Posts by Jason Vaughn482

darkbear14 said:It was quite a situation; I was dealing with a massive, deep fissure alongside hemorrhoids, which is what Dr. Smith diagnosed... the pain was nothing short of agonizing, to the point where I was practically counting down the minutes until surgery. Honestly, I didn't even care whether they administered anesthesia or not; the torment was so relentless that I felt I could have endured Dr. Smith performing the procedure while I was wide awake...
The operation itself is surprisingly brief, largely because I noticed the surgeon is exceptionally skilled and precise. Before they begin, you receive an injection locally and they apply a topical anesthetic to the area... the cauterization process isn't painful; you simply feel a gentle sensation of warmth. According to the doctor, the radiofrequency device he uses operates at a lower temperature specifically to prevent tissue damage... it essentially just smooths out the fissure. Post-op, you’ll be applying a cream he prescribes, though I should warn you that for a little while, there is some discharge—which you'll manage with a pad worn 24 hours a day. You’ll head to the restroom immediately after, and that sharp stinging sensation in the wound subsides. He also performs an anal dilation to stimulate the muscle and improve blood flow (mine had become incredibly constricted due to the sheer intensity of the fissure pain)... My impression is that he is an incredibly cautious and conscientious surgeon, and his rates are quite reasonable. There is always a queue at his clinic, because word travels fast when a professional does good work. As for my recovery, I’m already back to enjoying grilled meats, though I remain cautious with cured meats like prosciutto because of the hemorrhoids... the total cost for both the hemorrhoid and fissure surgery was $1167... and, naturally, as a preventative measure, I drink a glass of milk every morning. Best of luck.

Thanks for the reply. Did you experience much pain following the procedure, and if so, how intense was it? Also, what kind of examination did he perform beforehand—was it a rectoscopy or something else? And that anesthetic injection—is it excruciatingly painful, or does the topical numbing help mitigate it? I ask because the prospect of pain is genuinely daunting. Regarding the anal dilation, is it absolutely necessary? I've heard there can be side effects from that too. Furthermore, was the cauterization specifically for the fissure, or for the hemorrhoids, since you mentioned treating both? Do you get to go home the same day, and what is the follow-up process like? I need to gather all this information since I am not originally from New York City. Thanks.

Karen Thompson10 said:I would strongly advise you to arrive at your consultation fully prepared; go in knowing exactly what questions you intend to pose and insist upon clear, direct answers—that level of scrutiny was ultimately what allowed me to select my physician.
Furthermore, lean into your intuition; a doctor must be someone who instills an immediate sense of trust.
In my case, I chose to be incredibly blunt with my inquiries, even touching upon topics that felt slightly uncomfortable due to my own anxiety; I didn't hesitate to ask the doctor his candid opinion regarding the methods used by other specialists and why he believed his specific approach was superior.
One practitioner was exceptionally patient, meticulous, and provided concrete, honest responses, whereas the other attempted to obfuscate the facts—one can detect such evasiveness almost instantly.
Consequently, when speaking with Phil, demand a granular description of the exact procedure, inquire about potential long-term consequences, understand the rationale behind choosing this specific path over others, and then proceed to question him about every alternative method you have encountered.

I believe her mother picked it up at a standard local pharmacy; it should be readily available anywhere.

And honestly, I was trembling with fear and felt a desperate urge to flee the medical clinic when I arrived at 😁, but I understood that facing this was a necessity.
Afterward, I felt a certain sense of pride in my own strength and couldn't quite fathom why I had caused myself such immense distress.
We are talking about surgery involving general anesthesia, and the area being treated is... let's just say sensitive, so a certain degree of embarrassment is naturally present in most people.
For me, this forum was an invaluable lifeline; realizing that I wasn't navigating this ordeal in isolation and seeing that others faced similar struggles provided much-needed solace.
At one point, I truly felt as though I were the only person on the planet suffering from this "shameful" condition. But frankly, people face life-threatening illnesses every day; there is really no need to overcomplicate matters here.

You will get through this, and eventually, you'll look back and laugh at the whole ordeal! 😉

I stayed at the clinic for a single day, meaning I spent one night there. That falls under the category of minor procedures, and I suspect one might even be sent home immediately, but staying overnight is often required as a precautionary measure.

