You might want to point your doctor to the Mayo Clinic, as to the causes of anal fissures. http://www.mayoclinic.com/health/anal-fissure/DS00762/DSECTION=causes
Still, the basic thing is what he is like as a surgeon, even if he is more than stilted when it comes to his 'bedside manner'.

hi Sav - thanks for the link. So anal sex is an *uncommon* cause of fissures. That makes sense, otherwise it wouldn't be such a popular activity!
I am so grateful for this forum. I really needed to rant and I got such wonderful support that I feel and can assess my situation a bit more rationally now. You're right that what matters is surgical skill and I don't really have any good reason to doubt that. This clinic specializes in these kinds of problems. I did look into other options and it turns out that the wait times to see another specialist in my area is 6 months to a year. My doctor thinks I would be fine proceeding with surgery if that's what has to happen. I really can't wait much longer to heal with the ointment or to get the surgery. I'm down to 95lbs, blood tests indicate vitamin deficiencies and I am starting to get anemic. I'm going for the surgery as soon as it's offered and I will hope my surgeon loves me as much as he says God does!
I miss braais too! With sosaties and bobotie and Tafel lager! There is nothing like the southern sky ... the magellanic clouds, southern cross, and the best view of the core of the Milky Way. Just beautiful!

Hope to Heal....I am so sorry to hear about your doctor experience...I want you to know that I have cried...sobbed even...at all of my appts. Nurse Practitioner, GP, GI Docs, and finally the CRS; I was crying in the waiting rooms filling out my forms...so don't fret about being emotional.
I know that you have digestive issues, but have you tried eating some high calorie fiber foods to gain or stop losing weight?
I started eating lots of avocados...in guacamole (non dairy) on my salads, by themselves...they have protein in them as well as calories, nutrients, and fiber.
Also, I know people say not to eat nuts, but I eat them and chew and chew and chew them until they are mush. Again, protein, calories, fiber...
I also eat more creamy peanut butter than I ever did(love it on celery), ground flax seeds or flax oil even olive oil will add some calories to your diet. But of course you need to be the judge of what you eat. I had to do alot of trial and error.
Don't let that doctor make your stress worse. If he's your only option, you can keep him and then file a complaint later when you are all through with him.

Thanks so much for the great diet tips! I actually really like peanut butter - I don't know why I didn't think about it before. And there's lots to do with avocados.
It's nice to know I'm not the only one who has breakdowns in doctors' offices! I had a couples of good cries in the privacy of my own home yesterday - the pain was so bad I just could't bear it! Today's better, but I'm am sooooooo exhausted. I definitely need to eat better - crying takes a lot of energy!

I forgot to say that I eat "natural" peanut butter with only peanuts and salt in them. The commercial stuff (Jif, Peter Pan, generics, etc.) usually have alot of sugar which is bad for my BMs and sometimes other junk. Most stores here have Laura Scudder's or Adam's natural p butters. Also, health food stores sometimes have nut grinders and you can buy it freshly ground.
I know...the crying and anxiety are very exhausting!
I am already having anxiety, not about the surgery, but about the BMs afterward. I am worrying about a bowel movement I will have two weeks from now. Crazy.
Take Care Hope...

I hear ya, frustrated, I've been stressing about that BM two weeks from now too! The emotional side of this is sometimes overwhelming! I cry EVERY CRS visit, and usually all the way home too! My husband has seen me cry more in the last year than the 14 before put together! To deal with a doc like Hope's would push me over the edge I'm sure...does anybody else feel like a big failure if u have a bad day/bleeding after a few good days? This also leaves me emotionally drained. My biggest fear right now is that, like alpine, I'll get the flu or a cold and they'll cancel my surgery. It's easy to get bumped here too.

actually I recommend Almond Butter (natural) instead... it has lots of Fiber plus
"The essential fatty acids almonds contain are responsible for giving almonds anti-inflammatory and anti-spasmodic properties. In fact, Traditional Chinese Medicine uses almonds in tonics to ease swelling, heart and muscle spasms."
http://www.linda-rd.com/blog/nutritional-facts-almonds-health-benefits/

