Brilliant, thanks for the info Stratocaster. I am hoping I can too get to the stage you are at. Were your Fissures chronic?

I think you can certainly :). Just getting comfy bms daily will do a LOT of the work. I do believe I could have healed without the botox. It's just a tool. The onus is on me. It's one of the few things I've ever done that has to be *perfect*. If I miss something it's either a soft reset (few days to a week) or a hard reset (undoing a month+'s work).
Yeah they're def chronic. I've had them for about a year and a half to two years. Mind you the first year was wasted by my GP. He gave bad info and advice and is also somewhat homophobic. I get the sense he thinks I hurt myself with receptive sex. He always says 'its just a cut. It'll heal when it does'. When it's actually from having a high protein diet for fitness training for a year.
I'm actually not seeing a CRS. He's a general surgeon. He will refer me to a CRS if I want to get LIS or explore more invasive options then botox. I was supposed to see him on my 1 month day but I canceled as it wasn't close to healed. Since then once a month or so something dumb happens and I take a couple steps back. I think at this point I've nailed everything down as I need atleast 2 months with no mistakes to determine if I'm going to need LIS. The good thing is now that I'm sure I know where the mistakes were I'm planning ahead. Keeping 2-5 pounds of oats in the house at a time. 12-16 apples etc so I've got everything covered.

Thank you. I know where you are coming from, the GP kept giving me steroid creams, because I couldn't at first tolerate the Rectogesic. Then after all of the messing about, I ended up on the Rectogesic anyway! The pain got so bad that I didn't care about the headaches.
I am so pleased you are doing well.BM's are good most days, I keep on the stool softener, and stick to diet. It is the burning and knife pain that is getting me. Did you experience this?
My CRS wants to try the Botox as the first line treatment before LIS. He said there is a higher risk of incontenence in women, as the sphincter muscle is shorter?
I just want some relief.

Your diary is great. It shows how much you need to do to heal this thing. Now granted, I have a friend who has a fissure who's "heals and opens on its own all the time" but that is exactly the point, it needs to be done right to get it healed. I am someone you can tell something to, but I don't quite "get it" until I hear details like this. So when they say "keep stools soft" I throw in a half cap of Miralax in every few days and figure that is fine. Now for 5 days I have been much stricter. Now the diet is gonna be tough, but I am already much more cognizant of not so much bread-opting for oatmeals instead, and eating more fruit. I have increased my fluids considerably and today was like the first pain free BM I have had, which is great! Thanks for doing this reliably too, that is also good. So many would get to the point where they feel pretty good and stop.

The more I learn about fissures and the people that have them the more I realize that it is totally a personal experience. Everyone has wildly varying conditions. Some people can barely go to work due to the pain.\
I can def relate to the stabbing pain feeling. I get that when I have a 'bad' BM. For a few hours afterwards I get the spasm feeling of being really uncomfortable and then the fissure itself hurts to touch. Even just moving around it can give me a ping of pain. I can normally get it in a good place in 5 days to a week.
For me most of the issue with the fissure is of sexual nature. It's difficult for me to be in a relationship with someone but not be able to have that level of intimacy with someone. Luckily my boy is very understanding and has put no pressure on me.
I didn't realize the sphincter was shorter in women. The chance of incont. does seem to be pretty low. The good thing is from what I understand botox and LIS are very very similar. Botox being the temporary, chemical version of LIS.
I'm very glad that your getting something out of this diary. I have messed around long enough and spent enough money that I hope people can take something away from it and perhaps have a quicker experience. I've easily spent thousands of dollars on the problem and would love to save someone else the hassle.
The biggest advice I've got with the fissure is take responsibility for it. Our doctors can't fix the issue if we don't do our part. If our BMs can't be comfortable 100% of the time then we are never going to heal. With every setback just step back and figure where things went wrong and make adjustments.
I certainly don't advise people to eat whatever they want like I do and I do only do that for dinner. A good thought process that's helped me is to picture the food your going to eat if you threw it in a blender and blended it up. Is whats there going to come out of you easily? If my answer is no then I need to have softeners, lots of water etc with that meal.

So how long after the fissure is healed, does the tissue actually become back to the way it was...hence your relationship taking the next step. That has to be sooo hard. Not to mention the apprehension you will have about that. I am sure you will take further steps to prevent tearing. In OB we used to rub olive oil on a woman's peri area to prevent tearing during child birth....

Yeah thats really the golden question. The good thing is that my boyfriend is receptive (best term I can use without being graphic haha). Thus there isn't THAT much pressure on me at this point. Ideally we'd both be that way.
Once healed gotta figure out how elastic the tissue is. There probably will be scar tissue which won't be as stretchy which could lead to reinjury. I guess the trick will be leading upto it. Practicing with smaller devices so to speak. The main benefit is going to be that it'll give me greater sphincter control and the ability to relax. Obv we all have the problem of being too tight so things never heal.

I would think LIS would help all around, but I can't remember why u r doing Botox instead, I will re read. I am actually having a near pain free day ? That doc tomorrow is t getting a scope near my butt and undoing my hard work!

Well botox is normally what they try first before LIS. My surgeon has said I can make the call to get LIS at any point. Want to give the botox a clear shot to work so I just need to stay on track without any misteps for a long period of time :)

Actually, I would think you woukd want to absolutely positively exhaust everything before considering LIS. If your goal is to be able to have anal sex again, LIS is going to give you more scarring to overcome when it comes to the elasticity you will need to be able to receive anal sex.