Thank you, I think we're all kings and queens of pain and we all deserve the title! I think the hot water causes the blood to flow better in the area(not sure!) but I think it relaxes all your muscles including the splincter muscle that needs to relax. I always bath in either epsom salts or savlon, which are both really soothing. My crs told me not to put anything in the bath as it may irritate, but I read somewhere that plain water causes the skin to swell, but epsom salts draws inflamed areas out. Is that right, guys? I don't want to post wrong information! Possibly though, what works for one person, might not work for another. I also think that sometimes, whatever you do, whatever you put on the damn thing, and whatever pain meds you take, nothing seems to work! I've had LOTS of days like that!!

Yeah, Epsom salts does help to draw inflammation and inpurities out.
I can so relate to having days where nothing seems to work. Or you could have a great day and the next day is so bad, you wonder if you imagined feeling better at all!

Thanks Val and Lecia. I will try the Epsom salts. My pain broke by Monday evening, and I have been okay yesterday and today, so far. The area seems so weak like two pieces of paper stuck together with fresh glue. Any false move will cause things to become undone! But, my bms are soft again, and if I learned anything from my CRS, it's that we need to keep things soft. I'm chewing my food real fine, and trying to be careful to have a well-balanced and limited intake, so we'll see. At any rate, I'm happy for now because I started a class at church three weeks ago, and I really want to complete it (10 weeks long). I'm doing the homework way ahead of schedule (I read the textbook in one weekend), because I never know what condition I'll be in on any given day. Amazing how a fissure controls your life! I will see the CRS this Thursday, and will ask about the sigmoidoscopy procedure (Val) and risk of tearing, in case we ever need one in the offing. Praying for both of you.
Queenofpain (AgonyAnn)
For He Himself knows our frame; He is mindful that we are but dust. Psalm 103:14.
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Thank you for your prayers. I will pray for you too! :)

Thanks, Lecia!

Hi Guys,
Okay, I really need help. My questions are bolded far below. Just to recap, I have had my fissure for 13 months now, and had seen a CRS last Fall (2006). He had recommended the usual conservative route first of a supplementary fiber (Metamucil) plus sitz baths. I tried this regimen, but eventually (within a week or so), the fiber seemed to be too much for me. It gave the stools too much breadth, and I would re-tear myself. It also caused too much straining, and too many bms. Drinking 80 oz. of water did not help. When I explained to the CRS last December that I had to drop the fiber aspect of the regimen (I had even tried less than a teaspoon per day), he said he really did not need to see me anymore, and that it looked like I had my own regimen. I was shocked, since I was, and continue to be, FAR from being healed. At any rate, things improved somewhat beginning in February 2007, but began to deteriorate in late August/early September 2007 for some unknown reason.
Thus (I'm trying to make this short), I made another appointment with the CRS last Thursday to see what he would recommend in terms of treatment at this point. From the moment I walked into the office, I could tell he did not want to see me because I had given up his regimen of Metamucil plus sitz baths 10 months ago (I guess I didn't get the message back then). If I am not mistaken, he said that 95% of his patients heal with his regimen, and in so many words, I was not complying by taking the full dose (even he agreed last December that I should drop the dosage). I nicely explained to him that the fiber was too much (I was having 8 bms a day, and even he thought that was too much at the time). He said Thursday, i]"You've had this so long,"[/i] implying that I was the one prolonging it. I was totally shocked by his demeanor, but I persisted anyway, and asked if he would answer some questions. He replied that he did not see the point. He told me to Google the American Board of Colorectal surgeons, get a second opinion, and see if what he is saying is true. (Val, if you are reading this, I did manage to ask about how they would perform a sigmoidoscopy on a fissure patient, if warranted. He said they wouldn't do the procedure until the fissure was healed - or they would do a colonoscopy if they thought there was a greater problem, and they would use anesthesia. He really did not want to deal with me, so I could not ask anymore about it.)
At any rate, sorry for the long post, but I'd appreciate any replies to the following:
1) Anyone have a bad experience with a CRS where you felt greatly misunderstood? Anyone told to find another CRS, in so many words? I really left in shock and awe. It's not like I didn't try his regimen. I had expected that this time he would try to figure out why the fiber was causing so much trouble, and proceed with another recommendation, i.e., cream like diltiazem. It sounds like he goes straight to surgery from fiber/sitz treatment because only about 50% heal from the creams.
2) Anyone have a bad experience with supplementary fiber?I tried both Metamucil and Benefiber, with the same results. Of course, I want to follow his regimen, but I was so afraid of all the straining, soreness, and tearing, that I had to quit after a few weeks. I was terrified of causing more problems. What was I doing wrong? I was drowning myself in water.
3) Anyone know of an experienced, sensitive CRS on the North Side of Chicago (or downtown)? I don't have a car, so he/she has to be in the city. I really need someone who has performed hundreds of LASs (the surgeon I saw has done hundreds - I asked, and he is reputed to be very good), and who will listen, and try to understand what I am saying.
HELP!!! I have to get out of this pain. Last week, I was doing better until I stooped to wipe up something I spilled. I have been in pain since, but the CRS looked askance when I told him that certain postures seem to re-injure the fissure. He implied that it is not possible - it is all related to the bowel movement. But I didn't have a bm that day (which was not unusual). I have had the identical experience on other bm-less days. I just couldn't explain that to him.
Thanks for all your support. A lot of people just don't understand the pain unless they've been there.
QueenofPain (AgonyAnn)
O give thanks unto the Lord; for He is good: because His mercy endureth forever. Psalm 118:1[/u]

