Hi my name is Josh and I am a 42 year old male. I've have been struggling with what I believe is one Anal fissure at the 12 O'clock position since November 2015. So about 4 months. I've been on a high fiber mostly vegetables and fruit diet pretty consistently. I also use the Squatty Potty stool and have found this to be helpful. I've also lost 43 pounds. (258 to 215lbs) I'm 5' 10 and besides being over weight relatively active and fit. I've tried a number of prescription creams and supplements, Miralax, Metamucil, Over the counter stool softeners with marginal success. Basically I feel like I'm healing for 2-3 weeks and then I re-tear and this has happened 3 times since November. Right now I'm in a healing / superficially healed part of the cycle. I don't have any pain with a BM just the spasms afterwards. Right now the spasms are mild and only really last about 1 to 1 1/2 hours but I know I have an incompletely healed fissure. Besides the spasms an occasional twinge of sharp pain reminds of that. I never see any blood on the wet wipe or in the toilet. I did see blood the 1st couple of times when I think I originally tore the skin months ago. I also have a Sentinel /skin tag. I didn't know I hade a tag until the CRS examined me about 6 weeks ago. Now when I check for it... it's clear to me I do. The tag is internal and not visible same as the AF. MY CRS is very confident, reputable and was surprised when I asked him about the possibility of incontinence. He gave me the impression that when a CRS knows what they are doing it just doesn't happen. I pray he's right. He's accredited, board certified and has done about 300 of these procedures. I tried not to give him a strange look when he suggested that I could be back at work the following Monday. I've been working from home primarily since this whole ordeal began. I'm self-employed and have a functional home office but I've spent a lot of time away from my primary business location mostly because I know I'm just not my usual happy encouraging self and it's easier to hide this on a conference call. :)

I'm committed to the surgery because I don't see another way to change this cycle or to achieve complete healing.
I've been reminded I need to stay soft and be really careful about the 1st BM. I've read a number of posts sharing accounts of the post surgery experience. It seems there is quite a range of experiences. I guess I'm just looking for
any additional thoughts regarding best practices post-op ? I think I'm going to ask for Valium Thank you all in advance for any comments you might share.

Here is a great lot of posts by one of our moderators that will give you an idea of the whole procedure, beginning to end!

Good luck; feel free to come back and tell us how it goes!!

my-lis-diary-march-2012-fully-healed-in-4-weeks-t4589.html

Thank you Savaici. I will definitely circle back with my experience. I just want to get it over with. thanks again.

I've benefitted tremendously from reading so many posts over past few months regarding surgery experiences and promised myself that when I could return the favor I would. So here it goes. I had my LIS, fissurectomy and what I expected to be a skin tag removal yesterday at 9:00am. Friday March 4th. I was very anxious so my wife and I arrived at the Day Surgery Center in Springfield, OR USA about 30 minutes before our scheduled check-in. My CRS was 30 minutes late for surgery so I had plenty of time to digest the whole pre-op experience. After signing forms, confirming insurance information and reviewing my medical history/ prescription drug history etc. a nurse ushered me and my wife into a room for pre-op prep.
I changed into a gown, the nurse put a warm blanket on me and began attaching various sensors for monitoring vitals. Next the nurse installed the IV. Spoiler alert! You're about to read the most difficult part of the entire surgical experience. Soon after the sweet nurse installed the IV I became dizzy, my blood pressure dropped quickly and I nearly fainted. I thought to myself wow.. my wife is going to lose me on the pre-op table. I could hear a number of people including my wife asking me to take deep breaths. They adjusted the bed lowering my head and put a cold rag on my head. Within 5 minutes my vital all looked good and I was feeling better.. I remembered later that a similar thing occurred prior to my last surgery 14 years ago. In the following 45 minutes I met the surgery nurse the anesthesioligist and a few other nice medical personnel. The anesthesioligist gave me something called Verced ( I'm likely spelling it wrong) to relax me more prior to surgery and then I was off to surgery. It was a big room and I counted 4 people in theater. I always presumed I would be using general anesthesia for my surgery but the day before I was given the option for local anesthesia. After consulting my CRS and the anesthesia folks I opted for local anesthesia (technical term was called MAC). I was told that the most stimulating part of the whole experience would be the injections in my rear -end at the beginning but in truth I felt nothing. The anesthesiologist sent me to what he described as highly sedated stat very quickly and later to what is called twilight state where you drift in and out of consciousness. I remember nothing. My CRS said the procedure would last about 15 minutes. I think I was in the operating room about 30 minutes total. I remember being wheeled into recovery in a daze but within 45 minutes I was dressed and walking out the door. I have a shy bladder so I was a littl worried about peeing do to all the local and topical anesthetic applies but this as no problem. I urinated for the 1st time at the Walgreens on the way home and 6 more times ( a significant amount each time) before 2:00pm in the afternoon. I think this is owing to the large IV bag they fed me the whole time I was at the Day Surgery Center. I am very impressed with the comfortable, professional setting and the caring friendly people working there. This is part one: a little later I'll post what the Doctor said about the surgery and how Day 2 is going and my 1st BM etc.

Sorry folks I composed a follow-up post but it evidently didn't save.
I am now 5 weeks post-op and I am doing well. I feel 95% healed. Only the 1st week post-op was a bit rough due to some constipation. By the end of the 2nd week I was convinced the surgery was a good decision for me.
I had a Fissurectomy, a closed Lateral Internal Spincterotomy and a benign polyp removed from my anal verge/ rectum area. We thought it was a skin tag but in fact it was a polyp. I am now doing every activity I regularly did prior to surgery. Hiking and biking etc. I didn't drive for the 1st 10 days post-op but I could have earlier I'm sure. I went back to work full-time at 2 1/2 weeks. I do not have any pain when going to the bathroom and no spasms either. Just an occasional twinge of brief pain occurs every so often but even this is becoming less frequent all of the time. I did itch a little from 1 week to the end of the 4th week but it was not unbearable. I am pleased and thankful I did the procedure under local anesthesia and never took any prescription pain killers just the Tylenol and Advil at home. If surgery has been recommended and you have an experienced CRS please do not put it off. I know the mental anguish and severe pain we all have when battling a fissure. I am very glad I went ahead and just got it done so I can once again participate in my own life. In hope this might help someone on the fence or just concerned about surgery.