Report on First poop after LIS (lateral Internal Sphincterectomy and Fissureotomy):

Questions are dribbling in, asking how I am doing and I dribble out responses, and after a while, I forget to whom I told what, so I am writing ONE report now.

It’s still less than 72 hours since my LIS surgery. Less than 3 days, and considering how long I was told it would take for me to recover, I would appreciate some patience in your expectations for me. (It actually makes me sad when your hopefulness is out of line with reality, and I feel as if I have failed you or that I am bad or incompetent at healing or something.) On the other hand, healing energy, loving thoughts and prayers are all appreciated very much. What I prefer is a realistic (not pessimistic) approach. And stories and anecdotes from YOUR LIFE to that all my attention is not focused on the surgery site.

I was feeling significantly better (improved) earlier today, better than yesterday which was better than the day before, AND better than before the surgery. NOT WELL, mind you. I still had pain and felt “delicate” there, at the surgery site. I was unable to do my exercises or walk far.

All that has changed now, and I feel worse again.

The reason I feel worse is that I have pooped now, twice. Pooping was not only very painful during the course of evacuation, but for hours afterwards. I am trying to avoid taking the heavy-duty painkillers, since they cause constipation, but I may have to break down and do so. So far, I have only had ibuprofen for the last 3 days, counting today.

So currently, I am still bleeding and I am having an unpleasant and beyond uncomfortable amount of pain. I also slept very poorly and am exhausted. Worse yet, I feel as if there is more poop waiting to descend. I may have to give up and take the Tylenol 3 with codeine.

Just about 72 hours from right now, I was finally entering surgery after a LONG LONG WAIT.

Questions for Dr. Barbe

Anal Fissure Again:  L

After being free of anal fissures since I last saw you, I contracted, in the last week or so of March, an intestinal “bug” that caused fairly severe diarrhea (“squirt poops”).  My husband Keith also had diarrhea at the same time.  I had six days of diarrhea and my butt was getting sore.  I’d been avoiding taking anything for the diarrhea for fear it would cause constipation, but after about 5 days, I decided to try Pepto Bismo—in small doses.  I took a half dose after several attacks of diarrhea and the next thing that happened was terrible constipation and an anal fissure.

Anal Fissure Questions:

Ø  What dose of Canasa?  I am currently taking 1000 mg as prescribed by Dr. Beeai.  It is NOT working.  It improved from the beginning, but there has been NO FURTHER IMPROVEMENT and I have been on it for 18 days.

Ø  Am I doing something wrong, or not doing something right?

Ø  (Why did it work last time but seems to be not working this time?)

Ø  Dr. Beeai said not to push or strain when defecating, but IF I do NOT the feces come into the rectum, stall there, and do not come out.  They just stay there hurting, and eventually, they retract back in.  This happens over and over multiple times until I find myself inadvertently pushing even though I’m not supposed to.  L

Ø  Should I be taking a stool softener?  If so, what kind?  What about bran?  The stool softener Dr. Beeai recommended seems to give me a bellyache.  (This bellyache happened twice, but has stopped now. ) (Even flatulence hurts, and there isn’t anything much softer than gas.)

Ø  Is bran hurtful or helpful?  If hurtful, how do I wean myself off it without causing severe constipation?  I started taking it after the last event to keep the stools soft for fear of causing another anal fissure.

Ø  What should I do to properly care for my anus, rectum etc and promote healing?  What regimen should I follow?  Do you have a sheet of recommendations to follow?

Ø  Should I use any other suppositories during the day such as Preparation H?  Would it assist healing or impede it? I have been, but don’t know if I should.

Ø  What about externally?  Prep H, an anesthetic ointment, diaper rash ointment? Would it assist healing or impede it?  I tried using it, and then stopped, not knowing what to do. It seems to burn, as does the Lidocaine ointment, which I do NOT use (because it increases pain).

Ø  Should I use a sitz bath? (Dr. Beeai recommended I do this, and I have been).  A hot pad?  If so, for how long and how often?

