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Old 11-11-2009, 12:16 AM   #1
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Fissurectomy wound NOT healed after 4 months

I had a fissurectomy plus botox four months ago and it would possibly have to be the biggest regret of my entire life.

My op was postponed a month due to health insurance issues and I had around 6 weeks to wait until my new op date. Over that 6 weeks leading up to the op, I felt great. No regime of stool softeners etc, normal bms at any time of the day, no pain, sometimes just a faint twinge. The best I had felt since the birth of my son in Feb last year (which was when, of course, I developed this fissure). As my op date drew near, I decided to research just what a fissurectomy was. After reading that I would have a new, fresh wound created 'down there' every inch of me started to doubt that this was the right way to go. It felt weird thinking that I would go from feeling 99.9% great to having it stripped back to the start! I did have a vaginal nodule that had to be removed as well so I knew I had to turn up to the op, despite my concerns and I spoke to the surgeon before hand and stressed how good I was feeling and that I didn't want the op unless absolutely necessary.

Well, I should have just got up and left there and then. The surgeon couldn't even be bothered coming and seeing me afterwards and I had to wait for the invoice to arrive in the mail to find out I had only had a partial fissurectomy. I would dread to think what a full fissurectomy would feel like. The surgeon reckons about 2mm of fissure was excised and that it was the best thing to do as even though I felt great at the time, sometimes fissures 'lay low' and can then become full-on again.

I feel my problem is not the little bit of unhealed fissure but the hideous excision wound around it that gives me grief. Four months later and I feel nowhere near healed. When I had the fissure itself last year, I would have a bad morning on the toilet, be in pain for some of the day, usually half of the day and then like a switch, the pain would subside and it was as if I didn't even have a fissure. Since the op, I feel something down there all day, every day. On a good day, I feel hardly anything just a slight sting or sharp jab type feeling and then the next day, after taking the same routine of lactulose, water and all that hideous stuff, I can have a bad day, even though it didn't hurt when I went to the toilet. Other days I feel I aggravate it just from cleaning up after going to the toilet. So I think that a fissurectomy wound seems to be so sensitive to any kind of touch or aggravation because it is an external wound, regardless of how the fissure itself is healing. Some days I just cross my legs or lean over to grab something suddenly while sitting down and I feel like I have snagged something. I would love to hear from anyone who has had or is having a similar experience with this procedure. I had a look at it with a mirror the other day (never a pleasant task!) and lightly touched around the wound to try and see where I feel the pain the most (I have yet another post op with this surgeon tomorrow and want to be able to clearly explain where I feel it) and just from touching it - and this was ever so gently - I then dabbed it with a baby wipe and it was suddenly bleeding - just like that. So consequently, I seem to have severely aggravated it now and it hurt like heck going this morning, even though it wasn't a 'hard' bm and there was blood on the wipe afterwards. Again, I don't think this is the fissure re-tearing but the wound around it.

So sorry for this crazy, long story but this is a problem that is driving me crazy and really starting to ruin my life and this is my first post on any kind of board regarding this awful problem!! If you are reading this and considering a fissurectomy - think carefully! I had a 3rd degree tear during the birth of my son which is why an LIS is out of the question for me. One more thing I might add, I don't mind this pain if the long term outcome is recovery, but after 4 months I am beginning to think I will be stuck with an unhealed wound forever!

 
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Old 06-01-2010, 07:48 AM   #2
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Re: Fissurectomy wound NOT healed after 4 months

Hi There

I'm hoping you are still on line. Im going to cut a very long story short but since the birth of my baby 2 years ago i've had 5 ops on my bum. I started with Hemorhoids and the ops I had for that caused a fissure. I had the botox for the second time but with a fissurectomy 3 weeks ago and i'm sure the pain is getting worse. I had a few good days and thought it was the sign of getting better but now i'm house bound with two kids again. Just wondered if you were any better and could give me any hope. i'm not sure what they can do from here, but I cant live like this.


 
Old 06-01-2010, 01:38 PM   #3
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Re: Fissurectomy wound NOT healed after 4 months

Hey there - my heart truly goes out to you. I have since had a second fissurectomy with botox (two months ago today). After my last post it must sound crazy deciding to do it again but I was advised it was the right way to go. My specialist told me that statistically the second time around the odds are better of the fissurectomy and botox working. I went for a check up a month ago and he said it was healing, but not healed. From going down this road since the birth of my son I am now on antidepressants and seeing a psychologist for cognitive behaviour therapy! Believe me I have done many many things to try and avoid going down the road of antidepressants, various self help techniques etc but I think after a while after a bad birth experience and then a secondary health problem that won't go away it's hard to pull yourself together. I've got about my normal life, being a Mum, returning to work etc but I haven't felt 'right'. At one point I went to a counsellor who said I had post traumatic stress disorder from the birth ordeal. So I think for me, the first fissurectomy was around a time when I was in a bad place mentally and I wonder if that was half of my problem with healing.

