So I went in for my follow up visit with my surgeon from my dilation under anesthesia almost a month ago. He checked with his finger to see how everything turned out and apparently the stricture is forming again. The tool that he showed me last time that he gave me the option whether to use it in the office or under anesthesia I did not get a choice this time around. He wrapped it in a rubber glove put some KY Jelly on it and had me hold onto the end with him and insert it. I couldn't really master the art because I was scared of the terrible pain I was about to endure so he took over and stuck that bad boy in deep. He left it there for about a minute or so and then slid it out. He then told me it was going to be my new best friend and at that point I was a little concerned. So I got a script to pick up a Hegar 18mm Dilator. I asked him how often I have to do this and he told me everyday I'm the beginning. Wow this seemed a little extreme to me. Then he told me as things get better I could start to do it every other day then every week then hopefully the scar tissue will eventually stay stretched out where I will no longer have to do it anymore. Has anyone had to self dilate this often? I'm returning to work on Tuesday and am on my feet all day at work walking around how am I going to manage this after ramming this rod up my butt every night? For those that have done this have you really had to do it that often? Does it get any easier as time goes on because the first time around was definitely not pleasant? Thanks.
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Well, if you think of it this way, perhaps it is a little less barbaric sounding:
When you self-dilate at home after an office dilation, all you are really doing is maintaining the stretched opening your surgeon created with the office dilation. Doing it daily prevents the stricture from reforming. Not exactly the same, but consider it similar to keeping those studs in when you get your ears pierced. If you left them out, the piercing would close.
When you go in for the occasional dilation by your surgeon, it is a "real" dilation, each and every time. It is stretching the tissue and beaking up the scar. Much more traumatic by comparison, than the maintenance home dilation.
Jan
When you self-dilate at home after an office dilation, all you are really doing is maintaining the stretched opening your surgeon created with the office dilation. Doing it daily prevents the stricture from reforming. Not exactly the same, but consider it similar to keeping those studs in when you get your ears pierced. If you left them out, the piercing would close.
When you go in for the occasional dilation by your surgeon, it is a "real" dilation, each and every time. It is stretching the tissue and beaking up the scar. Much more traumatic by comparison, than the maintenance home dilation.
Jan
I assume your doctor told you how much he dilated. 10mm, 12mm... or the size of his second knuckle..... something, right?
IF you place your finger in your anal canal until it presses against the stricture opening, then place your thumb on your finger at your anus opening, that will tell you how far in your stricture is.
With those two dimensions, you can translate that to a candle. find the point on a candle where it is the thickness of the doctor's dilation, measure back and melt a wax ring around an inch farther back than the spot where your anus opening should be. Lastly, make sure there is only an inch or so past the point where the candle is at the proper width, and whittle that down to a dull rounded point. Not so sharp that it could possible puncture anything, but narrow enough to enter the stricture when it is narrowed. This will prevent you from inserting a sharp thing too far into your pouch. There should be more than enough candle outside your rectum that there is no danger of it all slipping in.
Then, with your fingers or thumb touching the ring you created, begin to insert it slowly until the ring reaches your anus opening. That will tell you it has been inserted far enough. But you should feel it pass through the stricture and the stretching as a slight discomfort. Never force it. Let your anal canal gently guide it to the pouch opening. You could puncture your anal canal if you rush and it is placed in the wrong spot.
Some people prefer to do this on their hands and knees. Others on their side with a one leg lifted up. Whatever position makes you feel comfortable and gives you the best and most relaxed access. I even know someone whose doctor taught their partner how do do it digitally. I wouldn't count on many doctors being that open-minded, but it might be worth asking if you trust your significant other.
None of the above is professional medical advise, because I'm not a doctor or a nurse. Just someone who has tried it and it worked (although in my case, the tissue was so excoriated and sensitive that it was usually too painful and my only choice was under full anesthesia.)
There are also dilation devices intended for dilating women in pregnancy. The sets consist of increasingly thicker slightly curved, round rods made of smooth plastic or metal. You can actually buy them new on the internet.
Many people practice self-dilation. I think doctors are hesitant to recommend it. I know my old doctor who retired at first said absolutely not.... then after a while, after we got to know each other, he was suggesting it, describing how to do it safely, and telling me he had several patients who did it very well on a regular basis.
i think this is something that may SOUND dramatic, but once you do it a couple of times, it becomes a regular, unremarkable procedure that you can do easily.
It is 3am as I write this, so I reserve the right to come back and edit any glaring omissions.
.
IF you place your finger in your anal canal until it presses against the stricture opening, then place your thumb on your finger at your anus opening, that will tell you how far in your stricture is.
