Just Joined - Newbie Intro

Newbie Intro - 3+ months of fissure "fun" so far

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Just Joined - Newbie Intro

Postby CreativeMuse » 16 Sep 2013, 22:09

Hello all! I joined the forum today, and am so grateful that it exists! Reading others posts have helped me mentally (and physically) while trying to deal with this not so wonderful experience.

I guess I've been lucky up until recently. I've had occasional issues with hard stools/constipation off and on throughout my life. The past few years, I've been really good about making sure that my fiber intake was high (to the point that sometimes large stools would even clog the toilet).

At the beginning of June, I ate a bowl of cheesy queso with chips on an empty stomach (just thinking about it is making my stomach gurgle). It didn't agree with me. Within 10 minutes, I could barely make it to the toilet before very explosive diarrhea occurred. This happened 3 times in less than an hour, and after the third time, there was blood on the toilet paper, and burning pain. I was clueless, googled the heck out of everything relating to blood with bowel movements. Initially I thought maybe it was an internal hemorrhoid that had been irritated by the diarrhea, but then read that internal hemorrhoids shouldn't cause pain. The pain was uncomfortable, small amounts of bleeding continued, and I concluded that it was a fissure. Of course, since I haven't had one before (or hemorrhoids for that matter), I wasn't sure, but since I had read that most heal in about 3 weeks, I decided to wait and see, and started stiz baths. The situation didn't improve. Increasing fiber only made stools larger, adding to the pain. I then fasted for 3 days, and still passed stools every day. Weak and miserable, I made an appointment with a GI doctor. I hadn't been to a general practitioner in over 10 years, and didn't have any history with one where I am currently living. They were able to get me in quickly.

I met with the PA, who did a visual inspection, as well as a digital inspection. He said he couldn't see the fissure, but there was some blood on his glove from probing around. He said he felt a mass as well, that would need to be examined. A sigmoidoscopy was scheduled for the following week. I went home, read online that it was a painless procedure, and that the worst part was the prep. It was a split dose prep....and it was extremely unpleasant to do with the fissure. And not being able to take Ibuprofen didn't help. Once I arrived, I was told again that it was painless by the nurse, and there would be no need for any topical anesthesia. When I told her I thought I had a fissure, her reply was, "How do you know? Have you had one before?" There wasn't any concern on their part about the pain.

At the initial insertion of the scope, I cried out in pain. The doctor paused after a few seconds, asked me if that was painful, I said yes, and he said he would try to avoid the area where it was until the end. With every movement he made, the pain grew in intensity. I was telling him to stop, cussing several times and then crying. He just told me to hold on, that it wouldn't take much longer. The pain became so intense that I starting holding my breath, and the monitor alarms
went off twice. It felt like I was being ripped in half, and there was nothing I could do. He still wouldn't stop. He found a polyp (the mass the PA had felt), removed it, and then on his way out with the scope, saw the fissure and took an image of it. After the exam was over, he told me he had to remove the polyp because it appeared cancerous, and that I would need a full colonoscopy. He then told me that my fissure was large and that I would probably need surgery, which had a risk of incontinence. I told him no, that I wanted to try Nitroglycerin. I was terrified, violated, and there was no way I was going to let him perform any additional actions.

Days following the procedure were miserable. I could not sit upright at all. I had muscle spasms going down my leg, and waking me up at night. I couldn't bend over past the waist. The prescription was for Rectiv, recently approved in the US. I was unable to apply it inside for the first two weeks (I could barely get a qtip up there without extreme pain). Once I started applying it correctly (using a syringe), there was intense stinging. I ignored it because I so badly wanted to heal, but it became too painful after applying....I would literally lay face down and cry after an application. The pain would subside after 10 minutes or so, but the reaction intensified (as if that even seemed possible) each day. (I also had a similar reaction to Preparation H, and it seems to be
lanolin that might be causing the problem - I am extremely allergic to wool).

I ended up going to a general practitioner, and he recommended a local, well respected general surgeon (who spent 3 months advanced training focused on the colon/anus. I met with him, and he told me he could do LIS surgery the following Monday (he hadn't even inspected the fissure when he was going on about surgery). I told him I'd like to avoid surgery if possible and that I had read about another cream that had great success for others, but I didn't remember the exact spelling or pronunciation. He prescribed Hydrocodone and Ibuprofen 800mg for pain. Well, he called in an RX for Dibucaine. When I called his office to get Diltiazam cream instead, the nurse said they couldn't
prescribe it if it wasn't in their healthcare systems database (they showed it, but only for high blood pressure treatment. She would talk to the doctor and get back to me. She didn't call back, and the next day I put a non-urgent call into his answering service. (He had repeatedly told me to call anytime, day or night, if I had any concerns or questions during our initial meeting). A few
hours later he called me back and he was annoyed. The friendly manner was non-existent, he asked me just how many creams did I have to go through, why I wasn't respecting his 25+ years of experience, and instead relying on some concoction I had found on the internet.That he didn't have time to research it, and that if it wasn't approved for that usage, then he wouldn't prescribe it. I about lost my temper, but I realized that if I did, I wasn't going to get anywhere, so I calmly (as I could) told him there were studies from the US National Health Library (mainly this link -
http://www.ncbi.nlm.nih.gov/pubmed/11298624 ), that there are substantial and valid proof that it has helped others heal and avoid surgery. Not to mention that it's in the 3rd round of FDA testing in the US, and should be on the RX market next year.

