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Hello

Postby cassius » 06 Jan 2020, 19:21

Hi All,

I'm a relatively new sufferer of AF, having had it for just over 2 months now. It was caused by the (overenthusiastic) use of sex toys, and it started as a tiny pain when I would sit down and over the next two weeks grew into a pretty crippling pain.

My symptoms are kind of different to most that I've read. I don't have any pain at all when doing a bowel movement or after. However sitting is a cause of intense pain within a minute of sitting down, as is lying down in pretty much any position other than on my stomach. Even walking for more than 5-10 minutes causes pain. Sometimes even standing causes pain. As you all would know constant pain like this is pretty difficult to bear psychologically and my life is pretty much on hold.

Treatment wise - I'm in Australia. I saw a GP who diagnosed the fissure and prescribed me Rectogesic (0.2% glyceryl) which I've been using for 7 weeks now, as well as fiber supplements. Five weeks ago I saw a specialist (general surgeon) who took a look at the fissure and said he was happy with how it was healing and simply said to continue using Rectogesic, which he assured me would heal it.

However in the 7 weeks of using it so far I don't really feel its gotten any better. I've gotten better at avoiding the pain - which sometimes gives me hope its healing - but as soon as I do anything that triggers it I get the pain all over again. In some ways I feel its getting worse since more things seem to trigger the pain but its hard to objectively judge this.

I've had difficulty applying Rectogesic with my finger since that seems to 'rip' the wound more ever time I've used it so I switched to applying it with the cotton tip ear things, which made it a lot easier to apply but makes me paranoid I'm not doing it right somehow.

I guess in general I was hoping to get some perspective on what other treatment options to seek, what healing times are 'reasonable' to expect with Rectogesic, and any other general advice on how to heal quicker. I don't really think I could handle having this kind of pain constantly for the rest of my life.

Thanks in advance.
cassius
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Re: Hello

Postby patience_and_healing » 07 Jan 2020, 22:34

7 weeks is a good amount of time for Rectogesic to help with healing. Nifedipine is another option to ask for if that's available in Australia. It's all right to not apply the rectogesic directly on the fissure. You definitely don't want to reinjure it everytime you apply.

Other than avoiding things that cause pain I suggest drinking plenty of water, taking warm sitz baths to promote blood flow, and eating a healthy well rounded diet. Add a stool softener like miralax if bowel movements are not the right consistency.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
patience_and_healing
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Re: Hello

Postby cassius » 08 Jan 2020, 18:25

Thanks for your reply. I'll ask about Nifedipine next time. It seems that it exists in Australia but I can only find references online to the oral rather than topical form. Its also good to know I don't have to be super anal (hah!) about applying the rectogesic. However I am finding that sometimes it feels like it has a lot of impact and other times little. Not sure if I'm not applying a consistent dose or if other factors are impacting this.

Whats the consensus here on sitz baths? Reading the literature, studies seem to show it has no or negligible impact on healing? I personally find taking a long hot bath (1 hour or so) is really good for alleviating pain and relaxing all the muscles - not sure if this has any downsides. The specialist i talked to thought it would not really help or hinder.

I forgot to mention last time I've got some kind of IBS which I suspect is what might be slowing down healing, not sure if people have any specific recommendations for how to combat this?
cassius
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Re: Hello

Postby patience_and_healing » 09 Jan 2020, 18:11

Do you have diarrhea predominant IBS or constipation? The fodmap diet is a good place to start if it's diarrhea predominant. For constipation I recommend a stool softener.

Try applying the ointment 20 minutes before a BM and see if that helps you more.

Sitz baths can promote healing simply by increasing blood flow. I haven't researched it though.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
patience_and_healing
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Posts: 970
Topics: 38
Joined: 24 Feb 2017, 15:46
Location: California
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Re: Hello

Postby cassius » 09 Jan 2020, 18:51

The symptoms I get are mostly gassiness and bloating, rather than either of those. Currently I'm taking Metamucil (basically fiber supplements) but constipation nor BM haven't really been an issue. When I get the gassiness it can irritate the AF, but i think the general inflammation in the colon from the IBS is the biggest threat.

I suspect applying the ointment shortly before a BM causes the BM to "wash out" the ointment (or at least it feels the effects of it stop). But in general the pain relief and muscle relaxation feels like it only works for 1-2 hours tops, often as little as 30 minutes.
cassius
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Re: Hello

Postby patience_and_healing » 11 Jan 2020, 14:12

You might want to get checked for SIBO if you have that much bloating. Fiber will only increase the bloating issue. Avoiding high fodmap foods like onion and garlic can also help.

I used to apply the ointment both before and after a BM. You could try doing that.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
patience_and_healing
Moderator
 
Posts: 970
Topics: 38
Joined: 24 Feb 2017, 15:46
Location: California
Has thanked: 58 times
Been thanked: 116 times
Gender: Female


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