Hey Zoe,
Couldn't your CRS just do a conservative cut for LIS?
Is there nobody near you who will perform dilation?
You would need to make sure the surgeon knew what they were doing, but I thought dilation was still common in England.
Personally I'd rather that than LIS. Especially if it were the controlled kind.
Davo,
My CRS appointment isn't til the 29th. I will be asking him about what Zoe's CRS said, because I had a forceps delivery (9 years ago) as well. Not fun. Took months to heal as well. I knew it would come back to haunt me.
Ah well.
But so far still doing better despite having 3 BMs so far today. -Sheesh- i hate those days. SOOOO wish I could just have one a day.
touch wood and whistle for both of us.
-Tanya

Hi WOI,
My head is all over the place at the moment - yesterday i was pain free and today (Week 11 GTN) i have some very mild soreness which doesn't really hurt to be honest. I am in two minds as to whether to keep my CRS appointment on Tuesday or whether to wait a week or two in the hope that it will heal. The thing is this has nearly gone on for six months now and i keep putting things back a week at a time - six month on soup, water and alcohol free is getting a bit much.
If i do visit the CRS he will pencil me in for Botox (even though i intend begging for LIS) - what are your thoughts WOI - are you keeping your appoinment or holding out in the hope of healing? If you do go are you asking for LIS or sticking with Botox?
Davo

Just realised I may have gone ‘off topic’ and some people maybe looking for GTN (Nitro) information. Over the past thirteen weeks I have been making a note of my daily pain scores, diet and medication. I thought it may be useful to show my pain score progress whilst using GTN so others can compare – feel free to ask any questions.
(Pain scores 0 = pain free, 10 = total agony)
2x WEEKS PRIOR TO STARTING GTN (Nitro)
Mon 6
Tues 7
Wed 2
Thurs 3.5
Fri 2.5
Sat 5
Sun 5
1x WEEK PRIOR TO STARTING GTN (Nitro)
Mon 6.5
Tues 3
Wed 6.5
Thurs 6
Fri 2
Sat 2
Sun 3
WEEK 1 Of GTN (GTN STARTED ON FRI MORNING)
Mon 4
Tues 4
Wed 2
Thurs 2.5
Fri 1.5
Sat 1.5
Sun 1.5
WEEK 2 OF GTN
The Wednesday was probably the most depressing day off my life – it probably sounds stupid but as a regular gym attender I had to remove my no longer used gym kit from my bag and replace it with medication to carry with me on my journey to work. Also it was the day of the works Christmas party so everyone was dressed up ready to go out for dinner & drinks and I just picked up my bag, went home and had water and soup. It still hurts me when I think about it now!!
Mon 1.5
Tues 3
Wed 4.5
Thurs 2
Fri 2
Sat 2
Sun 2
WEEK 3 – CHRISTMAS WEEK AND NO PAIN SCORES NOTED
WEEK 4 OF GTN
I washed a bit too vigorously on the Monday evening and I think this increased the pain on Tuesday. Also the Saturday evening was New Year’s Eve where I thought a few drinks won’t hurt me… WRONG! I had a very dry BM the following morning and had my first major re-tear
Mon 1
Tues 2.5
Wed 1.5
Thurs 1
Fri 1
Sat 1
Sun 4.5
WEEK 5 OF GTN
Mon 7
Tues 4.5
Wed 4.5
Thurs 3
Fri 2.5
Sat 2
Sun 2
WEEK 6 OF GTN
I decided to give Aloe Vera gel a try and applied it each day from Monday onwards. On Thursday evening I had a cereal bar with nuts which came out sharp – cue Re-tear number 2!!!!
Mon 1.5
Tues 2
Wed 1
Thurs 1.5
Fri 5
Sat 6
Sun 1.5
WEEK 7 OF GTN
A funny week really – the CRS inspection made it flare up on Tuesday and on Thursday I had a stomach bug which gave me diarrhoea
Mon 1
Tues 3
Wed 2
Thurs 4
Fri 2.5
Sat 1.5
Sun 1
WEEK 8 OF GTN
A brilliant week, visually the fissure had reduced incredibly, I no longer had pain during BM’s and the pain score just relates to very slight infrequent spasms
Mon 0.5
Tues 0.5
Wed 0.5
Thurs 0.5
Fri 0.5
Sat 0.5
Sun 0.5
WEEK 9 OF GTN
My best week yet – I was pain free and whilst still visible the fissure was almost healed.. until it re-tore for no reason whatsoever on the Saturday!! However my BM’s had increased from one a day to two a day during the time of the re-tear
Mon 0
Tues 0
Wed 0
Thurs 0
Fri 0
Sat 4
Sun 6
WEEK 10 OF GTN
Mon 3
Tues 5.5
Wed 4.5
Thurs 3.5
Fri 2.5
Sat 1.5
Sun 1.5
WEEK 11 OF GTN
Mon 1
Tues 1
Wed 0.5
Thurs 0.5
Fri 1.5
Sat 1.5
Sun 1.5