Thanks so much for the peanut butter advice - there are some good health food stores where I live, so I'm sure I'll be able to find some of the good stuff.
I definitely understand about BM anxiety - I have that every morning! But from everything I've read on this forum it sounds like even the first BM after the surgery is not nearly as bad as everyone expects - so try not to worry! I doubt it will be much fun, but it may not be too bad. I recall that people have said that Valium helps with the first few post-op BMs.
I also feel like a failure if I bleed after "going" . I know I shouldn't, but it's so hard no to feel completely discouraged! I've been bleeding pretty heavily for about six days - blood drips everywhere and fills the bowl. Even applying the dilt causes bleeding! (argh!) I'm pretty confident that I will end up getting the surgery too. All this bleeding can't be good and the painis getting worse ... I just hope I can get it soon. I'm looking forward to your surgeries, Elphie and Frustrated - you lead the way to healing and I'll follow right behind you!

Oh my gosh- I was just reading some of the recent posts and read your thread HopetoHeal. What a bizarre and incredible experience with this Dr. How disappointing as well because I know you had to wait and it isn't always easy to make a switch where you are. Have you been able to google him at all? I would feel better if I saw good reviews about his surgical skill. My CRS was rated highly- I am still thinking about what I will write and can't quite decide. What I really want to say is that the man obviously probably thinks he has a good bedside manner and tries to at certain times, but in reality he is rather an impatient jerk. When I was a couple of weeks post-op, he really made me feel stupid after I called him with questions. He doesn't have a nurse, so everything goes to him. I would have been happy to ask my fairly simple questions of someone else, but that option wasn't available. However, at other times, he seems friendlier. Bottom line is I know he is a good surgeon- if he was as goofy acting as this guy you saw, I'd want to make extra sure there was a really good reason to stay with him- as in excellent surgical skill and success.
At one of my followup appointments, I asked my CRS if it was ok to start having sex and there was definitely a look that passed over his face and I thought later- wow, maybe he thought that's what I meant! Like I would ever do that now, even if I ever had! I'm so butt phobic and scared about every little thing. Anyway- he gave a really good answer about as long as it was on "my terms" or something like that...
Bambi

Hi Bamibi – yep … that was one of the strangest encounters I’ve ever had with any doctor! As you can see, I had a wee ‘breakdown’ and had to vent here. I am so grateful that I can turn to the people in this forum for such wonderful support! Thank you so much for your sympathy and support too.
My GP told me that it can take about a year to see a specialist and recommended that I stay with the clinic as long as I’m comfortable doing so. I have googled the surgeon, and he seems quite qualified, but I can’t find anything out about his reputation. The comforting thing is that he works at a clinic that specializes in butt problems. Patient reviews of the clinic are generally positive – although many reviewers complained about rudeness, eccentricities/moralizing, and horrible bedside manner. However, the most common review goes something like “the doc is all business and rushed, but knows his stuff”. Well, that’ll do for me right now! Your doc sounds like a bit of a dork too. I’ve noticed that about surgeons – they seem to have no people skills at all and can make you feel really dumb or like you are a pest. I’m so glad that your CRS is very good at what he does. I’m pretty sure that mine is highly skilled, given where he works. He’s also not mean. In fact, he’s generally pretty friendly and tries to be reassuring. I just think he doesn’t quite know how to behave like a normal person.
I like your doc’s reaction to your question, but it would be nice to get more detailed advice about sex! I really think doctors should take workshops on sexuality – too many of them seem to have a problem handling sexuality and get all weirded-out. Mine at least should be educated about the many different kinds of perfectly safe and natural sex acts that people engage in so that he can get over his hang-ups. We are having some interesting controversies here in Canada – doctors using a ‘conscience clause’ to refuse to provide contraception – and even pap smears – to single women. I’ve done a lot of advocacy work concerning gender issues and sexual rights and it never ceases to amaze me how much morality there is in the supposedly ‘objective’ medical community!