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Old 01-25-2007, 01:25 PM   #1
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Thumbs up I Survived Sphincteroplasty Surgery!!

Well, I want to thank everyone for all the kind words and support as I ventured off to surgery last week. Here is the update for everyone.

I had a sphincteroplasty, levatorplasty, and perinealplasty on Thursday January 18th. I was in the hospital for 6 days. I had issues with a very low blood pressure, and since my surgery was so extensive, the doctors kept me a little longer. I was on a morphine drip at the hospital for pain, and other pain meds, so it was tolerable, although it sure did hurt! I am still on a liquid diet, and had my required first bowel movement today. ( I had to take milk of mag to induce a bm today) I was terrified to say the least, but the anticipation was worse than the actual event. It did hurt, but I managed to get through it. It was very soft and my nerves are a little more settled now that it is over. I am taking benefiber 1 tsp twice daily now. My doctor doesn't want me to take stool softeners, although I am not sure I agree with him. My rear-end is nearly un-recognizable at this time. It does not even closely resemble what it did before surgery. My surgeon is very pleased with how everything went, and sais I should be much better, and that I really needed the surgery. It was much more extensive than even he thought it would be. I have a ton of stitches, and am taking the sitz baths 3-4 times a day to keep clean. If anyone has any suggestions about the stool softeners and anything else during this tough recovery period-I would love to hear from you. I am pretty much still on restricted bed rest (no stairs, no lifting, small walks, no sitting and lots of rest) I am trying to stay down as much as possible because I do not want any complications. Thank you for all your help in advance.


Kelley

 
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Old 01-25-2007, 07:23 PM   #2
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lodgen HB User
Wink Re: I Survived Sphincteroplasty Surgery!!

kel123
i had a syhin,fissurmentry,and hemmroid surgery 35 days ago, i was in hospital
with morphine too. the first bm is tough ,it will get better,i had hemorrhoid surgery which is very painfull and takes longer to recover.you must not strain!
they have to be easy and soft when having a bm.if your bleeding stay away from sitz bath period they will cause you to bleed more,all i did was have a bm,then get wet pieces of tp and pat my rear till clean,then use a blow drier
and dry my rear dry, sitting no the toilet for any long time is bad news for you
rear.i had a lot of surgery too. you must keep your stools soft and if it comes
all out at once its better,docusate sodium did not work for me it,its a stool softern,my colorectal surgen told me of miralax its prescrition,it is not habit forming,all it is a white powder that mixes in water and and makes your stool softer.if i did not take this i would have a good soft easy bm,i will not take any chances during my recovery. i blend fruit and fiber one with benfiber in the morning,teaspoon of miralax a hour later,soup with veg and salmon with
benifiber for lunch and soup with eggs and veg for dinner and benifiber.
i take mult vitamins and olive with every meal.i have one or two bm every
morning which are soft and eay to come out. you will have good and bad days
but it will get better but since you did not have hemrroid surgery you recovery will be a lot faster
good luck

 
Old 01-26-2007, 06:07 AM   #3
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Brocallie HB UserBrocallie HB UserBrocallie HB UserBrocallie HB UserBrocallie HB User
Re: I Survived Sphincteroplasty Surgery!!

Glad you made it. Hope you soon recognize your own bum again!

Cally

 
Old 01-26-2007, 08:47 AM   #4
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Re: I Survived Sphincteroplasty Surgery!!

Lodgen, and brocallie,

Thank you for all the good info. I didn't realize that the sitz baths are bad if your bleeding--Thank you. I am still not on a a regular diet, so that may be why I am not on a stool softener now. They are very soft right now, and pretty much fall out with out much effort. My doctor said that will be the case since I have so many stitches in the perineal area and up in the rectum. He said I won't have control for 6-8 weeks. My stitches are now separating a little which bothers me, but my doctor said it is ok, and I will have a gaping bear bite down there for a while. He said it needs to stay open so it won't get infected. I will also ask him about the miralax. Thank you! Right now I seem to be living from pain pill and bath, to pain pill. I just keep telling myself to take it one day at a time. Thanks for all the great info.

Kel

 
Old 01-26-2007, 11:45 AM   #5
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Unhappy Re: I Survived Sphincteroplasty Surgery!!