With those two dimensions, you can translate that to a candle. find the point on a candle where it is the thickness of the doctor's dilation, measure back and melt a wax ring around an inch farther back than the spot where your anus opening should be. Lastly, make sure there is only an inch or so past the point where the candle is at the proper width, and whittle that down to a dull rounded point. Not so sharp that it could possible puncture anything, but narrow enough to enter the stricture when it is narrowed. This will prevent you from inserting a sharp thing too far into your pouch. There should be more than enough candle outside your rectum that there is no danger of it all slipping in.
Then, with your fingers or thumb touching the ring you created, begin to insert it slowly until the ring reaches your anus opening. That will tell you it has been inserted far enough. But you should feel it pass through the stricture and the stretching as a slight discomfort. Never force it. Let your anal canal gently guide it to the pouch opening. You could puncture your anal canal if you rush and it is placed in the wrong spot.
Some people prefer to do this on their hands and knees. Others on their side with a one leg lifted up. Whatever position makes you feel comfortable and gives you the best and most relaxed access. I even know someone whose doctor taught their partner how do do it digitally. I wouldn't count on many doctors being that open-minded, but it might be worth asking if you trust your significant other.
None of the above is professional medical advise, because I'm not a doctor or a nurse. Just someone who has tried it and it worked (although in my case, the tissue was so excoriated and sensitive that it was usually too painful and my only choice was under full anesthesia.)
There are also dilation devices intended for dilating women in pregnancy. The sets consist of increasingly thicker slightly curved, round rods made of smooth plastic or metal. You can actually buy them new on the internet.
Many people practice self-dilation. I think doctors are hesitant to recommend it. I know my old doctor who retired at first said absolutely not.... then after a while, after we got to know each other, he was suggesting it, describing how to do it safely, and telling me he had several patients who did it very well on a regular basis.
i think this is something that may SOUND dramatic, but once you do it a couple of times, it becomes a regular, unremarkable procedure that you can do easily.
It is 3am as I write this, so I reserve the right to come back and edit any glaring omissions.
.
Jan
Great analogy. For those brave enough to self dilate, I applaud you. I happen to cringe at the thought but I also live 20 minutes from a very qualified GI doctor who has been successfully treating mine. I know others have a farther travel and it is sn inconvenience to schedule this procedure every six months, although my last dilation has been the most successful thus far. Good luck. There has been some great advice offered here.
Great analogy. For those brave enough to self dilate, I applaud you. I happen to cringe at the thought but I also live 20 minutes from a very qualified GI doctor who has been successfully treating mine. I know others have a farther travel and it is sn inconvenience to schedule this procedure every six months, although my last dilation has been the most successful thus far. Good luck. There has been some great advice offered here.
Thank you for easing my mind a little. I feel horrible today after having it done yesterday. I am so sore and have problems moving around or walking without significant pain and soreness. Whether it is something I can handle doing I guess I'm not really going to be sure until I try it. I don't think I got the full grasp of it because he tried to have me do it and I was unable so he took over and explained it a little but I am still nervous about damaging something. If it comes down to it I'm not afraid to bow out and schedule another dilation under anesthesia.
I have had 7 in two years, love being knocked out first though. My doctor did not give me a prescription, he told me to buy a dildo and told me about the side of your index finger and have fun. That terrified me. Ok picture this, I am home alone, I am on the bed, with the dildo shoved up my butt and the wife walks in. My first response would be the doctor told me to do this...... Well got passed that and decided to have her shove it up there so I could get passed the male heterosexual issue. She refused. So one day I did and it hurt like hell. Never did it again, wish I could so I can stay open. Good luck
Phonix,
I say go for the procedure under anesthesia. You will feel nothing during it. I am never really sore the day after either and the benefit is worth it to be able to fully empty your pouch even if it only last 3-6 months before having to repeat the procedure. It sure seems to beat your current alternative. My GI has agreed to dilate every six months. He said if it becomes more frequent than that then I should really consider pouch advancement surgery which is the last thing on my list as I have heard you can also have strictures with hand sewn pouches as well.
I have a great GI and I bet I could talk him into dilating more often if really needed it as he knows I am petrified of any additional surgery.
I say go for the procedure under anesthesia. You will feel nothing during it. I am never really sore the day after either and the benefit is worth it to be able to fully empty your pouch even if it only last 3-6 months before having to repeat the procedure. It sure seems to beat your current alternative. My GI has agreed to dilate every six months. He said if it becomes more frequent than that then I should really consider pouch advancement surgery which is the last thing on my list as I have heard you can also have strictures with hand sewn pouches as well.
I have a great GI and I bet I could talk him into dilating more often if really needed it as he knows I am petrified of any additional surgery.
Thanks guys. Jeane I bowed out gracefully after a couple days of deep thought and said if I really need to go through with that again you can take advantage of me after you drug me up. Scott that's a funny story but disturbing mental picture still trying to erase that. I asked my wife also if she would do it for me just to see what she would say and she said "no effen way" ha ha I don't blame her.