I'm happy to report that I had my 3 month post-surgery follow up with my CRS today and he has reported that I look fully healed and it's all new skin now where the fissure / incision was.

This whole thing started around Christmas of 2015. We were making the drive to my Mom's for Christmas about a 10 hour drive, and the only thing I had to drink that day was a few cups of coffee and a diet coke. Top that off with some junk food on the road trip and that was enough to set things in motion. The next day I had a large very hard bowel movement. Took a lot of pushing and straining to get this thing out and when it did finally come out there was some blood with it, but not really any pain. I think most likely at this point I had obviously started to tear, but it wasn't that bad yet. I don't really remember being in serious pain till a week or so later. I remember having another BM but this time the pain was intense. I had no idea what was wrong but I had never had that level of pain before. I let this go on for a couple of weeks just trying to tough it out, but each bathroom trip was a nightmare. The pain wouldn't be immediate for me. I would have some pain initially while having a BM, then it would subside some and then about 15-20 minutes later the pain would kick in hard. Oddly enough, I never really had a large amount of blood like some people have though occasionally I would get some streaks on the toilet paper. The last straw in this was I had a dental appointment to get my teeth cleaned, but I had a BM about an hour before the appointment. I made it to the dentist and was sitting in the waiting room, but couldn't stand to sit. I had to walk up to the front desk and cancel the appointment because of a made up excuse, but I knew there was no way I was going to be able to sit still for 30-45 minutes. I knew that I had to get this thing looked at whatever it was.

I made an appointment with my primary care doctor for the next day. He did a quick exam, but didn't see anything wrong, but he called a CRS office here and got me an appointment for the next day, but in the meantime gave me a prescription for some anucort and some hydrocodone for the pain. Neither really helped that I could tell. I guess the hydrocodone helped take the edge off the pain some, but it was still pretty painful. When I went to the CRS I was pretty nervous. He had all these anal cancer brochures and pictures over the office, and of course at this point I'm thinking i got cancer or something and this is it. However, about 15 seconds into the exam he told me I had an anal fissure. He told me that his treament plan involved using diltiazem ointment and lidocaine for the first month or so. If that didn't work then he would do Botox and if Botox didn't work then we'd do LIS. He said that he thought I would heal with the ointment option though.

I went on for the next 2-3 months applying these ointments to myself down there. I also freeze little pellets of coconut oil and push them up inside before a bowel movement. That helped to coat the exit some for the BM and it also seemed to help with the pain some. For me, the lidocaine or diltiazem never really did much for the pain / discomfort. However, after a few months the pain did lessen considerably. I got to the point where Bm's were only minor discomfort. I thought I was on the road to recovery. I even saw the Doctor and he said just keep doing what I'm doing and I'll probably be set. However one day I had a little bit of a stomach bug and had a few extra bathroom trips that day. After that day I started getting some of that pain back, though it wasn't as bad as it was before, but definitely a setback. At this point in time I also developed an abscess that turned into a fistula. That abscess was pretty darn painful as well. Any sort of squeezing or touching back there would cause it to burn really bad.

I scheduled another appointment with the Doctor and this time he recommended that we go ahead with Surgery though not LIS. He said he wants to clean up the area a bit by doing a fissurectomy, drain the abscess, and perform a fistulotomy and a botox injection as well. I went ahead and scheduled surgery with him for a month later. I'll have to admit that I was pretty nervous at this point. My first surgery ever and it's going to be for my ass. Great...However, things didn't go as planned and my abscess got even more painful. I came back into the Doctors office 2 days later again because of the pain from the abscess. They went ahead and drained it for me right there and moved up my surgery from a month later to the following week and man am I so glad it got moved up. I was so nervous but in the end I had nothing to worry about.

Day of the surgery I did 2 enemas at home, plus I had consumed the 8 doses of milk of magnesia, between those 2 things I was clean as a whistle down there. Got to the surgery center in the morning, got taken back to pre-op and got changed into the surgery gown and met with the Doctor, anesthesiologist and my nurse. They briefed me on what was going to happen then wheeled me back to the OR. The nurse anesthetist gave me a mask for oxygen and then gave me 2 shots in my IV. She said this ones to make us friends, and this ones to make you feel good. I clearly remember one of the other nurses asking if they needed more KY jelly, and I cracked a joke about that's the last thing I wanted to hear then like magic I'm waking up in the recovery room. I don't even remember fighting the drowsiness or falling asleep. I've always heard stories of people counting backwards from 10 or trying to stay awake, but I got blindsided. I didn't even know I was being knocked out. I was just talking then I was waking up. Pretty awesome.

Met with the Doctor after surgery and he ended up not doing the botox injection. He said that while doing the fissurectomy he had to cut part of the muscle down there as the fissure had started to tunnel underneath the muscle. So it's kind of like a mini-LIS. Because of that, he felt the botox was not necessary anymore. He said my fistula was a simple one so no seton or anything. They gave me some tramadol for pain and some ketorolac for inflammation and wished me luck.

I had my first BM 2 days later and it was pretty easy. I was terrified it was going to be painful, but it wasn't. A little stinging / burning sensation, but I hopped into a waiting bath each time for the first 5 days after a BM and that calmed the pain down quickly. Each day was an improvement upon the next. I stopped taking the pain meds after a week. I don't think I even needed them that far honestly, but wanted to take them just in case. The only thing I will say is the first 2-3 weeks is a no wipe time. If your at home, I'd shower off after a BM. If at work, I'd take a squeezable water bottle thing with me and rinse off that way and dab a little bit with toilet paper to help. After a month I could wipe softly and now 3 months post op I can wipe, but I still do it carefully.

I've been taking miralax every day since surgery and I plan on continue taking it for at least another month. Up until today I kept putting gauze down there to help keep things dry however the Dr said I can stop that now. As far as washing the Dr still tells me to not use soap. He says I can splash some up there but don't scrub or rub up there with soap as it can dry out the skin and make it more prone to a rash.

So no more Dr visits for me. So glad to finally be done with all this craziness. Took forever to heal. Roughly 8 months total. I'd say about 2-3 of those months were fairly intense pain / low quality of life. The rest was just learning to live with this thing and be careful about what I eat and to stay hydrated. I eat whatever I want now, but I make sure I drink a lot of water and try to keep the fiber going.