Luka,
I'm glad your feeling a little bit better :).
Pls pls don't be afraid easier said than done I know. Really I was like you so afraid but my pain was so bad I thought one day I'd kill myself honestly fissures make you feel this way. I said to myself surgery can't be any worse. I had the passing glass pain & in horrible spasm for hrs Botox did help me to begin with but didn't last so I had to have LIS I couldn't face that pain again. I had my first BM 2 days after surgery I was terrified as I had stitches up inside me from tag removal but to my amazement there was no pain from BM. My only pain was from LIS site which was painful but very manageable.
I hope your not waiting too long for an appointment.
Take care x

Luka, sorry that I missed your post. I've been delaying surgery too due to panic attacks, irritable bowel and chronic pelvic pain syndrome. The CRS that I was seeing treated me like a complete coward because I asked questions about how the surgery would effect these conditions. He won't give any helpful answers or advice, just that the surgery is no big deal and that I need to "get myself together and face the facts". He's highly qualified, board certified, been in practice for almost twenty years but his personality trumps all of that. I keep thinking that if I do have the surgery (he wants to do LIS and Fissurectomy together), that he'll never take anything I say seriously if I have complications. I fully understand how you feel, panic attacks are pure torture in my opinion, and there is little if any support or understanding from most of the doctors out there. I hope that you continue to feel better. I'm always happy to talk about this so let me know if you need to talk some more or p.m. Take care.

I know my situation is different then yours as all of ours are, But what I do know, is when I had my setback, this forum and these amazing people have been incredible.
Plus, take notice in your set back, are they different, maybe less pain or blood or what ever then before. I know my setback, terrified me, but after I calmed my self down, with the aid of everyone here, I was able to re-access my situation.
It was a weaker set back, then before, painful, but the scale was less, so try to look at it that way, so you can get back on track again, try to relax more. we are all here for ya..
But what ever decision you make, glad you have a well recommended Doctor..:) 

Hi George - Thank you for your support. I'm sorry to hear you are suffering, too. It sounds like you should find another CRS. If I had someone like that who wasn't very understanding, I'd find someone else. I know doctors like that can be hard to find, but they do exist. Any surgery would freak a person out, especially one on your butt! Being prone to panic attacks makes everything so much worse. All I know is that if I got the surgery, I hope they knock me out completely because I won't be able to stand it. More than anything, though, I think it's the recovery from the surgery that scares me the most. I've heard horror stories about it online and it seems like it's brutal for 90% of people. Not something I am looking forward to! It seems like things have to get a lot worse (surgery recovery) before they get any better. : ( That really frightens me.
Please go-away! - Yes, I am very happy to have this forum to turn to. Nobody else in my life, including my boyfriend, family, and friends, understands. It's really difficult talking about this.

I know how you feel Luka, I have one sister, who does listen and help's , the other just argues, well, get another part-time job to compensate, how are you going to live. My brother, since I live with him, just cares if I have money to help pay what I can..it's difficult, I was feeling happy after my first day on the job, until my sister brought me down.
well I'm OK now, just taking a deep breath, and please take a deep breath Luka, until that time may come, stressing about it, is something you have to avoid. I know easier said then done.
There are a lot of successful stories.I'm so glad, yes that we are all here for each other too. all.

Hello Luka. I completely agree with you that the most frightening part is the period after the surgery. I've had two colonoscopies and had no problem with the procedure but the LIS and Fissurectomy are different. It's not even the pain that bothers me as much as the bleeding, risk of infection, urine retention etc. that I've read about. I think that I can deal with the pain if it's not severe, it's just all of the things that can go wrong and not knowing what's normal and what should be reason for concern. It's hard to explain. I guess if I was in severe pain like so many others, I'd go for the surgery and figure that I'm already in pain, what is there to lose. But, on most days if I don't have any more stress and anxiety than usual, I can deal with it. When I had the surgery scheduled last month and had to postpone it, it was due to high blood pressure and almost daily panic attacks. I felt like a quitter because I had everything set up and then postponed the appointment. It's been such a struggle to deal with and try to get past the panic attacks, not this is causing it all to come back again. I may try to see another CRS, but right now I'm trying to get the panic back under control. I hope that you're doing better, it's such a daily struggle. Good luck and I'll be glad to talk if you'd like.

