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declansmom 03-28-2007 08:42 AM

Sphincteroplasty Surgery
Jou Jou,
How are you doing? Are you feeling better after your surgery? How is eating and what are you eating to help with your movements? I am curious what to expect in that aspect?

Kel123 03-28-2007 09:37 AM

re: Sphincteroplasty Surgery
No problem Lisa, This thread is no way done with 3 more people needing surgery.
Jou Jou,

Glad your doing better. I know it is hard to have a big gaping wound, but it will heal up. I start work on Thursday. I am ready to get out of the house and have some adult time! I am feeling pretty good. I had a sore BM today, a little harder than usual, need to get to the store for more fruit! Hang in there! You will be back to yourself in no time.

declansmom 03-28-2007 09:42 AM

re: Sphincteroplasty Surgery
Kelley and JJ,
What kind of diet change have you had to adjust too? I know i will be on a liquid diet but you both have mentioned high fiber. What is your diet like now? Any major restrictions?

Jou Jou 03-28-2007 12:33 PM

re: Sphincteroplasty Surgery
Kelley, I was wondering if you had started back to work. Good luck tomorrow. I hope you will not be too worn out. My mental outlook is improved, but the wound opening has increased my pain, so I am back to taking Darvocet about twice daily. My diet is currently a regular diet, plus fiber supplement (Benefiber) in the morning. I am having very frequent, unformed stools, so I am NOT taking stool softeners. I will return to those if my bms ever firm up or begin to get hard. My bm pattern right now is nothing like what it was before, and I hope it will not stay like this. I was NPO for 4 days and on a liquid diet for 3-4 days, followed by just a couple of days of "soft, bland" diet. I believe that Kelley had a different progression with her diet and will be in a better position to give us info about any long term modifications she will need to continue. My understanding is that, following wound recovery and a return to "normal" bms, the right diet will contain ~25 gm fiber daily. Kelley, I tried the FiberOne bars before surgery-not my favorite but tolerable, and good for 9-10 gm fiber! Thanks for the tip. Edamane peas are another good source of fiber. JJ

Kel123 03-28-2007 02:00 PM

re: Sphincteroplasty Surgery
Lisa and JJ,

My diet following surgery was a clear liquid (broth, tea, juice, water, jello, italian ice--YUK!!) for 2 1/2 weeks, then a full liquid for a week (creamy soups, oatmeal, applesauce, pudding BETTER!) then a high fiber regular diet. I take Benefiber everyday. I used to take 1 tsp twice daily, but found I was missing and becoming non-compliant on my evening dose, so now I take 2 tsps every morning. I also drink a cup of coffee in the morning with my fiber and have had only 1 Bm everyday now first thing in the morning since starting this routine. We will all probably need to be on a fiber supplement for the rest of our lives. I am actually more regulated and feel better since taking it. I eat a lot of veggies, fruit, and pretty much anything I want to now. I have good soft formed Bm's with this. The only issue I have since my surgery is flat, ribbon like stools that come in a lot of pieces (sorry for the graphic mental picture) When I told my doctor, he said I will probably always have stools that look like this because that is the shape of my "outlet" now since surgery (I love that term! :) I am not overly concerned. I just wondered if they would ever bulk up more because they are relatively small (nickel sized in diameter) My only other complaint is that my "hole" for lack of any other term is still not closed! Every time I get the mirror, I think it will be all healed, and it seems to be stalled in the process. My dr. said it just keeps ripping open when I walk so it is taking a long time. It is only the outer skin layer left--Oh well, if that is all I have to deal with that's ok. Hope everyone is well.

Lisa, the main thing with the diet is to go slow and be careful in the beginning. The pain pills constipate you, and after being without regular food for so long, it takes your bowels a while to "wake up" and get regulated properly, I had 3 episodes of slight uncomfortable impactions in the first couple weeks, but have been fine since. I was not very good with my diet yesterday and went and found I bled a little. It is a life-long change for us, but one that is well worth it!