Kelly,
I am a newbie and can't tell you how much I have learned from reading your posts. My story begins with the birth of my 1st son (he is 8). It was a very traumatic birth that should have been a c-section. In a nutshell, his head was too big to fit through my small birth canal and they had to use forceps and everything else to get him out. It was horrible. I also tore from end to end and after I delivered him, they had to put me out because I was in so much pain. I had my 2nd son in 2001 (he is 5) with no problems, but I was noticing some leakage in my BMs. At first I thought, what is going on, but then it started to become more and more annoying and it seemed to be getting worse. I was too embarassed to say anything to my OB-GYN until last February and he told me and referred me to a colorectal and rectum surgeon. Needless to say, I was too scared to go and cancelled the appt. Well, it of course it not getting any better so I decided to read up on it and found out that the longer you wait the worse it will be. I can't tell you how much your posts have meant to me, because I had no idea that this could happen. I am too very scared of what they might find out. After reading and getting educated regarding this problem, I picked up the phone and made a call to the colorectal surgeon and made a appt. My appt. is on Monday (Jan. 29th) and I am really, really nervous.

I do have a question though, what exactly were your symptons. I can make it to the bathroom, but I seem to have a hard time getting it all out (pushing) and no matter how much I wipe, I can still go in later and there is some in my underwear. Sometimes more, sometimes less.

I am so glad you hear you are doing well. I know the recovery will be hard, but I know you will be just fine.. Take good care of yourself and thanks again for giving me some peace of mind to get this taken care of..
Mindy

 
Old 01-26-2007, 01:15 PM   #6
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Re: I Survived Sphincteroplasty Surgery!!

Mindy,

You just made my day! Just knowing that I helped you look into your problems makes me feel so good. I was beginning to think that I was alone in this problem. It is very humiliating and embarrassing. I guess you have read my other threads so you pretty much know my story (If not, let me know and I will tell you) I started having incontinence during my second pregnancy ( 2 years after the birth of my daughter with episiotomy and 4th degree tear). At the time, I just brushed it off as a another wonderful pregnancy side effect. Back then, I would have a hard time expelling all the bm and "cutting it off". I also always did a lot of wiping, and always soiled my underwear. It was soft stool, not diarhea. I also could not hold gas in. (embarassing!) I had my second daughter, and the problems continued. I never said anything to my dr. I became pregnant with my 3rd child, and the leaking got worse. It just slithered out. I could not hold it in to get to the bathroom. It was either a mad dash, or I would go on myself. After my third birth, The problems went really downhill. I finally talked to my ob/gyn about it at my 6 week post partum visit. He was wonderful, very compassionate and sais to wait about 6 mos because sometimes it would get better. He was really nice and said, "Kelley, you do not have to live like this, you are too young, and we can fix it) 6 mos later, I was referred to a colon-rectal surgeon. I had a bunch of tests done which proved a large defect to my internal and external shincter, as well as unilateral nerve damage. My perineal wall was shot (very thin) and surgery was recommended. I was scared to death, but went ahead with it. I have hopes that things will be better in the future. If you have any other questions, please don't hesitate to ask. Let me know how your visit on Monday goes. You owe it to yourself to look into in. It really does disrupt your life. More than anything, I want to go swimming with my children this summer. Now, I hope I will be able to. Good luck! Please don't be embarassed. My rectal exams have been far less humiliating than the ob/gyn (no stirrups, just lay on your side with a sheet over you and your knees pulled up)

Good luck, I will be thinking about you!
Kelley

 
Old 01-26-2007, 01:19 PM   #7
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Re: I Survived Sphincteroplasty Surgery!!

Kel,
Sorry it took me so long to post. I am so glad to hear that everything has gone well for you. I kept you in my prayers all last week and this week. Things will only get better for you now. Make sure that when you start solid foods that you are taking something to keep everything soft. Don't hesitate to ask here if you have questions that you think we may be able to help you answer. Hang in there.
ericollin

 
Old 01-27-2007, 06:09 AM   #8
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Re: I Survived Sphincteroplasty Surgery!!

Kelley,
How are you doing? I hope your recovery is going well and you are keeping comfortable. I am really glad that you went ahead with the surgery, because I know exactly how you feel. Unless you have this problem, you don't really know how it affects you, so it gives me some comfort to know I am not alone.

I have been thinking of you and your recovery. Even though I am scared to death on Monday of what they will find out, I do owe it to myself to feel normal again.

How long do you have to stay off your bum? How long did the Dr. say the recovery would be? I know it must be hard with little ones, but make sure you do what the Dr. ordered. I will for sure keep you posted on what the Dr. says at my appt. on Monday. I will be thinking and praying for your quick recovery.
Mindy

 
Old 01-27-2007, 10:10 AM   #9
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Re: I Survived Sphincteroplasty Surgery!!

