Healing Tips + Botox Success!

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Healing Tips + Botox Success!

Postby can-cervive » 04 Oct 2021, 19:05

Hi all,
Anal fissure sufferer for about 15 months total. Really brutal - 3 raging chronic fissures at once that developed due to chemotherapy and cancer treatments. I've posted the back-story under "CRS Says it's Healed - it's NOT" for further reading.
I can't believe I'm actually making the "I'm Healed" post as I never thought I'd get here. I have been struggling with this mentally and physically and nothing sucked the joy out of the last year more than this (and that's from someone who had a double mastectomy, reconstruction, lymph nodes out, 8 rounds of chemo, 18 rounds of immunotherapy, hospitalized 3 times... but I digress). Needless to say - it's the WORST and I totally get it. But mine were terrible and if I can heal - so can you! You will get there.
It's been 4 months since my Botox and I haven't had ANY pain or bleeding with bowel movements for the past 6 weeks. What worked for me was a combination of things but I didn't start really recovering until I tried the Botox (after I'd been suffering for about 10 months by that point).
I literally tried it all, including some of the following. Some worked and some didn't so I'll explain what was helpful below:
- Botox to sphincter - the most helpful
-Diltiazem/nitro - marginally helpful
- antibiotics 4 different times - not ultimately helpful
- manuka honey - not helpful
- miralax and stool softeners - very helpful
- various ointments: olive oil, ozone oil, coconut oil, cannabis oil, aloe vera, vitamin e, hydrocortisone, hemmorhoid creams, fissure cure essential oil blend, zinc oxide, witch hazel, calendula - not ultimately helpful
- lube up anus before each bowel movement - very helpful
- tea tree oil - very helpful
- preparation H wipes - helpful for when travelling or not able to BM at home (always in my purse)
- squatty potty - so very helpful (wish I ordered one sooner)
- vegetarian diet and different diets - ultimately not helpful
- heating pad - very helpful
- sitz bath with salts after each BM - very helpful
- support for my anxiety around fissures - very helpful
- this forum - honestly was very helpful and very detrimental at times, I'll explain
Okay so what I'll do now is explain in more detail the items that I'd class as "VERY HELPFUL"
1) Botox: first and foremost, your sphincter needs to be relaxed to heal. I waited so long on the Botox because of horror stories in this forum or people saying it didn't work. My colorectal surgeon and I had 4 different appointments 2 weeks apart each time where he would tell me it was so effective and to stop reading the forum stories but I couldn't help it - I lived on here for those months. When I finally listened to him, it was the best decision ever! The botox barely hurt at all, there was NO pain afterwards and the bowel movement was pretty much the same as it had been pre-botox for the first week or so and then after 10 days I started noticing progress. I was so scared but the procedure was done in all of 2 minutes and I walked outta there and drove home and went on with my day. Truly wish I did it upfront!
A few Botox tips:
1) I didn't start healing until 10 WEEKS! You read that right, 10 weeks. I was sure it failed. I went back to my CRS bawling and told him it didn't work. He told me to calm down and be patient. Sure enough, it took 4 full months to get to where I'm at in the healing journey. It definitely didn't work right away.
2) As the fissure heals, it's very common to notice pus or discharge oozing from the fissure. This only happened with 1 of my 3 fissures, the deepest one. It freaked me out when I saw it and I kept meticulously cleaning it away. Once I stopped doing this and just let nature run it's course, the healing was expedited from there. What I realized is that the sphincter was so tight that infection was being trapped inside there by the tight-clenched muscle. Antibiotics would work temporarily but then a few weeks later, the pain would return in that fissure because the stool would be re-trapped. Once the Botox had relaxed the fissure, my body was able to naturally clean away the infection and get to work on healing.
3) In light of the above, Botox works for the relaxation part but you need to take steps to keep the area clean. Which brings me to the next part:
2) Sitz Baths and Tea Tree Oil:
In the beginning, I would wipe with a wet cloth, use a spray bidet attachment OR a peri-bottle when I was away to clear away any feces residue, sit in a salt Sitz bath for 20 minutes and then I'd apply whatever ointment I was desperately trying that month and be done. I literally did this after EVERY bowel movement. And twice, my lateral fissure still got infected and I ended up on antibiotics or in the Emergency Room. I was able to tell it was infected only because of the fact that it extends out of the sphincter by a centimetre but for those of you that are entirely internal it makes me wonder: how many of you are going through periods of infection and not knowing it? The pain of infection is very similar to the spasm pain except it ONLY hurts in the fissure itself (i.e. it's very localized, not felt all over) so it's very hard to tell the difference. The game changer for me was the Botox as I said, but also adding this to my process: hopping in the shower after a BM and very gently soaping up my anus with Hypoallergenic baby soap. I would then apply vaseline and ONE DROP of tea tree oil for extra bacteria-fighting effects. I've noticed some people use Polysporin, others go natural with coconut oil - whatever works. The point is, the fissure needs to be kept clean to heal or your body is wasting precious healing resources between bowel movements removing the stool and bacteria instead of regenerating the tissue or worse - trapping infection in there like in my case! Help your body along by getting an air-tight cleaning routine.