I know your stools are soft and have been loose, but how is your control? Are you seing any difference yet? I think around 4 weeks, I started to see a real improvement.
Take care everyone,
Kelley :wave:

Jou Jou 03-30-2007 09:52 AM

re: Sphincteroplasty Surgery

I am holding onto your words about the 4 week mark. My stools have gotten firmer and occur usually twice daily, which is much more frequent than before the surgery. Like yours, my stools are narrow and ribbon-like, though mine are round, not flat. I am not sure that I can completely control them. I am always at home, a few feet from the toilet, so I haven't really tested myself, but sometimes the pressure seems to be more than the ability to hold it in, and there will be a small amount of bm already there when I get to the bathroom. On the other hand, I haven't had any completely out of control accidents since the first few days following surgery. I am hopeful. Right now the worst thing is the open incision. It seems to be getting worse/longer along the incision line. I am trying to take it easy until my dr appt on Monday. What do you think I can expect to see with this incision over the next week or so? I so want to get up a bit more without worrying about it coming apart. Is it ever necessary to have skin grafts down there? How was your return to work? Did you feel up to speed and full strength? Thank you for hanging in there with those of us who still need so much encouragement and support. I would also like to share information about food products and fiber sources. JJ

declansmom 03-30-2007 09:59 AM

re: Sphincteroplasty Surgery
Hi JJ,
How much are you doing at this point? Are you resting or trying to do things around the house? I am trying to judge what to expect with 'bed rest' and taking it easy. Do you think you opened up due to doing too much or it is inevitable?

Let us know how returing to work went.

Harry 03-30-2007 01:34 PM

re: Sphincteroplasty Surgery

I thought I would add my input for what it's worth since I have been on this board for years. I have kept up with and been reading all the posts.

Being a male I have not had the same problems recovering but some related ones --I have had hemorrhoid surgery and looking at your anus with all the stitches is an area that you don't want to mess with until it is healed. And, 5 years ago I had-- 2 1/2 feet of my colon removed because of chronic diverticular bleeding and literally lost half my blood before surgery. Recovery was not easy because 4 inches of my abdomen incision came loose and it has to heal from the inside out.

I have been taking psyllium-- a water soluble fiber supplement for 23 years -- I started with Metamucil but now use the Equate brand from Wal Mart -- orange flavored & sugarfree. Natrual fiber are broken down with digestion-- so it does ferment and produce gas --Benefiber that Kelley takes should do the same since it it guar gum and a natrual soluble fiber.
I have found that with any natual fiber that you take -- it will produce gas until your intestines gets use to it. So, start off slowly with any change in your diet.
It may help to do a search on--- Controlling Intestinal Gas-- there are many sites available about the do's and don't about gas.

The thing that makes a stool soft is the amount of water/fluid it absorbs and that is only done with soluble type fiber. Soluble fiber is the inner part of all grains, beans and peas. Also, root veggies like potatos including sweet potatos, carrots, beets, and turnips, And of course soluble fiber supplements. So, the selection is not alot!!

Insoluble fiber is the type fiber that causes muscles contractions and moves digested food through your intestines. All fruit and veggies are almost totally insoluble, all nuts & seeds. The outer part of grains is bran and is included in alot of cereals. Fibercon is considered an insoluble fiber supplement.

To have normal stools -- you need a combination of both type of fiber.

I have taken stool softeners and I don't like them because they make your stool too pasty and it takes too much cleaning in an area that is best left alone as much as possible until the healing is better.

All PAIN medications causes constipation to some extent. So, the less you take the better off your recovery will be but if you absolutely need it -- take it. Also, drink enough water --your body is made up of 70% water and nothing works without it -- including your intestines.

Kelley -- I don't know how you have time to work with 3 children 5 yo and less-- but how did you make out today-- at least it's Friday!!

