Botox worse?

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Botox worse?

Postby posertiermadness » 27 Dec 2020, 22:08

Hello,
I've been helped by reading other's stories for a little while, but I would really like the members insights.

Had an anterior fissure 6 years ago. Didn't know what it was and developed chronic tightness. Fissure healed and tightness about 80-90% better, but then I got a posterior fissure 2 years ago. Up and down since. Got really bad in Feb 2020. Finally found a local CRS who did botox. Seemed like he got everywhere (external and internal sphincter) except for the tip of the internal...You know...right where it was needed! So, that area was in great spasm for 3 months. Is that even possible?

I was in soooo much more pain. It took me to a low point I had never been in my life. CRS said never heard of worse with botox before. Made me think something more was going on (e.g., abscess, cancer). Recently, had an MRI and the colonoscopy, both clear for anything more insidious. Plus, a few days ago started bleeding again. it was a downer, but also a good sign...Just a fissure.

Next step is exploratory under anesthetic with possible fissurectomy to remove scar tissue to aid healing. However, it will be 1-3 months (ala covid). So, I would really appreciate any comment on whether botox can miss one portion of the Int sphincter and, if so, make things worse. If true, then I would consider botox again (with a stern look at the CRS to aim more carefully).

Thanks!
posertiermadness
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Re: Botox worse?

Postby patience_and_healing » 02 Jan 2021, 02:26

Sorry that the botox made you worse off. I'm not sure why it happens but I have read several accounts on this board of people who are worse after botox. Personally I don't think it's possible for the botox to be missing in one part of the sphincter because it migrates over time. So your surgeon did everything right I think, but it didn't have the intended effect. Take care and let us know how things go with you.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
patience_and_healing
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Re: Botox worse?

Postby posertiermadness » 02 Jan 2021, 10:06

I wonder if it was just not enough instruction from CRS. Here's my two bits based on reading a lot of published research and guidelines (nothing like pain to motivate). I will star * what I failed to do and why I think botox worsened my pain.

2-3 days prior to botox though to 2 weeks after:
1. Softeners: continue and even increase (a bit, you don't want diarrhea)*
2. Drink lots of water (min about 3 litres per day)*
3. Avoid foods that bulk up the stool, including fibre that you know leads to dryer bulk (This is where the water is so important)*

Expect and initially after:
1. Go straight home.*
2. Careful not to push on the area. Pelvic physio teaches great trigger point relief, but doing so initially after botox may migrate some away from where wanted and to the external.*
2. Expect initial increase/change of pain. Botox causes significant trauma to the area. You are poisoning your Int and maybe ext sphincter.
3. Move around and keep blood flow to the area, but don't do anything too rigorous for at least a week.*
4. Expect it to take 2-4 weeks to fully kick in.*
5. Plan your life for 2-3 months around healing. "Hey family, want me back? Well then, you get me even less for 2-3 months."*

As you can see from my stars * I may have been the cause of the increased pain, but I did my research after the pain increased and my CRS said none of this.
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Re: Botox worse?

Postby patience_and_healing » 04 Jan 2021, 00:43

I understand that optimum conditions are required for healing after botox, or even surgery, so perhaps that's why your pain was worse. But even so, it should have settled down eventually, which makes me wonder if repeat botox will really help you.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
patience_and_healing
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Posts: 981
Topics: 38
Joined: 24 Feb 2017, 15:46
Location: California
Has thanked: 58 times
Been thanked: 117 times
Gender: Female


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