Botox- Still undecided!

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Re: Botox- Still undecided!

Postby Guest » 18 Jul 2013, 07:30

notmuchfunanymore you say
If I could keep 'em soft on my own, that would be the best! But, I honestly can't get any better than the routine I'm already following---

Keep searching, it took me the longest to figure out how to keep my stools soft, but I finally found the combo without otc meds or stool softeners.
Do you get enough exercise, could you possibly scale back on your insolubles, did you try the elimination diet to see whats keeping you constipated.
Keep keep searching.
HTH GL
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Re: Botox- Still undecided!

Postby notmuchfunanymore » 19 Jul 2013, 09:16

Buttastic-- I haven't tried the elimination diet, (is there a specific outline to follow?), but after the past 18 months, including keeping a very detailed food/BM journal, I'm doing what's best for me, I have no constipating food in my diet. Like I said, pre-fissure this would have given me a Bristol 8, but now (without Miralax) I'd get a 3. Which makes me believe that my body's dependent on Miralax.
Originally I didn't care and I was hoping to totally heal before weaning off, but its been so long that either (A) I need help healing or (B) it just takes THAT long for me!
Long story short- My cutting back on Miralax has sent me back to horror hole. Bringing it back up to my standard dose is brings less and less pain daily, my muscles are relaxing again. Today, a mere hour after my BM, I don't have pain.
So it brings me back to my original question, will Botox be worth a try? Or do I still with Miralax for----- who knows how long!---- and oh. so. slowly. wean off?
I say a Hail Mary when I poo.
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Re: Botox- Still undecided!

Postby suzyljank » 19 Jul 2013, 09:58

Hi, I wouldn't worry about taking miralax. Your boby absorbs none of it. You can safely take it for the rest of your life. I've been through a hemrroidectomy, LIS and just 12 weeks ago today double advancement flaps. I'm doing good but I will always have to take miralax. I only take 4 tsp. at bedtime( less than a normal dose......before surgery I was taking a little over 2 doses daily) and it's to make sure to keep things soft. I have a formed bm most of the time and I'm grateful there is a product like miralax. I look at it this way, it's no different than taking medicine for high blood pressure. You don't want to set yourself up for more fissures so if it's working for you that's good.
You say you've had your fissures for 18 months, that would make them chronic. That makes them harder to heal because of the scar tissue involved. Has your CRS mentioned fissurectomy and botox or LIS. A few member have had that done with success. I hope you find what works for you so you can get your life back. All the best Suzy
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Re: Botox- Still undecided!

Postby WelshDoubleFissure » 19 Jul 2013, 10:39

In my opinion, (a 4 year sufferer) if I'd have known back then what I know now, i'd have gone for the surgery a lot sooner.
As you've said, you've tried reducing your miralax intake and it hasn't fixed the issue, I see it as the miralax is helping you deal with living with a fissure and Suzy is spot on, the scar tissue had an affect on the healing. So it's likely that the fissures are still there but won't heal.
It's difficult for anyone to give you the answer without knowing the full extent of your fissures.
My CRS suggested an examination under anaesthetic after seeing it was too painful for him to do an internal exam and would decide on the procedure once he'd had a good look. This is when I had a double fissurectomy to remove the scar tissue and make it fresh, then he gave me Botox.
If your fissures aren't able to heal, then I guess Botox wouldn't be too successful other than making a BM comfortable for a few months. I would suggest another conversation with your CRS to discuss how chronic your fissures are. If they don't know, then how can they judge without an examination planned?
Hope that helps
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Re: Botox- Still undecided!

Postby notmuchfunanymore » 19 Jul 2013, 11:12

I know! My CRS hasn't been the most helpful to date. He has been vague.
What I do know is this:
he is confident my fissures will heal without surgery. He did check things out and is sure that scar tissue will not prevent healing at this point!
He will not do surgery unless I try Botox.
He wouldn't advise me whether I should try Botox or not.
He insists I get off Miralax, and take fibre supplements (yet he doesn't take the time to listen about my current diet).
And he suggested I would heal in a couple months (that was a couple months ago).
Unfortunately for me, I have already been waiting over a year to get in to see a CRS in the first place.
Suzy- If I could take Miralax for life, I probably would opt for that! But it is quite expensive at this amount and I can not be covered for it.
I wonder if high resting pressure (without pain) might prevent a fissure from healing? In this case, maybe Botox WOULD work?
I say a Hail Mary when I poo.
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Re: Botox- Still undecided!

