Butthurt, but hopeful...after 4 months of agony...

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Butthurt, but hopeful...after 4 months of agony...

Postby butthurt2013 » 15 Mar 2013, 02:31

So it’s come to this…long time lurker, first time poster here. Male, 41, married, 2 kids, full time school. I’m relatively healthy. I drink over 100 oz. of water every day as part of a weight/fat loss regimen (its working I lost over 60 lbs. last year). I eat healthy for the most part with a fairly acceptable level of “crap food” intake. Busy. I am too busy for this. I Got my AF over Thanksgiving. I thought it was just bad hems, since I have suffered from that since I was 27. I am writing this in the order I discovered each of these revelations and the details surrounding them, I hope it helps someone. And if anyone reads through this and has advice, I'd love to hear it.
After Thanksgiving I spent about a month and a half in agonizing pain, trying every internet-home remedy I could and getting nowhere. Garlic-nothing, Apple cider vinegar- nothing. Witch Hazel- nothing. Vapo-rub provided instant relief but it fades fast and throbbed and swelled for hours after. Ice- nothing. I bought Anu-ice product online-no relief. I bought Hem-Away toilet seat online earlier this year for hems and I’m not sure but it might have even caused my fissure. If anyone has found relief with these products good for you- they didn’t do squat for me, and I wouldn’t recommend them to anyone. I never went to a doc for this before because these problems rarely if ever lasted this long. After Christmas the pain was so bad I decided to go see a doctor. I don’t have a PCP so I got online and went to a clinic specializing in our special fun brand of injury.
First tip here: look online and find a specializing hemdoc like this in your town, it will be educational even if it doesn’t solve your problems.
The doc said I had 4 large internal hems, each one the size of giant raspberries! And he said I had an AF, which freaked me out since I had never had one of those before (at least I thought). He probed me and zapped the hems with electro-something or other. It was hard to tell if it did me any good, when I left I was in more pain than when I showed up. In retrospect this could have been from being so inflamed from all the crappy home remedies, which the doc informed me every single one of the ones I mentioned are bad and will only make things worse. Garlic and ACV will remove the tender skin down there, literally burn it away! Vapo-rub has camphor, which can be poisonous when ingested or whatever anally! All bad all the time…
The positive from all this is I am 41 and got a sort of early mini-colonoscopy, the doc could safely tell me I had no polyps in my lower colon and did not detect any problems with my prostate. No butt cancer! Believe it or not I was a little worried about this after 14 years of fairly continuous problems with this issue. So that was at least some good news.
The doc advised me to adapt a high fiber diet and avoid spicy foods (both are good advice). He also gave me lidocaine gel, which I found not so useful, the numbing effect was weird and it just felt as though everything was really swollen (which it was) down there after using it. The best thing he gave me was Surgilube, very useful (I’ll get to that a little later)
So I followed the doc’s advice about the diet, eating only half-steamed broccoli and small amounts of lean meat as my dinner, almond milk, gluten free bread and cereal, etc. I eliminated almost 100% of gluten and dairy from my diet as well. I did it like I meant it, hardcore. I did not experience relief, even after my BM’s bulked up, they were still pretty hard to get out and I had to push.
Second tip: Never, ever push. Wait until that poop is going to destroy your favorite outfit then finally let it come out on its own. If you push you are destroying any progress you have made instantly. The only way for your sphincter to relax (more on this very important detail later) is if the poop is ready to come out on its own, if you have to push then the AF can tear since the muscle it lives on is so tight.
Third tip- Stand on the bowl and squat. Get good at this and you’ll be able to relax easier and you end up having less to clean up (less wiping). To avoid splashing put a bit of TP in the toilet water before you let your bombs drop.
Fourth tip: NO TOILET PAPER, ever. Use baby wipes. Only wipe off the big bits. Don’t rub hard or try and get all the way clean by wiping. This will aggravate everything every time. Put a freezer bag next to your toilet to keep the smell down, or buy flushable wipes (way more expensive and not as good overall).
Fifth tip: Get in the shower right after a BM. If you don’t have one, go buy one of those shower massage things that has a hose. Put it on a very GENTLE setting, squat, and spray clean with hot water. The heat will help sanitize the area without using too much soap (just a little bit at the end) most of which will irritate everything down there (I use Dr. Bronners Tea Tree oil castile soap, DON’T GET PEPPERMINT), this is all natural, no chems whatsoever, and it’s safe for the area. The heat will also increase blood flow down there, which might sound counterproductive, but it actually isn’t.
So after going back to see the doc a few more times, getting probed and zapped and wallet-pinched, I wasn’t feeling any better. The doc suggested stool softeners and referred me to vein doctor. He said the pain shouldn’t be so intense so he wanted to make sure he wasn’t missing anything. I was cool with that because I was tired of the pain and welcomed another chance to lay on my side and let some old man check out what I look like on the inside, yeah…great.
