Cheryl,
Thank you so much -- my real name is Chen btw :) I've also thought a lot about a colectomy, ileostomy, etc. I would love to just be able to eat what I want and not have to worry about the pain to come. I know no doc will ever authorize it for a fissure though. But I end up getting diagnosed with Crohn's or ulcerative colitis then that's going to be something I'll very seriously consider. I've heard of many cases of young people -- even younger than myself -- getting a stoma and being happy with the results because they are now able to live the lifestyle they used to enjoy. I've already discussed this possibility with my wife and she's all for it should it come to that because she knows the type of person I was before versus the one I am now. I used to travel the world, snowboard, moutain bike, and ride motorcycles avidly, and now I can barely leave the house.
I do try to keep in mind that there are people in this world in far more difficult situations. I had a friend of mine who was only 22 get murdered by some skinheads out in Poland years ago -- we used to go out on the town on the weekends, have a good time drinking beers, watching sports, and just hanging out... Then he went out to Poland for medical school and ended up dead a few months later with his throat slit. And I've seen a few people fight cancer (colon and stomach cancer) and lose. I've grateful that I've led such a full life: I have a wonderful wife, twin babies on the way, a secure and well-paying job, and have been all over the world on countless vacations throughout my 20's. Truthfully, I feel like I've experienced a lot more already than a lot of people do in a lifetime. So I'm pretty bummed about things every time I have a BM, but even if it were all to end today, I can't say that I haven't had a darn good run. Maybe it's a bit of a life lesson for me; all these years I've strived to go on vacation in foreign destinations, looked forward to buying fancy cars, taking expensive trips to watch NBA basketball games, etc., and life just wanted to remind me of what really matters above all else. I'm not really much of a philosophical or even spiritual guy, to be honest, but lately I've been wondering if this is some kind of punishment being doled out for being so focused on pointless things for so long.
I actually do have an antidepressant prescription, it's for something called Citalopram, one of the SSRI antidepressants. My doctor prescribed it to me along with Klonopin for anxiety and pretty much said I can have a lifelong prescription of both if I want. I've had moderate-severe (depending on the level of stress) obsessive-compulsive disorder and mild depression my entire life (I can remember the obsessive-compulsive tendencies as far back as about 3rd grade but the depression came later around college), and the doctor thought those might help me get a better grip on things that stress me. When I was in college I also suffered from panick disorder, complete with full blown panick attacks, for a few years, although that largely subsided after college. But now that I'm taking Valium and Percocet and also topical nitroglycerin and lidocaine, I figure it'd be best to leave the SSRI's out of the equation until the fissure is somehow contained. So yeah, I'm kind of a walking infirmary, probably one of those people who just wasn't intended to survive and has done okay even making it to this point.

I'm not really much of a philosophical or even spiritual guy, to be honest, but lately I've been wondering if this is some kind of punishment being doled out for being so focused on pointless things for so long.

That's another thought process that leads nowhere, IMHO, Chen. It's not. Just keep in mind this god-awful malady afflicts people of every race, creed, religion, socio-economic status, what have you. But you have shown great insight and wisdom in your remarks. This suffering you endure has brought the truly important things in your life to the forefront. It is something we all need, though not in the method you, I and others on this board would have chosen...to be shaken out of our "self" and suddenly see the world, and life, though a different and perhaps more fulfilling light...

Chen,
I can tell that you are intelligent! (only smart people get AF's ) I really never knew what suffering was until I had my AF and then I really suffered. I think there is often a spiritual and definitely a mental component to most illness. I made some big changes in those areas and decided to concentrate on others besides myself. That is one reason I now volunteer with the Red Cross. When we have a tombstone, it really won't matter how much money we earned or what we accumulated because it all has to stay here, unlike what the Egyptians believed!!

