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Kind of new

Postby tightybehind » 11 Jan 2017, 22:19

I've been lurking on this board for information and to post questions and thoughts from time to time, but I've never properly introduced myself.

I'm 38, fairly active, run 10 milers, half marathons, and go to the gym on a relatively regular basis. I do enjoy my food though - stay away from fried foods generally, but enjoy eating fatty foods like cheese, meats, and breads. During the week I generally eat whole healthy foods though - salads, fish, chicken, etc. Anyway, probably due to the weekend diet and allowing myself to get dehydrated during bouts of depression, I had my first fissure about three years ago, which seemed to miraculously heal with no special meds.

I was pain-free for three years, would have a little irritation now and again, but nothing major. Then this November I had back to back incidences of diarrhea, then constipation, then diarrhea again, which led to a major retear or new fissure at the 6 o'clock position. Didn't think much of it - I knew the drill - blood and pain during BM, take stool softeners, use coconut oil, and it would eventually go away. Well, guess I was being a little naive and optimistic. Fissure stuck around and seemed to get worse as the weeks went on with a pain level of about 7 out of 10 during BMs and pain sticking around 7-8 hours after - turned out, I made the fissure worse. Following all the advice I had read online, I was getting way too much fiber (40+ grams a day), and as a woman, I really should have been aiming to get 25 grams. All that fiber was making my stool huge and even with the stool softener, they were hard to pass. I figured this out after reading through posts on this board, etc. and seem to have a handle on the fiber, at least.

I was finally able to get an appointment with a CRS on December 16, who prescribed nifedipine and gave the regular spiel: fiber, water, etc. One week on nifedipine and my sphincter was finally able to relax and by the time Christmas rolled around, my pain decreased drastically to around 3 out of 10. The week of New Year's was even better with no pain at all, even during BMs, to the point that I felt I could stop taking the nifedipine.

Last week, I returned to the gym and lifted weights including squats and deadlifts, walked on the treadmill, etc. I had a heavenly week of living like a normal person, not stressing about my BMs, eating healthy, working out, etc. I even had the occasional glass of wine with dinner with no problem. Then Saturday rolls around, my husband and I went to a store to wax his snowboard, I didn't take water with me, and we ended up staying there around 1.5 waiting. Then we went to the gym, then dinner where they only had ice water and the restaurant was so busy, I couldn't get regular tap water without ice. Well, add this all up and it turns out I didn't get enough water, and bam, fissure comes back Sunday with a vengeance.

Now I'm back to applying nifedipine six times a day, making sure I get my fiber in, drinking one gallon of water a day, and jumping in a sitz bath after BM. Stool has stayed around Bristol 5/6 through water and diet alone. It appears to be soft enough, but the pain during BMs has been back up to around 7 out of 10. Sunday the pain lasted all day, I believe it was because my sentinel pile was irritated. The pain afterwards has been steadily decreasing this week, but the pain during BMs has stayed around 7/10. Sentinel pile seems to have calmed down as well.

I haven't taken stool softener this go around. My concern being that if stool is too soft, it will require straining to get out. I also don't take miralax, movicol, or anything else, as I'm scared it will cause diarrhea. I just started adding in 500mg of magnesium to make sure things are soft. Should I stick with what's working as far as diet and water to keep stools at Bristol 5/6?

I have a follow-up with the CRS scheduled for next Tuesday, but if things haven't calmed down, I'm tempted to push the appointment out because last time, she stuck her finger up my you know what, causing pain for hours. She mentioned that if fissure doesn't heal, next step is Botox, but I would like a few more weeks to see if I can get back to New Year's week level of comfort on my own without the Botox intervention.

Anyway, thank you for reading and I plan to keep this post updated for a while. Thanks for all your advice and support. This is a long and lonely road. I only recently told my husband what's been going on with me - he's support as can be, but I hate burdening him with this.
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Re: Kind of new

Postby Canadabum » 15 Jan 2017, 22:46

Hi and welcome to the forum!! Thanks for
Posting your story.

Sounds like you are familiar with how to deal with your fissure -- hope that all your efforts work well and that your fissure heals and pain subsides.

Dehydration is definitely something to avoid if you can...

