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Re: make it easier!

Postby owmybum » 11 Dec 2013, 13:49

Hi whoknew...... I've only just stumbled upon your thread.... And what an articulate sufferer you are. I feel guilty, but I actually found it an enjoyable read!!!

I second jrs recommendation for mirilax..... It has worked wonders for me in reliably keeping my bms soft and easy to pass... I would definatly give it a try...along with the gallons of water! Lol

I hope you start to get some relief soon... And will be reading your diary with interest.

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Re: make it easier!

Postby whoknew » 13 Dec 2013, 12:49

Thanks jr2 and owmybum! It's so helpful to be able to put all of this out there and get feedback, and just to get it out of my head. I'm hoping that one day, I will be able to look back through this diary and "remember when" or that some poor soul will find a shortcut through this process by reading about my trials and errors.

I did try starting miralax 1/2 dosage with lunch and dinner, and I can't decide if I'm having any improvement or not. I'm thinking about adding 1/2 dose to breakfast as well.

Yesterday's BM required a bit of a push to get out, and I could feel the muscles inside working to move it. Maybe my period made the whole situation worse like you mentioned jr2... but yesterday I was just in tears over the pain. The fissure itself and the spasms afterward were bad, and the ointment was not helping them.

And stress. I got a call on Wednesday 12/11 from work, asking for a doctor note saying when I can come back to work. Wednesday was a great day - no BM at all, thanks to the two I did on Tuesday - so I felt overly-confident. Or maybe yesterday's BM stole my confidence. Either way, I agreed to come back to work on Sunday - day after tomorrow - and I'm trying not to be too worried that I might not be able to actually do so.

Anyway, my diary is all out of order today. Wednesday the 11th I called the doctor and had the note faxed to work. Yesterday was Thursday, when I had the horrible BM in the morning. AJ was off work and I tried to fix breakfast... painfail. Cried and tried to not cry. Once I was feeling slightly better, at around 11am, we tried to go to Target but I wasn't able to sit in the car for more than a few blocks... painfail again, had to come back home and wait for more time to pass; didn't get out of the house successfully until about 2pm. Work hours on Sunday are 9am-4pm. I'm really trying to remind myself that every day is different, and that just because Thursday was a bad day does not mean that Sunday will also be a bad day. The mental/emotional component of this can be a real challenge!

And the diet thing. Now that I've identified the types of foods I should avoid (meat, dairy, wheat, tomatoes, eggs, processed foods, sugary foods, fried foods, bakery-type items, coffee, chocolate, spicy foods), what I can't eat too much of (grains, potatoes, other starchy vegetables, almond butter, kale) and found the acceptable foods (fruit without scratchy seeds, vegetables cooked soft, certain vegetables raw and chewed into liquid, lean proteins, oatmeal, quinoa, brown rice, coconut oil, olive oil)...

The next challenge is portion sizes. All year I have been working to fit my meals into a certain template: 1 palm-sized piece of protein, 1 thumb-sized portion of healthy fat, and the rest of the plate filled with vegetables; no snacks, no processed foods, 1-2 fruit per day. As a lifelong sugar-junkie, this template really worked for me. After a few weeks, cravings for sugar went away; BM were always regular (1-2 times a day, usually in the morning and either after breakfast or after lunch) and I had no digestion issues. I think part of the reason I've been having so many difficult BM is that I'm eating too much. There is just too much bulk. I'm not sure yet if this means that I need to eat more frequent, smaller meals throughout the day or if I should just stick with the 3 meals, just make them smaller. I'm concerned about not getting enough fuel - I have a large body, and especially once I'm back at work I will need energy to get through the day and to heal properly - but I'm more concerned about constantly being in agony from giant BM.

Yesterday's horrible morning experience made me want to just eat nothing, but I also wanted to take some Aleve for the pain. I ended up eating an apple with no skin and about 2 oz. smoked salmon for breakfast. I wasn't hungry until after we came back from Target at 3pm. I still wasn't THAT hungry, and just had an apple with no skin, a bit of almond butter, and a bit of roast chicken for lunch. Dinner was salmon, brown rice, green pepper, mushroom, and a bit of dried apricot, and a few dried cherries. I was hungry an hour after dinner - probably because of my skimpy early meals - and had a banana with a mix of almond butter and coconut oil.

This morning's BM was actually quite easy - almost no pushing, and it was small, formed, but definitely super-soft. It's been about 4 hours and I feel like there might be a bit more in there wanting to come out, but I don't want to push at all. Maybe after lunch it will happen. Who knows. The important thing is that I have very little pain from spasms after the BM so that I can sit and walk around at work, and to not irritate the fissure itself.