NG !
You are going to beat this buddy
What Kim said in particular, hold onto every word NG ! AdminKim is wise one !
I have had many of the thoughts you have had NG ! Wondering what the heck I had done to deserve such a pain and the mental turmoil that comes part and parcel but then I think about how much much worse this could be and I hold on tight ..
We all know others who would gladly swap their right arm for the small cut in the anus ! Good one Cheryl !
I am glad you are leaning towards LIS I think sooner the better too !
When are your babies due date ??
I do hope you are feeling a little better today

Babies are due in mid-late September. It'll be a caesarean section so we'll know exactly what date it's scheduled for in a few weeks. I've resigned myself to being in some kind of compromised state when the babies arrive, either recovering from LIS or still suffering the limbo of messing around with this ointment, that injection, etc., in the hopes that one of them will magically help when nothing else did. I just hope I'm able to be of at least some use around the house since my wife can't possibly handle two infants on her own after having a c-section.
LIS is definitely my preference at this point, if yesterday hadn't happened, I would've liked to try botox first, but after yesterday I just want to cut straight to what's going to give me the best shot, it's the fissure or my sanity at this point. These last days my spasm has been so bad that I can't even pass gas, and even liquidy stools feel huge and restrictive coming out. The pain level and sphincter tightness has definitely gone up several notches recently, it doesn't really respond much to nitro, and even the six Valiums I've taken today don't seem to put much of a dent in it.
But you guys are absolutely right, fissure or not, most of us are still pretty blessed, and should be thankful for what we do have, which so many others do not.

NG,
I forgot to mention that I also used to have panic attacks (a few decades ago ). Especially during my college years, and now they are no more. My son with autism has OCD, so I am familiar with that also!
One other thing that might help you. Feeling guilty because of your current predictament is not helpful (maybe you could get some outside help for your wife if necessary??). Try to get your mind right (w help if necessary) and focus on the great event that will occur in your life in a short while. When I used to get down in the dumps, I started focusing on what I COULD do as I started feeling better. (I.E. I couldn't travel at the time--or at least I didn't think so--but I could take tap dancing classes) That was the beginning of improvement for me. I thought I will just have to be content with this even if I cannot travel. Seeing a psychiatrist was also helpful. It gave me someone to talk with besides my spouse who was really, really tired of me talking about my butt all of the time. And I might add my mother was not very sympathetic towards my plight either!!! But she had a fissurectomy when she was in her 30's several decades ago with no pain killers for followup; she told me that she felt she was going to pass out the first time she had a bm post surgery. She is now 84 years old and is recovering from recent major surgery (hysterectomy for a tumor and also appendix removal). Just know your problem can be fixed; get that idea in your mind! Try tapping into spiritual power. It helps!!

NG, you will get better. I personally think the surgery will do wonders for you as you are new to this, as was I, and I believe the sooner they get to it, the better! Your body is telling you it's getting worse (as was mine but not to your extreme) and making your mind up for you...Hope your feeling better today..just hang on till those appointments. I had the exact same thoughts as you, and now look, I am much better..you will be too.

I think so too Sidra ! Spot on !
I hope you get all fixed up very soon NG so you can enjoy them babies ! :)
I think we need baby icon here ------

Guys, thank you so much, I hope you're right. I used to think I'd rather put up with any amount of pain rather than die, but now I know those were foolish words. This pain has brought me to my knees. Every day, things are fine until I have a BM, and after that the world flips upside down and I wish I'd never woken up.
I really can't deal with this any longer so I'm going to call both physicians right now and see if they can either scoot my appointment time up or administer the botox sooner. If I have to suffer the kind of post-BM pain I've been having these last few days for another 1.5 weeks then I'm just not going to last. I tried one of the Percocet last night, and it knocked me on my ass, but still didn't fully mask the pain (which is amazing because I thought an opiate would be strong enough to), and has left me kind of constipated today to boot :(

Ok I begged and pleaded and got my appointment with the local CRS bumped up to this Monday the 17th. I'm going to demand either Botox or LIS with her.
I saw a different CRS last week in San Francisco who said she was going to talk with my insurance and get a Botox injection authorized, so I can always try to get her to expedite things if things don't work out with the local CRS, I suppose. San Francisco is a good drive so I'd rather get things done locally if I can. She said the reason she couldn't give me Botox last week is because she needs to build a case with insurance that it's needed in my case. Well, I now have a discharge slip from the ER indicating that I have an anal fissure accompanied by severe proctalgia, so hopefully that helps my cause. If insurance is smart they ought to figure that it's cheaper to authorize the Botox injection rather than have me show up at the ER!!!
I've got my fingers crossed, but am not getting my hopes up, just have to somehow get through this weekend with this Percocet-induced constipation aaaaaargh! Thank you all so much for your support!