Well, other than that, he is good, after all he managed to reduce my fissure from 15mm to 3mm in 3 months and a half, which I think is pretty impressive (that's me, I forgive easily). Part of it is his merit, but I think he got a bit too zealous with the results and thought some massage would come handy. I'm starting to think he likes his job too much, you know what I mean... He has reasons also, since I had that folding issue, he wants to make sure it won't stick again. So far so good, the base of the triangle (that points upwards) that he cauterized last time, which is the place where the fold was, has now started to heal, turning the triangle into a rhomboid. Sure sign that it is closing in. At this pace, I should be really left with a real small thing on the next appointment. If it's a 3x3x3x3 rhomboid now, I'm hoping for a small cut of 1-2mm 3 weeks from now. But I will definitely not allow him to massage anymore.
Not sure nitro is a practice in my country, he keeps giving me all sorts of herbal ointments. I also cut back on Manuka, kinda neglecting it lately. Maybe I should restart the good old routines.
I already had botox and it was great while it last. But my doctor thinks it's ridiculous, since I got a long way already. I think he thinks I'm chicken :) The truth is my numbers look great, length and pain levels have decreased dramatically, but the duration of pain seems to be the same! And I got to the point where I'm so aware of what's going down there, that I can only fall asleep with a totally relaxed sphincter.
Anyways, it would cost me another $250 for a 2nd shot of botox... Other than that I payed a one time fee of about $650 for the whole treatment, which included two cauterizations, botox, ointments, anesthetic gel and hem banding to come. When he's all done with me, I'm suppose to walk away with a brand new arsehole for that money.

Date: July 21th 6:00PM
Days since last BM: 2
Bristol: 5, real easy and quick
Swelling: during BM
Blood: no
BM pain: 0, barely felt one single pinch
Post BM pain: peak of 3
Spasm: mild contraction
Hours in bed: 4-5, looks like I'm gonna sleep through the night
Pain next day: 0-1
OK, getting back on track. Still these annoying couch potato sessions...

Date: July 24th 0:30 AM
Days since last BM: 2
Bristol: 5-6
Swelling: yes
Blood: no
BM pain: 1
Post BM pain: 5-6
Spasm: strong
Hours in bed: awake all night, barely fell asleep at 9AM
Pain next day: 0-1
Unexplainable set back, serious spasm like a didn't have in months. It came fast, so couldn't sit long enough in the bath tub prior to BM. By the time I applied vaseline it was already popping its head out, so it just mixed with the stool and I don't think it covered the fissure properly. Soft stool, but the 6 part got stuck. Didn't quite strain, but it took longer to release. Strong spasm started right after BM and kept in the tub almost all night. It would just lock in and needed real hot water above 40C to relax it. I was on and off the tub for 9 hours.
I carried my 3 years old daughter and a heavy backpack for some kilometers yesterday, don't know if it has to do with that. Also drove like 500km. Didn't feel any discomfort at the time.
Asked for an appointment for botox, 2nd round, this long sleepless nights are becoming too much. It's a small fissure now, it doesn't suppose to give this kind of pain anymore. Don't get it. I wonder if there's something else going on there.

Sorry BGD about the setback. I have had quite a few, just when you think all is okay, BAM the monsters try to resurface. When did you have Botox? I am 16 wks in and I am so much better than I was, but not quite healed! I will have more Botox if required. I do hope you get back on track, nothing worse than having sleepless nights!!!

Date: July 27th 3 PM
Days since last BM: 3
Bristol: 5-6
Swelling: yes
Blood: no
BM pain: 1
Post BM pain: 4-5, with a 3-4h delay
Spasm: significant
Hours in bed: 0
Pain next day: 0-1
Major milestone. For the 1st time in 4 months I was able to walk away after BM and not go to bed. After 3-4h sitting/standing pain started to increase so I needed to lay down and pain stopped so I could sleep through the night

Date: July 29th 0 AM
Days since last BM: 2
Bristol: 4.5
Swelling: yes
Blood: yes
BM pain: 2-3
Post BM pain: 4-5
Spasm: significant
Hours in bed: 13
Pain next day: 1-2
Major setback. Slightly formed stool, non self running. Wasn't able to fall asleep till 9AM and continued to wake up every hour till 1PM. Got into a hot baths cycle that I think only made things worse. Annoying pulling that prevented me from sleeping. Called doctor and got scheduled for botox. Amazing how half unit on the Bristol scale can make the difference between no pain at all and over half a day of pain.

Date: Aug 1st 3 PM
Days since last BM: 3
Bristol: 5-6
Swelling: no
Blood: no
BM pain: 1
Post BM pain: 1-2
Spasm: no
Hours in bed: 0
Pain next day: 0-1
Another major milestone. Decided not to do hot baths anymore, did a cooler one instead and walked away. Rediscovered one of the older creams with lidocaine I was using before and I think it worked. Spasm never came, even after hours of sitting. I felt the sphincter getting more and more relaxed. It is exactly 4 months since I started the treatment with the first cauterization.

Date: Aug 3rd 11 PM
Days since last BM: 2
Bristol: 5-6
Swelling: no
Blood: no
BM pain: 1
Post BM pain: 4-5 with a delay
Spasm: yes
Hours in bed: 0
Pain next day: 0-1
Got encouraged with the previous successes and walked away again after BM. Pain came after 3-4 h of sitting, but went away immediately after laying down so I was able to fall asleep.

Date: Aug 5th 10 PM
Days since last BM: 2
Bristol: 5
Swelling: no
Blood: no
BM pain: 1
Post BM pain: 1-2
Spasm: no
Hours in bed: went to bed after BM and slept through the night
Pain next day: 0-1
No issues

Date: Aug 6th 4 PM
Days since last BM: 1
Bristol: 5-6
Swelling: no
Blood: no
BM pain: 1
Post BM pain: 1-2
Spasm: no
Hours in bed: 0
Pain next day: 0
Another major milestone: 1st BM outside home in 4 months. No laxatives, no baths before/after, no vaseline, no ointments. I was at the mall and hoping to get away with no.1 but no.2 came explosively so there was nothing I could do about it. Did some walking and sitting and 4h after BM I still have no pain. It would usually kick in by now.
After 4 successful BMs without an urge to lay down, but continue my daily activities I feel I'm slowly getting my life back. Feel like cancelling botox. On the other hand I could use some more sphincter relaxation, so I could eat some meat and get away with formed stools also, like Bristol 4.
I haven't felt so good since last year. It now feels like a small non-chronic fissure that is about to heal on its own.