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Greetings

Postby Paisley » 24 May 2013, 04:33

Hello all,
I've been lurking for several months and am extremely grateful for all the valuable information on this forum. I had never even heard of an AF before being diagnosed at the end of March. I'd been suffering for about 6 weeks and the pain got so intense I saw a CRS. She told me to use nitro/sitz bath/stool softener and it would heal in several weeks. She said LIS surgery would be a last resort.
I've been following a plant-based diet (no meat, fish, dairy, eggs or other animal products) for years, don't eat processed foods, always regular without any constipation/hard stool problems so I wondered how/why I got this. After some research I saw that poor blood flow is a cause. Unfortunately after a major relocation to another city, I was unable to afford a proper couch and spent my evenings with my laptop sitting on a hard futon couch -- and sometimes my butt would fall asleep! So after 2 years of this, I stupidly was cutting off the blood flow and am now paying the price. :(
After 6 weeks on the nitro, I felt that I was healing - spasms only lasted a couple hours and I was able to work/get on with my life by the afternoon. I had already planned a trip from the US to the UK to visit my boyfriend and was nervous about traveling but thought I was on the road to recovery. Flight was fine. We had planned a weekend away as soon as I arrived and from then on all hell broke loose. We stayed in a B & B without a private bathroom, so I was nervous about spending adequate amounts of time in there and didn't do the sitz baths. My body was all out of whack and i became constipated once we got back to his place. Then I experienced a major re-tear with copious amounts of blood and was back to the agony during BMs and for 10-12 hrs after. I've been totally non-functional for the past 3 weeks, dread getting up in the morning as that means an ordeal in the bathroom as my body tenses up in anticipation of pain. I couldn't even imagine traveling back home in a month's time in this condition. So I made an appt with a CRS (recommended on this forum-- thank you!).
He took a look and said that it was evidently a chronic fissure and recommended that I have the skin tag removed (he said it was hampering healing) and Botox injections. This would allow me to feel well enough to fly back home in 4 weeks. He has more experience than the surgeon I saw back home, so I have more confidence in his opinion. I'm penciled in for this procedure next Wednesday and need to let them know. (Given that this is an 'urgent care' issue -- I have my fingers crossed that my U.S. health insurance will reimburse me for the cost of the appt and procedure). Generally, I seek out natural/home remedies rather than resorting to traditional medical intervention, but I can't imagine living (not living!) like this any longer. The upside of having it done while I'm here is that my boyfriend can take care of me. :)
For those who have had this procedure, do you think I'm crazy to have this done and expect to be able to fly back to the States 3 1/2 weeks later? It's only a 6 1/2 hr flight so shouldn't be too bad. If there are any complications, I can always pay the price to change my flight dates.
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Re: Greetings

Postby Englanddevon » 24 May 2013, 06:03

Hi paisley, first of all so sorry to hear of your suffering, I fully understand the agony, I've had this problem for 6 months, most of which has been spent on bed.
So hopefully if I explain a little what I've been having done treatment wise then it may help you with your decision:
- First tear in December
-Tried all creams and went onto movicol and lactulose. Obviously this made things slightly more comfortable but I was unable to heal and still experienced high levels of pain daily.
- first round of Botox on 12 April
- Botox appeared to fail after 2 new re tears
- admitted to hospital 4 weeks after original Botox. Had second round of Botox along with a fissurectomy for each tear (3) and removal of a polyp. I wasn't in a great way after this so was kept in for a week.
- now at 2 weeks, not great but able to make it downstairs to the sofa!
In view if my experience I would say that if you are just having Botox without fissurectomy then go for it ASAP! The first Botox (under general) was absolutely fine with very little pain so don't let that factor worry you. I had a different experience with my second surgery as there was a large amount if tissue cut out and stitching.
Of course LIS seems to be the gold standard and of course the first round failed with me, but, don't be put off by this as it could work for you first time, and if so that would be fantastic as the side effects and recovery are so minimal. My view with a few Botox injections is that it's worth a try.
In view if the last 6 months my main regret is that treatment didn't start sooner and I wish I had Botox earlier than the 5 month mark, so I would if I was you start getting some treatment ASAP.
Hope that helps, sorry I can advise in skin tags, I have these but they did not advise removal? :)
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Re: Greetings

