thanks for the article link, jr! dowloaded full text. that is such great confirmation in my 2nd attempt at Botox. I couldn't help but remember an old teacher from years ago, regarding "hanging in there" when things are difficult - to not give up, because who's not to say that "it" (anything) would've worked if you you gave it one more ounce of time/effort - the actual parable/story is much more elloquent than my not-so-elloquent paraphrase. anyway, can't help but relate that concept to giving botox a 2nd go. would totally suck if i immediately went to LIS, if, for some reason, botox - THIS time, with THIS surgeon, with my DIFFERENT mindset would've worked. I also kinda see it as I'm giving it another chance for my maybe-future-not-conceived-yet-child, if I ever have a child. that's definitely worth a couple extra weeks/month of discomfort. LIS might seriously influence my decision to have children later considering things downunder are getting complicated/cut/compromised.
Anyway, Roho is the best-known company I am aware of regarding seat cushions to provide relief/decrease risk of ulcers:
http://www.therohogroup.com/products/seat%20cushions/index.jsp
they might be on the fancy,spendy side of things (often used by people who are in wheelchairs to prevent tissue breakdown). But again, something as simple as a peice of cut-out-egg-crate-foam (which I think you can even get at hardware/mattress stores) should also do the trick for you.
good luck, and keep me posted!
i think between now and next monday, i'm probably going to get in the zen-zone of things for preparation....and ellicit as many other people's good-healing-vibes as I can :)
Let the power of optimism (and humor) prevail!

Hi Sailorgal,
I thrilled for you that you've emerged from the "unknown zone" and are on a definitive path now....it's such a relief to unload that heavy burden and finally know where you're headed
Your doc sounds great His willingness to understand what you've been through and what you're not willing to go through again is fantastic. I'm so glad he's on the same page as you and you can move ahead as confident as you are
Best Wishes to you every step of the way
Angel

Thanks, Angel!
It is remarkable how differently I feel about things (even if the pain is not terribly different) this time around with a different doctor who can communication more thoroughly about a cohesive plan! Definitely a lesson to remember down the road if/when I need any medical attention for any other things.

Sailorgal,
Thanks so much for the link.
Your outlook is giving you the best possible shot at healing. I don't know if you have any kind of meditation practice, but you might want to check out some healing mp3 s to listen to for healing. I find them very helpful. The trouble with living in so much pain all the time is it puts the body into a constant state of stress, and as you already know, this causes biochemical changes in the body that inhibit healing. Using the power of the mind can significantly alter this stress state and allow for greater relaxation and promotion of healing. I really like Martin Rossman's guided imagery mp3s, my favorite one being "Self Healing with Guided Imagery:Session 2". There are many others out there too that are wonderful.
Buddha taught that emotion is thought plus a corresponding response in the body. I think our minds have far more capability to assist in our healing than we give them credit for. And i think when we hold an intention for someone else it exerts a powerful influence too. I'm so glad to hear that the things you are wanting to fill your mind with are thoughts of healing, positivity, and hopefulness, and that you are openly receiving that from others as well. Good for you!
It also helps the rest of us to remember to keep doing that too.
I'll be holding you close in my thoughts, prayers and intentions, and look forward to hearing all about your healing!

Thanks for the meditation link, jr
and for the encouraging words!
I will definitely check that meditation out.
I have an old meditation tape that I received when I was in middle school that my dad recently converted to digital and just yesterday sent them back to me in mp3form (downloaded to my itunes). Tanya on the forum here, (I think it was her) also had a great suggestion of m cullen free body scan meditation which is nice too.
Man oh man, you hit the nail on the head regarding positive healing thoughts and meditation. My practice has waxed and waned over the years, it's so hard to keep it going - was going strong when I was really involved with martial arts 10 years ago, and have tried to recommit myself every year or so, it's just a tough discipline to keep up. I've even moved my meditation cushion next to my side of the bed as a constant reminder and keep reminding myself that all things in life is a reminder to meditate - and that's certainly true for this AF. It's interesting that I still have a reluctance to sit my butt down for the zazen practice though. Forget about it when i'm in pain, the last thing it want to do is get quiet and try to focus on my breath (rather than distract myself with a lame reality show). But, I realize I really need to take this opportunity to connect to that practice again.
And I am super thankful to have my "mojo" back, so to speak - which I definitely didn't have for a few months at the beginning of the year. I'm used to being a pretty optimistic person, and sharing my optimism to help motivate and lift up others(which is a great fit for what I do professionally). I have of course never had that optimism and faith challenged by something that can be so painful, debilitating, relentless, confusing, and alienating as this fissure. It reminds me of some of the stuff I learned way back during a weekend seminar with Carolyn Myss (who has written Anatomy of the spirit). The seminar was about grace and healing. I went with a friend more for the experience of being at a hippy-dippy retreat not thinking the topic would pertain to me bcz there were lots of people with chronic pain/diseases/problems there. And she was bringing in the spiritual side of disease and healing to things . . . resulting me in questioning "what is injury?" "what does it meaning being cured?" "what does it mean to heal?" and she challenged the participants bcz of the process of disease and healing - the distress it can create if it doesn't happen fast enough or in the way we expect or want it to be, who's to say we are truly READY to be healed? and healed how? obviously people that struggle with chronic issues or terminal diseases have to learn to live with what they have (and we hopefully have to learn to live with what we have for a finite amount of time even if it feels like forever). But, looking back part of my distress earlier this year over this thing certainly didn't aid in my healing (and knowing this frusterated me further at the time bcz i couldn't get a handle on my emotional/mental state over it). Part of the distress/anger was anger that this even happened in the first place, in my body's inability to heal - like it was inferior and failed me, in how I believe my doctors were handling it (or not), in my inability to fufill my work duties and the burden it placed on my workmates (as well as the burden on my boyfriend who i live with). It really challenged my self-identity and had me wear new identities that are really "icky" to me; I can't stand the thought of being dependent on others, being a burden on others, being weak, debilitated. Anyway, through the process, I've come around again somehow to not totally identify these characteristics to who I truly am. Despite the challenges this fissure presented, I am not weak, pathetic, a burden. Bcz, as you mentioned, those thoughts (and subsequent feelings) are part of the illusion of this whole drama, not who we really are. It's a good one the universe has played on us. Geez, I ramble. But, in the end - I have learned the value of mental health (and unapologetically eliciting the support of willing-others) - that needs to be taken care of, in my case, foremost, because then the rest will follow.

