Anal Fissure Support Forum

[flamingo]

Hi - after using Diltiazem for about a month, things are definitely better, but not great. D. burns and I pretty much stopped using it. Saw the gastro last week and she still saw a fissure (no kidding) and also thought there were hemorrhoids ans suggested this CRS who she thought was very progressive, and might have other alternatives. He gave me a prescription for Nifedipine to try for 2 weeks, and if I was not better, thought I should schedule surgery. He said he would do botox and a house flap, and that he did not like to do LIS on women who have had children. He did not really see hemorrhoids, but said that if he saw any when he did the surgery, he would remove them. He also said to stop taking Miralax and just take metamucil powder. All very matter of fact - very little room for discussion. I asked about recovery, and he said 2 weeks or so. I've looked up house flap here and online -- does not seem like a great alternative to the LIS as far as being any less invasive - seems more invasive actually.
I did contact wecc's CRS and he gave me the name of someone in NYC, so I guess that may be my next stop.
Wondering if anyone is familiar with the house flap??
From what I've seen here not sure the Nifedipine will be any better than the Diltiazem - anyone?
Miralax is working fine for me -- I am concerned b/c I have taken metemucil before and remember very large poops. I don't think I will change at this point.
Well, thanks for "listening!"

[Sweet Bugaboo]

flamingo -
Don't hesitate to get another opinion. I will see my 3rd crs tomorrow. The first crs didn't even see my AFs!
I'm sure alot of women (who have had children) have had the LIS. If you're anywhere near NY, it would be worth it to give wecc's doc a try. If not, then seek a second opinion, because maybe a different crs would be able to communicate better with you . . .

[Sweet Bugaboo]

BTW - Miralax is quite gentle and has worked for so many people.
What gets me about these various crs's is that they all have their own opinions. I don't think I'd rush into anything, yet . . . JMHO

[sterlingbird]

I am going out on a limb here and saying If something is working don't mess with it. Trust your gut. Knowing what I know now I am more informed on how to live with a fissure and not kill your self or someone else than my doctor will ever be and he is a good doctor. He sent me home after surgery and said go ahead eat anything you want! I was so glad I had found this board BEFORE I had it done. I would have been crying the blues. I hope the best for you.

[Sweet Bugaboo]

sterling, did you have the LIS? If so, are you happy you did it?
ITA about trusting our guts. I'm really trying to give myself enough time and information, before I make any kind of decision.

[sterlingbird]

I had a mess. Had a GP slice up 2 fissure tags and said they were thrombosed hemorrhoids. After 3 weeks of pain They sent me to a CRS and 2 weeks later he did LIS, one fistula, 2 fissures and some hemorrhoids.I am so glad I did. While due to a abscessed tooth and antibiotic induced diarrhea a new fissure occured. It seems to only hurt when having a BM (5 in the pin scale). Do not seem to have any spasms.This has been going on since October last year. I was never a patient person until now. I would have the surgery if I had to make the decision over again. It was not worse than the pain I was in. Those 2 weeks after the first surgery were the worst pain I have ever had (15 on the 1 to 10 pain scale) :-)

[flamingo]

Hi - thanks for the quick support! I am not going to switch from the miralax. It does seem like everyone has their own opinions -- the GP, the Gastro, and this guy, all told me something different as far as fiber. I would not hesitate if it was wecc's actual CRS. He is quite far from me -- about 4 - 5 hours, but he knew of one doctor who does the procedure and is actually in NYC, and that is a more reasonable distance. The Diltiazem worked to a point that I can function and I am not in constant pain. It is managable with the occasional advil and/or tylenol, so at this point, I am kind of with sterling in terms of knowing how to live with this at least for right now. That being said, it is of course, on my mind constantly, and keeping me from exercising and doing other things that I know will just cause more pain. I will try this dr. and see from there. thanks again.

[Sweet Bugaboo]

flamingo - if you see that crs that wecc's crs recommended, will you please ask him if he knows anyone else in the country who does the AD? wecc asked his own crs, and he didn't know anyone else, but maybe that other crs does . . .
I'm thinking probably not, though . . . darn. I'm in CA.
At any rate, just be careful with whichever doc you see. Those guys are all over the place with their opinions, seems like.

[Guest]

You've already gotten some good advice from previous posters so I won't repeat, but I would definitely get more CRS opinions before even considering an advancement flap surgery.
Regarding the diltiazem vs nifedipine... I couldn't tolerate the diltiazem at all but I have no trouble with nifedipine. That being said, I had to work closely with my compounding pharmacist to find both a suitable base for the cream, as well as switching manufacturers of the nifedipine to a different company when I had an initial itching problem. My pharmacist is awesome, and she really stuck with me to get a formula that wouldn't bother my sensitive skin.
So, if you continue having problems it is well worth having a conversation with the pharmacist to see if he/she can work it out for you.

[Sue1962]

Hey Flamingo
I just had LIS 2 weeks ago, and I also had children and I am having no problems. I haven't felt this good in 3 years. I have had no problems, no pain, no blood. I am back to a normal life after 3 years of suffering. I was in pain all day for 8 months, and the months before that on/off with heal and retear. I would definately find and talk to another CRS before going forward with the flap!!! I also wouln't change what is working for you. If miralax works keep taking it. Metamucil, works for some and not for others. It bulks things way too much for me!! I just eat alot of fiber everyday and drink water. My CRS says Miralax is very gentle and safe forever if needed. I am not going to take it forever, and am decreasing my dose to 3/4 cap for now. In about 8 weeks I am going to try to come off of it. Good luck and I hope you can talk to another CRS soon.