Ø  What about painkillers?  Ibuprofen?  Acetaminophen? Or?  I’ve been taking Ibuprofen. 

Ø  Is there any way to prevent this from happening again?

Ø  I read that one should not ignore the urge to defecate.  I read that that doing so can cause constipation over the long-term.  But since I’ve had this anal fissure, I feel like I have to defecate all day long.  Then, when I get on the toilet, either nothing happens or only a little comes out.  So I find myself sometimes ignoring it (since I’ve had this anal fissure) so that I am not on the toilet all the time.  L  (I do not normally have a problem with any of this when there is no anal fissure.)

Note to self later:  The doctor did not even glance at this.  NEXT TIME, if there is a next time (I hope there isn't), make a brief outline of trigger words for myself.

Butt Report 4-23-13

I walked to the library yesterday, after five in the afternoon.  I only pooped once yesterday, early in the morning, and by 5, the pain, while still present, had subsided to the point where I could walk, with two ibuprofens.  (The day before, I pooped 3 times--awful! )  (It felt as if someone was pinching me--hard-down there-with every step.)  When I got there, I sat on the wall in the sun and the heat of the sun-warmed wall soothed my butt for the walk home.

Keith is fasting today for his colonoscopy tomorrow mornings and I am worrying terribly about the pain of my being there--I am required to be there.  My mornings are torture.

Today I am going to the specialist--it is NOT the same doctor I went to 2 1/2 weeks ago.  That doctor, my GP, gave me NO instructions, other than to take the suppositories and a stool softener.  She said to take them for 15 days unless I had a relapse--I'm still taking them--I didn't have a relapse because I didn't get better.  OH, and she also said not to push when I defecate.  Impossible.  If I feel a poop coming on, and sit on the toilet, it moves into my rectum, which hurts like mad, and then hangs out there.  It sits there and sits and there and sits there and doesn't come out until suddenly I can't help pushing.  I've really tried hard not to push, but it NEVER works.  The poop won't come until I do.  I've tried waiting 15 or 20 minutes.  If I wait too long, it retracts back up inside and then 5 minutes later, I have to go again.  Meanwhile, I had 20 minutes of pain.  I have pain all day, but the pain of pooping is worse, a lot worse.

But I have a whole BUNCH of additional questions.  I am wondering, for example, of the GP gave me the same DOSAGE as Barbe gave me last time (2 1/2 years ago, or whenever it was.) 

This is painful, I am sitting on a heating pad which only partly relieves the pain.  For the ten minutes after I pooped, I was crying.

But THAT last time was worse, verging on unbearable.  JUST terrible pain.  I don't want to go there again.

The Red-hot Poker

The red-hot poker
This is not my image.
I got is here.

OK, I admit, it is a BIT of an exaggeration.  But I couldn't find a red-hot poker at the exact correct degree of heat.  So, imagine jamming that thing up your butt.  (Only not QUITE that hot!  (HOT, but not THAT hot!))  That will give you an idea of what an anal fissure feels like--to me.  Especially while pooping and for a good hour afterwards.

I had a perfect exercise day yesterday--though I was in so much pain that it took all day to get the exercises done. I did get a little extra walking in, but not a lot. Today I lept up and did the exercises as fast as I could before I pooped.

I had just barely got them done when I pooped. My pain and bleeding was worse than yesterday, which was worse than the day before. I sat in the tub for 42 minutes and had to leap dripping out to poop a second time.

I am embarrassed to say that I howled so loud from the pain I was afraid someone would call the cops.

(I am really ANGRY at that receptionist who not only wouldn't let me come in to see Barbe, but also wouldn't even lat me talk to him on the phone.)

Then I sat in the tub again, and now I am sitting on the heating pad. I took two acetaminophens. NOTE, in case I haven't previously mentioned it, you can't take codeine-based pain pills--they worsen the problem.  (Something is worsening MY problem even though I am NOT taking codeine-based pain relievers.)