3) Squatty Potty:
GET A SQUATTY POTTY! I waited way too long to take this advice and didn’t get the squatty potty until I’d already been suffering for 11 months. Once I got the squatty potty, I found I was keeping my BMs to one per day more routinely! The squatty potty helped totally clear my colon so that there was no un-evacuated stool that would cause me to go later in the day. I wish I had listened to the advice and ordered one sooner; they are like $20 on amazon and worth it. I’ll use it forever.
4) Lubing up anus before going #2 and stool softeners:
This is easy - you need to avoid retears. I use vaseline before each BM and take a Colace + half cup of Miralax every night. I talked to my CRS this past week and told him how well I'm doing, that I don't even feel like I had fissures anymore. And he told me to stay on the stool softeners for 2 more months! A re-tear can ruin all your progress. Not worth it! :)
5) Getting my anxiety around fissures under control:
Honestly, I had to talk to my doctor about this and get some meds + a therapist because the condition was so debilitating to my quality of life - I was severely anxious/depressed and on the worst pain/spasm days I didn't want to go on. One of the issues is that I was obsessive-compulsively checking my fissures with a hand mirror multiple times every day. This is not helpful - I probably re-tore or damaged the fissure by constantly spreading my cheeks to look. Your body is not meant to expose your anus that constantly and so I stopped doing this and now go ONLY base on feel and allow my CRS to be the only one to look. That's why I say this forum was helpful and harmful for me personally... I think I read every single post that exists on the site here. Unfortunately along with the successes, this means I read every horror story, every failed procedure... it definitely got me way more worked up than I needed to be. I'm not blaming the forum because it also helped me SOOO much at times, but I would use it in moderation if you are a personality like mine and find yourself getting OBSESSED with healing like I was.

Anyways, I hope this post helps people out there. I know how horrible this condition can be but I promise you all - YOU WILL HEAL! It takes time and patience. Healing is truly a journey but you will get there and never look back!! :)
Wishing you all anal help.
can-cervive
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Re: Healing Tips + Botox Success!

Postby Conifer » 05 Oct 2021, 02:02

Hi can-cervive. Thank you for this post, it’s really helpful and positive. I am so’s Rory to hear about your journey and how you got here. It puts a lot of things into perspective. And I think it’s a real spotlight on how bad a fissure is when you compare it to your other health experiences the way you do. I got mine as a result of two miscarriages this year and currently feel that I would take another MC and everything that comes with it over the fissure experience. I obviously don’t want another one but the fissure is far far worse. I can’t believe I’ve even had that thought let alone write it down.

I’m happy to see your Botox experience. I was booked for next week to have it under GA but have postponed to December due to trying again for baby first. Probably a crazy thing to do but I have my reasons. One of my issues for postponing was I’m terrified of what it’s going to do to me based on what I’ve read here. I appreciate a forum like this is going to attract people that are in pain and feeling pretty desperate (it’s how I feel) which biases what we see here. I am also aware of the peer reviewed studies though which whilst don’t go into detail on pain do say the success rate of Botox isn’t perfect. But I think it might be better than what we see in this forum. Anyway I guess what I’m saying is I see a lot of myself in what you wrote - reading literally every post since 2007 or something that’s relevant and getting myself into a total stew about it.

Thank you for your post though, it helps to balance everything out and I really hope your health in all respects improves.
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Re: Healing Tips + Botox Success!

Postby can-cervive » 05 Oct 2021, 20:40

Thanks so much Conifer. I'm so sorry to hear about your miscarriages. I was actually given my cancer diagnosis at 8 months pregnant and so as a mom I truly feel for what you went through. <3

Are you able to have the botox if pregnant? Are you able to try for a baby with botox? Has your CRS said anything about that? I wonder if it's worth looking into...

I read all of the peer-reviewed studies myself but there are lots of conflicting ones out there! The other thing too is lack of standardization in how many units of Botox is used, technique issues, etc. compared to the surgery which is pretty universal. So it might depend on your CRS's personal success rate. Mine was super confident. Maybe worth asking him?
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Re: Healing Tips + Botox Success!