At Target I bought a blender, and I'm going to try making mixed fruit/veg smoothies for lunch today and tomorrow, and see if that helps with regularity/bulkiness of stools/stool consistency. Normally I would never consider a smoothie to be a meal, but it might help? I have no idea, but I can't just eat an apple with no skin, and a bit of protein for breakfast and lunch every day, even if it creates tiny, unoffensive BM.

This morning's breakfast was oatmeal with coconut oil, almond butter, honey, and dried apricots in it. I'll do a smoothie for lunch, with a bit of salmon on the side, and then probably roasted chicken and some squash for dinner. I'm also planning to roast another chicken today, and to make some healing chicken-garlic-ginger broth with the bones. Not for the sitz bath, for eating!

In my life pre-AF, I really enjoyed spending hours in the kitchen, going outside for walks in nature and playing in the woods, spending time with my friends in settings other than my living room or bedroom, and believe it or not, I enjoy my job as well. Part of me wants to stay in my little cocoon until the fissure is totally healed, so I can just jump right back into life. I realize that is not an option, due to the nature of the fissure, and to the fact that there is a limit to the amount of time I can take off work before they'll give my job to someone else. I read the emails from work and I feel so disconnected already, and it hasn't been even two full weeks yet. To say "I don't feel like myself" would be accurate, though a bit of an understatement, but at the same time, this experience has revealed an adaptability that I haven't had to access in a while. It's comforting to know that I can do this, even though I would obviously rather not have to.

I hope everyone's day is good, free from cactus-like BM and horrible spasms. The light through the window tells me it's a sunny day, so maybe a walk around the neighborhood would be fun later.
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Re: make it easier!

Postby jr2 » 14 Dec 2013, 00:59

The diet/supplement aspect is just the hardest to nail down because for everyone the results are just so different. But it is helpful that you're keeping a diary to refer back to your foods and your stool softener levels, etc. Add in the complexities of hormone changes with menstrual cycles and it can feel like you're never finding any kind of consistency. During times of the cycle when progesterone is naturally higher, most women also find firmer stools, if not outright constipation. Then, of course, during the menstrual cycle, most of us just get really discouraged.

Yes, it's so true that some days can feel excruciating and disabling, and other days can feel a bit less desperate. It's a very rough affliction to live with because it affects the ability to exercise, it affects the desire to eat, it creates anxiety and more muscle tension with bowel movements, and it takes such an emotional toll. Couple that with the fact that it isn't exactly something we go around discussing with others, and even if we do, most people have no clue how to relate to the intensity of the pain we're dealing with.

It's a lot.

Two other suggestions come to mind. If you generally know the approximate time you have BMs, you can try applying whatever topical relaxant you are using (I can't remember which one you're using) approximately 45 minutes or so before your anticipated BM. this can help get that muscle a little more relaxed for the upcoming BM. Secondly, if you haven't tried to do so already, it can be helpful for some people to get a footstool and place your feet on the footstool during a BM to mimic a kind of squatting position. This position facilitates the relaxation of the pelvic floor during a BM and pretty much eliminates the need for straining for most people. You would want to place footstool in front of the toilet, elevate your feet on it, and then lean forward to close the angle between your legs and your abdomen.

Hang in there. You're doing everything you can possibly do at this point to support your body in healing. That's all any of us can do.
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Re: make it easier!

Postby whoknew » 15 Dec 2013, 20:01

Thanks, jr2. The joys of being a woman! When is the progesterone higher? I'll be sure to mark my calendar so I remember to bake a cake :) I did try the footstools suggestion... Only I don't have stools so I used the mop bucket, which is long enough for both feet. I will try applying the ointment when I wake up, the bm usually follows shortly after.

Actually, I don't want to jinx myself, but I have had several good days in a row. By good I mean: minimal pain during bm, no straining, and manageable spasms so I can sit and walk more. Today I went to work and it wasn't bad for the most part. After work I had a bm that was not painful and there were almost no spasms. I think we've finally found the right balance of foods, fibers, supplements...

The smoothie was just ok. I was hungry shortly after drinking it, and it only tasted so-so. Not sure it had a noticeable difference the following day, and the blender is super loud.

I did start following a suggestion I read here somewhere that says to eat soluble fiber first and then insoluble fiber. I like the results... I also find that soluble fiber agrees with me much better than insoluble, as long as I don't have too much. How much is too much? That's the puzzle I'm working on now . There's a list posted on my fridge so I don't just eat steel cut oats with maple syrup for every meal.

Meals lately have been a lot of the same: oats with coconut oil and dried fruit with a couple oz of chicken or fish for breakfast;, chicken broth soup with chicken and potato, and a banana for lunch; rice and veggies and chicken or tuna salad for dinner with a skinless apple for dessert. With almond butter, of course.