Mindy,

Your exactly right about this ruining your life. It got to the point where I would have to schedule what I ate and where I had to go around my BM's. I knew that if I didn't eat, I wouldn't have to find a bathroom and have the risk of a accident. It was getting really hard. My doctor said the recovery would be tough--and it has been. I have been vigilant, maybe over-vigilant about staying in bed and relaxing so I don't open up my stitches too much. As it is, they are already opening up. The dr. said it is ok, but it scares me to have an open hole down there. The recovery is 6-8 weeks of no lifting anything over 5 lbs, few stairs, and a lot of rest. I am allowed to sit now briefly, but frankly it hurts too much, so I lay down on my sides. I have a 1, 3, and 5 year old, so that has been hard. I can't pick up my 1 yr old, so I have help here always to take care of them. I can walk a little bit, but I have not been pushing myself. I pretty much lay in bed, take short walks, bathe a lot and eat upstairs in my bed. I can't take any chances in screwing up my recovery. All of my family lives out of town, so arranging help has been hard and I don't want any complications. The pain is now tolerable. I have been trying to wean myself off the percocet, but my body is just not ready yet, it hurts too much. You probably won't get a whole bunch of info from the dr. on Monday. He will probaby order some tests. My rectal exam at that first visit showed markedly decreased rectal tone. He also *****ed me all around with a toothpick and found that I had decreased sensory function on one side. Further tests showed nerve damage on that side. I wish you well. Thanks for all the prayers and please keep me posted. This is a really hard thing to deal with on your own.

hugs,
kelley

 
Old 01-27-2007, 10:26 AM   #10
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Re: I Survived Sphincteroplasty Surgery!!

Hi Ericollin,

Thank you so much for all the kind words. I think about you often also. Are you doing better? Exactly how much fiber supplement and stool softener are you taking now? I am a little scared about experimenting because I don't want to end up with loose stools. It hurts so much to have a bm I am now taking 1 tsp of benefiber in the am and pm, and no stool softener. I want to talk to my surgeon about the stool softener. I am only eating creamed soups, yogurt, jello, pudding, ice cream, shakes, tea, water, and gatorade now. So far, the bms are really soft, but they still hurt! I can't imagine having a normal one at this point. There is an almost constant throbbing feeling for hours after, and I am going almost continously all day (3-6 times). I will be on thie full liquid diet until Feb 5th when I see my surgeon. Have you made a decision about the hyperbaric oxygen treatment yet? I will keep you in my prayers, and thank you for all the info.

Kelley

 
Old 01-27-2007, 06:19 PM   #11
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Re: I Survived Sphincteroplasty Surgery!!

Kelley,
I have not decided on my course of treatment yet. I am trying to do my homework so that I have ideas of some options before seeing the doctors. I am doing a bit better but still know that I need to follow up with the colorectal docs. I see one this coming Wednesday. He is the one who has been treating my fissure so far. And then I see this top-rated colorectal doc in mid-February. If I do have to have surgery, then this top-rated guy is the one who I will let do it. I know that many people have success with this fissure surgery called a sphincterotomy or LIS which is where the doctor cuts the internal sphincter so that it can get out of spasm. However, I am worried that my hemorrhoid surgery might have done some minor damage to my sphincter(s) as I seem to not be able to control my gas these days and I seem to be having more than one bowel movement a day. I also know that I have a very minor rectocele from delivering my babies. Did you have one of these and if you did, did your recent surgery fix that too? I also want to ask you some questions about the types of tests you had before your surgery. Are there tests that can be done to test how well both of the sphincters are working? If there are tests, what are the names of them and how were they performed? Did you have to be put under anesthesia to have any of the tests done? Please let me know as I would like to have this information before I see the doctors. Thanks.

I am still taking 1 stool softener and a teaspoon of metamucil before breakfast and then 1 stool softener and a teaspoon of metamucil before dinner. I am trying to only eat healthy foods that contain fiber. I am also taking a supplement called L-Glutamine that is supposed to help strengthen the tissue down there (not sure if it is helping but I figure it is not hurting). I had tried Benefiber around the first of this month but stopped and switched back to metamucil because I think it was making my stools harder.

You are still in my prayers and thanks for keeping me in yours. We both need them right now.
ericollin

 
Old 01-28-2007, 09:22 AM   #12
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Re: I Survived Sphincteroplasty Surgery!!