I wish you all Well --- Harry

Kel123 03-30-2007 02:20 PM

re: Sphincteroplasty Surgery
Hi Lisa and JJ,

Work was good last night. I was tired....It's hard being up at the crack of dawn with 3 kids, and then up working until midnight, and not in bed until around 1 am and asleep at 2 am just to do it all again. I am sort of down because I also have an autoimmune disorder (possible lupus) and that has been bothering me a lot lately. I also seem to keep ripping myself open at the small unhealed spot near my rectum. It has become frustrating. I was playing with my 1 year old yesterday, and made a fast move chasing him (a little) on my hands and knees, and I instantly felt a twinge of pain. The last little spot just will not heal. Now I am sore again, and it is slightly uncomfortable sitting. I just want it to close up. I want to resume intimacy with my husband and am scared to death of doing more harm, plus the scar tissue on the perineal incision still hurts. I don't know if that spot needs to be cauterized again or what. I am on the verge of feeling "normal" if this wound would just leave me alone and close up! On a lighter note, I do enjoy my job and it was nice to see my friends and get away from my darling little children. I have an appt with a new dr. for my autoimmune problems, so hopefully I can get that under control and start feeling better in that aspect. I vowed that 2007 would be the year I took care of myself and I am on my way!! Take care everyone,

Kel123 03-30-2007 02:38 PM

re: Sphincteroplasty Surgery

Thanks for your wonderful insight and wisdom. I also have read a lot of your posts including your sticky thread. It has been very helpful with the whole bm and fiber department. You have a wealth of knowledge, and it is wonderful for you to share it all with everyone on this board.

Jou Jou,

The wound was and has been the hardest problem for me to deal with also. Unfortunately, you cannot stay in bed forever. Around 3 weeks, I started to do more-- being careful with bending, picking up heavy objects, and straining too much. I really didn't sit very much at all for what seemed like forever because my wound just hurt :mad: The sitz baths really help with the healing. The warm hydrotherapy is also used to heal burn victims wounds and it really will speed things up. I always soaked in very warm water for 30 mins 4 times a day. Keeping as clean as possible is also key. Drainage breaks down the skin more, so keeping the area dry and clean is important. You are doing everything right. I do think that the dehiscing is inevitable in this type of surgery. My surgeon told me until he was blue in the face that it would heal, and it has Except this bothersome last little bit. As far as diet, I eat a bowl of raison bran, oatmeal, or shredded wheat every am, activia yogurt, 1 or 2 fiber one snack granola bars, 2 tsp benefiber, and fruit, veggies amd meat or fish. I pretty much have consistantly soft bowel movements as long as I do the raison bran or high fiber cereal. I also snack on raisons, dried fruit, and prunes. I also had 2 bm's per day until about 2 mos or so, now I have 1 per day in the morning I don't have the horrible leaking gas issues anymore. I think as Harry said, it was my body getting used to the increased fiber. I have found that I can hold my gas in most of the time now also. For a while, It was aweful and very embarrasing. Its a good thing my husband thought it was funny :) Glad to hear you are doing better, keep up the good work at healing!

Jou Jou 03-31-2007 12:29 PM

re: Sphincteroplasty Surgery
Hello All,

Harry, thanks for the input. I am going to follow your suggestion of doing more research on controlling intestinal gas. More information is better than less!

Kelley, I'm glad that your return to work was ok. Of course, you are tired. You seem to have such a consistently positive attitude; I'm sure that that goes a long way in helping you return to normal as well as deal with the auto immune issue. Do you think the auto immune problem affected your recovery from surgery, at all? Thank you for the reminder about drainage breaking down the skin. I am using gauze to absorb the drainage, and I am now going to be even more vigilant. You have become my role model, of sorts. I tell myself, "If Kelley healed enough to return to work, so will I". Some of the tissue surrounding the incision itches at times. Did you experience that? I am trying a little Boudreaux's Butt Paste around the area (not on the incision itself) to try for a little relief. I am not yet prepared to tackle a high fiber diet, I don't think. The thought of a bulky stool is very scary right now. I will definitely ask the dr on Mon how quickly he thinks I should proceed with adding high fiber sources. Thank you again for all your encouragement. I am praying for your last open area to heal and that you soon break through that verge to full fledged normalcy! At this point, can you pick up and carry your children? My youngest is about 35 pounds. I hope you quickly resume your full strength and energy for work!

