Hi, I’ve been suffering with anal fissures for a couple years now but I thought it was hemorrhoids. I recently visited a colorectal surgeon and he confirmed it is definitely an anal fissure. He prescribed me a compound topical medication with lidocaine an a calcium channel blocker and I’ve been using it about a week now and while it has seemed to help some, after a bowel movement is still very painful. I tried to exercise today and it hurt very bad.

Anyways, I’m scheduled for a sigmoidoscopy and Botox injections next week. I talked to my insurance company and it’s going to at the very least hit my $1500 deductible. Probably more but insurance will cover 90% after that. I am having trouble convincing myself that the procedure is worth it. The cream seems to help a little and that is a lot of money for me. I know there are a lot of Botox threads on here and I did search around, but I’m still on the fence. Should I fork over some of my savings for the possibility of relief or just keep hoping for the best? It’s been two months since this particularly bad flare up and I am feeling overwhelmed.

Would the sigmoidoscopy alone be covered by your insurance? And I'm wondering why you'd be scheduled for these procedures before the 6 week mark (minimum), since you don't know if the current treatment will work or not. Personally, I wouldn't bother with Botox at all, because my surgeon feels that it is a waste of time. He tries non-invasive methods first, and then goes to LIS. When I asked him about Botox, he said that he'd inject it, but since the cost isn't covered by our Canadian health system, I would have had to fork out about $500 for it. Has your CRS had a lot of success with Botox? That could be something to consider. Since you're going to have to pay for this out of pocket, I'd ask him if most of his patients see good relief from the product.

chachacha wrote:Would the sigmoidoscopy alone be covered by your insurance? And I'm wondering why you'd be scheduled for these procedures before the 6 week mark (minimum), since you don't know if the current treatment will work or not. Personally, I wouldn't bother with Botox at all, because my surgeon feels that it is a waste of time. He tries non-invasive methods first, and then goes to LIS. When I asked him about Botox, he said that he'd inject it, but since the cost isn't covered by our Canadian health system, I would have had to fork out about $500 for it. Has your CRS had a lot of success with Botox? That could be something to consider. Since you're going to have to pay for this out of pocket, I'd ask him if most of his patients see good relief from the product.

That’s interesting that it is not covered under your health system. Does that mean it’s because it doesn’t quite meet criteria for a treatment? I’m not really sure why it was rushed other than I came in in obvious pain and he may have wanted to help asap.

I’m also not sure the reason for the sigmoidoscopy other than it’s necessary for the Botox. The insurance won’t pay anything until I hit that $1500 mark. It makes this very frustrating and hard to decide especially when the results seem mixed yet I’m feeling desperate.

Aaah. So that's your deductible. That really sucks.

My guess is that since most CRS's don't believe that it works, the government won't pay for it.

Maybe you'll have some relief from the cream over the next few days and can then make a final decision. Can you check with the CRS though, to find out what he thinks the chance of success is? If only 10% of his patients find that it works, I'm sure that that would influence your decision.

Have you ever tried it? I’ve done some research but it seems to be mixed results. I’m having a hard time committing to something so expensive that I’m not even sure will work and I just reaggravate after a couple months anyway. I’m leaning towards putting it off until my next episode assuming this one eventually heals. It feels like it’s been forever.

No. I did several creams and then LIS. I'm really glad that I did it too.

My CRS said he didn’t want to do LIS right away because of a chance of fecal incontinence and I’m only 32. I’m going to cancel the Botox. I feel like the cream is slowly getting me where I want to be...I can handle discomfort or small windows of pain after a BM. It’s when it’s all day and never ending that I think I’ll consider a crazy expensive and not a sure thing procedure. Maybe when it’s reaggravated I’ll get plane up to Canada for the procedure

Yeah, my 65 year old surgeon has done a LOT of LIS's and has never had anyone come out with fecal incontinence and told me that only one of his colleagues had a bad outcome patient, and that was only incontinence to gas. I guess that the more your surgeon has done the procedure, the better. Good luck!

Yikes! My surgeon looked no older than 35. Lol maybe I should look into a second opinion

Even at 35, he could have done enough to make him more than competent, but you really need to ask about his success rate before making a decision.