All best - Canadabum
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Re: Kind of new

Postby Kathy64 » 17 Jan 2017, 11:21

Welcome!!

Sounds like you know the routine of caring for anal fissures....I have had an anal fissure for 20 years although most years have been symptom-free with occasional flare ups. All of my flare ups have self healed except nine months ago when I re-injured this fissure and now will not heal! I have tried everything with no success or decrease in pain. I spend my days either managing my pain or fearing my next BM. I had surgery scheduled last November but canceled clinging to hope it would still heal...My GI told me my anxiety prevents it from healing...I have since left work and have decreased my life anxieties as best I can... BUT no results...My surgeon told me a chronic anal fissure develops scar tissue that eventually will not heal without surgical intervention... I also have the tag which causes much pain although I have read on other websites the skin tags usually remains painless... which simply is not true! I will probably be forced to have the surgery but I am waiting now for the birth of a granddaughter next month. (What's another month?) I have tried everything! I hope very very much you experience positive results and your fissure eventually heals!! This forum is a wonderful place for people to find support! Both my GI and my surgeon have mentioned how common anal fissures are yet I know no one who remotely knows the agony they cause! And just like you... I feel so sorry for my husband!! My heart breaks for him!!! My whole life has changed in the last nine months.....I do not eat out....will not go anywhere in the early morning....eat most of my food in the evening.....and... the fact he must watch my pain and anxiety day in and day out!! Our vacation time last summer was wasted....I will not travel either! It is a terrible affliction!!!! Praying for your fast recovery! Please let me know how you are doing!!!
Kathy
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Re: Kind of new

Postby tightybehind » 17 Jan 2017, 11:41

Hello Kathy! Good to hear from you.

How is your diet?

I'm managing the pain with advil, heating pad, and keeping stool medium soft with stool softeners and lots of water. But it's not healing and I think it's because my diet is not perfect as I haven't been terribly disciplined about limiting cheese/bread/meats.
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Re: Kind of new

Postby Kathy64 » 17 Jan 2017, 12:32

Thank you for replying!!! So very much!!!!
My diet varies! In the last nine months I have tried everything with my diet. Bland foods...no foods...high fiber foods... fiber supplements... increased water intake....increase fruits and vegetables.... avoid cheese...avoid meat....avoid nuts... etc.etc. Seems like I have a decrease in my BMS or softer BMs and I'm relieved of SOME pain TEMPORARILY ( pain never goes away completely unless I have no BM for a whole day)...then I get hungry... I eat (even something healthy and non-irritating)...and I find myself back to square one. I have suffered constipation and the pain increases as well as diarrhea with the same increase in pain! I also have normal BMs most of the time and the same pain occurs. My pain has changed thou....Where once it was painful during the BM is now painful after the BM and lasts for sometimes 10 hours. I have taken Miralax every day for many years and continue to do so....tried the heating pad....tried ice packs....tried OTC creams and ointments....tried prescribed creams and ointments.... I had to even allow my husband to insert the prescribed ointment rectally as prescribed because I just could not do it alone and this was totally humiliating and degrading.....I just tried Coconut oil ( with much anticipation) topically and in sitz baths and NOTHING! I do not want to discourage you! I feel after 20 years....I have just reached a point where I need surgical intervention yet I am so very scared of surgery!! I would not wish this agony on my worst enemy! I spend each day either poorly managing my pain with much Advil and for break through pain while on Advil...I will supplement with Vodka when the pain is just unbearable and I can't take it anymore...! OR... I am awaiting my next BM with heightened anxiety and stress!! I have described the pain to my husband as a very, very bad toothache (the worst toothache ever imagined) but just inside your rectum.... (Both my GI and my surgeon are reluctant and have NOT prescribed a pain killer for fear of constipation)... That is the only way I can begin to describe the pain to someone who has never experienced it! AND You are so very right.... It is a long and lonely road!!!! I am beginning to feel more sorry for my husband than for me. I had a horrible day yesterday with two BMS...( the more BMS per day...the more pain) and the pain on his face is becoming far worse for me than my physical pain is! When I accept the fact I need surgery....I will be ready to move forward! I hope so very very much you have success in your healing!!! I have experienced success with healing for twenty years....with the unfortunate exception of up to nine months ago! Please do not let this discourage you!!! Bless you for answering so quickly....It truly helps me so very much to simply know there are people out there also living this terrible agony!!!