I am so incredibly grateful to have "met" you like this out of the blue; I feel a genuine sense of relief, which means so much—the support and everything you've shared... I will certainly take your advice to heart. For now, my priority is returning to the hospital for a follow-up; I actually fled last time because they wanted to perform a rectoscopy, so I plan to ask the doctor every single thing on my mind. Until then, I’ll try sticking to a diet and using some creams... this likely stemmed from my regular use of laxatives because I struggle with chronic constipation. And even now, I can't stop, because if I miss a day without a bowel movement, I lose my mind; it causes such discomfort, though perhaps I am mistaken.

How long did you end up staying at the hospital? Or rather, how long were you confined to that specific facility where you were being treated?

Karen Thompson10 said:Look, if it means the whole ordeal is finally over, I truly believe those three days of post-op pain are worth every second. My best advice to you is to stop obsessing over the recovery period and the inevitable discomfort; you’re just torturing yourself mentally, and frankly, it serves no purpose.
The absolute priority is selecting a top-tier procedure and a surgeon you can actually trust; once that’s settled, try to push those "what-if" post-operative thoughts out of your head.
Admittedly, those first three days were more intense than the entire month and a half leading up to it, but when I woke up on the fourth day, I felt zero regret because the pain was gone for good.

In all my experience, I have never heard of anyone suffering such catastrophic complications—it's incredibly rare, though I won't pretend the risk doesn't exist.
I understand your fear completely; I was absolutely terrified myself, but listen... everyone will tell you the same thing: once you’ve lived through it, you realize it wasn't nearly as monstrous as you imagined.

I stayed on a strict diet, sticking to very light, clean foods, but my biggest mistake was applying Facto directly to the area.
My doctor at Merkur advised me to use Pavlovic cream, which I only applied for a few days before the surgery date arrived.
Try washing with warm water; while heat isn't ideal for hemorrhoids generally, it helps relax the sphincter, which significantly dulls the pain from a fissure.

Let me know what Dr. Phil tells you; I am genuinely curious, as I have a hunch his approach might be the right way to go.

I did, and I walked into the second doctor's office with the mindset that I didn't need surgery at all—I just wanted him to prescribe nitroglycerin ointment, thinking that would be my silver bullet.
Mhm, that stuff only works for a little while, maybe the first two weeks, until the fissure turns chronic; after that, it becomes utterly useless.

I am keeping my fingers crossed that things settle down for you; I truly feel for you...

Dr. Phil was completely MIA for an entire month (I even tried calling his cell), and even then, he wouldn't explain the specifics—he just told me to come in for an exam. Honestly, all these exams are becoming so infuriating because they are uncomfortable and painful, yet nobody takes the time to actually walk you through the surgical process or any of the details. That's why I'm so grateful I stumbled upon you here; it seems people with this specific issue are hard to find. Tell me, where did you pick up that Pavlovic cream? I might give it a shot. Regardless, you're right—you shouldn't overthink it. It’s much like how I used to console people who had to undergo gallbladder surgery; since I went through it myself, I always felt I could say, "Hey, I did it, so you can too." I felt quite proud of myself afterward, haha! But now that I'm facing something unknown and hearing all these horror stories, I can't help but feel uneasy.

Sophia Brooks50 said:You really are a kind soul; I spent some time yesterday wading through your older comments, and they provided a bit of much-needed solace. Knowing you didn't have to endure a rectoscopy and that general anesthesia is an option makes things feel slightly more manageable. My primary anxiety now lies with the aftermath—the lingering pain and the specter of potential complications. Has anyone actually experienced that later incontinence? It sounds utterly harrowing. To give you some context, my doctor at the hospital performed a digital exam earlier, which was fine until he applied sudden, intense pressure to the area, and then it was all downhill from there. He suggested a rectoscopy, but I was too rattled to go back, so I sought a private opinion instead. The specialist mentioned an anoscopy, but seeing how visibly I was trembling from fear, he offered to administer an injection first—though I must admit, those one or two stabs were quite painful. I did undergo a colonoscopy under anesthesia last year, which went smoothly enough, though it confirmed the presence of hemorrhoids and a fissure. For now, the hemorrhoids are dormant, and I’m content to leave them be, while I attempt to endure this fissure a little longer before making a final decision this autumn—despite the overwhelming dread. Currently, I am sticking to pediatric ointments, a strict diet, and chamomile baths. Is that the regimen you followed? Or perhaps there is a specific cream I’ve overlooked? Thank you truly for your help thus far. Next week, I intend to call Dr. Phil in the city to get a clear explanation of what cauterization actually entails. This private specialist mentioned something about incisions and cauterizing, suggesting the subsequent pain shouldn't be too severe, but I simply cannot afford $2333 so I am left in limbo. Meanwhile, a practitioner over on Chicago Street keeps pushing dilation, yet I’ve read accounts similar to what we discussed regarding incontinence, and Dr. Bagatin doesn't even recommend surgery, opting instead for nitroglycerin ointment. Have you ever heard of that approach?