Vein doc said “yep, you have a fissure. I can cut it out no problem.” He offered me codeine which I gladly took. This was a mistake. The pain is bad but codeine is worse. The constipation effect was instant and unreal. All progress made, completely gone in 2 days of not pooping and one horrible morning trying to pass golf-ball sized clay-feeling nuggets. Just don’t go there. The pain is nothing compared to haw bad it could be. Plus the pain meds made my head fuzzy, and I couldn’t concentrate and had to get a medical withdrawal from one of my classes, which really sucked. I'm a 4.0 student and if this stupid injury screws that up for me I am gonna be pretty bummed out. I've worked really hard.
So I go home and look up fissurectomy on google. Nope, not for me, no thanks. More like hell no, just shoot me instead. Horror stories of not being properly healed 2 years after surgery combined with the threat of incontinence is enough to scare me out of eating , I’d rather switch to a liquid diet. Absolutely horrified at the prospect of surgery, I redouble my efforts with respect to diet and maintain this nightly regimen (even now):
Sixth tip: Soft poops are good poops- Every night take this cocktail- Miralax (mix with any liquid except beer, it makes it flat) Colace (3) Citrucel (3) and Senna (2). This will practically guarantee a nice, big, soft poop in the morning. Generic equivalents are fine with this stuff, and will save you a ton of money. And you can take it all safely forever if you need to. (I read that on the internet-don't take my word alone, NOT A DOCTOR)
This goes on for a while and I feel a slight bit of improvement, until one day when I must have gone off-track with the diet or water or something, but I was constipated for 2 days even with the regimen and had a horrible episode in the can that pretty much destroyed all my progress again. This seemed to be a pattern forming and I hated it. At this point my social life has all but dried up. All of my friends are tired of hearing about my “back pain” (yeah I’m really going to share this, how humiliating). My wife is having trouble accepting that I can be in this much pain for this long, so I showed her some of the posts I found here with women comparing the pain to their c-sections or even worse and that helped with that. No one can really understand this unless they have lived with it themselves. My 14-year old son doesn’t give a poop about my pain, and my 2-1/2 year old misses me, since I end up lying on my side upstairs every waking moment that isn’t fulfilled by an obligation to support my family. At this point I am completely fed up with life as it is and really hate every day more than the next. I go to a new doctor and get the codeine switched to Tramadol, constipation gone, pain still bad but better than nothing. She also gave me a scrip for Diltiazem, AKA on some forums as the “non-surgical fissurectomy”. This is good stuff, burns a little, but no bad headaches like nitro paste apparently gives. Diltiazem is compounded scrip; they have to mix it up. I’ve read horror stories about the dosage or the mix base being wrong. Mine was mixed with surgilube, which is perfect for dilation as well (more on this below).
Recently I started digging around on the forums again for some hope (I’m sure some of you can relate), and I think I might have found some. I read a post about dilation. Apparently some doctor in NY (along with a bunch of others all over the world) practices a new form of anal dilation, very different from the oldschool hand stretch they used to do. They basically fill up a balloon in your butt or jam a series of what are essentially progressively larger dildos up there for 1-8 minutes. The idea is that this dilation allows the muscle to relax, which removes pressure from the fissure and allows it to heal. I was intrigued but not ready to order a 50 dollar dildo kit form amazon yet lol.
Well, needless to say it sounded weird at first, and I’m a straight male who is not into having stuff up there generally speaking. I had already discovered something before this though- a lubed up finger can clean you better than any wipe or hot water or soap, because you can be gentler and not damage anything, and you can wash your hands with something stronger. So my finger had been up there, just not for any length of time really. So when I was cleaning up there anyway, I tried it. I left my index finger up as far as I could for as long as I could, which turns out is not that long, maybe one minute or so. After the minute passed, I slowly and carefully withdraw my finger, wash up, and notice almost instantly that I feel better. Not only does some of the pressure on the AF go away immediately, but 2 external hems that were thrombosed and really painful slid back inside almost magically. The sense of relief was profound, just huge. I felt better for a few hours and the pain returned.
Seventh Tip (lucky seven): Self-dilate!
Since then, maybe 3 or 4 days ago, I have been self-dilating with my finger 3-5 times a day, for as long as I can each time(up to maybe 4-5 min). So far using just my finger, I haven’t experience any incontinence, which apparently can be a concern. The relief I feel right after is worth the weird, lame humiliation I experience by probing myself so regularly, and being so grossed out by my dirty finger. My overall sense of relief is up, big time. I actually feel like I am healing now. I’ll repeat that. After nearly 4 months of agonizing pain and a general sense of hopelessness, I THINK IT MIGHT BE HEALING UP THIS TIME!
I was going to wait until I healed all the way to post but I thought about the level of pain I’ve had and the relief this brought me and I thought I should post it sooner than later so maybe it could help someone else feel better too. I hope you all feel better soon.
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Re: Butthurt, but hopeful...after 4 months of agony...