Kathy
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Re: Kind of new

Postby Mypoorbutt » 17 Jan 2017, 13:33

So sorry to hear you are suffering so much,
I have spent the last 18 months in agony it has been the worst pain imaginable worse than childbirth dislocated bones and crohns. I have lost over 8 stone...I had a lot of extra weight though lol
Please if your fissure is chronic...please have the surgery if you have high resting sphincter tone then nothing and trust me I do mean nothing other than surgery will get rid of this pain and heal you.
I had never had an op before as I am terrified of being put to sleep but after trying everything else I had the op and was I nervous...heck yes...did I cry....heck yes...I was sobbing in the theatre and had to be taken out to calm down for ten mins but it needs doing, no one can live in this kind if pain it's not normal.
I'm a complicated case due to crohns and IBS, but even I have seen some improvement and 97% of people who have the op are back to life pre fissure after 2 weeks and are basically pain free from day two.
I really feel for you but sometimes what we perceive as being a huge step is actually the right choice for use.
Fingers crossed for you
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Re: Kind of new

Postby mamafizz » 19 Jan 2017, 18:43

MPB, First I want to thank you for your helpfulness and I just had a quick question maybe you could help with.
I went to the 2 week check up and the Dr said the fissure was healed, and if you remember I was in horrible pain after the Botox, it's been a month now. (6 months prior with fissure). He said I had 2 hems, (I assume internal since the discomfort and pain seems to be higher up-there is one external or prolapse or sent -he said hem>) andway it feels like either the Botox Froze my muscle stiff in whatever position it was in when it kicked on lol or my muscle is as hard as granite up to the tailbone, it feels achy and pulling sensation sort of like a spasm but more streching not like the original, (I don t think he used much botox since I had 6 children he might have used a small amount, but just enough for fissure to heal I guess, but its like there is a rock high up all the time almost as though there is a knot there from being constantly angry muscle and still needs more time to learn to relax, and it aggravated alot of the surrounding muscles too, sometimes I can feel tight muscles in a horshoe like feeling, except for first thing in the morning seems to be a tad less and then increases as the day goes on. I know it's only 2 weeks since he said it was healed, but it feels like I had stiches which I did not and this pulling sensation and tightness as though there is something there, would you presume this to be the ling tissues from the shots and fissure, and thea inflammed hems? It would make sense since there is not fissure pain or the old horrible spasms. But this tightness high up is worse on standing seems like gravity and pressure makes it worse and I still have to go lie down most of the time, or maybe it's the aggravated nerves, I still am afraid to sit down and it really seems to be getting better hate to think I have to walk around the rest of the time with feeling like something is stuck in there.. ugh. I know you seemed to bounce back from the botox pretty good, but does this sound normal and does it fade after weeks? months? Thanks Much
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Re: Kind of new

Postby mamafizz » 19 Jan 2017, 19:01

Kathy, sorry to hear you are dealing with this.. I had a first time fissure (that I knew of diagosed last July) Suffered what we all have, my husband helped with the nitro for 2 months, ugh so I know how you feel about that, God love him, but I had Botox a month ago and 2 weeks ago had the 2 week check up and told he could not see it, it was inside but that it healed. I am starting to get better, so although I could not bare the thought of having any procedure there since it is such a nerve sensitive area, I did go through it, anxiety and all, and it is getting better, Although I have hems he said, they must be higher up since It seems to go all the way to the tailbone muscles. Still feels like a knot up there all the time, really drives you crazy but my hope is that the hems will come down and this charley horse knotted achy feeling will subside. This gives you health anxiety for sure, but God only gives you what you can handle and it will make us stronger. You will get past this.. as we all will. Cant wait to sit down once again... and drive my car and take the grandkids to the movies. Will be a blessing can't wait...If you have any experience with hems, let me know, I had no idea I had those either and now it feels like I constantly have to go and there is a granite hard knot in there all the time... Those muscles and nerves really need a margarita!!
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