Anyway, I shall just try to keep my fingers crossed that this settles down somewhat...

And if you don't mind a potentially foolish question: did the recovery period immediately following the surgery—those first three days—actually hurt more than the subsequent month and a half?

Karen Thompson10 said:Don't mention it! 🙂
Just ask whatever is on your mind. You should probably comb through my earliest posts because I think I laid out my entire ordeal in quite a bit of detail there.
They didn't tell me whether it was shallow or deep, so I couldn't possibly say, but if they felt the need to hand you an anesthetic just for a basic exam, then I’d venture to guess your pain threshold is unfortunately quite low, too.

I went through my examination with an anoscope without any numbing at all, but the aftermath was absolutely agonizing.
I can't tell you if your doctor gave you bad advice—I'm hardly a medical professional—but I can tell you what two different doctors told me.
Whatever you do, stay away from using hemorrhoid creams on a fissure, especially not anything like Faktu, because it just makes the condition worse and intensifies the pain.

They didn't perform a rectoscopy on me.
I had mine done under general anesthesia; I was in the operating room for about an hour and a half, but they were performing two procedures simultaneously, so yours will surely be quicker.
Yes, if it has been lasting that long, then it has definitely become chronic. I know you're terrified and everything, but I have to tell you: once you get through the recovery after surgery, you start seeing everything in a completely different light. Once all that pain vanishes and you can finally return to your daily life without that constant fear of being struck by agony, your psyche begins to heal.

My bowel movements are back to normal now, and I actually had them returning as early as a week after the surgery. I didn't even have to get the stitches removed; they just dissolved on their own and didn't cause any pain whatsoever.

You really are kind; I spent yesterday reading through your old comments and things are a little clearer now. It comforted me a bit to hear that they didn't do a rectoscopy on you and that general anesthesia was used—that sounds much more manageable for me. My only real fears now are the post-op pain and potential complications. I mean, has anyone actually dealt with incontinence later on? That sounds horrific. The doctor gave me an injection because I had been at the hospital earlier where he only checked me with his finger; it wasn't even painful until the moment he applied heavy pressure right on the spot. Then he suggested a rectoscopy, but I didn't go through with it; instead, I went to see someone privately to see what they would say. He suggested an anoscopy, but when he saw how much I was shaking from sheer terror, he said he'd give me an injection, and honestly, those one or two stabs hurt like hell... anyway, I had a colonoscopy last year under anesthesia and that went fine, aside from the hemorrhoids and the fissure. The hemorrhoids are dormant for now, so I don't plan on touching them, and I'll just endure this fissure a little longer before making a decision this fall, even though I am soooo scared. For now, I'm starting on some pediatric ointment, a strict diet, and chamomile baths... did you do the same thing? Maybe there's a cream I don't know about? Thank you so much for everything so far. Next week, I'm calling Dr. Phil in Chicago to find out more about cauterization, though my private doctor mentioned something about cutting and burning, claiming it shouldn't hurt too much afterward, but I simply cannot face $2333 so I'm stuck. Meanwhile, a specialist over at the local clinic keeps pushing dilation, but I read that it causes the same incontinence issues I mentioned, and apparently, Dr. Bagatin doesn't even recommend surgery, suggesting nitroglycerin ointment instead—have you heard of that?

Anyway, I'll just sit here and pray that things calm down a bit...

I suppose I’ll go ahead and address him as Dr. Phil as well... I find myself wondering, though, what exactly does this process of cauterization entail?

