6 months...what to do??

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Re: 6 months...what to do??

Postby Darialuce » 13 Jun 2015, 23:27

Sorry i accidentally took over the thread, i don't know how to start my own. Please help?
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Re: 6 months...what to do??

Postby msimon » 16 Jun 2015, 16:38

How are you doing Canadabum?
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: 6 months...what to do??

Postby Canadabum » 16 Jun 2015, 17:01

Hi msimon et al...thanks for asking.

I am pretty good but not totally better. I dont have the pain, haven't had the bleeding since my last setback a couple weeks back...but have a general sense of some discomfort and what i call an awareness of something that is not quite right down there.

I actually went to see my GP today to ask again if he had any insight in to the matter...basically he suggested i use an anusol cream with some hydrocortisone and some sort of pain relieving medication for a couple weeks to see if i could -- as he put it "break the cycle". At this point I have no idea if this will help, hurt or be indifferent. On top of that he has referred me to a gastroentorologist so that they can take a peek up there and potentially see wht is going on...not sure when my appointment is yet.

My bowel movements are ok...though if they get on the larger side i feel some amount of pressure/pain so i am still very cognizant of keeping them smaller and softer. The level of discomfort is manageable but...i really would love to be done with all of this. It has been 8 months solid of my butt being centre of attention...its too long, quite frankly it is all a bit exhausting physically and mentally. That said, I know i am in such a better place than i was for the first 4/5 months where were a bit of a hell....so i am thankful each and every day.

I do think i am progressing....somehow the last 10% seems very elusive and stubborn. I was joking with my wife the other day and suggested to her that I would try out Scientist's Estrogen method...at this point i would be open to pretty much anything.

I will keep you all posted -- you have all been such a HUGE help to me over this difficult experience and I cant thank you enough for the feedback, the "listening" and the community.

Best to all,
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Re: 6 months...what to do??

Postby Canadabum » 03 Jul 2015, 10:30

Happy Canada Day and Happy 4th of July....

Just wanted to give a quick update.

I have been off Diltiazem for a number of weeks now with no real consequence...so i will remain off. I have started using coconut oil in the morning and evening just to provide some sort of barrier...and honestly i have no idea if this is helpful or neutral.

My BMs are not painful and since my last set back a number of weeks back there has been no blood. I decided to give Restoralax a try...thinking that if i really soften things up i will help myself heal the last 10% or so. So it works pretty well but is really expensive...i am surprised by how expensive the stuff is. Anyways, while it seem to work (not wonders mind you) i have also noticed that the (sorry for the details) diameter of my stool is really small and i am a bit concerned that i am not at all stretching the passage....could this lead to other complications over time -- if one does not use the plumbing the way it was designed could it loose some of its ability to stretch down the road??? Anyone have any thoughts on this?

My issue is that I have near constant awareness and some discomfort. It feels rough down there and from time to time i get a bit of a jab....but mostly just rough or slightly inflamed sort of feeling. I really have no idea how to deal with this effectively and on some level hoping it just disappears.....can get really frustrating.

While I am very thankful to not be in severe pain (and as i said in a much earlier post, never thought i would emerge from those painful days intact) i am at a loss and shaking my head each day wondering why i cant just heal. My worry is that i dont think the surgery will do much for me -- i could be wrong but i dont think my issue is a tight sphincter...just dont know what it is.

Anyways...I now have an appt with a CRS for September (that was booked...get this, 4 months ago...and it is not for another 3 months) and my GP has also asked me to see a Gastroentorologist -- that appointment is booked for 6 months from now. I do want someone to look up there...but am still shaking in my boots that they will cause damage (memories of the pain days are still fresh enough for me). I just wonder if the CRS will simply look and determine whether it is operable or not....and the Gastro may have alternate methods of dealing since they are not a surgeon....has anyone been to both and compared the experience.

Thanks as always for listening and the feedback....I hope we all get better each day over this summer...

Best,
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Re: 6 months...what to do??

Postby msimon » 03 Jul 2015, 11:26

Glad to hear things have improved for you Canadabum but sorry to hear you struggle with that last 10%. I too feel I have plateaued, and nowhere near where I need to be yet. I am seeing a physio for pelvic floor issues and we have talked about the very thing you are inquiring about, the narrow stools. I also use Miralax (Restorlax/Laxaday here) and it works wonderfully at keeping things very loose for me. So does magnesium. But I am now coming up to a time that we are going to start stretching back there. Things are very narrow for me and difficult to go. They have been for a very long time but I used to stretch before the fissure and then the 2 surgeries. Now I have the added bonus of a large area of scar tissue from my unroofing surgery. I have a follow up with my surgeon on July 7th and will be asking about these things. I can let you know what he says. We won't do anything until he okays it, just in case.

As for the Miralax, I was prescribed this before it was available over the counter and continue to get my Doctor to write me a prescription for it, precisely because it is so expensive (it's generic name is PEG-3350). So with health insurance coverage the cost is minimal for me.

As for your wait times, are you on their cancellation lists? If you are flexible, and they have one, that may help you get in sooner. These long wait times suck so bad here in Canada!

I have been to a GI Doctor a few times in my life and found them completely useless. But that is just my opinion. I had a brutal colonoscopy done by one and the others just looked dumbfounded and were no help for my functional disorders (IBS and pelvic floor dysfunction). I am sure they are much more helpful with the straightforward illnesses like IBD, which can actually be identified and treated.

