected (and he expected it to be pretty bad) I am 9 weeks post-op and was just barely given clearance by my dr. to bend over and get things off the floor. I can only sit for 15-30 minute periods. (depending on what I'm sitting on) I spend a lot of my day wandering around the house, because I can't sit, or still laying in bed. I have 2 children...5 and 9 months. It is difficult to care for them in the way I'd like to.

I'm just a little frusterated with the time frame, but am told by my Dr. that I'm healing wonderfully and that I'm right on schedule with my ability to do regular things. (sitting, bending over, walking etc.) From your experiences is this really what should be happening? And, how long should I expect before I can sit without being in a lot of pain?

Again, thank you for taking the time to share your stories. It's weird but it makes me feel better!
hi taquito bunny
I had the same surgery as you minus the rectocele...I'm 4 weeks post op and cant sit for any length of time either...but 9 weeks out??? I'm so sorry.
I'm scheduled to start a new RN job on Jan 28 and I am terrified about walking and sitting for 12 hours a night.
I know that just from reading Parts 1-5 and speaking with my surgeon yesterday, this is a long healing process. Months. I have found warm baths to be extremely comforting. Do you have a Boppy from the kids? That really thick Semi circular pillow? With a big hole in the middle. That is what I use. I love it.
Keep in touch.
Hellol everybody.
I had my surgery September 27th. I was off of work for 12-13 weeks. I couldn't imagine going back earlier. I have a desk job and it would not have been pretty. Even at 9 weeks out, it was still very uncomfortable to sit for a period of time. I would keep shifting from cheek to cheek. I has the sphincteroplasty, perinealoplasty and levotoroplasty. I still have issues with going to the bathroom. Don't get me wrong, my incontinence has gone away, but it is still painful when I have a hard bm, and getting regulated is another story. I am still trying to figure it all out. It is a very long process to recovery from this. I would bet on a year until your bowels are completely back to normal. My surgeon did tell me that I could never become constipated, because I have stiches inside that I could rip out. I was very irregular before my surgery, and didn't go maybe every 3-4 days, I know am on a fiber supplement which seems to help, but I have not mastered the perfect bm yet. It is a struggle. Keep up the baths, I loved them. Also, keep some gauze inbetween your cheeks to catch the drainage. I had that for over 9 weeks, which really sucked but it helped tremendously with chaffing.

Mary,
In answer to your question, I am so glad I waited until my boys were back in school. I knew the recovery was going to be rough, but you have no real idea until you go through it. Thank god for this board. I hope you are doing well. I will try and keep in touch.
Mindy
Thank you so much for your posts. I am going to try some of your tips. And, it's so reassuring to know that I am on an okay recovery timeline. (no matter how frustrating that timeline is!!) I too spend every day trying to get the fiber/stool softener/milk of mag cocktail, just right. And some days, like today, I get it wrong. And then it feels like I am pooping little pieces of glass! (So pleasant!:)

Anyway, please keep posting your progress! I know you all have families and busy lives...but it is really great to read your stories.
Hi Suzq and Taquito bunny... everyone heals on a different timeline, but it is sooo helpful to hear others' stories, I agree!. TQ, your comment about pooping little pieces of glass reminds me of one of the earlier posters - Kelley I believe - talking about the fissure (or fistula) she developed at the anus. Might be good to tell your dr what this feels like and have it checked out. I don't want to worry you, but I remember the comparison.

I gave up fiber supplements/softeners/anti-diarrheals/milk of mag -- just started back to eating "normally" -- about 2 months post op and then started tweaking that. Miralax did help to keep me away from the constipation. (1/2 dose daily). You all will get through this and it will get different before it gets better. I find I still have to pay close attention to what works each day and to try not to make it as perfect as it was before the damage.

As far as moving, bending, etc., again everyone is different. But I could sit comfortably at 6 weeks ( as I recall) and my surgeon told me not to use a doughnut pillow as that could stretch the incision and I might open. So I got a microfiber pillow and sat on one cheek or the other for quite a while. Also I had an abscess at the perineal incision site which made me feel like I was sitting on a walnut between the vagina and anus. Once that abscess drained I was OK for sitting straight-on.

I've been rambling here, have been gone all day and am tired, but wanted to reply. Hope this helps.

Mary
Mary,
Thanks for your info as well. And that comment doesn't scare me at all...I have a 2nd post op on Thursday, I'll be sure to mention it! Really, around here this whole thing has become one of those laugh while you cry kind of things and the whole "pooping glass" is kind of a joke/terminology that tries to express to my family members what this all feels like. Although it really does feel that way sometimes! Anyway, I really appreciate your info as well and again, it will give me some extra questions for my dr. Thanks! Lara
correction -- it was a microbead pillow, not microfiber. Ya know, the kind with the little beads that squish around...

And Lara, let us know how your MD visit goes Thurs. Don't hesitate to share info; that's what this thread is about.
Mary
Taquito Bunny, I had the same problem with my delivering doctor hiding my injuries from me. It was very frustrating seeking information online to learn of my problems and seeing so many doctors before I could get an explanation.

Mary, my doctor's appointment went well. Thanks for asking. I have my surgery date for Feb 4. and the Dr. expects me to be in the hospital for 2-3 days. He said no strenuous(sp?) activity for 5-6 weeks but from all the resourceful information on this board I am expecting a longer recovery. I'm so excited and hopeful that my problems will get better. He did say that if I had nerve damage the outcome would not be as successful and asked me if I wanted to do the test to see if there was nerve damage. I declined because if there is any chance the surgery can make me better I will just have the surgery. I can't take anymore tests!

Lisa
Hello...

Lisa, I am thinking of you with your surgery date coming up. I hope everything goes well for you and you have a speedy recovery. I know you will be anxious about the prep & surgery and that is normal....we've all been through it.


Will be thinking of you.

MK
Hello, All:

As of today, I am 14 days postop from a Total vaginal hysterectomy, Anterior/Posterior repair, and Overlapping anal sphinteroplasty. I'm very shocked to find the recovery so difficult. I truly expected to be up and about by now but unfortunately, it's still a work out just to go to the bathroom. I had a couple of good days last week where I walked about a 1/2 block in front of my house and back. I even ventured downstairs and made myself a bowl of cereal, twice. Yestereday, I graced the family with my presence at the Easter dinner table for all of 15 minutes and man was that a stretch for me.

This was all the result of three traumic births each of which resulted in 4th degree lacerations. The birth weights of my kids tell the story (please see my signature line.) My last birth was 17 years ago. I was persistent with all of my regular annual exams. I usually didn't complain about anything because I just thought everything I was dealing with was "normal" for the amount of trauma I had been through. A few years ago when I really did start to explain, I was dismissed and told it was "normal". It wasn't until we moved to Virginia and I was finally sent to the UroGYN did someone finally listen to me. This was back last October. I've been under constant care of my UroGYN regularly ever since.

I had my surgery on 3/10 and came home on 3/15. I was discharged with OxyContin and Percocet, as well at 800 mg. motrin, Surfac. I removed myself from the OxyContin and Percocet because I just have an issue with pain killers when I can just "handle" the pain. A couple of times especially after a BM, I've had to take something. My doctor informed me today that I I take the pain meds, the energy that would normally be directed to the pain would be directly to healing. So, I'm going to just take the Percocet about every 8 hours or so if I do have some pain.