I am still having 'discomfort'. I think if I had to be really honest I couldn't call it pain as I can go about any daily activity I need to - it's just 'there'. Some days I have none at all, which makes it harder for the next time when I do!! So I know what you mean about having a couple of good days where you think it is all getting better. Everything I have read about a fissurectomy has told me that out of all the procedures for a fissure, the fissurectomy is the one of the most unpleasant and longest to heal from.

It's hard not to think about it all day every day. The psychologist has told me I must stay away from things like these message boards etc and the worst thing to do is compare yourself to other people's experiences as it can give you un-realistic expectations about your own healing and body. I tend to disagree!! I can see his point but I also think talking to other people about their experience with the same problem can be a huge help - which is why I decided to take a quick look this morning and if I hadn't, I wouldn't have seen your post!

I am finding as well that my monthly cycle has an effect on pain/discomfort down there. When I have my period I have more of a rectal pain, where as when the fissure is bothering its a stinging 'cut' type pain, where I am very aware that I have been cut down there from the fissurectomy. My doctor has suggested the rectal pain could be a touch of endometriosis and advised me to see a gyno, but I am going to wait and see what my next check up regarding the fissure says. The first specialist I saw regarding rectal pain tended to think that the fissure was a red herring as to him it looked nearly completely healed and he couldn't figure out why I was experiencing the type of discomfort I was feeling from a small fissure. So part of my does think that the first fissurectomy may have been un-necessary and has just given me a whole new set of problems. Its so hard not to over think and wonder what you could have done differently. PLus it is awful how the 'gold standard' procedure - LIS - that seems to be the best way to go, is so risky for women like us that it can't even really be an option, yet we know it would probably heal us once and for all.

So I would say give it plenty of time (and I mean plenty) to see if the fissurectomy has been a success. Three weeks out I was still feeling pain from the fissurectomy too. That pain will soon subside. I remember thinking that the pain was almost worst than before the procedure, very swollen and tender feeling. I think healing from a fissure is a very bumpy road, up and down all the time. When I was feeling my worse mentally from this I used to constantly think over and over "I can't be expected to go on living like this" it seemed ridiculous that it can be so hard to heal from what is essentially just a cut. But as small as they are they cause such awful pain at their worse. Although I am still not completely healed I am feeling generally better down there this time around and more optimistic. Plus I am being extra careful with my diet and staying on the lactulose for as long as it takes.

Sorry about the long post but I really want to give you hope. I always look at it that one way or another, things have to heal down there. You are 3 weeks post op and I think it would be more surprising NOT to be feeling pain at 3 weeks out. To have gone through 5 ops already is so brave of you, I shouldn't be complaining at having just 2.

The good thing with a fissurectomy is that, although it leaves this painful wound for us, it has completely freshened that fissure up, taking away the edges, smoothed it back to give it every possible chance of healing, almost like a clean slate to start trying to heal again. Some people after LIS still have trouble healing it as the fissure is so chronic.

Another piece of advice I was given was to let the surgeon/specialist worry about why it isn't healing - its their job and that's what we are paying them to do. Easier said than done, but it is true. It costs so much money, even with health insurance covering some of it.

Do you have to go for a post op check up any time soon??

I know what you are going through and let me know if you want to know anything else Take care

 
Old 06-01-2010, 05:20 PM   #4
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Re: Fissurectomy wound NOT healed after 4 months

Start taking vitamin c (250mg) tablets and zinc (25mg) tablets twice every day, they can realy speed wound healing.

You could also try applying Ungvita (Vitamin A Ointment) to the wound

Taking 2 Ibuprofen tablets before your morning toilet visit could help reduce the pain you feel after it.

Best of luck,

Jon

Last edited by jonnstar; 06-01-2010 at 05:22 PM.

 
Old 06-07-2010, 02:19 AM   #5
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Re: Fissurectomy wound NOT healed after 4 months

Thank you so much for your message back. It does give me hope and although your counsilor is probably right about these message boards knowing 'm not the only one is a big help. I'm also just hangining in there and not taking antidepresants. My birth was actually fine so I know the exact reason i'm down and thats what I need sorting and again i'm going to try and remmeber your words to let the surgeons and doctors worry about why im not healing.

Im still in the same pain as before and probably worse than before the op but my friends and family are amazing. Im desperate to be normal and enjoy my children and go back to work. Im just going to keep hoping.

Please keep me posted on how you are doing and if you have any more improvement. Were you advised on good healing foods to eat by any chance?