Lisa, I think the incision opening was just inevitable, as I was literally doing NOTHING except turning in bed and getting up for the shower or bathroom. I did have dry heaves on the first day that I got out of bed, and that is very stressful on every know and unknown muscle everywhere. For the first week following surgery, the whole area from anus to vagina was horribly bruised, swollen, and impossible to really see what was happening. When the swelling subsided slightly, there appeared a gooey, yellowish area along part of the incision line. The next day, that was gone, but instead there was a deep gaping gash. Now, at 2 1/2 weeks, the gooey yellow stuff has appeared again further down the incision line. The open incision is extremely sore and does drain a fair amount. As for bed rest, please plan to get help for the first 2-3 weeks following surgery. You will need it! Thank God that my mother and mother in law have taken turns helping us. They do the laundry, cooking, and driving the kids to school and activities. I am sick of being in bed but more worried about prolonging the recovery time. When I asked the dr how to prevent more of the incision from opening, his only recommedation was "take it easy". After my appt this coming Mon, I am hoping to get up and begin to do more around the house. I cannot sit at all. I hope this helps you prepare for what may be a similar experience. I also experienced some short-lived but very discouraging depression immediately following the surgery and return home. Preparing mentally for what can only be described as a tough (initial) recovery might help. Good luck! JJ

Kel123 03-31-2007 06:22 PM

re: Sphincteroplasty Surgery
Hi Jou Jou,

Yes, I definitely have experienced a lot of itching. As the stitches heal, it causes them to become very itchy. The drainage can also cause severe itching. I found myself waking up at night with a lot of itching. I really didn't use anything for it. I remember severe itchiness when my internal rectal stitches were starting to heal. I still have this going on even now. My son is about 24 pounds, and my lifting restrictions were lifted at 5 weeks (I think only because my Dr. knew how hard it was to not lift my sweet little boy!) I didn't lift my 36 pound daughter until probably 8 weeks or so. I spent a lot of time cuddling with her- her climbing to me instead. As far as your opening goes, mine pretty much "stabilized" a few days after the initial tear. It got bigger over the course of a few days, and then pretty much stayed the same. Soon after, It started healing up. It will granulate from the inside out. Basically, it should look "beefy red". You will start to see some healing soon. I looked at it every day with the mirror to make sure I wasn't doing more harm. The yellowish stuff will come and go--it is just drainage. I don't think the lupus had anything to do with the healing really. The problem is that stress makes the lupus flare, so the stress from the surgery and recovery has been hard. I also was going to begin immunosuppressive therapy but couldn't until after the surgery because that would have caused major problems with the healing. My surgeon said I am far enough along in the healing process that I can go on the immunosuppresants now to get some relief. My appt with the rheumatologist is monday, so we will see. If I can get this under control, I will truly feel like a new person. I feel like God only gives you what you can handle. Just go slow with your diet. You should start adding in protein soon, because it will help with your healing. I also drank tons of water and that helps with the bowels. If you ever feel like you are getting stopped up, Take a little milk of mag. It helped me tremendously, and didn't seem to give me diarhea at all. I think it is normal to have some ups and downs with getting your gut working normally. Just listen to your body. It will also help when your up and around walking more. (The nurse in me is coming out!) The 3 worst things for your digestive tract are immobility, narcotic medications, and surgery/anesthesia. As you wean off the meds, get some light walking and exercise in, and start eating, everything will start working better. Hang in there, your doing great! I re-opened my wound pretty good in a new spot :dizzy: I am back to trying to get this thing closed. My husband wants me to put neosporin on it???? I don't know. Talk to you soon.