I have seen my doc three times since being disharged from the hospital. Twice was for the pain in the perineal area where my doc ended up removing three of the stitches. This was a major relief. However, my doc is not happy with the cosmetic result. I could care a less what it looks like as long as it works! I was seen again today for bleeding and fatigue. But I was told that the wound is very "raw" and granulating. She said that each time they would touch it with a q-tip it would bleed. So the irritation from a BM would make it much more so. I went into the hospital anemic and came home anemic. So the fatigue is normal, or so I was told.

So i guess that's my story. Beleive it or not, that's more the short version but it's been a long day.

Blessings to all,

Denise
TVH, AP Repair, Overlapping Anal Sphincteroplasty 3/10/08
DD 12 lbs. 12 oz. 11/16/1985
DS: 10 lbs. 12 oz. 10/19/1987
DS: 11 lbs. 4 oz. 4/13/91
Hello to anyone who can help me. I am so surprised to have found this, I have felt so alone, and I am learning so much from all of these threads. I am 26 y/o, and I gave birth to my daughter 4 months ago, and resulted in a fourth degree tear. .I have seen a colorectal specialist, and he said that my tear is sever, into the internal and external sphinchter, and I have no perinium at all. I am sched. for surgery on May 29th, and then an additional surgery to cosmetically "bring it all together' to create a perinium. My concern is the post surgery recovery. My dr. said that he wants me eating solid foods right away. He wants my stool to be a certain consistancy, not diarhhea, and not constipating, high fiber, and that i would need to figure out what that was. My concern is that eating high fiber right away worries me that it could risk it to tear open the stitches. It makes more sense to eat light with at least a stool softener for a week or two. If anyone could give me any advise in the post care I would be so grateful!!! Thank you, and good luck to all of you suffering through this. It least I know that im not alone with this horrible problem.
Hi Missy82,
I am so sorry your are going through all of this. I know how awful you must feel. I suffered for almost a year before I had surgery. I only had a 3rd degree tear, but I ended up with a fistula and torn sphincter muscle. A fistula is basically a hole between the rectum and vagina, and it was causing me to pass gas and stool through the vagina. Gross, I know! I had constant vaginal infections and just felt dirty all the time. What type of surgery is your surgeon recommending? It sounds like sphincteroplasty surgery to me, which is what I had. They corrected the fistula and muscle at the same time. I will not lie, the recovery is very long and for me, has been very emotional. I have felt very alone and frustrated, especially since I can't take care of my son (I still can't lift him). Make sure you plan ahead and either have help from family members, or hire help around the house. You will not be able to lift for a long time, depending on whether your wound opens up or not (mine did). I can now (6-weeks post-op) do some laundry, unload and load the dishwasher, and do small things around the house, but I still can't drive very well. I have to sit on one cheek and am probably very dangerous! But I don't drive far and am avoiding the freeway.
As for your concerns about diarrea and everything after the surgery, the anxiety is so normal. I would not stop asking the nurses and doctors while I was in the hospital about my future BM's; I was so anxious about them. I was in the hospital for 5 days and 4 nights, on morphine and ice chips for 48 hours, then they let me go to a liquid diet, then finally on day 5 solids. My doctor had me on 1 stool softener and 1 tsp. of mineral oil 2x/day, but every doctor is different. I still take the stool softener and a little tiny bit of minteral oil (they say it protects you as you have a BM) once a day, but am slowly weaning myself off. I eat a TON of fiber (20-25 grams per day), and I think if you read over some of the boards you will see that everyone does after this type of surgery. Your doc is right in that you don't want to get diarrea or constipation b/c it can disrupt the surgery, so it is a delicate balance in your diet for a while so that your stool is soft but formed. Sorry for the details, but it's amazing how comfortable you become talking about all this after going through this type of surgery. I was constipated one day after the surgery and it was HELL. I felt awful all day and felt the urge to go but could not and knew I was not allowed to push. So just make sure you take something whether it be fiber supplements or stool softener/mineral oil to keep things soft and easy.
The other thing I wanted to mention to you is that my surgeon (and another one I saw on this site) recommended waiting at least 6 months post-delivery before having any surgery in the area b/c your body is still healing. I would mention this to him/her and see what they say. Apparently your body is still creating scar tissue following tears from delivery, and they want it to be completely healed before they go back in there.
I hope all of this helps you. I know it is scary, but I would definitely get the surgery as soon as you can so you can get on with your life. It's a horrible thing to have to go through, but we are all here for support.
Take care!
Spring
I made corrections in next message
Hello everyone,

I really appreciate the honesty and support that this site provides! Not feeling alone is a blessing. My girls are 8 and 3. I had 4th degree tears with both births. My youngest even broke her collarbone on the way out; she wanted both shoulders out at the same time and tore us both up in the process.

I just had a sphincteroplasty performed on 4/28/08 so I'm about 11 days post-op. I'm doing better and better everyday. I had surgery on a Monday and was released on the following Friday. In the hospital, I enjoyed the demoral, movable bed, and nurses' help in the bathroom. I stopped taking the Vicodin 3days ago, because I don't like them and they constipate me (which is the last thing I want). The doctor said I'm doing great keeping the area clean and dry, but my wound opened up a little bit causing slightly uncomfortable drainage.

Some tips that I've discovered either on this site or on my own follow:
[LIST]
[*]Get a competent and experienced doctor. My original doctor didn't seem confident about the procedure so I sought a different one. Luckily, my good friend's husband is an anesthesiologist and recommended a doctor who he had actually seen do the procedure before.
[*]FIBER, FIBER, FIBER! I mix a high-fiber cereal like Organic Flax plus pumpkin raisin crunch (yummy!) with Brad Buds (which has over 12 grams per THIRD cup).
[*]My first week of going to the bathroom, I didn't even sit on the toilet seat because the seat would stretch my cheeks (& sutures) too much. So I would actully hover over the toilet seat (using hand/arm support) and pee and poo semi-standing. It was so much less painful (& gave my quads a great workout :)).
[*]I asked for 2 peri-bottles from the hospital and would get in the shower after a BM and clean myself with the peri-bottles. I tried the shower head when I first got home and I thought the pressure was a little too much. The peri-bottles work great.
[*]Fluffing the guaze pads between my cheeks has worked wonderfully for the uncomfortable drainage.
[*]Be horizontal as much as possible. When I sit, I sit on my leg or on a memory foam pillow.
[*]Take it easy--REALLY! My primary job for these 2 weeks postop is to be horizontal as much as possible and keep the site clean and dry.
[*]I had my hubby buy a raised toilet seat from Walgreens so my target was closer for the hovering and, now that I can sit, don't have to sit as far down.
[*]Use a mirror to check yourself. Sometimes I didn't know if I was done with a BM or if I was having drainage. It's not as scary as you think, especially because you're getting better with each passing day.
[*]Remind your kids to take it easy on you. And my girls have turned out to be the best little nurses/doctors. They like making sure I have fresh water by my bed in the morning and giving me my Tylenol pills.
[*]CELEBRATE the small milestones (e.g., sitting for your first meal, walking semi-upright most the time, scaling pain meds down, being able to walk up stairs). Everyday, my eight-year-old surprisingly comments on how FAST I'm walking lately (Now that it doesn't take me 15 minutes to get up and to the next room; it's all relative, right?).
[/LIST]