Postby Conifer » 06 Oct 2021, 02:51

Hi CC. Thank you for the kind words. I can’t begin to imagine what you went through. I know everyone’s battle is relative but yours has put mine into perspective a lot. I can understand if you don’t want to talk about it but can I ask how you are now doing with your cancer treatment?

As for Botox and pregnancy. My CRS showed me a study where they did this to a group of women and there were jo issues with births/babies but when I said I wouldn’t be doing that esp given my history with MC he said “don’t worry, it’s not something that would be on offer from me”!
Plenty have Botox (and lis) when breastfeeding so i expect I can do it then try for baby. It’s more the recovery that’s an issue esp what we’ve all read on the forum. I worry I have overread the horror stories but then the literature stays speak from themselves. And I’m a biologist so I understand these papers amd their statistics well.

My CRS felt confident Botox was the next step but now I wish I’d done this during the summer when the fissure(s?) reappeared and I’d be fixed now perhaps and moving on with things. My main worry is time as I had MC screening in August and whilst all my bloods came back normal my egg count is SUPER low so this is my issue just now. I’m between a rock amd a hard place - fissure and egg count/time. Really not how I saw my baby making plans lay out but then I’m sure you’d say something very similar about your pregnancy.

We’ve tried again this month so in the 2 week wait period and have one more try after that before I’m just going to do the Botox (though I actually want lis and just get it sorted and done). Then we’ll see what happens.

How are you doing day to day with your fissure now? Are you confident you’re past it now?
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Re: Healing Tips + Botox Success!

Postby can-cervive » 06 Oct 2021, 21:52

I see - wow, such a complex situation and so much to juggle! I totally understand how you feel so conflicted. I think the hardest part can be the mental toll so just remind yourself that you WILL HEAL! The question is just 'when' in terms of pre-baby or post-baby! :)

Cancer treatment is going well, on immunotherapy now which isn't as bad as chemo/surgery so I'm seeing light at the end of the tunnel. I truly think my fissures are 90% healed! I've had no pain or bleeding at all with BMs since August 15th. Even when I've had to strain a bit or if I go more than once per day - no issues! My entire anus area does feel really tight so I have some discomfort from time to time but I think that's my body's response from months of clenching and tucking my tailbone under so I'm seeing a pelvic floor physio to relax the area. I will call myself 100% healed once the appearance of the fissures matches up with the feeling of them (i.e. they look as healed as they feel) but so far, life is back to normal. I can even go down the twisty slide with my daughter now which I never would have dreamed of before...

Best of luck with whatever you decide!
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Re: Healing Tips + Botox Success!

Postby JohnP » 17 Oct 2021, 03:41

:Rock: Hi can-cervive. Thank you for your very detailed post. I can't begin to think how you coped mentally and physically with all of this. You provide a beacon of hope and light for all of us. I wish you well. My affiction was caused by a serious bout of constipation 2 years ago which I put down to eating too much cheese, bread combined with dehydration from extreme cycling. 18 months of hell ensued. Like you I felt this would never end. Pain everyday, all day, 15 mins reprieve in the morning until my next BM. The anxiety build up before each BM was often intolerable in itself. Then off to work everyday in pain. Anyway after 2 x Diltazem doses (Dubious???), 3 x Botox surgeries (Much better results), the development of both external and internal haemorrhoids, Steroidal creams and thrush treatment things started to look up when I started a new diet including a mixed oat, cereal and fruit breakfast (first in soft, first out soft right?) and 30 to 50ml of Actilax (Osmotic stool softener) after dinner (my saviour) the cycle of true healing began. Just as well as I was about to book in for a LIS. As you said it takes about 4 weeks to slowly reduce the pain and about 4 months overall to really complete the healing. I still can't believe how good it feels to be without the pain. I have healed now but have been left with scars which I need to be mindful of as this tissue cannot stretch and can tear again. My caution to anyone is even though it may reduce the pain do not use steroidal cream on your anal passage. It can cause thrush and only thins the skin so it is easier to tear again. So the diet continues of cereal breakfasts and lots of salads included with main meals. I can finally ride my bike again and sit down comfortably most of the time. (Extreme days are over) I still suffer some anxiety before a BM but it is waining thank god. Anyway hope this helps someone out there. You can heal without a LIS!
Once again a big shout out to you can-cervive. Thank you for your valuable post and I sooo feel for you and very sincere wishes for a quick recovery!
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