Keith is at work. He, ironically, has a colonoscopy scheduled for April 24 with Dr. Barbe (My proctologist). He is now on a special preparatory diet. He is pleased because he can have mac and cheese and beer for three days, then beer the day before the event. I am worried because I have to take him for the procedure in the morning when my pain is at its worst, and when I may have to poop without access to a tub etc. I don't want to be sitting there screaming and howling in pain. I do not want to be without access to something that helps soothe the pain.

First and most important, I want to heal from this terrible pain. I hope on Tuesday at 2:30, Dr. Barbe will be able to help me.

Red-hot Poker Plant
This is not my image.
I got it here.
THEY got it here.

When I was looking for an image of a red-hot poker (a real poker), I kept finding instead the red-hot poker flower.  Unlike reporters from the Miami New Times, I DID know there was such a flower.  This plant is pretty, but does not have the power to evoke the pain I am experiencing.  My pain is somewhere between the image above and this.  Maybe halfway between, or slightly more toward the actual poker.

Not and not, "A Tear, not a Fissure"

This is about my walk back from the doctor this noon.  And what the doctor said about my "pain in the butt."  It is also about attempting to use the iPad to type on while walking.

I am walking down Kercheval with iOla after seeing Beeai about my “bottom” (anus and rectum).  I was also trying to carry a bag and separately, loose papers, prescriptions and appointment cards while typing on iOla.  That wasn't working.  However, I now how the papers in the bag and the bag over my shoulder and am trying to type with iOla in landscape,  I can see the test slightly better this way, but the keyboard is so large it is hard to reach the center keys. I have to suspend the iPad from my bent fingers and this could get quite tiresome.

Dr. Beeai said that I do not have hemorrhoids.  She said this as if it were a good thing.  I also do not have an actual anal fissures, which is also a good thing,  I guess, from her attitude.  What I do have is "a tear in the anus and rectum, an injury from a too large, too hard poop.  This takes time to heal and it is essential not to allow constipation to occur again," she says.  Does she think I want to be constipated?  That I choose to be?  No, she simply wants me to take extra precautions.

She gave me two prescription, but I could only get ONE of them filled at the Kerchival pharmacy.  So I have to drive CVS and leave the other one and go back for it, probably.

Meanwhile, this has taken the whole morning and will take more time before it is over.  And I am supposed to be packing for trip.  K told Sam and Joan that we do this every time.  We are often, but not always late, but I almost always start like week ahead planning and making various preparations, shopping, etc.  The fact that K himself does little until the last minutes doesn't mean WE "always wait until the last minute." I was sad that he would say that; it means he doesn't notice or appreciate or care about the effort I put into shopping and preparation, and doesn’t care if Sam and Joan think I’m a lazy piece of shit. This time, I have NOT done much because I was NOT sure we were even going or how long we'd be gone and I’ve been VERY under the weather.

Keith is wrong about the fact that we "never" do anything to get ready, that it's always like this.  We are often later and slower leaving than we ought to be, or than we want to be, but this time it's much worse.  MUCH WORSE, as I've been unable to do much of anything.  And yes, normally, I would have shopped once for staples and once for perishables by now, and had them all organized.  Grr, Keith.  You mean bad man-- you make me feel bad.  I feel unloved when you say things like that.
Keith was right, though, about Lidocaine ointment.  I didn't like the idea of it, but Dr. Beeai prescribed it.  so it put some on--but it only helps on the OUTSIDE, and it also hurts on the INside.  she gave me some suppositories which I’ve been afraid to try.  I’m afraid they will hurt going in.  But--I guess I will try them--now.

            I am back at my car—I drove halfway there and walked the rest of the way—I wanted to walk the WHOLE way, but I didn’t have time from the time I called to the available time slot.  And I was able to write this on the iPad, iOla.  It was a little slower but might improve as I get used to it.  In many ways, I like the Psion better.  But LOOK, I downloaded this—with a bit of effort—to Leo and will be able to print it.  It SHOULD be easier.  But since the Psion’s software won’t download on Leo, I guess it is better than nothing.  I’m still not sure how well it will all work, but hey--