Take care and keep those tips coming!
thanks,
Kim
Missy,
To answer your question about high fiber... When I finally sought help for my fecal incontinence that started a little over a year and a half ago, a gastro doctor recommended high fiber in January 2008. So I've had a few months pre-op to play around with what worked. I find the the more pasty stools were so much harder to vacate so it was like having a BM all day long (as described on earlier posts from other "survivors"). So when I upped my fiber and water intake (which sometimes caused a lot of uncontrollable gas--not fun!), my stools became bigger and easier to push out, pinch off, and/or hold in. It seems somewhat counter-intuitive to increase fiber for better control, but it's really worked for me. My colo-rectal surgeon who performed the operation 13 days ago recommended the following:
[LIST]
[*]SUNDAY: clear liquid fast the day before surgery
[*]SUNDAY NIGHT: full bowel prep starting at 5pm (where I litrally camped on the toilet with books and computer for 4 hours)
[*]MONDAY: fast day of surgery (which was performed at about 2pm)
[*]Post-op through TUES NOON: only ice chips for 24 hours after the surgery because I was nauseous post-op and they didn't want me vomiting
[*]TUES night through THURSDAY am: clear liquids
[*]THURSDAY lunch: high fiber meals
[*]FRIDAY noon: released from hospital; continue high fiber
[/LIST]


In the hospital I was getting demoral IV shots about every 4 hours for pain and 3-5 antibiotic IV bags per day to prevent infection. The antibiotic made my stools really watery which didn't allow me to make it to the toilet sometimes, but I was thankful that my BM weren't painful because I was just dreading that! I even wore big ugly diapers (with velcro like Huggies) in the hospital the last few days in the hospital, because I could ensure not messing the floor. But control was better than it had been in over a year and a half--even with the really black watery stools. I was nervous and excited at the same time to eat solids again. Once I got home I resumed eating my high-fiber cereal in the morning with fruits and veggies accompanying lunch and dinner. Except for last Tuesday, my stools have been a good consistency ever since without pain (mostly semi-standing hovering over the toilet to avoid pressure on my cheeks). That Tuesday was awful because I was straining (and trying not to at the same time) to vacate little pellets, then rinse off in the shower, then start over again--doubled over cramping because I felt like there was always something left in me. My mom had me drink prune juice and a cup of coffee (which I never drink). That helped empty me out in the afternoon after cramping in the bathroom all morning long. That's when I stopped taking Vicodin because I think that added to the constipation. So now I'm having pretty good luck with my normal regimen of high-fiber food and drinking plenty of water.

On Thursday, I saw my doc for a follow-up appt and he told me I had a small wound open up, but that it was to be expected. I left the house with my family for several hours yeasterday (which was the most sitting and walking I've done since surgery). Today I feel sliced and raw. So I'm trying to take it easy. AARGH!

The pain is much less. The first 9 days felt like a 2-inch deep canker sore with lemon on it. Pain meds would "dilute the lemon" but the canker was still there. On the 10th day, the stinging canker was gone and I just felt a lot of pressure.

How is everyone else doing out there?
in sisterhood,
Kim
Hi Kim,

I had a similar experience to yours, only my surgery was March 28 (a month before yours). I believe the feeling that you can't vacate is normal following this surgery b/c the area has been messed around with (that's what the dr. told me). I too had a day where I could not go and cramped the entire day. I called my doc begging him to let me take Milk of Magnesia, but he said no because he didn't want me having diarrea (he said it would burn like crazy). So I just took my stool softener and mineral oil at night and the next day I finally went. It takes a while to find a good balance of fiber and diet so that you are not in pain during BM's.
I still have a small wound open in my perinium which is driving me nuts. I too went out yesterday with my family, then later we had a cookout with the in-laws and nephews and last night I felt raw and achy. The area near my vagina just stings and drains a lot; it is really tender. The strange thing is that my doc told me at my 4-week follow-up appointment that it was my last appt. He even said, "Good luck!". I was flabbergasted afterwards b/c I couldn't believe anyone would release me after 4 weeks with a gaping wound. I still had lifting and bending restrictions, but he basically said that the wound would close up on its own, and once it does I can do whatever I want. HOWEVER, I am making an appointment for this week to have him examine the wound again just to be sure it is closing ok and I don't have any problems. Plus, I want to ask him about the stinging feeling, it's so annoying.
Kim, it sounds like you are doing really well and that you are feeling better. Did your wound open up?
Hey Spring,

Yes, I have a small open wound. My doctor told me before the surgery to expect a quarter-size opening because the sutures usually don't hold the delicate skin down there. When I went for my follow-up appt last Thurs (10 days post-op), my doc told me that I had a small opening but it was not big at all. I wonder if he told me worst-case scenario when he mentioned the probability of a quarter-size wound. Of course, reading the other posts/threads makes me worry if I'm going to open it up even more and how long it'll take to heal. Kelley (who started this board a couple of years ago) even mentioned opening up the wound after it had healed by crawling around on the floor with her kids. So it's a reminder to take it EASY basically all summer for me. It's frustrating because I was hoping to be really active this summer with my girls, but it's better than having leakage issues--for sure. My doctor sounds like yours; he told me he'd see me in 2 weeks and that would be the last time:confused: I was extremely taken aback, because I don't even know much about whats going on down there like what kind of sutures I have, if I'm doing enough for wound care, how active I can be, etc. He told me to start doing some Kegal excercises and go back to work, etc. I'm a college professor so I chose the end of the semester to do the surgery. Thank goodness for the internet so I can tele-commute (take care of grading, work on research papers, etc.). But I'm teaching a summer school course that started today. Luckily, my T.A. and friends are covering my first week of classes so I can rest another week.

How are you dealing with your wound? I'm just rinsing with water in the shower and place 2x2 guaze between my cheeks.

How is your incontinence/continence doing now that your 6 weeks post-op? I'm really happy with the control I have; some urgency but overall good (knock on wood). I'm only taking Tylenol PM at night because I'm having trouble going to sleep at night and getting up in the morning.

Hope to hear from you soon!

in joy,
Kim
Hi Kim,
I am glad I am not the only one whose dr. told her that the 4-week appt. would be the last one. I am taking it upon myself, however, to go tomorrow and have him re-check everything because I still have an open wound (about the size of a dime or so) and drainage and I want to make sure everything is healing ok. I read in one of the previous posts that there was a girl who developed a "pocket" and had constant stool drainage. I still have some stool in my gauze after BM's, but it seems to be getting better. I just can't imagine having stool drainage for the rest of my life b/c I didn't have it before the surgery!

My case was a little bit different than everyone else's b/c I had a rare fistula along with my dysfunctional sphincter muscle. I had a recto-vaginal fistula, which is bascially a hole between the vagina and rectum. As a result, I was having constant fecal drainage into the vagina, causing horrible bacterial infections. Also, when I did mess myself, I could never tell if it had come from my vagina or rectum b/c the build up of gas or feces in the rectum would sometimes spill over into the vagina and exit that way. It is such a horrible, disgusting, humiliating condition, I just had to have it fixed ASAP. I really hope the surgery lasts and that the fistula doesn't return b/c this surgery have been really difficult for my family and me. I have a 1-year-old and I have had to hire help b/c I still cannot lift over 20 lbs (my son weighs about 20 lbs). I too will take it easy this summer; I doubt I will return to work any time soon. I teach elementary school and am constantly bending, squatting (a big no-no), getting on the floor, etc., so I am petrified of splitting the wound back open. I have been on disability for almost 7 weeks....not fun.

As for my wound, I rinse w/a peri-bottle and still do sitz or tub baths once or twice a day. I take care to clean really well after BM's as well. I use a 4x4 gauze between my cheeks to catch the drainage, which is really uncomfortable when I go out in public because I am constantly worried the gauze is falling out or full or whatever.