Karen Thompson10 said:For me, the intense pain lasted for three full days, though I was fortunate enough to be prescribed medication that actually provided some relief.
And look, I can't help but wonder if I was just a statistical outlier—perhaps I’m simply a "mimosa" with an incredibly low pain threshold, which is why it hit me so hard.
You mention experiencing nothing more than a stinging sensation, whereas I was practically incapacitated.
The reason I bring this up is to suggest that someone else might not endure such agony following the procedure; my experience might not be the universal standard.

Everything seemed to settle down perfectly about a week after the surgery. Generally speaking, a fissure requires four to five weeks to heal completely, but the acute pain usually subsides just a few days post-op, and then you're on the mend.

I dealt with my fissure for about a month and a half, but I mistakenly assumed the pain was coming from hemorrhoids, so I kept applying hemorrhoid creams. My doctor later informed me that I was actually making the situation worse by doing that.
I am not entirely sure what you are using for topical relief, but both of my doctors insisted on nothing more than a mild soothing cream—the kind used for infants—with the strict warning that the area must be properly treated and that one should absolutely avoid anything aggressive.

It is important to understand that dilation and cauterization are two distinct procedures.
To be perfectly honest, my medical knowledge on the subject is limited. When the doctor first described the dilation process to me, I felt a wave of pure dread wash over me; I had no idea it carried its own set of consequences.

Ultimately, it seems every surgical intervention carries its own price.
I opted for a private specialist, but the surgeon noted that they perform the exact same procedures at the public hospital and left the choice to me, insisting there was no functional difference.
The only real drawback with the hospital was the grueling wait time, and frankly, I simply couldn't endure the waiting any longer.

If you are heading toward surgery, please try to track down a highly skilled and experienced surgeon...

Best of luck! 😉

First of all, thank you so much for responding. I’ve been searching for months for anyone who has undergone this surgery, but I haven't found anyone, so if you don't mind, I’m going to pick your brain a little more. I also have a very low pain threshold and have been struggling for six months now; however, my diagnosis is a shallow fissure (type 2), so perhaps my pain will be less severe. When I visited a private specialist, he had to perform an anoscopy using two anesthetic injections, and I ended up screaming from the pain—though, truth be told, it was the injections themselves that hurt, not the exam. You see, I think he might have misdiagnosed me; I’ve been using hemorrhoid cream, and maybe that’s why I’m not healing. The hospital staff suggested a baby cream or Pantexol, so I think I’ll go back to that. Did they perform a rectoscopy on you before your surgery? I am terrified of that, especially while the fissure is still so painful. Also, did you undergo the operation under local or general anesthesia, and how long does it typically take? I know I'm asking a thousand questions, but I am honestly losing my mind here. This actually started last year, flared up again two months later, and now it's been ongoing for six months—it has become chronic. Now that some time has passed since your surgery, is your bowel movement back to normal? Is everything okay now, and did you have to have stitches removed, or did they just dissolve on their own?

Karen Thompson10 said:Are you referring to a lateral sphincterotomy?
I recall a fellow member mentioning here that certain surgeons advised against it, citing potential fallout from the procedure.
Now, I haven't been able to unearth much substantial data or hard statistics online, but the most harrowing complications seem to involve a loss of control over gas and bowel movements following surgery.
Is that enough information for you?

Look, my pain was so debilitating that my capacity for rational thought practically evaporated; if they had told me they needed to amputate my arm just to stop the agony, I probably would have said yes—hyperbole aside, of course.
In my case, everything turned out perfectly, truly couldn't have been better, but there is always that nagging "what if" lurking in the back of your mind.
I've seen more severe cases discussed on this forum, and it wouldn't have been a stretch to think the same thing could have happened to me.

If I were faced with this choice again, I would seek a consultation with Dr. Phil to get a precise explanation of what cauterization with an RF device actually entails, because the internet is frustratingly sparse on details regarding this specific method.
My final decision would hinge entirely on his clinical insight.

As for the DG HAL, I wouldn't hesitate to do it all over again; I am quite satisfied with those results. However, I wouldn't take such risks anymore unless absolutely necessary, naturally.

