First Time Long Time

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First Time Long Time

Postby BrooklynButt » 30 Jul 2018, 13:41

Hi everyone,

Well, as you can see from my subject header I have been a lurker on this board for a little while and I thought I would take the plunge so to speak. It has been an up-and-down journey for me so far (as I have gathered that it has been for many, many people) and I just wanted to say that this board has already been life-saver both in terms of practical advice and general emotional support. Anyways, my story, hopefully not too long:

I am 35, male, have been dealing with this fissure on and off(I think?) for nearly a year plus two months now. It started in early June of 2017 (I remember it well) though in retrospect it had probably been brewing for a little while from some stress/constipation issues. It's anterior (starting right at 12:00 and branching off to the side a little bit) and I can see it (or at least part of it) when it is acting up.

Also like many people, I had some difficulty getting a good diagnosis off the bat and didn't even see a CRS until 2 months into it. I received a Rx for a diltiazem/lidocaine and eventually through trial-and-error settled into what I thought was a good routine regarding diet/butt care. My situation plateaued/did not fully resolve after a few months and my CRS seemed surprised by this (in retrospect I am surprised he was surprised) and I decided to try a new CRS, Dr. Marsha Harris, whose name I actually got from this board after seeing she had been helpful on some challenging cases. She has been helpful for me as well.

Still though, I am not healed. I have gone through periods where it has appeared to have healed, only for bleeding and pain to return (as is the case now). I have also intermittently experienced external hemorrhoids, though fortunately that is not the case at the moment. The fissure itself causes extreme irritation while defecating and noticeable-though-not-at-all-incapacitating irritation during the day - which I think is one reason I have let it go on so long, I have not yet had the truly excruciating pain that I know some of you have had. Still no fun though.

I think Botox may be the next step for me. Dr. Harris mentioned it during my last visit with her when things seemed to be more on the mend but I decided to pass at that time and hope the then-ongoing improvement would continue. It did for a little while until it didn't.

I already use squatty potty, apply vaseline before a bowel movement, use wet wipes (or if at home, a shower) rather than dry toilet paper. 3/4 a cap of Miralax with plenty of water each night before bed. I had been applying aloe vera gel (Lily of the Desert, carefully chosen as it does not contain alcohol) after bms and that had been soothing. Two lengthy courses of diltiazem/lidocaine already tried. I had been using konsyl as my fiber supplement because I found this to be the best for actual regularity, but this may now be too bulking for me with the bleeding returning. Considering a switch to Benefiber since it seems like others on this board have had success with that.

Going to try and schedule another appointment soon and discuss the Botox, or any other options. For those of you who have used this as a treatment option, have any of you found it to be successful after having already had a fissure for as long (1 year plus, with a few retears in there) as I have? Also have any of you had success with it on an anterior-located fissure? I feel like I read somewhere that Botox is much more effective on posterior rather than anterior location, unfortunately for me. I am trying to acclimate to the idea of an LIS eventually being in my future, and I know there are some good success stories on here regarding it, but considering the risks I know it is not something to be undertaken lightly.

Anyways, this is a great place, and this board has already been tremendously helpful for me even before I decided to dip my toe in here. Thank you everyone.
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Re: First Time Long Time

Postby MarkM » 25 Oct 2018, 10:12

Any update on your case?
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Re: First Time Long Time

Postby BrooklynButt » 25 Oct 2018, 11:53

Hi there Mark. Yes, there have been a few updates. I decided to try self-dilation for a bit which seemed to be working well for me through August into mid-September. Around mid-September I developed an irritation/butt moisture (for lack of a better medical term, we can be frank on here) issue which I had initially scared myself into thinking had resulted from me damaging my sphincter through my self-dilation routine. I was able to see my specialist, who lightly but appropriately admonished for undergoing something like that without medical direction and who did not find any sphincter issues upon digital exam. Also that particular issue did resolve itself, so it's possible I just had some kind of stomach upset/minor infection around that time.