As for the tight sphincter, you could get anorectal manometry done to see if you sphincter is indeed tight. Then you would know if you need LIS. A GI or CRS Doc can order that test.

Just wondering why you stopped the Diltiazem? There is no harm in continuing with it. Unless you are fully healed, it could still help you get there, albeit slowly.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: 6 months...what to do??

Postby hurtinend » 03 Jul 2015, 19:12

I think I am In a very similar situation to you Canadabum

I am not in great pain, but it's far from right down there, I never have blood, but it hurts down there, sometimes it stings and burns, sometimes it jabs, sometimes more spasm type pain.

I have never tried Miralax, yes, it is expensive, $ 18.00 Canadian dollars for a 10 day supply

I am currently void of how to cure this. I found Diltiazem to be useless.
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Re: 6 months...what to do??

Postby Canadabum » 06 Jul 2015, 09:42

Thanks for the feedback Msimon...

I would really appreciate the feedback you get from the Dr. about the usage of Restoralax over the long term...not that you need to ask my ?, but I am interested in understanding....if we keep it soft and dont challenge the sphincter and passage to open up more will we somehow be damaging our ability to keep the passage flexible and able to open once the fissure is cured/gone?

Curious -- how much Magnesium do you take per day and when do you take it. Right now i am taking about 250mg -- 150 in the morning and 100 in the early evening.

As for PEG-3350....i will speak with my dr. once i am able to get another appointment -- that is a great piece of info!!

I did put myself on a cancellation list....so far no calls from the office...keeping my fingers crossed.

Dilt -- I initially stopped because it was the only way I could stick my middle finger up at my fissure. I know it makes no rational sense but I was so frustrated with this whole thing i decided to pretend it was not there. After a few days I noticed no difference in how i felt...and the mild itch and rash also vanished which was a bonus...so i decided to stop. Now I use coconut oil (i dont make suppositories, just a glob of oil on the finger and...you get the idea) and am feeling pretty good.

Truth is that the past few days have actually been quite good...again, not 100%, but i may be making some strides forward.

The best news/development for me is that I got on my bike the other day....and it was ok!!! My plan is to go for a real ride this Friday...cant wait to test out my endurance and my butt...I will be sure to wear some padded liners under my shorts!

Time seems to be the best healer for me....that and ignoring this condition :)

Best to all,
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Re: 6 months...what to do??

Postby msimon » 06 Jul 2015, 11:25

You are very welcome Canadabum! As for this:

"but I am interested in understanding....if we keep it soft and dont challenge the sphincter and passage to open up more will we somehow be damaging our ability to keep the passage flexible and able to open once the fissure is cured/gone?"

My physios answer to this is a resounding YES! I will ask my CRS but I suspect he will say the same. The trick is to get the muscle to stretch in a controlled manner first, like with a finger and work up to dilators. This is my plan anyway. Then, when it is able to open more, one can make the stool less soft.

As for the Doctor's cancellation list, depending on the office, I often found that calling once a week or so is more effective as I think they are often too busy to look for the list and call people. Have gotten in sooner that way a few times. Of course it depends on the office staff as some may be annoyed by this, others don't seem to care and some even seem to think you are doing them a favour, which you probably are if you happen to luck out.

I take a lot of magnesium, let's see...150mg with supper and 200mg before bed with a product called Magsense (also has malic acid - this gets the bowels moving) which may also give another 100mg. I need it almost watery at this point :(

Glad to hear you are feeling better. On you bike! That's awesome! That is a goal of mine. Even my grannie-seat exercise bike in the basement will do for now...can't wait (how sad is that?)!

As for the diltiazem, what about nifedipine instead? I find it the least irritating of the 3. Even if you are feeling better it might be good to have on hand.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: 6 months...what to do??

Postby JHH » 06 Jul 2015, 14:47

Just wanted to pop in, to remind everyone that healing takes time. Lots of time!!!

I had botox 2 years ago, and I guess it took about 4 months to heal, and then about a year to feel mostly normal down there. In the last 3 to 5 months, I felt completely normal. Even when having firmer that normal BM.

Just give it time. Those weird sensations and jabs etc. will go away eventually.
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- Now Feb '16, all is good. Still take magnesia, and squat precautionary.
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Re: 6 months...what to do??

Postby girlfrompak » 08 Jul 2015, 05:30

Hi Fellow Canadians,

I too have lived in Canada for 8 years, originally from Pakistan.. Canada is surely my second home! OH CANADA!

Anyways, please help.. I too am an anal fissure sufferer, similar story as you guys. Got my fissure post my hernia surgery in April.
Want to say I believe I am healing but quite slow.
My treatments: Lots of water and fibre.. mangoes help with softening.. metamucil and restorolax, chai seeds, no red meat chocolate or coffee.. tea sometimes
GTN 0.2% post BM- used to apply alot but have reduced the quantity.
hot water sitz baths with coconut oil..
homeopathic meds- local application: calendula
what has helped the most is applying potash alum (grinded) with oliveoil at night. it is a natural antiseptic. really helps..

My question to all you fissure veterans is this:
When i stand or walk for 10 mins or more, I have a pain in my anus like a constant pain which only goes if i sit on it. It has made me handicap.. I used to walk/run 6 km now I cant even stroll a quarter of a km.

Please any help or advice will be appreciated. I feel like this isnt a common side effect of the fissure so its scary.

Much love to all and lots of healing vibes :)
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