My incontinence has been better, especially in the gas department. I had a hard time holding in gas pre-op because it would pass through my vagina. Soooooooooooo embarassing. I pray each and every time I hold it in that it stays in there and doesn't come out the wrong way. I don't usually need pain killers anymore, it is generally just a feeling of discomfort in the whole perinium. I am going to see my OB Friday and ask him if there is any cream or anything I could put near the vagina b/c it is just irritated. I also have air bubbles that escape from my urethra. NO IDEA why that is happeneing, and when I mentioned it to my surgeon he looked at me like I was crazy. I just hope it is not some other type of fistula brewing in my bladder or urethra. Ugh!

I am surprised you will be able to return to work next week; I could not imagine returning 3 weeks post-op. Make sure you take it easy b/c you probably still have internal stitches. Alternate between sitting and standing so you don't aggravate the area. Do you teach full-time?

'Hope you will be feeling better soon. I'm glad I have someone to relate to during this whole process!
Hi Spring,
I'll write more later, but just a quick note for now. How much drainage are you experiencing? I use 2x2 guaze from walgreens which is softer than other guaze I've tried. One of those 2x2 guaze sheets will last me through the whole night. Now it's just a little bit of blood (slightly pink) and drainage (which is mostly clear but sometimes icky brown). My wound is probably the size of a pea but an inch long.

take care,
Kim
I have had a lot of drainage (still), however since I go to the bathroom so frequently (pee), I end up changing my gauze more often than I would like. As a result, it is hard to guage how much drainage I have. The drainage I have had is a little pink, too; however, mine is not clear but a yucky yellowish color. I was worried for a long time that I had an infection, but the dr. kept reassuring me that the mucus-like (sp?) drainage was normal. You're lucky that your wound is so small 2 weeks out; mine was huge and is still the size of a dime. I have been having pains toward the inside of the wound near the vaginal area, almost like it is tearing. I am seeing the dr. tomorrow and will ask him about it.
Keep me updated as to your progress! Mine sure has been slow!
Hey Spring,
The drainage is nasty but I just keep thinking about how skinned knees have the same type of colored drainage. The stinging you have is definitely something to have checked out. I had awful stinging for the first 9 days post-op (felt like a canker sore 2 inches deep with concentrated lemon juice in it). But the stinging has subsided and now just feel sliced, sore, and pressure--especially after sitting or walking quite a bit. I change my gauze after using the bathroom but not too much ickiness as before.

I feel like I'm on the mend, but nervous about going back to work. Luckily though, I only will teach about 3 hours in the morning and then will do mostly computer work. But don't fret about comparing our situations. Remember that your surgeries were much more extensive. I pretty much had a sphincteroplasty and perineal repair. I didn't have a fistula like you. My doctor said it was much worse than he thought it was going to be. He said the sphincter muscles on the right side were pretty thrashed (which explains why I felt that awful stinging on the right side) and he was surprised I wasn't in diapers before surgery.

Chin up, Spring! Think of the long term--the quality of life issue. I can't imagine how hard it must be for you with a baby. My 8-year old is a big help with my 3-year old. And my 3-year old is an independent spirit who doesn't expect to be carried or helped too much. She's also old enough to know and understand that I have an owie on my behind; she even tries to give me band-aids for it :)

What grade do you teach usually? I taught Pre-K and special ed. Now I work with future and in-service teachers at the university level. With lots of rest this summer, you may be able to go back to work for fall. The students could be big helps with your everyday duties so you can limit your bending, walking, fetching, etc.

take care,
Kim
Hi Kim,
That is a good way to describe the stinging feeling (canker sore). I too feel sliced and raw, especially by the end of the day. I hope the wound will close in the next month or so and that the drainage will subside. It gets really old after a while!

That is good that you only have to teach 3 hours a day. I teach 1st graders, so they are very needy and little; it would be really hard to go back with a sore bottom. I really hope I will feel better to go back this fall. I know I should not compare recoveries, but I just feel like it is taking a really long time compared to other recovery stories I have read on this board. The fistula was closed somehow with the muscle, (I had a hard time visualizing exactly what they did) and I think they also did work on the perineum. So maybe you're right in saying that my surgery was a little different. I am definitely going to check w/the dr. today, though. Have you read a lot of success stories from people who had a sphincteroplasty? I have read that short-term it works, but long-term it breaks down. Let's keep our fingers crossed that that's not the case with us! ;)

'Hope you are feeling better.
Hey Spring,
TO be honest, I don't even want to think about the result back-sliding. I, too, saw some reports regarding that. I'll ask my doc when I see him in a week. Luckily, I feel like my surgeon was really good so I hope that it'll be a long-term (forever--knock on wood) result.

Actually, when I read all the stories in these threads, I got really nervous about recovery. If anything, I feel like I'm in really good shape in comparison. You, too! Remember that you're not only recovering from surgery but also childbirth and assumingly sleep deprivation (with a little one in the house). What are you able to do as far as daily activities? Do you have help with kids and chores? I haven't been helping around the house (with dishes or laundry or anything). This week I'm able to sit long enough to fix my girls' hair and tuck them in. Yesterday I went to a work lunch (sitting on one leg) and today I drove to campus to meet my students at the tail end of class and went and had lunch with my eldest at her school. I'm trying to ease back into the idea of leaving my house, because next week I'll have to be ready and out of the house for at least 5-6 hours a day. One of my biggest fears is making sure I can have a BM BEFORE I leave the house. I'll take moist wipes and gauze, but it's not as nice as having the shower head handy--for sure.

Spring, I was reading on some of the other posts that sitz baths were not recommended by all doctors (including mine). I'm not sure why mine doesn't recommend them, but other posters mentioned that sitz baths may spread cheeks apart too much causing stretching of the wound area. I don't sit on a doughnut pillow for that same reason. After the birth of both girls (4th degree tears with both), I lived on a Boppie pillow for 6 weeks post-partum both times. I wonder if that's one of the many reasons I didn't heal right and ultimately needed this surgery.
Just a thought...

Keep me posted onn what your doctor tells you...

-Kim
Hi!
Well I had my appointment today and the dr. said that the wound is closing up and is open about the size of a pea now. I was pleased with that because I have been so concerned that things weren't closing.
I was disappointed with him today though because I feel like I am bothering him when I ask questions. He is a nice guy I guess, but he really doesn't offer a lot of information and I feel like I have to literally pry things out of him. Anyway, let's hope he did his job correctly and I will let his communication flaws slide... 'Guess that's why I didn't know about the sitz baths (he didn't really say much about them). Luckily, I have not done too many because I did feel like it was stretching the wound. I, too, used a doughnut while recovering from childbirth. I'm sure it didn't help things, but I doubt it caused our problems! ;)
I am so glad to hear that you have been getting out and doing things! That is so great. I didn't venture out for a very long time; I was very paranoid about disturbing the fistula repair. You sound like you are coming along great. I would definitely take some wipes and gauze with you when you go to work next week. I don't leave the house without gauze!
Hi Spring,

GREAT NEWS about your wound closing up!! My doc and your doc sound like they are cut from the same cloth. Good, confident surgeons in a big hurry. Did he give you any insight about the burning? Is the burning from the wound or somewhere else?

Keep taking it easy and keep me posted. I see my doc a week from tomorrow. Between us, maybe we can patchwork some thorough doc advice ;)

take care,
Kim
Hi Kim,
I'm glad I'm not the only one whose doc doesn't provide a lot of communication! It is very frustrating at times, especially since after reading this board I see that a lot of the ladies' doctors provided them with plenty of advice and information. Oh well.
I think he put something on it yesterday (silver nitrate??) because I have been having a silver/grayish drainage. Yet again he didn't disclose to me what he did! And to answer your question, NO, he didn't really say anything about the stinging. He said itching can be normal (I have terrible itching), but didn't say anything about the stinging. I am just going to assume that is normal, too; I think he would have voiced his concern if he thought it was a problem...

