Just wanted to start a thread for my experience with botox so far.
I got it less than a week ago (1/10). The procedure itself was simple. My doc wiped my butt with some anasthesia, and then gave me two shots. The shots were certainly not pleasant, but compared to the mental/physical pain of dealing with this af for the last 8 months, the shots were an absolute breeze.
My doctor said she used a relatively high dosage.
So far, I haven't noticed any change... actually the last couple of days I've been bleeding more than usual. But I definitely need to give it some time.
My doctor said botox works 50% of the time in her experience (although she says some studies claim it to be work 85% of the time).
I'll repost here with updates. Hope you're all feeling better.

how are the spasms and the pain?

You know, I've never had spasms...at least, not that I know of. And my pain has always been relatively mild compared to what I've read from other folks...more like mild discomfort to major discomfort immediately after BM or periodically throughout the day...and sharp pricking/burning/irritation during BM. I think bleeding has always been my more troublesome symptom.
Perhaps the post-BM pain has lessened a bit since botox. Might be wishful thinking though -- too early to tell. I had some nasty pricking sensations today during BM (and lots of bleeding). I don't know -- it's always hard to tell for me. The second I think I see signs of improvement, BAM, I'm back to square one.
Has bleeding been a problem for you? If so, how long after botox did it subside? Any other advice?
And just curious...Did you try nifedipine/diltiazem ever? Did that help at all? It did nothing for me.
Hope all is well.

I got botox to heal the last nasty bit, so I wasn't bleeding at the time. After about 2 weeks of non-spasm i was healed, but I had to keep up the diet, etc... or risk retear. I'm really not much of a bleeder in ther first place, so I am a bad person to ask.
The nifedipine does very little for me. Nitro is more effective, but I get really lightheaded and headachy from it, so I don't use it that often. It seemed to add to the effect of the botox when I used them together. I couldn't control my farts if I tried when I was on both, well, I could but barely.

Hey Steve,
I have had Botox twice. I had to be put out in the OR for it. You and Buttgirl are brave. lol I am a chicken. It took at least 2/3 weeks for it to start working. I have had no bleeding since the end of November. It does take the edge off the pain and make it more bearable. I am 90% healed as of my last CRS visit 12/27/07. He said that it looked good and he probably would not have to see me again. We will see. It still hurts when I have a BM in the morning but just a little 2 minute pain and then it is gone. I am staying with my routine of diet, cream, supplements and baths. I also use Nefedipine cream and it helps me.
Good Luck and keep us posted. Give it some time it will help.
Patty

Thanks Steve for detailed update ! Please keep us posted !
Patty, I really hope your fissure will be gone completely soon - stay on your regiment of diet and creams for at least 3 more months and when you decide to cut back do it VERY gradually. I was too eager to get off MOM and mineral oil because they made me go 5 times a day to the loo, and I was actually advised by my CRS to start cutting back and after 3 weeks my fissure reopened : (.
Take care and the best of luck to you all !!!!

Thanks Fiss!!
I am going to stay on this routine for a long time......Even when I am healed I will be careful about my eating habits. This is pain you just don't forget. Thanks..
Steve keep us posted!!
Patty

Hope everything makes a big shift for the better, Steve. I'm sure the effects will kick in any time now...!

Thanks everyone! Patty, good to hear that it might take at least 2 weeks to work... And I don't think you're a chicken... glad to hear your 90% healed. Fiss, i'll definitely keep you all posted -- and sorry to hear about your setback. Thanks for the encouragement, Kim.

Hope you see some improvement soon Steve.
Do you have to go back and be checked at any point? or do they just say to go back if it doesn't help?
Fingers crossed for you!