Thanks both. Just bought some lactulose!
Actually things got even worse. A few hours later I had to go again, but I couldnt get it out because it was so hard. It took like half an hour, and I had to use hot water from the shower to relax the muscle. Yes, I crapped in the shower, and yes, Im in horrible pain. 

Hi JHH,
Human should not tolerate pain. Take some painkiller pill and put some cortisone down there. Don't suffer from pain and spasm.
One-time cortisone will not make your skin thin, but limited blood supply will.

Hi igrik
Painkillers doesnt help me. Tried a few times in the past, but its like eating vitamins. Besides, Im so used to pain, its not really a big issue. The feeling of hopelessness however...

Oh, JHH. I know the hopelessness and depression is horrid. I find if I have 2 BM's I go into more pain! Ugh. Are you lubricating before BM? I find this helps, although not too sure if it is too soon after your Botox to do this. I was in hell pain, that I just wanted to end it! The nearest bridge or cliff was becoming more appealing. I think the pain will improve, but might take a bit more time! I know it is horrid, if you are anything like me, you want it now!!!  I hope you can improve the BM and hopefully the Lactulose will save you.

Forgot to say, my constipation was horrendous that I would sit there for ages. Bad decision. Maybe you could cut constipation foods from your diet to see if you improve. Then maybe stick to foods that help. I know it is soul destroying day in, day out having to think about what goes in and if it will come out okay. Sigh. Going Wheat and Gluten free has helped me digest and have BM much better. Maybe you could try it.

Hi JHH,
your 2 wks post botox and you've had hard bm yikes sorry for your pain. This is exactly what happened me and it unfortunately for me it never got better. I still gave it another 3 wks before i caved and gave into lis. I agree lactulose is great but if you could give the movicol another chance its so much better your nearly guaranteed a soft bm. I hope its only a minor setback for you.

Thanks all!
Im better now. Almost painfree, but it has been a rough day.
Hopefully the lactulose will work fast and help my BM tomorrow.
I do not dare go back to movicol. Both times I tried, it made me so sick. Like I could barely move, dizzy, heart pounding, and just waiting to die.
Formed BMs had been the reason for every setback so far. Usually when they are formed, they are soft, but basically, anything else but 5-6 on the bristol scale is hurting me. 
I really dont see how it is possible to keep my BMs like cowpad every day, but I guess I need to :(

P.S. Even eating the same day in and day out, doesnt produce the same output. I assume there will always be a variation.

JHH,
Sorry to read of your ongoing struggle to get your diet and BMs on track. I really would suggest a visit to your GP to discuss this because if you can get your diet on sorted/ any food intolerances eliminated etc. I'm sure this would really help lots in your recovery?
You didn't say, but just the basics - Guessing you do drink LOTS of fluids?? Do you eat lots of Olive Oil and have "good" fats in your diet - All these things are really important - Do you get your 5 a day?? Sorry, if I'm being blatantly obvious with stuff, but sometimes, it is SO easy just to overlook the basic things when you're searching for other solutions. Is there also a possibility you are consuming too much fibre?
Really hoping you get this issue sorted soon but do make sure you are getting some regular exercise too (even walking 20 minutes a day) if you aren't already, and keep your stress levels down too!! Both really help :)

Hi JHH,
I have one scheme I my mind, to try after I will get botox. But this would be something to suggest you to attack stupid fissure.
1. Botox, you already got it.
2. Nitro, you already got it.
3. General muscle relaxants.
4. Super soft BMs, if you getting first peace breaking wound, try enema. 
(drinking water, stool softeners, etc)
5. Bio supplements, vitamins.
6. There is one more thing used to heal wound, working on DNA level. Named "methyluracil". Not sure if available in your country.
7. Sitz baths with coconut oil, if they only help you to relax. I don't feel major relaxation with them now.
8. Time and patience, if got good day, don't run to eat, stick for this routine at least for 1-2 months