Love my babies. Hate the AFs

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Love my babies. Hate the AFs

Postby goodlife » 13 Mar 2014, 08:25

Hello Everyone,
I'm new to the forum but not to anal fissures. I'll try and keep this brief. I got my first AF after my first son was born in Jan 2011. It was a difficult birth, forceps assisted and 3rd degree tear. I went to my family doc a few weeks after because of the pain during BMs. She actually diagnosed the fissure and gave me diltiazem to apply to the "affect area" and told me to up the fibre and take colace. I didn't understand where the affected area was (since my entire bottom was a mess) and actually applied the cream to the perineal tear instead of the AF. Regardless, the pain during BMs went away in the next few weeks.

When I saw my OB 6 weeks post partum she told me to stop with the diltiazem because I didn't have an AF but my perineal tear wasn't healing so she cauterized the granulation tissue. All seemed fine.

Six months later the AF came back... sharp pain and blood with a BM one morning. This time I could tell the pain was anal and I googled diltiazem. I realized I wasn't taking it properly and I in fact, did have a AF. I started the diltiazem again, 3 times a day. Started back on colace and 3 sitz baths a day. My diet was perfect. I did that for 2 months. Then slowly weaned off colace. I continued a perfect diet with lots of fibre and water and was fissure free for 16 months.

Then I got pregnant again in Nov 2012. I was scared about getting another AF so I tried to eat lots of fibre/water. But unfortunately I got severe morning sickness (hyperemesis) and ended up in the hospital with IVs and medication. I couldn't keep anything but crackers down. I, of course, became constipated and the AF returned.

Since I couldn't take dilitizem while pregnant I took restrolax (miralax) my entire pregnancy. That kept the pain way. My birth was okay except for an episiotomy. But I didn't get constipated. I stayed on mirlax until the episiotomy healed then started weaning off it. Then just before Christmas.. BAM! the AF returned. I started taking the dilitazem again but I fear it might be expired. I'm still taking miralax daily but my BMs are pretty loose. But if I try and decrease the dose it is painful.

Anyway, I have an appt with my doctor this afternoon. I'm so fearful of what's to come. It seems like diltiazem isn't working. Everything is ok while I'm on miralax but I can't take that forever. When the fissure is "active" I only feel pain during the BM. I have read what a lot of you are going through pain-wise and I'm not at that point. But I'm also afraid it will get worse.

I'm thankful I found this forum. It is hard to talk about. Only my husband knows what is going on.
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Re: Love my babies. Hate the AFs

Postby sugarspice » 13 Mar 2014, 14:45

You poor thing, pregnancy and birth are hard enough without a stupid AF!!! I really empathise with you as mine came shortly after the birth of my second child. Mine is chronic and the pain was unbearable so had botox very quickly. You are certainly doing all the right things seeing the doctor early on whilst the pain is still bearable so please don't worry. Let us know how you get on.

Love SS x
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Re: Love my babies. Hate the AFs

Postby goodlife » 14 Mar 2014, 07:28

Thanks for your reply sugar and spice. I'm sorry you are suffering as well. Does your botox seem to be working?

I went to the doc yesterday and saw a resident who clearly was not familiar with AFs. He tried to prescribe a hemorrhoid cream. Grrr. Luckily I talked him into diltiazem.

So my plan for now is to take the diltiazem for two months, sitz baths, healthy diet and miralax for a couple of months. Oh.. and patience. That is what worked the first time.

If that doesn't help me I will go back to my doc and demand a referral to a CRS.
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Re: Love my babies. Hate the AFs

Postby Sakura1 » 14 Mar 2014, 17:19

Hi Goodlife

Sorry to hear about what you are going through.

The active ingredient in the cream does become inactive, the same with GTN ointment, so after about 8 weeks you should get a new tube if you still need it. Also, my colorectal surgeon told me it doesn't need to go inside as it is very well absorbed by the body, so just rub it on the general area and that should still work :)

I do sometimes still pop some gtn ointment inside a bit as it helps to lubricate stuff :) but its nice knowing that you don't have to do this when the fissure is at its worst and you really don't want to be aggravating it.

Take care.
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Re: Love my babies. Hate the AFs

Postby sugarspice » 16 Mar 2014, 12:28

Goodlife, that seems like the perfect plan to me and a very sensible one. My botox hasn't worked but there are SO many people on here that it has worked for. I am under general anesthetic again in two weeks and they will decide what to do...so we will see! xxx
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Re: Love my babies. Hate the AFs

Postby Sorebottoms1 » 21 Mar 2014, 04:29

Hello Everyone,

Your experience sounds very similar to me, Goodlife. I've had two children (first in 2009, second in 2013) and have had AF both times. Both after the birth and usually attributed to the pregnancy itself (both my babies were big and heavy to carry). The first time I was misdiagnosed with haemorrhoids, then a correct diagnosis of AF, then had three lots of botox, and finally (3 years later) some kind of flap repair they did inside (I'm still not clear what it was but apparently the AF was the symptom for a rectocele that was inside and that was what they needed to fix to clear up the AF). After my second child was born, bam, it all starts up again. Only this time worse. I can't take diltiazam because I'm breastfeeding so I'm currently just putting up with it all. Horrible though. I'm booked in for an op in about 12 weeks for them to have a look under a general - they might need to do a skin graft or cut my sphincter muscle :( I love my boys to pieces and would do anything for them. I wonder when it will end though! I hope your treatment is successful Goodlife - I'm sure it will be. Hopefully we'll both be fixed and then neither of us will look back!

Best wishes
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