Early the following week, he called the pharmacy and had it filled. I didn't notice much difference the first two weeks, except it didn't hurt when applied. I started taking the Hydrocodone, and had some uncomfortable bms, so I increased the colace and milarax. Week 3, I could bend over and pick things off the floor and was in alot less pain. Muscle spasms down my leg was gone.I felt like I was finally on the road to recovery. I stopped taking the RX painkillers and just took over the counter Ibuprofen and Tylenol as needed.

Unfortunately, when I did that, my stools went haywire. I started going 2-3 times each morning, each progressively looser and watery. I cut out the miralax completely, and the colace next. I had been taking magnesium 500mg, so I cut that in half as well. I started drinking one cup of
sage tea in the evening, from fresh sage leaves, just in case going off of everything was going to cause a constipation problem.

Four days ago, after another bout of 3x going in the morning with the same result, something felt like it was falling out. And there was a intense painful spot when I was using the wipes. I checked in the mirror, and there was a bump that looked like a pimple close to where the fissure opening is. I upped my baths to 5x/day for a half hour each, and stopped eating solids. It became painful and inflamed, and developed into a lump about the size of a large pea. Blood and small amounts of pus were coming from it, blood especially after applying antibiotic ointment. (I checked the inactive ingredients and there is lanolin in it, so I switched to hydrogen peroxide and warm cotton balls soaked in salty water. Thinking that I had an anal abscess, and because there was a little pus draining, I went to the emergency care clinic this morning.

After being inspected and having the area pulled and tugged, the doctor said it was hemorrhoids. There was one inflamed one right were the fissure is, and several small ones. She said there was nothing to drain, to use hydrocortisone cream for the inflammation, and prescribed a 10 day
treatment of Cipro. She also recommended I take a probiotic (Cultural). I got those immediately, took my first dose of Cipro at 1pm (after eating one scrambled egg with mushrooms at 11AM). At 3pm, i took the Cultural, but opened the capsule and poured out half of it, just in case it was too strong. At 4:15pm, I had a very strong, explosive episode of diarrhea. I'm drinking water, and added a little juice to it around 6:30pm, and nothing bad happened. Five minutes ago I ate
2 saltine crackers....waiting to see if there is a reaction, but have given up on the idea of eating anything else today. I can't go through that again....there was blood coming from inside where the fissure is, and I feel like the progress I was making is coming undone. :( The only thing giving me relief right now is the heating pad I have between my legs. Ibuprofen isn't recommended to take
while on Cipro, so I've only taken 2 Tylenol today after the pain got too intense. I'm hoping the reaction was to the probiotic and not the Cipro. Also, since all this started, and I couldn't figure out how to keep my stools small, I kept eating less and less. I've lost 25 pounds over the past 3 months....last week I started eating more, and now this happened. I'm exhausted.

Anyways, that's a little history on my situation up to today. I look forward to being active on this board, and hopefully help (and be helped) along the way.

I've read so many posts that others have made, and it helps to not feel so alone through this. :)
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Re: Just Joined - Newbie Intro