Thank you Sailorgal for caring enough to share such deep, personal insights, thoughts and feelings with us. Your words were so beautifully written and many of these feelings are so relatable to my own life since my fissure condition began.
This read was therapeutically inspiring for me, what a wonderful way to start my day.
Best Wishes and Thank You Again,
Angel

Sailorgal,
Beautifully said.
First, there is pain. Second, there are our thoughts about the pain. This is the basis of suffering. We can work on the first part by trying treatments and visiting doctors, but what if none of this works? The second part, our thoughts, are critical for practice. What are we thinking about our pain. As you point out... We hate it, we are frightened by it, we feel weak and we feel we are a burden. Instead of being compassionate with our own pain, we aim our aggression at it. Most people when they are in pain don't want to examine deeply the potential roots of that pain, and what their body is communicating to them through pain. Doing so makes them feel that they are somehow adding the burden of blaming themselves for getting sick. But that isn't the point at all. Anal pain and illness usually has its roots in the inability to let go of something, perhaps a resentment, an old hurt, a thought pattern, a job, a relationship, or any number of things. Going deeper and meditating often allows some of these things to bubble up to the surface where we can meet with them, understand them, and offer compassion to them. Mostly, the way Western medicine works it only addresses the physical problem and seeks to fix it. Okay. Sometimes that works and works well. But when we are challenged with something chronic and ongoing in our bodies the degree of difficulty increases and it isn't just a matter of going to a doctor and having him or her fix it. A person can take that approach, of course, and maybe even have some success for that particular problem, but in my experience the root cause usually just goes deeper underground and finds another way to talk to you. A better and more balanced approach, in my opinion, is to address the illness from a more whole person perspective.

My Dear Jr,
I just had a total emotional and psychological AHA Moment! I have never experienced this before...oh my God, I hear about it on Oprah (I'm a fan), but have never actually had it happen to me until now! This gives me a whole new perspective on all that is ailing me, not just my fissure!!! This was eye opening as I, in a flash, had sooo many surpressed deep down emotions emerge upon taking just a moment to think about what I just read. I don't know what to say right now, other than, thanks again Doc and are you taking on new clients?!
This all may sound kinda crazy and strange, but it definitely touched on some major hurt and sadness that I somehow didn't realize, or have been in denial about, that I am evidentally still so wounded by....as dealing with the pain of it has, since it occurred, been too much to bear. I pushed it down, inside, as if hiding it away will make it go away....I'm just carrying around that baggage full of pain, pretending it's not there. Unbelieveable, how much stuff I've got going on inside...I'm amazed that this is surfacing in such a flood of emotion right now...but it's a really good thing. I got alot more than just a fissure to heal, I've got a heart that needs mending....it's about time I start focusing on that, and then maybe like Sailorgal said, maybe the rest will follow!
What an amazingly insightful day this has been for me on my beloved Anal Fissure Forum!!!!
Who'd of thunk it?!?
Ok, I think I'm gonna pour myself a shot of something and just relax, that totally wore me out!
I Love You My Friends and thank you for your trust and caring!!
Angel

jr.you.rock.
thank you so much for taking the time to respond so thoughtfully and insightfully.
i've been struggling with the "root" problem behind the fissure.
In Carolyn's book, she connects potential chakra obstacles with illness and disease. I've tried to consider what my anal fissure my also be connected with in my life depending on what chakra it might be connected to. Depending, it could be the root chakra or 2nd chakra (she attributes 1st chakra with base of spine, physical body support, rectum; 2nd chakra with sexual organs, large intestive, pelvis, bladder); but doesn't specify what chakra the anus could be connected to. And I've come up empty each time (and of course avoiding REALLY meditating). But what you've offerred, the inability to let go of something, really hits the nail on the head, and reveals the work set forth before me.
And once again, it keeps coming to that little meditation cushion - for that is THE way, I believe, that will lead me to the answer if I can just sit myself down, let myself get quiet enough to do the "excavation work" so-to-speak to let it reveal itself, bubble up, unravel and untangle itself for true salvation and healing of the heart (and a**hole) :) Who knew the 2 were connected!

Angel and Sailorgal...
The excavation work, and subsequent evacuation work :) is really draining to go through. I'm so glad you feel there was something helpful here for you.
Thank you both so much for being open to sharing your thoughts and experiences. I am so grateful ...