Just wanted to put my history out there and get some advice.
March 16: Had surgery to repair an Umbilical Hernia. Was constipated for 5-6 days. When I finally did go, it was very tough. And for the next week or so, BMs were difficult.

March 27: Noticed some blood on my toilet paper, figured I had just irritated it by wiping too much.

March 28: Woke up in excruciating pain. Figured I had another hemorrhoid flare-up. I get them occasionally, but they usually go away on their own in a week or so, treating them with prep-h and witch hazel wipes. So I started just doing that, and over the next week or so, it seemed to get better. I was able to sit down and go about my day, but it never totally went away.

April 6: Called a Telehealth doctor, due to limited options with COVID-19. Told him I thought I had a hemorrhoid flare-up, he prescribed Hydrocortisone suppositories and said that if it doesnt go away in 3-4 days, to call my regular doctor. This probably made it a bit worse.

April 9: Called regular doctor, she was not available, but I did telehealth with another doctor at the practice. Told him I thought I had a hemorrhoid. He told me that I should use a green tea bag, or at least some strong green tea liquid to put on there, and it will make the hemorrhoid go away, That made things 10x worse. Sounds like a hokey cure to begin with, but in his defense, he had no idea that I had a fissure as well. Neither did I.

April 11: Go to urgent care. Had a nice nurse practicioner who used to work in Labor and Delivery check me out. She actually did a digital exam and such. She told me I definitely had a hemorrhoid and "some kind of abrasion" as well. She prescribed Procort Cream. That did not seem to help much. Especially since it called for being inserted inside the rectum, it probably just irritated the hell out of it.

April 15: Go to see G-I Doctor. He pokes and prods me, very painfully, and finds an “angry-looking” hemorrhoid in there. Sends me to a Colo-Rectal Surgeon to get a second opinion.

Surgeon says, “Ya, he should not have poked and prodded you, because it sounds like you have a fissure, and probably a hemorrhoid, but the fissure is the main issue.” He prescribes me Nifedipine cream and encourages me to try it for 4-6 weeks, and says that if it does not work, then LIS surgery is an option. He told me the nifedipine + fiber + water + sitz baths are the way to go, and work 70% of the time. Otherwise, the LIS surgery works 99% of the time.

So Now we’re at May 6th, and while I don’t think it has gotten any worse, it has not really gotten any better. I realize that’s only 21 days into treatment, whereby the doctor says the treatment needs 28-42 days to work, but I’m in constant discomfort and sometimes in pain.

Questions:
Should I stick it out with this treatment for 4 weeks? 6 weeks? Maybe if I don’t feel ANY improvement by 4 weeks, that’s a sign that I should go ahead and have the surgery?
Tell me about the surgery, in layman’s terms. What are the risks, what is the probability of me having issues with surgery or in my recovery? What does typical recovery post-surgery look like? Should I be scared of post-surgery incontinence (and potential PERMANENT issues with this)?

If I do have surgery, I’m gonna probably be given painkillers. Which seems to be what caused this problem to begin with. If I get constipated, that will just hurt me again. How could I prevent this
It seems like everything irritates it, walking, laying down in a not quite right position, etc. Nurse told me that it’s going to be irritated, but just because it’s irritated, doesn’t mean it’s not healing. She mentioned that as long as my BM’s are where they need to be, and I’m taking the cream, it should heal. Is this true?
Bottom line, I want this to go away and never come back. I’m scared to death of a major surgery like this, but I want my life back. I can’t stomach the thought of this becoming a recurring issue. What is my best chance for making this go away and it never coming back?

Update: It feels like it's pulsing a lot, especially after I put the Nifedipine ointment on. I thought it was a bad thing, like my muscles contracting and spasming, but the nurse says that the warm feeling and the pulsing means that the medication is working. Which makes sense, because it's only been happening for the last few days. I thought it was getting worse, but maybe not? Anyone else have experience with this?

Thank you!!! Any advice/encouragement/feedback is welcomed!

Sorry I have no advice but I’m going through this too. I’m looking to schedule an appointment next week. I’m terrified of the exam. I can’t imagine them softly examining me. I’m in a lot of pain as it is. I just want to keep up with you to see when you eventually heal and if you need the lis.

Our advancing medical technology is helpless against the hemorrhoid

Take magnesium oxides to combat constipation

Can’t give advice about potential surgery

I agree! When will there be a cure? Hope you’re seeing improvement. How’s the nifedipine working?

I feel like the fissure might be getting a bit better, but that damn hemorrhoid. I can't get comfortable unless I take a hearty dose of sleeping meds, and even then it's touch and go. Trying to sleep with my legs propped. About 10 days ago, I could still sleep on my side, but it's gotten worse and worse to where I can only get a bit comfortable by laying on my back with my feet propped. God, I would do ANYTHING to make this stop.

I'm strongly considering surgery (LIS and Hemorrhoidectomy). Any thoughts?

Screw it. LIS and Hemorrhoidectomy tomorrow. I can't sleep. I can't sit. My life is a living hell.

I know surgery won't be an instant fix by any means, but my CRS says that this is the next best step and assures me that things will be fine.

Wish me luck and pray for me. I'll update when I can.

I had an acute thrombosed hemmie a long time ago, and was shocked when the CRS told me that it would get a lot worse (I was at about day 3 or 4 at that point and in substantial pain already), but would peak at about day 10 (at which point it was unbearable) and then be resolved after about 2 weeks. I was so glad to know ahead of time that there was a timeline that could be a light at the end of a tunnel. You may want to see how things are in a few days, before committing to surgery.

Chachacha, this has been going on for 6 weeks now. I'm in agony. So we're beyond that timeline at this point.

Then it may not be a hemmie. When do you next see the surgeon?

Check out my original post. I have a fissure AND a hemorrhoid. Thanks though.