We will get through this! Keep me updated as to your progress! Take care of that bottom! ;)
Hey Spring,
As teachers, we're so used to doing "think-alouds" especially with our young students that it seems so strange that doctors wouldn't clue us into what they're doing. I mean--how hard is it to think outloud, "I'm getting silver nitrate ready to put on your wound. This will help with ..."?

Maybe we should design a mini-lesson for doctors on how to do think-alouds when they meet with their patients :jester:

I'm doing fine! I went out again today to meet with my university students and to lunch with a couple of colleagues. Last night I felt slightly woozy after being up so much and cleaning my wound. Gotta remember to ease back into life.

Hope all is well on your end...

IS ANYBODY ELSE OUT THERE THAT WOULD LIKE TO JOIN IN THE CONVERSATION?

Take care,
Kim
I know, I feel like we're the only ones out there that's had sphincterosplasty surgery lately! I guess it's a good sign; everyone must have healed and gotten on with their lives!:)

I totally agree about the think-aloud class for doctors. They definitely need a course while in med school, perhaps entitled: "Patient Care and Communication 101". My principal at school tells us that if we flood parents in the beginning of the year with tons of information about the curriculum and classroom philosophies, that parents will have less questions and we can spend more time planning our lessons instead of answering emails and phone calls. She is so right! My doctor gets annoyed at me when I ask questions, but maybe they need to join us teachers and flood us with information so that we leave them alone! Then maybe we wouldn't be so annoying to them! ;)

I am so glad you're doing so well; you really bounced back quickly. Tomorrow will be 7 weeks and I am definitely on the mend, but I honestly expected to be completely healed by now. Before the surgery he told me 2-3 week recovery period...yah right! That's a joke and he should have known better, especially for this type of surgery. *Sigh*. Oh well.

On another note, do you every get the feeling like you have air bubbles around the vaginal/urethral area? I have been struggling with this lately, and my surgeon looked at me like I was crazy. I had it somewhat following the delivery of the baby, but since the surgery they have been SO annoying. It's like an air bubble down there that needs to pop. It eventually does, only to bring about another one a little while later. I can't seem to find much information on it so I may need to see a urologist. I have an appointment tomorrow w/my GYN and I am going to ask him about it. Just thought I'd ask...

Take care!
Hey Spring,
I have no idea about the air bubble in the urethra. That sounds awful. Is it painful? Does it pop when you pee?

I am familiar with the vaginal gas that you mentioned in an earlier post. It hasn't happened since the surgery though...Who knows... The human body is quite a complex, mysterious machine, isn't it?

keep me posted,
Kim
It is not painful, just more of an annoyance. It does not pop when I pee, but just pops at random times. It usually appears right after I shower, bathe, or pee. I will let you know what my GYN says today about it.

I have had a lot of soreness (yesterday and today), I think from the surgeon inspecting my wound on Wed. I am not sure if it is normal after an application of silver nitrate...once again he didn't provide me with any information!! Ugh.

'Hope you are doing well.
Hmm...No, I've never heard of the bubbles in the urethra. Any news from your GYN?

On my end, I guess I've been doing too much, because I'm really sore as of yesterday. I even had to take Aleve today for the pain. I'm avoiding the Vicodin for fear of constipation. I'm nervous about a full day of work Monday teaching at 8am and meetings all afternoon across town. I'm thinking I may have to bail out on some of the afternoon obligations. Geez!!! Hate this. Haven't helped around the house at all and I'm falling behind in my work.

Okay...I'm going to relax, take some deep breaths, and read a bit.

take care,
Kim
Hi Kim,
My GYN made that "huh?" face when I told him about the air bubbbles. He said once I'm healed from this surgery that I should go to a urogynecologist. Wonderful! Yet another thing to have to deal with. I have to say that this whole ordeal has really gotten me down. My husband and I would like to expand our family, but I'm worried that it's going to be years before that happens because of all of my problems! Ugh. Did you ever contact a lawyer regarding your problems or is it too late?

I am sorry you're not feeling too great. You do need to take it easy. How many weeks ago was your surgery? Three? I still have to take Advil from time to time, especially now that he applied the silver nitrate. I'm very sore and feel raw. From everything I've read it's a very long recovery and you have to be careful not to irritate the wound too much because it opens up very easily. You may want to see if you can get out of those meetings next week. I will most likely not return to work for the rest of the school year. I could not handle 25 children on my own!

Take care and rest up! We will get through this! ;)
I'm a little better today, but just feel like there's a spikey stick up my rear that makes me walk with my boody out and difficult to get comfortable. Yeah, you're right. I'm either going to have to get someone to cover my class in the morning or cancel meetings in the pm. Won't be able to do both.

I'm sorry you'll have to see another specialist. Geez! Out of the 3 holes down there, we've had trouble with all of them and ripped ourselves some new ones. Gives that expression "rip you a new one" a whole new and painful meaning. So how much do you get out of the house?

Keep me posted!
I know what you mean about the stick up your behind. I often feel like something is lodged way up in there and it makes me walk funny! Yah, I've had problems with all three outlets down there. Not fun!

I try to get out of the house at least once a day, even if it is just to go to the store. On the weekends I get out more because my husband is home and we can go together with the baby. I don't last long though because I get frustrated from not being able to sit right. I have a woman that comes over from daycare after I pick up the baby and who helps me until my husband gets home at night. It's been very hard on our family...

I hope you will be able to work something out with your job. I'm not going back while this wound is open, it is too uncomfortable and painful. I think one of the worst parts is having the gauze constantly stuck up in there. I am always worried it is full or sliding out. Ugh!

'Hope you're feeling better!
Hi everyone, It's Kelley, the original poster of this thread. I just stopped back in for a quick hello and was suprised but happy to find the thread continuing and you supporting one another through this.

I thought I would offer a bit of encouraging news by offering an update on myself. I had surgery back in January 2007 (overlapping sphincteroplasty, perinealplasty, and levatorplasty) It was a very long recovery for me. My wound took 5 months to heal up completely. I can say that it has been 1 year and 4 months, and I am still 100% continent. I have absolutely no issues whatsoever!! I still have to do toilet gymnastics sometimes because of the nerve issues I had, but my surgery was a complete success. It is truly a distant memory now. I hope you are all doing well, hang in there! It does get easier. This surgery was the best thing I ever did for myself. I still worry sometimes about the long term prognosis, so I thought I would give you all an update....1 year down and going strong!! Take care everyone.

Kelley:wave:
Hi Kelley,
I have read most of your thread and have found it SO helpful during my recovery. It is so nice to read others' experiences, and I am so happy that you are doing so well and are still 100% continent! That is such encouraging news.

I have a question for you if you're still around: when your doc applied the silver nitrate to your wound, were you sore afterwards for a while? My surgeon applied it last Wednesday, and I felt a little burning while he did it, but now have been really sore and raw since then. I just hope I am not developing an infection. I wanted to find out if this is normal or not for such a long time (it's been 5 days). Thanks for your help!!

I hope you continue to feel great, and thanks again!
Hi Kelley,
How is your daughter doing? I, too, am so grateful for all the support and information this thread has provided. Great to hear that you're doing so well over a year out.