Back to work again tomorrow as long as my butt allows.
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Re: make it easier!

Postby jr2 » 15 Dec 2013, 20:32

Big thumbs up on the soluble vs. insoluble fiber balancing act, and getting better clarity on what works for you. And big yay that you've achieved some relief! That is great news!

Generally speaking, progesterone levels begin to rise around mid cycle, approximately day 14, around the time of ovulation. They will continue to rise and then peak at around day 22 (again, approximately), and then begin to decrease over the next days heading toward day 1 of the menstrual cycle. So, a lot f women find firmer stools and outright constipation in the second half of their cycle and generally try to adjust to accommodate for it.

I hope you have continued success!
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Re: make it easier!

Postby whoknew » 19 Dec 2013, 09:50

I'm feeling pretty good about this past week. I managed to make it through 4 days of work - full work days - with minimal pain and usually just some discomfort. This would not have been possible without my trusty heating pad under me. Tuesday was extra-uncomfortable because I had 4 meetings to attend and of course had to sit through all of them without the heating pad. However, I was able to do rounds every day with no pain, just some discomfort, and it definitely wasn't as bad as before I got the nifedipine.

Diet-wise not much has changed. I'm finding that dried fruits - apples, apricots, cherries - really help make things move more smoothly... moreso even than fresh fruit, and is easier on my stomach and produces less gas. I'm having to work to get enough water during the workday, but still managing to get at least 100 oz per day.

BMs have been pretty much across-the-board soft and strain-free. I'm finding that I have fewer spasms when there is no straining at all, which is making life much easier. However, yesterday I pooped FOUR TIMES - 3 of which happened at work. Luckily the restrooms are all singles with sinks right next to the toilet, so I was able to use water and papertowels to blot myself clean. I keep scaring myself by forgetting where I've put the ointment - which clearly says my name and the instructions to "Apply to anal opening 3x per day" - but I've never actually left it anywhere but inside my purse or pocket.

Anyway back to the 4 poops in one day. Seriously, body?? It wasn't that bad, despite the horrible nightmare scenario the words describe. No pushing, little gas, and the first 3 were small. The last one was enormous in volume, but was very soft and easy to get out. I noticed that there were dried apples from breakfast that morning floating in the bowl - is it possible to digest that quickly? It was maybe 5 hours after breakfast! I think the butternut squash and spinach and mushrooms I'd had for the last couple of meals were bulkier than I'd thought. For future reference: small quantities of butternut squash go a long way! I mean, I didn't go overboard and gorge on squash - I ate about 3/4 cut at each meal - but in combination with the other high-fiber foods, it must have been too much.

One change this week is that I'm really focusing on soluble fiber as the base of the meal, and building around it. I try to get a different source at each meal - usually oatmeal, rice, potato, sweet potato, or banana - and add things as needed. Like spinach and mushrooms, or some cooked blueberries, or kale, or an apple with skin. It really is helping. Last night I had to reduce my Miralax to 1/4 cap in the evening, because I needed to stop pooping!

I weighed myself. I'm down 5 lbs since 2 weeks ago.
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Re: make it easier!

Postby ButtQueen » 22 Jan 2014, 01:16

Dear whoknew, I must say your constant sharing is so much relief to me! I have been reading your posts regularly so decided to make a post myself :) I am 22, female with 2 months ahead of a bad anal fissure. The issue with me is, I seem to get my fissure healing after 10 to 14 days. Unless, there is time for that "Aunt Flo". Time for me to get constipated again and VOILA! The fun with the fissure begins all over again. Today again, since my "Aunt Flo" is due any time right now, I am beginning to get constipated after two whole weeks of perfect BM with the fissure pain almost zero. Today's harder BM caused my fissure to be injured again and I don't know what to do about my pre-period constipation. It takes me back to square one :( It's the second time that this has happened in two months!
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Re: make it easier!

Postby whoknew » 01 Feb 2014, 12:14

Hi ButtQueen, and all,

I'm sorry to say that I feel your period-related pain! My January cycle was extra-long, possibly due to stress at work, possibly due to lazy diet, and as a result I felt I was in the progesterone zone for a very long time. My period finally came and I feel back to square one again, too. Very frustrating!

I just realized it's been over a month since I've updated. The holidays were distracting, to say the least. We had a Yule gathering at my house over the weekend of 12/21 and I learned that I could eat "bad" things if I balanced that out with extra Miralax... what a bad, bad, lesson to learn. The last month+ I have been slowly slipping off whole foods and into processed "food" territory. As a result, my BM are harder and more irritating, and that combined with January's menses has put me in a somewhat-confusing place regarding my healing.