Postby Guest » 19 Jul 2013, 11:27

notmuchfunanymore
I have to admit. You're at a crossroads. You are now realizing the ohh soo long and tedious journey it is to beat these monsters.
You say you have no constipating foods in your diet, and I hope you are right about that; but the elimination diet would only confirm that for you. All you basically have to do, is eliminate one food--track your bm for a week or so--then eliminate another food--track your bm for another week or so.
If that one eliminated food does not change your consistency, reintroduce it and try another.
A variation of this would be to eliminate a combo of foods at the same time as I learned in my case that it was a combinations of foods that I needed to eliminate.
I would not be too set in any one routine just yet notmuchfun; I would continue to question everything I do if I were you. I would try to bump up certain(soluble) foods, especially if I wanted to be weaned off the miralax.
It's ll about trial and error as you most likely have heard by now. So with that, back to your original question, Is botox worth a try. Personally I would ultimately say yes, simply because you haven't tried it yet.
It may give you a window of opportunity to indeed decrease the miralax, without worrying about going into spasm. It may give you several weeks and months of healing that you have not experienced before ( although you say you were pain free before, the heal rate may be quicker and stronger this time).
Also notmuchfun, you mention your current diet would give you a bristol 8 pre-fissure. And that your getting a three now. So is this really the diet your looking for. I thought a bristol 4-6 diet was the optimum.
Please don't give up whatever you decide. Keep fighting these monster any and everyway you can. Throw everything you can think of at it, and sooner or (unfortunately sometimes) later, you will find the missing link on how to beat these rogue monsters.
Its a long road notmuchfunanymore, your fissures sure aren't going to give in, and please don't you dare give in. Lets not forget too that botox has healing properties in bringing the much needed blood to the area via the relaxing of the sphincter.
HTH GL
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Re: Botox- Still undecided!

Postby suzyljank » 19 Jul 2013, 11:39

Hi notmuchfunanymore, I might suggest you get a second opinion. I had my fissure for 9 months when I saw a CRS for the first time and he told me it would not heal on it's own because of the scar tissue. He wouldn't even do botox for me because you get the best outcome with acute fissures not chronic ones that's why I tried LIS. Unfortunately I had anal stenosis too so LIS didn't help much. I finally had the scar tissue removed and two flaps covered it. It was an uncomfortable surgery but I wish I would have done this at the beginning. My CRS suggested it but I opted for a lesser invasive surgery like LIS and still I wound up with the surgery I should have had. As far as metamucil goes, it's a bulking fiber and stretches the rectum and so it's stretching your fissures. I was told not to use that just high fiber foods. I start my day off with shredded wheat and peaches now. 18 months is a long time for a fissure to remain unhealed. I hope you find a solution soon. Wishing you well Suzy
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Re: Botox- Still undecided!

Postby notmuchfunanymore » 19 Jul 2013, 11:54

Thanks buttastic. I'll get there one day!
For now I can be happy that I'm not experiencing the kind of pain I had when these were fresh. And I'm also thankful that I've learned how to eat ridiculously healthy, so while my dear old ass is in tears, the rest of me is thriving.
I will consider the elimination diet, but not sold on it just yet, since I'm already hugely restricted in what I eat, that to eliminate another thing, or a combination of foods, would be quite the challenge!
Potentially a contributor to my BM's would be that I'm breastfeeding, but breastfeeding my babe is more important to me than giving up Miralax.
I say a Hail Mary when I poo.
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Re: Botox- Still undecided!

Postby notmuchfunanymore » 19 Jul 2013, 11:56

hey Suzy,
I'm afraid a second opinion would mean waiting about another year to see someone else. Also, if in the end I do need surgery, my current CRS is the best for that.
So, it'd be ideal to see a good doctor that I trusted, but it's not really an option at this point.
I say a Hail Mary when I poo.
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