Postby Ever the Optimist » 17 Sep 2013, 16:08

Hi Creativemuse,
I'm so sorry to read your story - it's horrendous and the treatment you have received along the way is a classic example of medics that have no empathy or compassion whatsoever for those suffering with anal issues such as yours. Quite frankly, it's awful and shocking & I so hope you have other options and possibilities you can try out.
A fissure is certainly not a wonderful experience and to have to undergo all that too is just horrible. I hope you have other support networks out there offering you comfort & helping you through the mental trauma of it all.
You do however sound like you have a very down-to-earth and practical approach to it all and you sound incredibly strong & level-headed.
Eating less will certainly keep your stools smaller but it also depends very much on what you are eating too. Fibre can be notorious for producing larger stools, even if they are soft, so it might be worth just checking out your balance of soluble & insoluble fibres (there is so much info on this site regarding this & on the net generally) Also instead of eating 3 large meals a day (if you do) it might be worth spreading them out a bit and having 5 smaller meals.....and keep eating light for now, just plain crackers, wholemeal toast, chicken soup etc...just whilst your stomach is so volatile & your BMs so loose & until you feel back on track again.
No wonder you are so exhausted after all this!! Are you able to rest much at the moment or are you working? It might help if you are able to take a couple of days off just to rest your body and sleep, to rest your mind.
It does seem there is a bit of experimentation to be done when it comes to Miralax, although people swear by it, but it's not probably the best thing at the moment for you? - I am also a big fan of Magnesium and take 300 mg daily - A large tablespoon of olive oil orally & lots of olive oil in food is also very helpful for softening stools.
Hemmorrhoids are really irritating because they are troublesome when inflammed and it's not surprising they have worsened after the rough handling you have received in the last few weeks, but they will calm down. Many of us here have had issues following surgery, with hems that were aggravated because of that very reason and with gentle cleaning methods/ light exercise & solid (but soft) stools & no straining, they do start to improve over time again as the area starts to settle down again. Ice packs & a cold shower head on them help to numb the area and provide relief. I found pure Aloe Vera very helpful and changing position to ensure I was not applying direct pressure on them for too long was also important. They really are a pain! but they do become more manageable and I'm sure once you are able to overcome your diarrhea issue, they will start to feel better.
I also used Diltiazem and for me it was my saviour, allowing my fissure the time it needed to start healing. I sincerely hope it helps you considerably and your body is happy to accept it too.
If you are not already, I would also suggest applying a generous dollop of Vaseline to your bottom prior to a BM as it will "coat" that area and form a barrier to help protect that delicate area from the harsh effects of diarrhea. It will also lubricate the passage to pass stools more easily.
I truly wish you all the very best with all of this and hope things calm down for you very soon.
Just try to stay mentally strong & rest up too & thanks for sharing.......You are so NOT alone with all this! :)
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Just Joined - Newbie Intro

Postby Now66 » 17 Sep 2013, 22:10

As Ever the Optimist says .......You are so NOT alone with all this! Sadly, your experience with this is not unique as you will see in the forum. I have come to believe, from this experience, that we need to take charge of our own healing and be strong about it. One of the best things I did, for me, was to cancel the surgery with a CRS who neglected to tell me a great deal of the consequences of the surgery. I deserve better than that. Furthermore, if I have to cram a finger full of whatever up there every day to heal, then so be it. (Besides, I keep a bar of soap handy. There actually can be some humor in all this.)
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Re: Just Joined - Newbie Intro

Postby CreativeMuse » 18 Sep 2013, 21:10

Thank you both for the positive words. :)

Now66 - Yes, when I'm having a good day, I do find some dark humor in all this. I tend to like dark humor anyway, so I guess it's fitting. When I'm having a bad day, though, it hurts to laugh ;)

Ever the Optimist - Yes, it was traumatic. The way I'm going to deal with what happened with the GI visit/sigmoidoscopy is put out some negative reviews on the web. When I was searching for a doctor, I didn't see reviews on him. I want to make sure that the next person in the town I live in (that thinks they have a fissure) is aware of what I went through. I also got a recommendation from the emergency care doctor for another person to consult with if there are any additional problems that I can't resolve myself.

As far as working....I'm an independent web designer, so I tend to work out of the home as much as possible. If I had a normal job that I had to go into every day, I would have already been fired, or quit, or put on disability. I have not been able to sit upright (even with pillows) since July. I've got my computer set up on a stand with wheels, and I work from bed, lying on my stomach. It's actually been building up those arm and shoulder muscles ;)

I'm a big fan of olive oil too...recently my roommate purchased some yummy infused oil, and I use that on lightly toasted Oatmeal bread (instead of butter). And I've started eating avocados & raw cashews (very well chewed). Speaking of chewing, before this all happened, I realize now that I wasn't really chewing my food well. Now, I make sure any food I put in my mouth is pulverized before I swallow it. I bought some krill oil capsules on Monday (that I haven't been able to try yet), and I think that might help too.

My stomach has calmed down a bit since the other day, but not completely. Definitely staying off the stool softeners and Miralax till I at least have some kind of semi-solid movement in the morning. Miralax I rarely have to use, and I learned if I use more than a tablespoon, things get messy. But if I'm ever brave enough to have a slice of pizza or some red meat again in the near future, I'll be using it. (I really miss pizza the most, and haven't indulged in red meat or alcohol since this began.)

Glad to hear the Diltiazem worked for you!:) Mine is compounded with cocoa butter, so it's been painless when applying. I haven't used it in the last 3 days as things are just too messy right now with my stomach issues and the inflamed hemorrhoid, but I'm looking forward to starting back on it and having this thing healed!

Thank you for the suggestion of using cold, instead of just heat, as I was doing before. That did help with some of the painfulness today. So now after the warm baths, I'm following up with a cold spray for a bit (I have a hand held shower nozzle, so that really helps too).
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