Unfortunately however my fissure(s) are still active. I actually have both an anterior and a posterior, though one is apparently superficial (I keep forgetting which). Per the specialist neither appear deep (cannot see sphincter muscle fibers) and since I am not in excruciating pain (definitely some pain on defecation and twinges during the day but not horrific as described by some people on here) we are still going to stay fairly conservative and go with botox prior to surgery. I am actually going to undergo this early next week, so good turnaround time there.

Trying to be optimistic about the botox, though as noted above it seems not to be as effective on anterior fissures. Figure it is worth a shot (no pun intended) and will see where I stand upon the post-botox follow-up.
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Re: First Time Long Time

Postby MarkM » 25 Oct 2018, 12:41

Thanks for the quick reply.... i wish the medical industry find some quick solution for these issue :)

Good luck and hope you have super fast recovery

Keep us updated
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Re: First Time Long Time

Postby BrooklynButt » 30 Oct 2018, 15:36

Hey everyone,

I figured I would leave a quick update to my condition here. Further significant developments I will probably start a new thread on. I received Botox injections yesterday, 2 injections, I believe at the base of each of my fissures (I have both an anterior and a posterior). Follow-up appointment in early December to see how things are progressing.

The procedure itself was basically nothing, didn't really hurt any more than any other shot would (and less than some of my exams have). Was a little tender the rest of that day but feel completely normal (well, fissure-normal) today. If I have any noteworthy side-effects (or COMPLETELY MIRACULOUS HEALING) prior to my follow-up I will share it, other than that will likely stay quiet on my own threads for a while.

The only other thing I'll say, just to get off my chest, is having had this for a while now (coming up on 17 months) I am becoming pessimistic regarding being able to avoid surgery. And I know there are many people here who have had complete recoveries after surgery, but the incontinence aspect of it is still scary especially since getting this far already puts me on the bad side of several probabilities. I remember June of last year when I first came down with this and it was awful but I honestly did not think I would still be dealing with it close to a year and a half later. I know many of you have dealt with this for longer, and with worse things, so I will keep my head up. But some days it really gets to me.
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Re: First Time Long Time

Postby Shannon » 07 Dec 2018, 16:13

How are you doing now Brooklynbutt?
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Re: First Time Long Time

Postby Shannon » 08 Dec 2018, 00:12

BrooklynButt wrote:Hey everyone,

I figured I would leave a quick update to my condition here. Further significant developments I will probably start a new thread on. I received Botox injections yesterday, 2 injections, I believe at the base of each of my fissures (I have both an anterior and a posterior). Follow-up appointment in early December to see how things are progressing.

The procedure itself was basically nothing, didn't really hurt any more than any other shot would (and less than some of my exams have). Was a little tender the rest of that day but feel completely normal (well, fissure-normal) today. If I have any noteworthy side-effects (or COMPLETELY MIRACULOUS HEALING) prior to my follow-up I will share it, other than that will likely stay quiet on my own threads for a while.

The only other thing I'll say, just to get off my chest, is having had this for a while now (coming up on 17 months) I am becoming pessimistic regarding being able to avoid surgery. And I know there are many people here who have had complete recoveries after surgery, but the incontinence aspect of it is still scary especially since getting this far already puts me on the bad side of several probabilities. I remember June of last year when I first came down with this and it was awful but I honestly did not think I would still be dealing with it close to a year and a half later. I know many of you have dealt with this for longer, and with worse things, so I will keep my head up. But some days it really gets to me.
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Re: First Time Long Time

Postby BrooklynButt » 08 Dec 2018, 11:50

Hi Shannon,

I have actually been seeing some improvement! I had my 6-week follow up with my CRS towards the end of this week and she said that the anterior fissure had scarred over and that the posterior one was looking more "superficial." I have another appointment in an additional 6 weeks by which time the Botox should have just about worn off. I have to say I am feeling better too though still not "normal." Still, aside from being very careful about diet/poopin habits I am able to, at least for now, function more or less normally and for that I am very grateful. Of course with Botox the major issue seems to be recurrence rather than initial healing (and I am not even all the way initially healed) so I am far from out of the woods on this one. I would say I am cautiously (very) optimistic. I had at least one other spate of time when I thought I had really beaten this thing only for it to come back. I understand that is very common.

How are you holding up?
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