George - It sounds like we are in a similar situation when it comes to getting the surgery done. My pain seems on and off, even during the worst of times. It's not a constant problem and I don't have pain during bowel movements or any bleeding (never have I once bled from there in my entire life). The pain comes afterward and can last a few hours. When I'm under a lot of stress, I will get flare-ups with a lot of burning and stinging around the fissure area.
Even though surgery has a 95%+ chance of curing the problem, there is a high possibility it will get a lot worse for me in recovery before it gets any better. Recovery is horrid for so many people (except those that get really lucky, it seems). That alone scares the heck out of me. Some people are in a lot more pain with their fissure, so surgery isn't as difficult a choice for them. That's not the case with me, though, as it doesn't seem for you, either. It's a very difficult decision.
I've had surgery before (hernia surgery when I was 8, which terrified me... I cried through the whole thing) and got really ill from the general anesthetic afterward, so that freaks me out, too. No way would I want to be awake during the surgery, though! I'd completely freak out!
Do you take antidepressants or other medication for your panic attacks? I know Prozac helps me a lot. It doesn't completely get rid of them or prevent them when things are really bad for me, but it helps to take the edge off. I was a complete mess before I started it years ago.
I guess we will both know when the time is right to get the surgery. I'm still holding out hope that this will go away on its own, though. I still want to give myself a full year to get over this. Then I will consider other options after that.

Hello Luka, Yes, it seems that we're both in the same situation. I don't have pain during bowel movements anymore since I started using the Nifedipine ointment. I did prior to starting so I don't know whether it will come back if I stop using it. I've had other surgeries that were painful and it really didn't bother me that much. I had all of my toe nails removed, two at a time, due to chronic ingrown toenails which were coming from a birth defect on my right foot. The pain to numb the toes being worked on was bad, then the area where the nail was removed hurt for almost a week. I've also had moles removed and the skin removed around them for skin cancer. The difference for me was that I could let those areas rest. After the toe nail removal I cut the front half of an old pair of shoes and kept them elevated as much as possible and the area could rest. Same deal with the mole removal. The area around the fissure doesn't get a chance to heal due to bowel movements and seems to me an area very likely to get infected. Having irritable bowel syndrome means that I can have as many as five bowel movements per day so I don't see how it can heal properly. I've tried every common treatment for the IBS and it's still a problem. This combined with the panic is what is making this so difficult. I do have bleeding from time to time but not much pain unless I don't eat for awhile. Then I get a feeling like there's hard stool that is causing the pain then it eases up after a bowel movement and the ointment. What a situation!
As for medication for the panic attacks, I take Xanax 0.5mg twice daily. I've been on the same dosage since I started when I was 19. I'm now 48 so tolerance has not been an issue. I was given every SSRI medication (like Prozac) and it made my anxiety and panic worse.
I'm going to talk to the primary care doctor on Monday and ask about seeing another surgeon. Maybe it'll help me if he/she is a bit more understanding about my situation. The guy that I see now is completely insensitive and doesn't want to hear my concerns or answer questions. Maybe another dr. will give me a better perspective. Like you, I still would like to give this more time, unless the pain suddenly gets worse. Then the decision will be made for me. Hope that you're having a good day, glad to hear from you.