1) Anyone have a bad experience with a CRS where you felt greatly misunderstood? Anyone told to find another CRS, in so many words?
Yes-The first CRS I saw dismissed me as having post-partum depression and told me there was nothing he could do. I never went back. Of course I was depressed-I was in severe pain and wasn't being taken seriously.
2) Anyone have a bad experience with supplementary fiber?No, but that doesn't mean that it can't happen. I don't use fiber anymore just because it does create more bulk and I get enough dietary fiber. You know your body best and the CRS sounds very arrogant to assume that "his" method is sure-fire. I try to take a doctor's advice but if it isn't working I don't continue because in the end it is my body and I have to live with the treatment regimen and the effects. I have had some bad outcomes from following a doctor's advice against my own intuition. I think you are right to cut out the fiber. You may need to try probiotics like acidophilis.
3) Anyone know of an experienced, sensitive CRS on the North Side of Chicago (or downtown)? I don't but I can ask my CRS in a few weeks when I see her if she recommends anyone. Just remind me. But frankly, anyone sounds better than this guy.
HELP!!! I have to get out of this pain. Last week, I was doing better until I stooped to wipe up something I spilled. I have been in pain since, but the CRS practically laughed when I told him that certain postures seem to re-injure the fissure. He implied that it is not possible - it is all related to the bowel movement. I didn't have a bm that day (which was not unusual). I have had the identical experience on other bm-less days.He is wrong, and my CRS told me I could reinjure the fissure from squatting or picking up my child etc. Any doctor who thinks he has all the answers is scary. Doctors should be humble and able to synthesize information the patients gives him into his "equation."
Thanks for all your support. A lot of people just don't understand the pain unless they've been there.
We are glad to be of service. At least from my pain I can help others so it doesn't get wasted. I am so sorry you are going through this and that you haven't had the treatment you deserve. I will pray for your healing and the guidance to find the right doctor.
QueenofPain (AgonyAnn)
O give thanks unto the Lord; for He is good: because His mercy endureth forever. Psalm 118:1[/u]

oh i am very tight and i had a colonoscopy. and no tear/retear by the CRS. he was perfect. i think the colonoscopy actually helped giving me a nice little stretch and relief afterwards as everything felt really good after it.
i was only twilight sedated and not totally under.
i wish i could feel twilight every day! :-)

Hi Lecia and Happyass:
Thank you very much for the replies. Lecia, you are an awesome moderator (thanks for the prayer). You sound like you endure so much pain, yet you continue to reach out to us with your wisdom. I think my CRS (former) is probably an excellent surgeon. I'm just baffled why I don't fall into the 95% success rate with conservative treatment. From what I tend to read, only about 40-50% of fissure patients heal without surgery (I don't know how valid these studies are, so I take them with a grain of salt), so I don't know how any CRS can have a 95% success rate with conservative means. I'm thinking, if fiber and sitz baths were all that were needed for most of us, we would be taking away a lot of the CRSs business! Plus, it would be all over the internet. I hope I can heal with natural means, too, or at least with creams, but I need better pain management. I felt so unwelcome in there, I couldn't even ask about Ultram, like I had planned. I know that 5 Advil in the course of a few hours isn't helping enough.
Happyass - Thanks so much for the encouragement about the colonoscopy. I just wanted to know in case I ever have one for routine purposes down the line. I know that everyone's experience is unique, but it is good to read of success.
I pray for both of your healing.
QueenofPain (AgonyAnn)

I'm thinking, if fiber and sitz baths were all that were needed for most of us, we would be taking away a lot of the CRSs business! Plus, it would be all over the internet. That made me laugh! If it were that easy, none of us would be moaning and groaning on this board. If you had told me I would have ever been a moderator for an anal condition I would have died laughing! But butt problems are no laughing matter.
I hope I can heal with natural means, too, or at least with creams, but I need better pain management. I felt so unwelcome in there, I couldn't even ask about Ultram, like I had planned. I know that 5 Advil in the course of a few hours isn't helping enough. I think the cream will help you with the pain too by relaxing the muscle. Do you have a general practitioner that you like? Maybe they can prescribe the ultram for you. That is where I got mine from. Are you taking 4 advil at the same time? I wouldn't wait for the pain to start. Take it as soon as you get up before you go to the bathroom.
I pray for both of your healing.Thank you so much.
Lecia