Spring,
Bad news! I have started to have some stool leakage in the last week. I didn't have this problem pre-op. Fecal incontinence: yes, a couple times a month. But not slight, continual leakage of stool. YUCK! Maybe Kegals will help a little bit. I also need to drink more water probably b/c I haven't been as diligent about that lately. I'll see my doctor thursday and will keep y'all posted.

take care,
Kim
Kim,
Oh no! How much leakage are you having? Do you wear a gauze between your cheeks? Are you finding it on the gauze or in your underpants? I find stool post-BM in my gauze for about 2-3 hours. It used to be a lot, but it has lessened with time. I have read through most of the "I Survived" threads, and almost all of the girls had this. Most of them say it lessened with time. I read somewhere that one of the doctors said this is normal and very common with this surgery. I know how you feel though, it is VERY frustrating. I didn't have stool leakage pre-op either, but now am having it after surgery. When I bring it up to my doctor he doesn't address it....

Keep me posted!!! We will get through this together! :)
Hey Spring,
Thank goodness for our connection! It's so nice to have someone to relate to about all of this. It's not a lot of leakage, mostly found on the gauze. It's definitely more watery than my regular BMs. I'm trying to determine (with mirror & flashlight in hand) if it's coming from the wound mostly or the anus.

More later... Gotta teach early in the morn...Wish me luck!
take care,
Kim
Spring,

I had the silver nitrate cauterizing every 2 weeks for a couple months. Yes it did burn, and it actually makes the tissue slough off and re-granulate. I was definitly sore depending on how aggressive the cauterizing was for up to a week. I tried not to sit on the area and such. He may have really cauterized a lot, and now the "new, raw" tissue is what is hurting. keep up the sitz baths to speed up the healing 24 hours after cauterizing. Sometimes it looks worse after the silver nitrate before it gets better. I am glad my posts have been able to help so many others. I felt so alone and overwhelmed in the beginning of this whole endeavor.

As for the stool leaking, and extra wiping....I had that for a long time (months??) it's hard to remember now! It took a long time to regulate my bowels with the fiber and such, but when I found the right balance, everything went back to normal. I do not take any fiber supplements anymore or anything, and I am very regular now with just diet. The urgency will go away also....in time.

Kim,

Thanks for asking about my daughter. She was diagnosed with crohn's disease and we finally think she is in remission! :) It has been a long road...she takes 12 medications a day and is 4 years old. Thankfully, she is doing great now. She is one tuff little cookie, and has been very brave for all she has been through. She put me to shame with her colonoscopy prep :D I will say some prayers that you all will heal up soon and be ready for summer fun! Take care

Kelley
Kelley,
Wow, I did not know your daughter had Crohn's Disease. That must be so hard for a 4-year-old. My father has that and it's very hard for him, but he's an adult!! I can't believe she went through a colonoscopy prep!!!! I was floored when I read that! What a brave little girl! :)

Thank you for your response regarding the silver nitrate and leakage. It makes me feel better knowing that someone else has gone through this and can give me advice. It is so much better talking to someone who actually HAD the operation than talking to the nurses or doctors who, in essence, have no clue what you're going through. The tissue around the area he cauterized is definitely VERY tender, and I have had much more drainage. Hopefully it will calm down soon.

I am hoping the leakage will go away with time because I did not have this issue before the surgery. I had a little trouble holding stool and gas from a
3rd degree tear, but it was more the recto vaginal fistula that bothered me. As the fistula became bigger, everything would pass out the wrong outlet...(sorry for the details). My doctor found that my squeezing numbers were really low, so they performed a sphincteroplasty and fixed the fistula at the same time.

Again, the previous threads have really been a Godsend for me; they have not only helped me feel less alone, but have helped reassure me that everything I am feeling (both physically and emotionally) is normal. Thanks again!!! :angel:
Kim,
Good luck teaching today! Let me know how it goes!
I, too, find stool on my gauze every morning after the BMs. It's frustrating...you will have to let me know what your doc says about it on Thursday. I think you are making great progress given the fact that you feel up to teaching. I just can't be on my feet for long; my wound gets very sore. I was really, really sore last night after a few hours at my brother-in-laws with the kids. I just can't get comfortable sitting or standing!!!
You know the saying, "This too shall pass!" :)

Keep me posted!
Spring,

My poor little 4 year old has been through barium studies, enemas, colonoscopy, ct scans, biopsies, constant bloodwork, endoscopy, the works. She is truly a trooper! I should not have sid the "r" word yesterday...she woke up with her tummy hurting today. We take each day at a time now. She is very young to be diagnosed with it.

I just noticed your from Virginia--I am too. I am in Richmond. I was just curious if you were from the same area, and if so, who did your surgery.

I also wanted to let you know that I had a hard time being on my feet for quite a while also. My bottom would just throb if I was up and around for too long. That too gets better. Are you on any fiber supplements now?

Kelley
Kelley,
Oh my gosh, your poor daughter! I'm so sorry she is going through all of that, that's awful. At least she has a strong mommy who can sympathize with her. You've been through rough times, too! ;)

I'm in Northern VA just outside of DC. The docs I had were ok, but not big on communication, unfortunately. I just feel like I annoy them when I ask questions; like they don't want to listen to me. He was ready to release me at 4 weeks forever. :confused: I finally took it upon myself and made a 6 week and 10 week appointment, not caring what he thinks. I want to make sure everything is healing correctly!

My bottom throbs when I am on my feet for to long, too. How long did this last for you? I am an elementary school teacher and am on disability because I just can't deal with the open wound and soreness all day. I hope I will be okay the next school year! I am on Benefiber (my own doing from reading your threads) and I take one stool softener at night. They had me on 2 stool softeners and 2 tsps. mineral oil per day after surgery. My doc said it was okay to continue with one softener per day until the wound closes up so that my stools are soft. I have a sore bottom when they are hard, it's awful. I would like to wean myself off them though and only take fiber, but I'm afraid of constipation...

Thanks again for all your support!!!
Hey ladies,
Kelley, give the li'l one smooches from the "boody buddies." We all send her positive, healing energy.

Today went alright. I'm almost 3 weeks post-op. I had my longest day of work out and about. I was moving slow, but able to have fun with my students for 3 hours this morning. Then a couple hours of desk work. My boody was trembling by the end of class. I cancelled my afternoon commitments and was home by 2pm. It was bearable, but I'm going to try and make the other days shorter so I can make it through to Friday.

Will keep you posted.
stay healthy,
Kim
Kim,
Glad you were about to make it through the day. Sounds hard, though. How do you sit to do desk work? Do you sit on any special type of pillow? I am still sitting on one butt cheek or the other and my hips are paying big time now. Yesterday my left hip was killing me from compensating. I tried to sit flat today and it was ok, but then I started to feel a pull and quickly moved to a butt cheek. Very frustrating!!!!!


Keep me posted on your progress! :)
Hello Ladies,
I was the first to respond to Kelley way back when, when she was having the surgery. I too had a sphincteroplasty, levatorplasty and perrinealoplasty. I had my surgery in September 2007. My Dr. also told me 2-3 weeks recovery. What a joke! I was off for 9 weeks. I wore the gauze up until maybe the 8-9 week. I couldn't wait to not use it anymore, but it did help tremendously. Everything you are experiencing is very normal and I too have had total success with this surgery. I did however have nerve damage also, so it is still a struggle to find the right fiber dosage for regular bms. Before the surgery I was very irregular, so I think it is much harder for me to find that perfect balance.