Ericollin,

I think you are doing the right thing by having an expert look at you. My colorectal surgeon came highly recommended as the best in my area and that is why I went ahead with him. I did not have a rectocele. I was very incontinent of formed and loose stool as well as gas. My sphincter was torn through my internal and external at 180 degrees (out of 360 degree circle so 1/2 of it was completely torn and ineffective) I also had a very thin perineal wall that was built up with surrounding muscle and tissue. I had three tests done before sugery. The first was called an anal manometry. They put a small catheter (rubber) with a ballon into the rectum and blew the balloon up with air and water and let it out several times. This measured my holding capacity, my squeeze pressures, and measured how long till I felt the urge to go. It was not painful, however I did not have surgery prior to it. It took about 40 mins. Mine showed very low resting pressures and squeeze pressures, and I obviously could not wait to go(the urge) very long. The second test was an anal ultrasound. It was much like a vaginal ultrasound when your pregnant. No pain. This clearly showed the large tear in my sphincters. The third test was ptnl nerve testing. This tested my pudendal nerves. and was not painful either. The dr. put his finger in there and had me in stirrups laying almost on my head with my rear in the air (I guess the pudendal nerve is deep in there and this is the best position to find it.) He had an electode taped to his finger and he touched the nerve and it was measured by a machine. Sounds scary but was not bad and very quick. Mine showed unilateral nerve damage. It might set your mind at ease to have these tests done and make sure there is no problem. I know the anal ultrasound shows a wealth of info in itself. All in all, I was in the hospital for 6 hours with the waits in between the tests. I had to do 2 enemas prior to the tests. To be honest, I am already feeling so much better now at 10 days post op. my surgery entailed cutting the internal and external shincters, looping them around, overlapping the muscles, and stitching them all back together. I have stitches from my vagina down the perineum to the rectum and all the way around and in the rectum. I am amazed that I feel as good as I do with how it looks. I have a quarter sized hole that has opened up near my rectum now, but the dr. sais that is ok. If you do have surgery, I would have your rectocele repaired at the same time so it doesn't cause problems for you down the road. Ericollin, maybe surgery is the best route for you now. If you get up the courage to endure it one more time, I really don't think it would be as bad as your hemrhoid surgery. I have read all of your posts, and I also had extensive surgery myself, but I don't think my recovery has been anywhere near as horrible as your hemmroid surgery was. It may be the only way to get your life back. I look at this surgery I had as getting my normal life back, and I feel like I am going to be ok now. my sphincter already feels better and tighter, and that makes me feel like I did the right thing. I now that you are terrified, and I am here for you. Ask all the questions, and ask your surgeon about those tests to rule out any other problems prior to making a decision. Take care and I will keep you in my prayers.

Kelley

 
Old 01-30-2007, 04:39 AM   #13
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Re: I Survived Sphincteroplasty Surgery!!

Kelley,
Well, I went to my appt. yesterday and he examined me and asked a ton of questions. After he examined me, he said that I have a large tear to my sphincter muscle. He said it should be a circle, but because I tore so badly it was shaped as a U. Because I am not totally incontinent he doesn't want to rush into surgery quite yet. He said my perineal wall is very thin and that I have a prolapsed utereous (sp) that is pushing on my rectum. He recommended that I take metamucil 2 tablets twice a day and do kegal exercises for the next 6 weeks then see him again and go from there. If it has not gotten any better, he will order more tests and possibly talk about surgery.

My question is, even though I don't like the idea of having surgery, I don't like the idea of living with this either.. I totally understand that I am not totally incontinent, but isn't it just going to get worse to where I might be? Not to mention that I can't hold my gas which you know if totally embarrassing. He said taking the metamucil will empty my stools therefore no leaking or soiling. I know he is the Dr., but does this sound right to you?

On another note, how are you doing? I hope with each day that passes, you are healing and doing better. I have been thinking about you and hoping you are keeping yourself from doing too much.

Please let me know how your recovery is going, I have been thinking of you. Take Care and keep me posted.
Mindy

 
Old 01-31-2007, 06:37 PM   #14
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Re: I Survived Sphincteroplasty Surgery!!

