I'm sorry to hear you are suffering too. I hope that you are able to heal again with the miralax & Diltiazem, so that you can avoid the LIS surgery. It's a shame about the tags, but I guess they are more of a cosmetic problem than causing pain. Hopefully once the fissure heals I will go back to my daily routine of NOT looking at my bum everyday and then I won't be bothered by a tag.

My boyfriend is also the only one who knows about my postpartum issues. I don't think a day has passed that I haven't talked about my bum/an update of my bm.... He must really love me. ha ha

Hello Flax, I have a fully healed fissure after many long months, and had botox, I wanted to let you know to check out Abigail Steidley she is a healer coach, etc and suffered an anal fissure after the birth of her daughter , but her story could be helpful as well. Although it takes a long while you will be fully healed..! Best Wishes...

What did you decide to do?

So almost 2 weeks since I posted.

The next day was the start of a 2/3 day period where I suddenly felt much better, the increased lactulose was working well at keeping stools soft, bm's were 90% less painful with little resistance (still used lidocain), a trip to the bathroom was 5-10 minutes instead of 30. I also felt some itching (haven't felt this the entire time) I was convinced I must be healing and that maybe I didn't need to go onto the GTN after all..

Then I let slip with my water intake and diet and within 2 days I was back to how I was a few months ago, bleeding, intense pain, unable to stop the spasm to let the bm pass, resulting in a 45 minute long agonising bm. It's scary how quickly you can undo healing progress.

I went to the pharmacy to get the GTN and mentioned that I would take it whilst breastfeeding, they insisted that due to lack of research, using GTN whilst breastfeeding was not only 'not advised' but also 'irresponsible'... I left without the GTN and in tears...

I did 2 days of clean eating, tons of water and I'm now somewhere back in the middle.

So to answer, I didn't end up using the GTN (yet) but I think about it every day when I'm having my daily trip to hell....

Oh no, that's awful! Is GTN the same as the Diltiazem? I just don't understand how some providers and pharmacists will insist that it's 100% safe while others will say that you shouldn't take it. It was an incredibly difficult decision for me to make too, but my doctor told me that she prescribed the Diltiazem to lots of breastfeeding women, and I also saw online that the oral version was also prescribed. That being said, there really aren't any real studies so there's always a level of risk. I finally reached a point where I was in intense pain and had to make my choice. It's so hard when you just want to continue doing what's best for your baby, but being in that amount of pain is just impossible.

Not a great solution, but maybe you could try to pump and dump for a few weeks while you're taking the medicine and then you could resume nursing again? Pumping sucks though, so maybe not a great solution but at least you could get healed and then continue nursing if you wanted.

It's so annoying isn't it, from what I've read online (UK & US providers don't see it as a problem and consider it ok to use) I'm currently living in Scandinavia so perhaps its more strict over here? The GTN they have prescribed is called Rectogesic 4 mg. I might pluck up the courage and go back to the pharmacy tomorrow and ask them to look up Diltiazem instead and see what they say. I'm getting by, by taking 90ml of lactulose (3 x 30ml) a day and basically giving myself a really loose belly to avoid any fissure pain, instead I'm just getting a bit of stomach cramping and urgency when it's time to go.... maybe this is stupid and won't help the healing process either...

It's just so bizzare, during my rectoscopy (performed by the head of the department) when I mentioned breastfeeding that 1. he seemed like he had never been faced with this issue before and 2. why he didn't to check for an alternative cream. Surely I'm not the only woman in this area to have been referred to the hospital for a fissure whilst breastfeeding in the history of his career? haha

I have been looking into electric pumps, I agree they look like a big faff and seeing as baby will have to switch to formula during this process anyway, it kind of makes me wonder why I would stress myself to maintain my milk supply then switch baby back to breast milk.

Maybe you could try seeing another doctor? The one I saw was a female and she said she treated lots of breastfeeding women. Are your stools really soft with the lactulose? I use Miralax and it typically keeps things very soft and easy to pass no matter what I eat.

It's such a hard decision to make, especially if breastfeeding is otherwise going really well. For me, I just reached a point where the pain was unbearable, but I was lucky that the doctors reassured me with the medicine. If they hadn't, I think I would have stopped nursing. I would have been sad to give it up, but I know my baby at least benefitted from the amount of time that we did nurse and she would likely be fine with formula (my other two nursed for much shorter time and had formula).

Hopefully you can find a solution that works for you!