These questions are kind of mainly for the people who have healed naturally after having their fissure for a long period of time but any words of wisdom are welcome...
Throughout the duration of your fissure, were you still having spasms? Did the spasms die down to become a different sort of pain as you healed?
Did you have pain with/after BMs even when you were eating all the right "soft" foods and taking all the right supplements? Every day is like a roller coaster for me, no matter what i eat. i don't have spasms though, just pain about 20 min after a BM and for the rest of the day after that.
Also, I'm concerned about scar tissue in and around my fissure. It seems i've had the fissure long enough for scar tissue to develop, and that may be prolonging or preventing the healing (from what i've read online). Does anyone know about this? So many people on here have just had the regular LIS, even after months/years of a fissure, yet still managed to heal. That doesn't seem possible to me. Does anyone know anything about fissurectomies, and why it doesn't seem like dr's do those as often?
Also for people like Gareth who had their fissure for years before healing it naturally, how is that possible if scar tissue has developed? Did your dr's ever mention anything about that?
lots of questions i know. it's like all i think about all day is this stupid fissure and how much it confuses me by not healing!

I did not have a long lasting fissure. I only had spasms I could feel for a week or two of the 8 weeks or so of symptoms. Often my pain was intense for a short period of time 2-4 hours after a BM.

I understand how a fissure or any pain can be consuming and I have spent time analyzing my pain and worrying about when it would end a lot so I can relate.
Throughout the duration of your fissure, were you still having spasms? Did the spasms die down to become a different sort of pain as you healed? I have to say I didn't get a lot of spasming except for that time of the month when I had uterine contractions that would cause the smooth muscle in the anus to contract. The pain I has was more like feeling a cut in your bottom.
Did you have pain with/after BMs even when you were eating all the right "soft" foods and taking all the right supplements? Every day is like a roller coaster for me, no matter what i eat. i don't have spasms though, just pain about 20 min after a BM and for the rest of the day after that.Yes, I still had pain even after doing all the "right" things. The things I did didn't really help the pain but did help with overall healing without surgery.
Also, I'm concerned about scar tissue in and around my fissure. It seems i've had the fissure long enough for scar tissue to develop, and that may be prolonging or preventing the healing (from what i've read online). Does anyone know about this? So many people on here have just had the regular LIS, even after months/years of a fissure, yet still managed to heal. That doesn't seem possible to me. Does anyone know anything about fissurectomies, and why it doesn't seem like dr's do those as often?
I don't know much about this but I would think that maybe a fissurectomy would be indicated in this case. I don't know much about it though as my CRS doesn't do these usually.
When do you go back and see the doctor? Do you think you will want to have the second LIS done? Have you tried aloe vera there?
I understand completely and can sympathize. We should be able to just go to the bathroom and forget about it.

Thank you both for the replies. I know everyone here understands what it's like dealing with something like this. it's so unfair to all of us!
Lecia, my next appt (technically, my pre-op) is in 2 weeks. My 2nd surgery is exactly 3 weeks after that. i don't know why they have those appts so far apart, but it's Kaiser so i'm just glad i got in so quick at all! i'm writing a list of questions and concerns to ask my dr, including the possibility that there might be something else wrong.
i have recently tried aloe vera. it's very soothing, but after 2 weeks i didn't feel any difference so i'm going to let up on that. i'm a little weary of putting anything down there now.

I think I am just about healed, so if you don't count botox as a surgery...

I read that scar tissue prevented healing as well, and I am skeptical of that partly because of the reasons you mentioned (people with scar tissue often get LIS and heal just fine) and partly because it just doesn't make sense to me that scar tissue would prevent healing. Think about it. Have you ever had a cut one a former scar? I had tons of skinned knees, which made for scars on top of scars, and my knees healed up every time.

What I think might be the reason for lack of healing of scar tissue is that scar tissue is often less flexible than regular tissue, so in an area like the anus, it is more prone to retears. Scar tissue is also still in the process of healing sometimes for years after the initial wound, so again it is not like the rest of the skin and is more prone to retear. (That is until one has had the scar for a while and it has synthesized collgen, regrown nerve endings, etc... that make the skin more pliant). This is why when the reinjury of the area stops because of LIS, diet, or what have you, the cut heals. At least this is what I think.

What that means is that it is possible to heal even after a while of being in pain, like Gareth. One just needs to control the reinjury.

It is also important to remember that pain is not necessarily an indication of lack of healing. I'm sorry to say, but you will probably be in pain after bm until the last bit of the fissure heals over. It will lessen as the wound gets smaller, though, and soon there won't be any pain. It's hard to measure this progress day-by day and discouraging to do so. I decided to keep a journal and think of mine in terms of week-by-week or even month-by-month progress.