Yes, I’ve heard about those consequences and honestly, the thought terrifies me—not to mention the post-op pain. How long does that actually last, and can you manage it with medication? Is everything okay for you now? How long have you been dealing with this fissure? I'm at the six-month mark now, though it isn't sharp pain so much as a constant, irritating burning sensation. I have two shallow ones and I'm slathering every cream imaginable on them; do you have any specific recommendations? On Dr. Phil's website, it mentions dilation and cauterization, which might be done together, but I also read that dilation carries a risk of incontinence. Now I'm stuck—I live in Rijeka and we don't really have many options here besides what you did. Did you go through a private clinic or a hospital?

Karen Thompson10 said:There are also Botox injections that can be administered near the fissure to relax the entire area, allowing the wound to heal. You’d need several rounds, spaced about two weeks apart, and let me tell you, they are painful—though technically non-invasive and without permanent risks. The catch? They are obscenely expensive, and there is a very high chance the fissure will just crawl right back.

Lateral sphincterotomy is an invasive procedure—essentially a minor surgery—where a small or larger incision is made above the fissure to relax the sphincter tone, which allows the wound to gradually mend itself. It takes about four to five weeks to fully heal, though the intense pain usually subsides about a week after the operation. I won't sugarcoat it: for those first three days, I felt like screaming from the agony, but once that window passed, the pain vanished completely. Now, because this is an invasive surgery, there are numerous potential complications to weigh; if you decide to go this route, you absolutely must find a top-tier surgeon. I rushed into my procedure quite abruptly without fully grasping the potential fallout, which is why I jumped in when I did. Honestly, looking back at some of the stories shared on this forum, I’m not entirely sure I would make the same choice again. I think I was simply lucky.

Then there is anal dilation... another user might have experience with that, so it might be wise to reach out to them directly. It is essentially a less intensive procedure than a sphincterotomy, but I don't know the finer details. One thing strikes me as odd, though: why didn't your doctor offer local anesthesia to manage the pain? Is that even an option for this? And is it a "one and done" situation, or is it something you have to repeat indefinitely? If it's a single session, it might actually be worth the effort. Just make sure to ask about the possible side effects beforehand.

A bit of advice: seek out multiple doctors. Yes, everyone will push their own specific methodology, but eventually, you'll encounter one who actually inspires confidence...
Good luck! 🙂

Please, tell me what exactly you read on the forum and what kind of complications we're talking about... I'm terrified of having surgery myself, but I've been dealing with this for six months now and I'm reaching my breaking point.

darkbear14 said:Greetings. I recently underwent surgery to address both hemorrhoids and a fissure under the care of Dr. Phil, and I must say, the recovery process is proceeding quite smoothly. The hemorrhoids were managed via ligation, while the fissure was treated using RF cauterization. That persistent, agonizing burning sensation from the fissure has finally vanished, and with each passing day, things feel increasingly more normalized. I am optimistic that this healing journey will continue on this positive trajectory, and once the full recovery process has reached its conclusion, I shall certainly return to share my comprehensive observations...

Hey, would you mind telling me exactly what this cauterization procedure entails? Does it actually hurt? I’m looking for a clinic recommendation as well, because I’m currently battling the exact same issue—that dreaded fissure. Please, if you could walk me through the details, I would truly appreciate it.

Karen Thompson10 said:Dennis White43, if there is any solace to be found in my words, it’s this: I am only 24 years old, yet I still found myself facing surgery after battling hemorrhoids for several years now.
In my experience, it is purely a matter of genetics; besides, from what I gather, an increasing number of young people are being plagued by these very same issues.
The examination itself isn't nearly as terrifying as the rumors suggest, nor is the surgery; the recovery process afterward simply depends on the specifics of your particular situation. It is nothing one cannot endure. Honestly, I believe you have made the absolute right call by scheduling that doctor's visit, because if I could turn back the clock, I would have sought help much, much sooner.
The true nightmare is when complications begin to arise.
Do not let fear take hold; first, listen intently to what your doctor has to say. If you aren't experiencing excruciating pain, you might not even be a "severe case," which would make your recovery far more manageable. As for postoperative complications, they are remarkably rare—at least, that is what I was told.
Wishing you the best of luck; there truly is nothing to fear! 🙂

Hey, I'm dealing with a fissure myself, but they're sending me in for a sigmoidoscopy. Did you have to go through that exam first, or did they jump straight to surgery?