Postby PIA » 15 Mar 2013, 02:46

Hi Butthurt, Great post. Lots of useful info. I have to say the same about everything you said about the finger up the butt. I hold it there for a while after inserting the nitro and it does relax the sphincter. The first few weeks after I tore my fissure I don't think I could have stood the pain of doing it..butt I will never know cause embaressment and fear prevented me doing so until recently. Please keep us posted. Xx Pia
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Re: Butthurt, but hopeful...after 4 months of agony...

Postby butthurt2013 » 15 Mar 2013, 02:48

I almost forgot one other great tip I got somewhere on this forum: Desitin.Get the Maximum strength, I think it's 40% zinc oxide. Use this post BM, post dilation, anytime really. It forms a moisture barrier and really helps with the irritation and itching, almost instant relief...
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Re: Butthurt, but hopeful...after 4 months of agony...

Postby butthurt2013 » 15 Mar 2013, 02:50

Embarrassment and fear is a good way of putting it, PIA. I wish I would have started dilating sooner.
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Re: Butthurt, but hopeful...after 4 months of agony...

Postby owmybum » 15 Mar 2013, 04:58

Thanks for sharing your experiences butthurt.
I hope you continue to improve!!
OMB xx
fissure after hem banding and tag removal feb 11
Pelvic floor therapy
Diltiazem
Botox June 13
Nitro
Internal flap July 14
EUA and polyps removed Nov 14
Diagnosed with neuropathy Jan 15
Diagnosed with HS EDS type 3 (causes poor wound healing )
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Re: Butthurt, but hopeful...after 4 months of agony...

Postby delasama » 15 Mar 2013, 10:14

Butthurt2013- my story is kind of like yours. My fissure even started right after thanksgiving also lol.
How long have your been on stool softeners?
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Re: Butthurt, but hopeful...after 4 months of agony...

Postby butthurt2013 » 15 Mar 2013, 12:28

Del- I've been on my nightly "cocktail" for about 2 months. So far no adverse effects from that, it seems to help a lot because if I forget everything is worse the next day.
3 colace, 3 citrucel, 2 senna, washed down with a cap of miralax in 8 oz. water.
Yum.
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