Kelley,
Hi! I have a question. I have been taking fiber pills, 2 in the morning and 2 at night and I still am having trouble. What do you suggest? I do drink coffee in the morning, but it doesn't help like it does for most. I wish it did. I am really having a hard time trying to get regular. Any help would be much appreciated.

It is good to hear how good you have been doing. It has been a long time! Your daughter is in my prayers. She sounds like a very strong little girl and I am sure she will be just fine.
Take Care,
Mindy
Hi Mindy,
I'm so happy to hear you're doing well and that you had success with this surgery. It is always good to hear that people didn't go through h$%* for nothing! How long was your wound open? Did you also have to have it cauterized? I am 7 1/2 weeks post-op and still have an open wound. It has definitely gotten smaller, but it is taking forever to close up. Also, did you have stool leakage and if so, how long did it last? I think the leakage is one of the most distressing side-effects, as I didn't have it before the surgery!

I'm sorry to hear you're struggling with fiber issues. I think it will be a life-long search for the correct balance for us. I try to eat a lot of fiber and take 1 stool softener per day still because I am petrified of getting constipated.

Thanks for your message and take good care!
Hello ladies,

I have a friend who swears by eating a small apple before each meal to get and stay regular. Maybe you could try that, Mindy.

Teaching went a little better today than yesterday. I didn't walk or stand as much during class as yesterday. The classroom has a high, comfortable stool with arms that I could ease myself on and off. Luckily, my wound is about pea-size so sitting is getting easier although never fun or pain-free. When I sit, I usually do what you mentioned, Spring, and sit on one cheek or my thigh bones. I use a memory foam pillow at the dinner table and to drive.

The slight stool leakage is a concern of mine as well, Spring. The doctor told me to ease into doing Kegals, but maybe avoid them until your wound closes up more. I'll know more when I see the doc on Thurs.

stay healthy,
Kim
Hello ladies,
I will try and apple. Thanks for the suggestion. I will take anything I can get!

My wound opened up to about the size of a dime. I didn't have it cauterized though and it closed up probably around the 9 week mark. I did have some stool leakage for a while and was very discouraged. I was also petrified of constipation. I was on a stool softner also, and also took milk of mag when I thought I was getting into trouble. I didn't eat much after I got home for fear of going. My thought was, whatever goes in my mouth has to come out the other end and it scared me to death! I have to say though, after a couple of months there was no more leaking or smearing in my undies! Keep your chin up, you still have some recovery to go through. I did hear it takes up to a year to feel completely back to normal. You both did the right thing. If you don't have this problem you have no idea what it does to a person. After I found this board it was a god send to finally talk to women in the same situation as myself. In fact it was because of this board that I finally had the surgery after 5 years of dealing with it.

I remember my bum just throbbing for a long time when I stood for a long time. Not a fun surgery, however the outcome it well worth it.

You are both well on your way to a full recovery. Don't let the small leakage get you down, it can happen. I even to this day might have some after a bm, but NOTHING compared to what I did have. I don't have to carry extra undies and wipes anymore..:)

Talk to you later.. Take Care,
Mindy
Hi ladies,

I actually eat one large apple every evening and I swear by it, too! My mom taught me that! :)

Mindy, thanks for the encouraging words. It is very frustrating to find stool leakage, but it seems that almost everyone who had this surgery had leakage up until a certain point. Did you also have a little gas leakage? I find that when I try to hold it a little bit slips out. I hope this will go away!! :(

Kim, I am glad to hear that your day went a little better. I will have to invest in a memory foam pillow; I just sit on whatever surface is there and sometimes it is very uncomfortable! I've been meaning to ask you what you teach?

Thanks again ladies for such great support!! :angel:
Yes, Mindy, I look forward to down-sizing my purse (no more gauze, wipes, and extra undies stuffed away) :D The smallest things in life make us happy, right?

Spring, I teach literacy and bilingual ed classes to undergrad and graduate students who are currently or plan to be elementary teachers.

stay healthy,
Kim
Hi everyone,

Mindy,
Good to hear from you! Glad your doing so well. I actually stopped all fiber supplements because I was having a hard time with "pasty"stools that were hard to get out. Then I felt like I had the wiping issues again. I felt like the fiber was just bulking me up to much. I try to eat a lot of fruit, and veggies, and add fiber into my diet that way. Once I did that, it was a a while before my stools started to become regular. I also tried to make myself go every day. That has also helped. Maybe it is worth a try to go off the fiber pills?

Spring,

When I had an anal fissure, I was on stool softeners, and had horrible leaking issues on them. I can't seem to tolerate them at all. It is really a juggling act to get your stools right. It seems to take the body a while to get back to normal. My best advice is to experiment. I was on benefiber for a long time, but slowely cut back and I do not need it now. I am more regular now than I have ever been in my life. For me, the fiber bulks me up to much, and the stool softener makes me leak. I like to use milk of mag if ever I feel like I am getting into trouble and need some help. Take care everyone. The throbbing for me lasted about 3-4 months if I ever over-did it.

Kelley
Kelley,
Thanks for the advice. Maybe I should try stopping the stool softener and see what happens. I am just petrified of being constipated. I also leak gas sometimes, which is frustrating as well. It's like I can hold it, but then once I relax the muscle, a little bit leaks out. Did this ever happen to you? I hope it doesn't last....I am trying to stay positive, but it is sort-of a distressing thing to have. My family gave me a lecture today on feeling sorry for myself. I didn't think I was acting that badly, but they think I should be getting out more and even going back to work. I try to explain that I can't sit flat, I can't stand for long periods of time (I teach elementary school), and I still have drainage. Not to mention my bottom starts to hurt when I'm up and about for too long. I just would not feel comfortable yet. I know things could be so much worse for me, believe me, but it has been almost 8 weeks and it just gets frustrating; especially since I have not picked up my child in 8 weeks...it's just wrong! The whole ordeal has just been physically and emotionally draining. *Sigh*. Sorry for the venting! Thanks for listening! :)

Take care everyone.
Spring,
Don't feel like you need to go back to work yet. Folks just don't understand. What we need to focus on right now is healing as completely as we can right now, because otherwise we'll PROLONG the entire process. You're getting better; your wound is closing up. Give yourself the time and permission to heal. The school year is almost over so no need to run back to work now. Give yourself the summer to enjoy your little one and heal.

my 2 cents...
virtual hugs,
Kim
Spring,

Unless others who have had this surgery are giving you advice, I would turn your head to their recommendations. I was out of work for 9 weeks, but only worked 1 or 2 4 hour shifts (I'm a nurse) for several more weeks. My bottom was still throbbing at that point, and I still had gauze between the cheeks! Also, some bad news........I DO LEAK GAS. I can hold it a little, but it is loud and almost always audible. I really have to squeeze em and run away from people (including myself! LOL) if you know what I mean. It is a small price to pay for not crapping on myself all day everyday. It bothered me a lot in the begining, but I am ok with it now. Most of the time, it sounds like I am firing bullets from my behind. I try to do it as discretely as possible, but that is not always possible. Hang in there.

Kelley
Kelly & Kim,
Thanks for your responses and your support. I am going to listen to my body, which tells me that being on my feet and dealing with little children right now would just not be good for the situation. As you said, Kim, I can prolong the whole healing process if I am not careful.
Kelley, I am sorry to hear you leak gas. I guess it is definitely better than pooping in your pants every day, that is for sure. I never had that problem, I had other issues: if I had loose stool it would pass through the vagina (a different form of incontinence), and if I tried to hold my gas long enough it would also pass through the vagina (and was audible). I guess I would rather have the gas come out my bottom than my vagina; it definitely was not a pleasant feeling. It is just frustrating because it makes me socially anxious.