Postby Paisley » 24 May 2013, 07:19

Thank you for sharing your experience, Englanddevon. I'm glad that you are seeing improvement now, even if it was a long time in coming.
Can you explain a little about "Botox appeared to fail after 2 new re-tears." Is it that the Botox did not take effect? Or not enough to relax the muscle?
I was in pain and trying to take in all that the CRS said but I think in the little diagram he drew, he said that the skin tag was causing the edges of the tear to be such that the tear might not heal on its own.
Having been through this a bit longer than I have, your opinion is appreciated. Thank you.
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Re: Greetings

Postby Englanddevon » 24 May 2013, 07:43

Hi paisley, not a problem it's the support from other members that has really helped.
With regards to my first round of Botox this is what happened, but I don't really want to scare you off with it as I didn't read this happening with anyone else, and I didn't let it put it off me trying Botox a second time.
The immediate aftermath of the surgery was fine, but unfortunately 3 days later after not feeling too bad I tried to do some light housework. I ended up strangely with my first ever obvious experience of spasms, which was on a 10 for pain level. Strangely I developed a prolapsed polyp from this spasm attack. ( meaning to post about this as this was a bit odd)
So after that I visited my surgeon the following day. He was a bit useless with giving a lot of advice on what happened. He said that he could not explain the pain and the fact that it occurred from light housework as opposed to a bm. He worryingly also missed the polyp even though I pointed it out to him. It was the second surgeon who confirmed the polyp and also removed. It appeared that this polyp occurred from the stress of such a bad spasm attack.
3 weeks after this I had 2 tears re opened and I was then sent up to hospital. The second Botox and fissurectomy followed the next day.
I'm really sorry that I can't give a definite answer as to why the Botox failed as neither of my two surgeons have been able to give me an answer. Their view was its failed, we don't know why, but we will try again along with a fissurectomy! Very reassuring!
I'm afraid that the above is not the most encouraging post, however, without wishing to sound like a drama queen my second surgeon said after the surgery that it had been worse than he had been expecting with 3 large tears and a grat deal of scar tissue. I think I've just even a little unlucky with having more than one and I was at the 5 month mark before first surgery. I think that perhaps if the Botox had been fine earlier on when there was just one tear them I may have healed up quicker. So I think my advice generally is go with what your surgeon suggests ASAP.
However, it's up to you whether you want to skip the Botox stage and just go for the LIS as this is the gold standard. On the other hand if the Botox does work for you then you will have a quick recovery (although I don't know about how the skin tag will affect this?)
Let me know if I can answer anything else and keep us posted x
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Re: Greetings

Postby Englanddevon » 24 May 2013, 07:45

Ahh sorry for the typos - I phone! Lol
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Re: Greetings

Postby Paisley » 28 May 2013, 05:26

Thanks for the explanation, Englanddevon. What an ordeal for you! I understand that everyone reacts differently to Botox, so I'm not .put off by your experience.
Wouldn't you know-- now that the Botox is scheduled for tomorrow, I've started improving. Although there is still blood, there is far less pain during a BM and the spasms have decreased in intensity. I don't feel that I had enough time with the surgeon to ask enough questions, so I'm going to postpone (or possible cancel) the procedure and see how things go this week.
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Re: Greetings

Postby JHH » 28 May 2013, 06:57

I was scheduled for botox 15 may, but canceled because I got multiple near pain free days. However this week things went south again, and now I'm kicking my ass for not having the botox done. Just a warning Image
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- Now Feb '16, all is good. Still take magnesia, and squat precautionary.
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Re: Greetings

Postby Paisley » 28 May 2013, 07:09

Thanks for the warning :) I realize that might be the case. I guess I'm relying on the fact that I seemed to be healing for a good 4 weeks before I flew to the UK, had constipation after a few days and experienced a re-tear. If I'm just extra careful, I'm hoping that I can replicate that daily improvement.
JHH, have you re-scheduled the botox?
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Re: Greetings

Postby Englanddevon » 28 May 2013, 07:10

That's great news paisley that your feeling better. Definitely a good idea to discuss a few of your concerns with the surgeon before making a final decision. The only thing I would say to consider in view of my experience and others on here is that it can sometimes seem as if things are getting better and then all of a sudden it rears its ugly head. Of course however having anything done is a last resort and I'm a firm believer that you know your own body best, maybe the best bet would be to re-schedule for a week or two later and then worst case scenario you've got a back up plan, but fingers crossed the healing will continue x
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Re: Greetings

Postby JHH » 28 May 2013, 12:11

Yes. I postponed it 3 weeks. Going in June 5th. And this time I will go no matter what.
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- Now Feb '16, all is good. Still take magnesia, and squat precautionary.
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