Thanksx

 
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Old 06-07-2010, 04:47 PM   #6
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Re: Fissurectomy wound NOT healed after 4 months

Quote:
Originally Posted by Fruit Factory View Post
Thank you so much for your message back. It does give me hope and although your counsilor is probably right about these message boards knowing 'm not the only one is a big help. I'm also just hangining in there and not taking antidepresants. My birth was actually fine so I know the exact reason i'm down and thats what I need sorting and again i'm going to try and remmeber your words to let the surgeons and doctors worry about why im not healing.

Im still in the same pain as before and probably worse than before the op but my friends and family are amazing. Im desperate to be normal and enjoy my children and go back to work. Im just going to keep hoping.

Please keep me posted on how you are doing and if you have any more improvement. Were you advised on good healing foods to eat by any chance?

Thanksx

 
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Old 06-07-2010, 05:03 PM   #7
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Re: Fissurectomy wound NOT healed after 4 months

It is so hard when you just want to be enjoying your children and getting on with things, such as going back to work. I totally emphathise with you. It made me so mad that the first few years of my son's life were being spent in pain.

I have received conflicting advice over the past two years on diet and I am not too sure if any foods are 'healing' as such but any foods that are easy for for your body to digest and then pass, have to be healing in that respect! Plus after a while you get to know what works for you, some people avoid bananas for example, yet bananas work fine for me.
This time around, I have a lighter diet and avoid heavy foods like red meat and too much dairy. It is only just now, two months on that I am starting to be a little more relaxed about what I am eating, but still keeping up the fruit (kiwifruit are fantastic for your bowels), prunes, wholemeal bread. I am just allowing myself a few more 'treat' foods - just not overdoing it. Drinking way more water than I used to has made a big difference.

I took Jon's advice who posted the other day and added Zinc to my vitamin intake - so thank you Jon for that. I have found this past week that the discomfort is a little less and there is still a (sorry to be gross) slight oozing or discharge from the fissurectomy site, but it is not troubling me, so there is improvement from my last post even.

Looking back to week two, three or six after my fissurectomy things have improved each week and some times it will feel like improving and then I would have a bad day so I think with this kind of procedure it will be an 'up and down' recovery. You will find you move from pain to discomfort. I had a friend who has a similar op who said that it took a good 6 months before she noticed no discomfort at all so it takes a while for that area to de-sensitise too I think. My specialist did say after my first go at fissurectomy that after being operated on 'down there' that you will have a heightened sensitivity to that area. No kidding!!

Please also keep me posted on how you are doing and ask anything at any time, regardless of what the counsellor says, these boards have been a huge help to me so I am happy if I can now help someone else

 
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Old 06-07-2010, 05:23 PM   #8
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Re: Fissurectomy wound NOT healed after 4 months

Do Panadol or Nurofen help the pain? Dont be afraid to use a simple analgesic if you need to, thats what they are there for. (though discuss prolonged use with your doctor)

Have you tried taking Zinc and Vitamin C to speed healing? Ask your doc, and I am sure he will conform that they can be very helpful.

The pain could also be relieved by 5% lignocaine ointment (Xylocaine, avaliable from pharmacies) again, discuss with your doc.

 
Old 07-03-2010, 06:02 PM   #9
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Re: Fissurectomy wound NOT healed after 4 months

Hi Fruit Factory - hope you are still checking this board and that you are starting to feel better.

It has always bummed me out from reading different message boards etc over the past few years where you read about someone's experience and then you never hear back if they healed or not, which I can understand as once you are healed you never feel the need obviously to go searching through message boards!! So I thought I would make sure I still post back with updates - good or bad!

I went for a 3 month check up yesterday and my fissure has healed! I never, ever thought this thing would ever heal so it goes to show that it can happen eventually. I still have discomfort down there but apparently that is all normal as it take a while for everything to settle down.

The funny thing is that the physical problem has healed but mentally I am still very fearful. I guess that will take time. It's almost like I don't want to get too excited about it just yet as I could get complacent about my diet etc and the fissure could recur. I think with time that fear will go.

Hang in there, I never thought I would get better but I did.

 
Old 07-06-2010, 11:08 AM   #10
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Re: Fissurectomy wound NOT healed after 4 months

Thank you so much for letting me know you are doing well. It does give me hope. Im not good still and had my follow up appointment yesterday which didnt fill me with confidence. The registrar saw me rather than the surgeon and I feel like i'm being fobed off. They are however sending me to a clinic to have full tests done on my pelvic floor and all my mussels around that area so it might reveal more than just the fissure.

I really do hope you now live a Fissure free life and thank you once again for your support and being kind enough to let me know I can keep thinking my future will be good.

thank you.

 
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