Thanks again for everyone's support!
Okay, I had a bit of a scare last night. I was laying on the couch with my legs up and over the back of it. My 3 year old was on the other end when she kicked me right where the sun don't shine. I mean--right where all my woes have been. Of course, she didn't mean to; she was just putting her feet on me. She felt awful because I yelped like an injured animal. Then we snuggled, b/c she felt so bad she hurt me where my owie is. I don't think she did much damage, but I'm definitely sorer today. YIKES!

I just got back from my doctor (after waiting almost 2 hours in the waiting room). While I was on the table in side-lying position, I had a stash of things at the ready: a list of topics/questions, a pen, and a mirror. Here's the run-down of what was covered:
[LIST]
[*]stool leakage: I told him that I have had watery stool leakage in the past week. He dabbed my bum with gauze and showed me the brown stain. He said it was not stool, but the drainage from the wound which is often dark brown (without particles). Then I told him that sometimes I did see flecks and small pea-size chucks of stool. He agreed that that was probably stool. He went on to say that the wound, being so close to the anus, often acts like an irrigation ditch--meaning that it will sometimes get the run-off from the anus (including mucus, stool particles, etc.). He said that as the wound closed up, the "irrigation ditch" effect would be filled in and not have that problem.
[*]state of the wound: He said that it's the size of a couple of peas with a small slit extending out. He said that it's looking really good. That's when I took out my mirror and asked him to give me a "tour" of what he sees. It was a bit dark but he helped to orient me so I could be better informed. I thought I understood (more or less) where everything was, but lately the drainage and leakage seemed to be exiting from the wound. So I wasn't sure if that was my wound or my new slightly off-centered anus. Sounds crazy, but it gets confusing. So, from what I understand, after BMs, the drainage and seapage exits the wound (drainage ditch in action). I thought I was going insane! Being informed has calmed me down though.
[*]Sutures: He said he used "vycral" (sp?) sutures which the body attacks and breaks down. A couple of the sutures were dangling loose so he trimmed them today.
[*]creams/ointments: I told him that I get raw from the constant drainage. He said since my wound is really just superficial now that I could use zinc-oxide (butt cream) to alleviate the irritation.
[*]long-term success of surgery: I told him that I read some reports that indicate that this type of surgery may break down over time. He discussed the problem with a lot of studies because there are so many factors to take into account. He's been doing the surgery since 1993 and hasn't had patients relapse, perse. He also discussed that over time, with age, muscles naturally get weaker. He emphasized the benefits of ROUTINE Kegal exercises over time--not just sporadically or inconsistently. The more we strengthen the muscle the better results we see over time.
[*]follow-up exam: I was happy when he asked to see me in 3 weeks, because he mentioned during my exam 2 weeks ago that today would probably be the last visit. I also asked him about swimming, but he said that he would evaluate things in 3 weeks and see if swimming was in my immediate future.
[*]recup time: I told him that I haven't been able to handle a full day of work yet. He reassured me to listen to my body and to not over-do things.
[/LIST]

That's all I remember. I wanted to write y'all before I forgot the details. Wishing everyone health & happiness.
take care,
Kim
Kim,
Wow, this email is so great an informative! Thank you so much for sharing your doctor's thoughts and views. My doctor doesn't want to give me any information, but it is nice to hear from another one.

I'm so sorry your daughter kicked you by accident. That's no fun, but I'm sure she felt really badly. I am always practically covering my bum because I'm so afraid someone will bump into it by accident! At the grocery store I literally look behind me every second to make sure no one bumps me with a cart!!

That's good to hear about the stool leakage. Now that I can see a definite separation between the wound and the anus, I notice that my drainage is definitely from the anus. I am sure some of it is coming from the wound, but I usually wipe myself to see, and it's definitely from Outlet #3. Hopefully this will improve. I've been testing my gas holding abilities too, and trying to see what I can do to fully control the leakage. I really have to concentrate and squeeze real hard (LOL), but it is definitely better than it going through the vagina. Let's hope that doesn't return...

It's also very reassuring that your doctor has had 0 patient relapses. Did he say when you could start the Kegels? I am not sure if I should be doing them right now or waiting until things are 100% healed. Did he cauterize the wound at all? My irritation and pain from that has subsided for the most part (unless I have too many BM's), which I was relieved about. Hopefully it helped, but my wound looks pretty much the same.

Thanks again, Kim, and take care! :)
Good. I'm glad my post helped. He didn't cauterize the wound. Since it's superficial, I didn't even inquire about it. 2 weeks ago he told me I could start doing Kegals a little bit. Today he said I could start doing them some more. But I forget. He said to make it a habit like during comercials. But, Spring, I think you should ask your doctor because you don't want Kegals to "stress" the wound (if that's possible).

lots of love,
Kim
I'm very happy i found this thread A LOT of informative information.

Okay i have a few ques. I went to a colon surgeon the other day he performed a digital exam and was told i have a muscle gap and needed sphincteroplasty. He didn't seem very informative as other docs. he mostly focus on post op procedures.

1. I'm a bit worried that it would be outpatient procedure. What do you all think about that?

2. What type of questions should i ask on a next visit?

3. Also I'm thinking about seeking out another doctor. for a more in depth testing and who can explain everything that is going on down there in detail.

4. I noticed Kel123 had multiple (3) surgeries did the colon surgeon preform them or ob-gyn in conjunction with the colon rectal surgeon? From my understanding All the different surgeries was in support of or to repair ONLY rectal issues? What did they find that sphincteroplasty wasn't enough? I'm asking because reading your story sounded VERY similar to my own and wondering if the sphincteroplasty would cure my problem.

I'm in the DFW area can anyone recommend a good doc.?
Hi rgold,

Welcome to our little community of royal pains in the bum. I would be EXTREMELY reluctant to go with a doc who favors this as an out-patient procedure. I spent Mon-Fri in the hospital and thank my lucky stars for the drugs, the adjustable bed, and help in the bathroom. I'd seek a second opinion.

My original doctor told me that her success rate with the surgery was about one third and that I would recover in about a week to 10 days. I sought out a second doctor, because I didn't trust her odds or her confidence level. The doctor who ended up doing the surgery is a colo-rectal surgeon in the San Antonio area. A friend's hubby is an anasthesiologist and he recommended my doc b/c my friend's hubby actually saw him in action. Do you have anybody who could give you the inside scoop on docs in your area?

look forward to continuing the conversation.
-Kim
Today was a ARGGGHHH day! I spent all day calling doctors with ques. About the sphincteroplasty procedure and and if it was outpatient or inpatient. ALL of them said it was outpatient!
The docs said the ins. company wouldn't pay for it. Some said the hospital wont allow it. But when i called my insurance company they told me its all on how the doctor will bills them. If the doc says i want this patient in the hospital 23hr for observation then it would be considered inpatient. Anything under 23hr is out patient. Being that i don't have any help at home and badly need this surgery. whats a gal to do?!
See if i can talk some doc into allowing me to stay at least a min of 2 to 3 days.
or just do it as an outpatient procedure?


Kim71 i seen you were in TX i was hoping you would say your in DALLAS!!! lol.
I just moved to TX. I'm a lone ranger in the huge state!
Rgold,
Tell us a little bit more about your situation. Assuming fecal incontinence due to tearing during delivery, right? I have a friend who is an anestisiologist (sp?)nurse in Ft Worth. Maybe she could find a recommended colo-rectal surgeon. Would you consider going to Ft Worth for surgery and consults?

-Kim





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