Finally went to Pelvic Physiotherapist early last week. Internal rectum exam outcome super tight spincture and surrounding muscles. Even though I had botox 8 weeks ago. She only could get index finger in slightly. She suggested slowly using dilators twice a day for 5 mins. The silicone even with lube feel dry so resorted using pinkie finger then now slowly with index finger. The weird thing is since 9 days ago I now have very little pain opposed to daily 5 hours plus pain. I have been also massaging muscles and tissues around rectum.
This is a huge positive change for me so feeling there is finally hope in this 1.5 year af story.

That’s great! I have a Pelvic Floor Pt appointment in August - hoping to have my fissure healed by then w diet and nitro (really trying to stay away from surgery rn) Was the digital exam gentle? I’m worried about any exam they do irritating or reopening/retearing

No not at all. As she took it very easy as I was so tight. She didn't get far so she was aware not to traumatize that area