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Bowel Disorders Message Board

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I had the LIS surgery to treat a anal fissure the Friday after Christmas and now it's 4 weeks later and I had my second post op today from my surgeon who did not give me good news. He basically said because Im still in pain during and after my bowel movements that I have not healed from the surgery and that he needs to go back in and perform a second surgery and to take a look around to see why I havent healed. He admitted that because I'm a bigger guy he was very conservative when he was performing the first surgery.

Im so scared as I do not want to go back through this type of hell again. Im finally past the anal muscle spasms I experienced after surgery, although I do still have the pain. I also have alot of gas which sometimes hurt when its strong. I do have the soiling after BM but it seems like its not as bad anymore as it was during the first couple of weeks. My mom doesn't think I should have this surgery again and to get a second opinion.

Anybody have any recommendatons or suggestions on what to do?
I created an account just so I could respond to your inquiry.

Back in Nov I had a hemorrhoidectomy, fissurectomy, and lateral internal sphincterotomy. I was healing and was not encountering significant issues outside of what was expected given the surgery (slight anal leakage, pain and blood after BMs, etc,). I went back for my post op and was told that I was on the road to recovery. By week four my anal leakage had stopped and for the most part was doing OK but still had the blood and pain with bowel movements. At my 6 week checkup I was told that I had a new rather large fissure. The surgeon said he was certain that reg medicine would not take care of the issue and that I needed another surgery. I was sick to my stomach upon hearing this news but was actually convinced by most everyone I spoke with that it was the right decision to move forward with the second surgery. I ended up having a three surgeries a second time two weeks later. I will refrain from ranting to you about the fact that I had only agreed to another fissurectomy and found out afterward that the additional surgeries inluding LIS were done as well. The main reason I wanted to respond was to encourage you to get a second opinion. I'm not saying that a second surgery might not be the right thing to do in your situation but I'm having a lot of complications after this second surgery inckuding many butt spasms, shatp pains, and fecal incontinence. I did not encounter these with the first and my absolute biggest regret is not having gotten a second opinion. Someone else might have an alternative solution to prevent you from having to go through this hell all over again. I'm also surprised a second surgery was suggested after just four weeks of healing. That doesn't seem like enough time to ensure your issues won't resolve on there own.

For my own personal knowledge, you mentioned you were past your spasms. How long did it take you to get over those? I'm currently two weeks post op and like I said, didn't have them the first time so was hoping for a guide. You also mentioned your soiling is getting better. Can you tell me when you started to notice an improvement on that as well?
Well I had the second operation on yesterday....turns out the surgeon was too conservative in the first surgery as he stated to my family and that the fissure was not getting any blood to the area so it had not healed. He cut more tissue He originally though I might have had a infection due to the pain but turns out there was no infection. Today is day two of the surgery. still have not had a BM....yesterday when I woke up I was in pain immediately and they gave me two muscle relaxers for the extreme muscle spasms i was having in my butt. Pain hasn't been too bad today but I have that packing up there that feels like i have a golf ball in my rectum. Nervous as hell for that first BM again. I ate soup last night and had regular food today with stool softener and fiber bar. So far I don't see any drainage but may be due to packing. Will have a bath tonight.
I had the muscle spasms for the first couple of weeks and they subsided quite a bit after that along with the major soiling. The pain and swelling never went away though LOL. The spasms were less frequent but still would have a random spasm here and there but wasn't nearly as painful as those first couple of weeks and the spasms only started after I had that first bm which was three days after the surgery. When I had the first surgery I had no pain at all when I awoke but on that third day it was hell pushing out that BM and literally had me sweating and barely able to move. Those first couple were like that.

I have been having a very difficult time with this recovery if you can even call it that. I have tried to be optimistic but every time I think I'm getting better I have another bowel movement where the pain is unbearable for 6-8 hours afterwards. I have had two follows since then and the doctor said he didn't see anything but he only did a visual examination inside my butt cheeks as he didn't want to put me in any more pain with a full rectal exam. He told me he wanted to give me some more time as he didn't feel comfortable going back in for a third time just yet.

It has now been 7 weeks since my first surgery back on December 27th and 3 weeks since the second surgery January 26th. I go back to work on Monday as my FMLA is up and I'm not getting paid but I'm so concerned as how will I be able to function if I have to have a BM at work. I seem to have BM in the morning when I awake. Today was a horrible day. Pain and blood with the BM but after I got out of the tub soaking for several hours the pain was unbearable and had me actually crying. I'm a 32 year old grown man so that should tell you something.

It seems if the BM is very soft or loose almost like diarrhea then the pain u afterwards is bearable and not that bad and I can take a ibuprofen or two extra strength tylenol and deal with the minor aching/throbbing. If its firm and I have to grit my teeth to get it out then I'm in trouble. I had took the Citrate Magnesium last Sunday because I had been constipated for six days from the following Friday from taking the Norco pain pills and then it gave me diarrhea which was tolerable but obviously inconvenient.

My diet has been fiber one bars, applesauce, prunes, pineapples, mandarin oranges along with a normal diet and stool softeners. I was taking the Metamucil wafers too but he told me that can make constipation worse because it bulks up your stool. My doc told me to eat a normal diet with the stool softeners and Miralax if the stool is too painful or constipated.

I don't know what else to do at this point. I just keep praying and trying to not get depressed as sometimes I feel as if I will never get through this as this is worse than the fissure pain I had before then. At least then I could take two prescription ibuprofen, nap and be like it never happen. This after surgery pain...uhhhh not so much.
I'm so sorry to hear that you are going through all of this. I too am still not healed. I was supposed to have my six week post op visit for my second surgery next week but the pain was so bad this week that I went in early. Doctor said he doesn't know why I'm not healing and now plans to refer me to some specialists at the university of Iowa. That appt is in two weeks. On top of everything related to my rear, I've also now developed an ulcer from all the ibuprofen I was taking. It just seriously makes you start to question what you did in your life to deserve this kind of retribution. You mentioned you were 32... Seems too young to be dealing with these issues doesn't it? Im 30 so I understand.

My biggest struggle is staying optimistic as well... It just feels like there is no light at the end of the tunnel most days and even the days where maybe there is hope of improvement don't seem to be lasting. My biggest issue right now is the regret. All the consequences thus far of the second surgery have honestly made it one of my biggest regrets. I keep trying to tell myself that things will get better. One can hope anyway.

I'm sorry we don't have better news for one another but at the very least we have someone else to talk to that understands the situation. Hang in there.

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