Hello again George – I also use the ointment, though I use Diltiazem. I’ve been using it for months and I’m not sure when to stop using it. It helps the spasms when they are at their worst, though, so I keep using it. It’s better than nothing and at least it gets blood flow to the area.
Ouch! I’m sorry to hear about having to get all your toenails removed. I know it’s nothing compared to that, but I also had an ingrown toenail on my pinky toe when I was 10 or 11, as well as a nasty wart that wouldn’ t go away. Unfortunately, I got stuck with a quack doctor and he did surgery on me, which did nothing to correct the ingrown toenail problem. He supposedly used a laser, but it grew back a month afterward. I’ve just learned to live with it, though, since it doesn’t cause me any pain and is just ugly-looking. I also had a gaping hole left in my toe from the wart removal, which turns out was completely unnecessary because I could have just used over the counter medication to get rid of it (freeze it off). The shot I had to get in my toe was horrendous pain and recovery was awful, too. I never want to go through that again. What I’ve learned from that experience is always find a reputable doctor and always get a second opinion. I was a kid at the time, though, so I didn’t know any better.
I used to take Xanax for anxiety and panic attacks, but it caused terrible fainting spells in me when I used it on a regular basis and I also started to become addicted to it (addiction to drugs and alcohol runs in my family). I only take it if I’m really stressed out about something, like before I have to do surgery or a medical exam. I know Prozac can make anxiety worse in some people (it actually made my anxiety worse before it made it a lot better, strangely), but it works for me, so I keep taking it.
I also have several bowel movements a day, which I know doesn’t help healing like you said. I usually have 3 in the morning, which I think is enough to irritate the area. I don’t think I have IBS, but I wonder sometimes. I rarely ever get constipation. I’ve changed my diet and done all sorts of things (eating less, eating less fiber, etc), but I still have that many bowel movements. I don’t want to eat even less or I’ll lose more weight and won’t have any energy to heal. I think it’s just normal for my digestive system since I know everyone is different. I envy those people who only go a few times a week (not every day) and don’t have any issues with constipation despite going less often. *sigh* I’d love to only have a few a week, but I just don’t see that happening because of the way my system is.
I think that’s a great idea about finding another CRS. I hope you can find someone a lot more understanding and that will care about you as a patient by addressing your concerns and questions. I wouldn’t settle for someone uncaring and cold. It’s best to always get a second opinion, too. I wish you the best of luck finding someone that you are comfortable with! I am going to do the same.
Hope you are feeling better today, too.

Hang in there Luka, (and George too)

It's SO normal to fear the after effects of any surgery and anal surgery seems so much worse because of where it is, BUT please try not to google too much and absorb some of those "horror" stories you will come across online. It's very rare that most people suffer to a great extent and I do believe some people relish over-exaggeration and drama in their lives. If you read the stories on this site, which is by far, the best and most practical, I have ever come across, people are simply relieved to have been there, got it done and embrace the fresh opportunity to get on with their lives again. I don't believe I have come across anything here that is scary and awful and sure, there's always some pain and discomfort in any recovery but it fades with time. There is no question of you being awake during the surgery as a good CRS will want you asleep for both their needs and yours. You have to keep a sense of pespective and it is ultimately about weighing up whether you want to spend your life living the way you are right now or take a bold step and convince yourself you are doing it for the best. I so believe that you are actually doing OK but you do need to speak with your CRS and weigh up your options for sure. I so understand too how your anxiety makes this all 100 times worse for you and it's so easy for people to say "Pull yourself together and just do it" but they are not you and unless, you suffer that anxiety syndrome, no one has any idea of how powerless and terrible it can make you feel. It's incredibly debilidating -I know too, having been there, & I feel so much for you. I would just say however, from my own experience, the most powerful boost I had, was just knowing that I was healing and the final confirmation that I had healed. My confidence just accelerated as I got better and better and felt more liberated again. The AD's really helped take the edge off for me too, but constant support from my GP and family just helped immensely.......I also had to adopt a lot of positive thinking & self talk strategies to get me through it all and I took great comfort in meditation/ relaxation techniques too.
Have you had any cognitive therapy to help you deal with your anxiety? Have you considered Hypnotherapy or any alternative therapies too? I have read some great self help books through my worst times and tried a lot of strategies too to get me through my anxiety & depression - I can recommend you some great books if you need them??
I also found a lot of comfort in reassuring quotations -
Anais Nin is one of my favourites and the one quote I now have framed, which really inspired me through some of my darkest hours (although not AF related at that time), when I was truly stuck in a rut and living my days in constant fear & with relentless panic attacks, is as follows : -
"And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom"
She has many more quotes on this site if you are interested -http://www.brainyquote.com/quotes/quotes/a/anaisnin120256.html
You just do what you need to, in your own time and own way, but try to stay strong and keep telling yourself that life will not always be like this for you. It WILL get better. x x