Hi Mindy,
I read your post about your doctors visit. First of all, if your not happy with what the doctor said, seek another opinion. You owe it to yourself. You do not need to live with this. I saw 3 doctors about my condition. What I don't understand is how the dr. made the definitive diagnosis of a " 1/2 torn sphincter" unless an anal ultrasound was performed. He should of been able to tell you that you had a thin perineal area, as well as decreased tone in your sphincter, but you can not tell that it has been torn unless an anal ultrasound is performed. My anal tone was horrble, but even my surgeon said he would not be able to tell if it was torn unless an ultrasound is perforemed. The sphincter muscles consist of 2 circular muscles--the internal and the external sphincters. Because they are circular they form 360 degrees. My sphincter was shown to be torn through both the internal and the external muscles to 180 degrees (a 180 degree defect, or 1/2 of the muscle torn) I was told that a 1/2 torn muscle is a HUGE DEFECT. My OB dr. had me doing kegal exercises daily for 6 mos, and to to be frank, I had been doing them everyday for about 2 years! Needless to say, It did not help at all! Even my surgeon said that with a 180 degree defect, all the kegals in the world would not help it. A torn muscle needs to be repaired in order for it to be able to work properly. My sphincter was also squeezing in a "u" or flat horizontal pattern, and was totally ineffective. Because of this, I was unable to "cut of the stool" at the end of a bowel movement, and I also had no "pushing power" to get the sttol out. My sphincter was totally unable to do the job. I also leaked gas. "Totally incontinent" is a relative term. The most annoying part of this whole ordeal, is that a bowel movement lasts all day, because of the constant wiping, chaffing, and soiliing of the clothes. It does not need to be a full blown out accident to ruin your life. I did, however have a lot of oozing or slithering out of stool (sorry to be so graphic) when I couldn't get to the bathroom in time. I think you should see another doctor who is compassionate about what you are going through. I love my dr! He was the first person who validated all my feelings and seemed to understand what I was going through. I feel great now! My sphincter is so much tighter, I am having only tender bowel movements now (no excruciating pain) and I can tell that The surgery was a success and I am going to be better. I really could kiss my dr! I went for a post op appointment yesterday (earlier than scheduled) because I though I was impacted, and I was worried. I was able to go to the bathroom with a couple doses of milk of mag, and corrected the problem, and I feel much better! I don't really feel much worse than after having my childen now. I am only taking Ibuprofen for pain. I know I will have my life back now. I am 100% convinced I did the right thing. I was also taking the fiber supplement, and it did help a little, but not completely. Your sphincter will not work properly until it is fixed. read my post above to ericollin, and I explained all the tests and what they test for. I am here for you. Any questions, please ask. I will keep you posted. Sorry it took me a long time to get back to you. All 3 of my kids and my husband have strep throat! It is a good thing that I am feeling well, because I am convinced that MOMS are Not allowed to ever get sick, recover from surgery or anything! Oh well, I wouldn't change it for the world. Oh, and my 3 yr old now has a urinary tract infection too. Between my husband , myself, and the kids, we have been to the doctor everyday this week! It can't get much worse (except we live in Virginia, and are getting snow and ice tomorrow, so schools will be closed and they will all be home Take care Mindy.

Kelley

 
Old 02-01-2007, 05:38 AM   #15
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Re: I Survived Sphincteroplasty Surgery!!

Hey Kelley,
I was getting alittle worried that I had not heard from you. It is good to hear that your recovery is going well. I also hope your family all gets healthy too. I will keep my fingers crossed for everybody to get well again..

After my Dr. appt on Monday, it has all that has been on my mind. My husband said that I deserve a 2nd opinion, and I totally agree. So I searched and found a Dr. that was rated one of the best in the country and she is about 1 1/2 hours away. So I called and scheduled an appt. with her. The only problem is I can't get into see her until April 11. I did, however was put on the cancellations list to call if anybody cancels. In looking back at my exam, after it was over and he told me what to do, I said to him, so I don't have a tear in my sphincter muscle and he said "Oh yes, you have a large tear" and proceded to show me how it was suppose to be a "O" shaped and mine was a "U" shaped. I do remember that he used what looked like a "whoopie cushion" but I don't understand how he could all of that when I was only in his exam room for 30 minutes. You took tests for 6 hours (including waiting) so I am more confused. I could just kick myself for not asking more questions. I totally agree with having a BM all day because you can't get it all out. I have a hard time cutting it off also. There have been times that I am in the bathroom all day wiping and sometimes it is so much my bottom starts to hurt. Just because I am not "totally incontenent" doesn't mean it is not a problem. I know that I should have worn a pad sometimes, but I think I was in denial. My gas it all the time and it is pretty much uncontrollable. There have been times that I have been out and I can feel it in my undies and I know that I have to get to a bathroom, sometimes I can't and it is a terrible feeling. It is really depressing and I am so thankful that I have you to talk to about this. I can talk to my husband, but in his defense, he really doesn't know how it feels or affects a person. That is why I am so glad you are being so honest with me, it makes me feel that I am not alone in this horrible ordeal. I just don't see how taking metamucil and doing kegal exercises is going to help. Am I wrong?


Anyway, please keep me posted on your recovery... Hang in there, I am so happy that you got the help you needed. I hope your family is on the road to recovery as well as yourself. We will talk soon..

Take Care,
Mindy

 
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