Jou Jou 04-01-2007 04:31 PM

re: Sphincteroplasty Surgery
Hello all,

Well, I had my mother (a retired RN) look at the incision today (talk about retreating to childhood, having mommy check my butt), and she seemed to think the goopy part was "granulating tissue", YAY! Another appt tomorrow will give me a better gauge of my progress. The forward most part of the incision (near my vagina) is just a deep open gaping gash, the edges aren't together; I am still most concerned about it. Plus, after a tour through some of the other threads, I am becoming concerned (paranoid? hypochondriacal? God, save me from that!) about my bms. They are regular and soft, but not bulky. They continue to be narrow, ribbon-like, and very long. It's like playdough being extruded through a shaping tool. Is anal stenosis a likely complication from this surgery? Should I be trying to encourage a bulky stool? I will do it if that will prevent long term consequences, although the thought of a bulky stool is scary. Also, some of the other posts mentioned "self-propelling" stools. What actually is that? On most of my trips to the bathroom (for a bm), there is some urgency involved, yet I still have to deliberately empty my bowels. I am not talking about severe straining, just "normal" pushing to evacuate? Does this seem on target? What is the right balance between being able to hold in stool (I sometimes can and sometimes can't still) and not having to push too hard to get it out? I am now at 2 1/2 weeks post-op. Kelley, did you have control at this point? And what were your bms like then, if you don't mind me asking? I am feeling better and more encouraged about some things and more worried and anxious about others. One thing I am sure of, that this surgery, as tough as it is, doesn't seem nearly as horrible as what some on this board have experienced! I am earnestly praying for all of us who are supporting each other through this. Thanks again for the responses and support. JJ

Kel123 04-01-2007 07:30 PM

re: Sphincteroplasty Surgery

Your stools sound exactly like how mine have been and how they are now. The playdough explanations was right on target. When I talked to my dr, he said that was normal and probably would be how they will stay. I take the fiber, eat a good diet, and this is just how my stool is. It is the least of my worries as long as I can hold them in. He said the outlet has been re-shaped and the stool is the shape of the outlet. Let me know if your dr. sais anything different, I would love to know. My dr. in the beginning didn't want to use stool softeners due to the risk of anal stenosis, and he just didn't think it was needed. I would relax, I think your doing great. I didn't have an issue with the vaginal area opening up--mine was just the rectal area. It is opened up again and bleeding with BM's now--UGH! I remember testing myself a little at about 3 weeks or so, and feeling like I I had a little control, but I could see a big difference at 4 weeks. I also pretty much always had to push to have a bm. When I started on solid food, I become impacted 3 times (severe bloating, stomach ache, fullness) and pushed so hard to have a bm that I swore I was going to rip the entire surgery apart. This didn't happen. I became scared and waited patiently for the milk of mag to work, walked around a lot, and drank a lot of water. I also backed off of eating. ( my worry is pushing too hard and developing a fissure) My bm's only fell out in the first few days. Ever since, they are sort of like tooth paste in long strands. I think they are as bulky as they can be taking into account the outlet size. Hope this gross info helps you;) Take care,

declansmom 04-02-2007 07:50 AM

re: Sphincteroplasty Surgery
Hey girls!
Hang in there Jou Jou! You sound like you are on track and I can't believe it has already been two weeks. I am praying for you and just keep thinking of the life you will have this summer. I will need you this summer when I have my surgery.

Uggh, I am so nervous and was starting to rethink it more. But I am determined to go through with it. I tried to go walking at the mall with my husband this weekend and I kept thinking my son had an accident because I was smelling something. I kept checking his diaper and nothing. When i went to the bathroom, I realized it was me! Oh how horrible I felt. After this weekend, I was so mad that I am going through with the surgery. Not being able to walk around the mall with my family was so depressing. We had to leave so I could go home and clean up. I can't wait to get past it all!

JJ and Kelley,
What are stairs like for you both? When i get home from surgery, I have about 15 stairs to walk up in my house. My husband was asking me how we are going to get me upstairs? Will I be able to walk up them slowly after one week? Should I consider staying in our downstairs guest room for a few weeks? What were/is your experiences?

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