Hey Davo,
What's your algorithm for pain?
I think you should see your CRS as scheduled. You don't know what he will say. You're just guessing.
He might just say well lets wait 2 more week. Or he might schedule you for botox which will take a while and in the meantime you might heal anyways...
I like to hedge my bets ; )
I will definitley see my CRS if only to get off the nifedipine. The anxiety is just awful in the wee hours. I wake a bit from a dream and immediately feel an adrenaline surge. I know it isn't natural.
So your appointment is on Friday? Mine is the following Wednesday. I think I may call him later though cause i haven't mentioned the anxiety to him yet.
-Tanya

i once posted my pain scale but cant seem to find it anymore but basically its
(anything over a 6 is a day off work)
0 = Pain free
1 = Virtually pain free but with mild intermittent spasms
2 = Mild spasms lasting no longer than a few minutes at a time
3 = spasms are a constant annoyance but not painful (slightly uncomfortable)
4 = Quite uncomfortable spasms
5 = slightly painful - very uncomfortable and annoying
6 = quite painful, pain is visible on my face
7 = very painful, would bring most people to tears
8 = extremely painful, curled up in pain on bed
9 = Requires emergency doctors
10 = Hospital!
My appointment is next Tuesday evening and i think i will still attend as its gone on far for too long now. It looks like we both maybe the next botox guinea pigs!!

Oh yes,
I remember reading this. My scale would be different as I don't get spasms. Well maybe some burning feeling now and then. I wonder if that isn't from the nifedipine too.
I am open to botox, though of course, would like it to not be necessary. I think before I get it I would at least get a consultation from that chinese clinic near me. Just to see what they say. How they would approach fixing an AF.
I'm going to use a bit less nifedipine for a couple days and see if that helps. Like 1/2 a pea in size instead of a whole pea :)
Would you mind asking your doc about coconut oil and lanolin. Just to see what he says?
So you aren't too bad today, that's great! I hope you have a great weekend!
-Tanya

Hope you keep on getting better and better Davo!

Hi Ras/WOI
Thanks for your support.
I changed my diet a little on Saturday as my doctor suggested i 'trial and error' a few foods - anyway i had white pasta, white rice, courgettes, turkey, etc. and for some reason i did not need a BM on Sunday. I did however need to go this morning and things were bulked up so yet again another set back and a pain score of four.
I really have had enough now!! Five months of eating soft food, no alcohol and lots of medication and i am still not healed and something as stupid as pasta can cause a set back!
Anyway its my CRS visit tomorrow and i am quite looking forward to it - I know he is going to suggest Botox but i am going to ask him why Botox over LIS - I want him to tell me why ites better!!!
WOI - I will mention about coconut oil, etc. but my CRS is fairly much an advocate of modern medicine and last time i suggested something different such as wheatgrass he said "yeah, try it and see if it works but if the GTN is working for you why bother with anything else???"
I think the only non medicine things he suggested was to use vaseline to lube up before a BM (or lidocaine) and to take magnesium tablets.
Anyway i will let you know how it goes
Davo

Good luck Davo. Seven days and counting now before I go in for my LIS surgery. Remember, you won't get what you don't push for, and I'm learning that sometimes this means pushing really hard at folks society has mostly trained us to accept at face value.
I was going along with all my doctors suggestions, and it hasn't been working, at least not for my neuro-psych issues and back. Now that I am seriously pushing back, I'm starting to wake a few minds, and may yet get the help I really need. Don't be afraid to answer back disapprovingly, and don't be afraid to put your foot down and just say NO. After all, it is our bodies they are playing with as a child plays with a hamster!

Just in case anyone is following this post..
I had my 12 weeks GTN follow up last night and i am now scheduled for LIS (See my other post for GTN/Botox/LIS info)
For GTN users dont lose hope, the ride can be rocky and set backs during the journey should be expected but the oinment does work.
Here are the comments from my CRS last night regarding GTN:
GTN - Firstly if you dont see any results within two weeks its probably not going to work for you. For those that are going to heal with GTN, they will normally do so within 6-8 weeks. The human body actually gets used to the GTN and therefore its effectiveness wears off as the weeks go by so by weeks 8-12 re-tears are very common as the GTN is hardly effective anymore (that was my problem)