On the plus side, the nifedipine/lidocaine ointment really is working very well. So well that some days I don't have to use it at all. Even though I may have some discomfort during BM, I am not having the painful spasms that are so common with this condition. The absence of pain put me in a false sense of being further along the healing path than I actually was. Then I fell down the slippery slope of diet.

Now I'm dealing with a new issue that is... I don't know what it is. I am not excited about the idea of going back to the CRS already, especially since I fear another exam may re-tear any healing that's happened, not to mention I finally got the bill in the mail... Yikes! The absence of serious pain has made me complacent. I'm not proud of this and I'm struggling to get myself back on top of myself again.

Anyway, the new issue: in the area where the fissure is/was, there is a little bump. It's not very painful, just uncomfortable, but if I push on it at the one side, then it does hurt a bit. Early on in the fissure healing, I had been using the prescribed ointment during the day, and then just before bed, I would apply a comfrey ointment that an herbalist friend had given me. The comfrey is supposed to heal wounds very quickly. So anyway, after my last period when I'd felt like I un-healed, I started using that again periodically. It's a very pale yellow color. Anyway. The bump. Yesterday I had an uncomfortable BM in the morning and then had to rush off to the dermatologist (for a biopsy of a spot on the bridge of my nose, joy of joys). I didn't have time for a real breakfast (real breakfasts include high-fiber foods, fruits, and lean proteins) so I had a piece of a breakfast sandwich from a gas station. Ugh. When I came home, I just wanted to lay down, so I did. As I was laying there, I began to feel the bump near the fissure throb with my heartbeat. A few times when I went to the bathroom, there was blood or pinkish/yellowish stuff - just a bit - on the toilet paper, even though I didn't actually have a BM.

So now I am wondering if this is just a pile, or skin tag? Was the pinkish-yellowish stuff a combination of the comfrey ointment with blood from the fissure? So today I had a BM first thing in the morning, soft and good thanks to Miralax, and then made breakfast, ate breakfast, and took a shower and did not apply any ointment or anything to the fissure area. About half an hour later, I checked it, and found clear/slightly-colored discharge, just a bit, in the anal area. I wiped it away and applied a bit of the nifedipine/lidocaine ointment because the act of wiping the area irritated it a bit. The bump was not swollen or irritated until after I messed with it.

So, hmm. I'm relieved to have less pain, but worried that I'm not healing well and that there is something going wrong back there. And, I am disappointed in myself that I have gotten so off-track with the diet piece of the healing process. So, I'm taking this moment to re-dedicate myself to healing and to visiting this site more often so that I can remind myself of what I'm supposed to be doing.

Happy Imbolc, everyone.
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Re: make it easier!

Postby hoonoo » 01 Feb 2014, 18:55

OK So now not only am I having problems with the fissure, but also problems with the forum. I forgot my password and even though I tried to recover it by clicking "forgot my password" it's just not happening for me. I waited several hours and no email with the new password has materialized in my inbox. So, since forum access is something I DO have control over, unlike my unruly butthole, I just made a new account. Take that, feelings of helplessness and self-pity!

I went out for a while to a social gathering and while I was there I started to feel like a BM was coming. I made it home before I really had to go, and when I finally did, I had some pain afterward similar to what I remember the spasms felt like. The stool itself was formed and seemed firm-ish. The bump was hard and warm and painful, and I put some ointment on it and went to lay down. I'm now sitting on a heating pad and I can feel some discomfort, but the pain itself is much less. Had some miralax and am defrosting salmon for dinner.

I don't want to sound ungrateful, because I really am thankful that this forum exists, but I'm bummed out (hah, bummed, no pun intended) that I'm back to having to log diet and stool again. It had gotten to the point where diet was the same every day, and as a result, stool was the same. I eventually got back to the norm for me, which is 2-3 BM early in the day (between waking up and after lunch) but there were no issues, even when I was at work and couldn't shower afterward. It was almost like I was back to normal life, except for taking miralax after lunch and dinner.

So now I need to go back to no dairy, no wheat, no sugar, no citrus, no tomatoes, no processed food. SIGH. MINI TANTRUM.

At least I'm in good company, and at least I know what to do now, and at least this is something that won't kill me. But I have to go to work tomorrow and am not looking forward to finding out what that means, exactly. I'll have to make sure to bring my heating pad just in case I need it... and the ointment, and something full of fiber for lunch.

And on Monday I will be calling my CRS... wah, sad butthole.
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Re: make it easier!

Postby hoonoo » 02 Feb 2014, 13:09

Sooooooo... Yeah, there is something unfortunate happening in my fissure zone. Something involving pinkish yellow discharge and ouching. Oh well.

At work today and thankful for the heating pad. For some reason, 5 people cam in today with delicious baked goods... The universe must be trying to help me celebrate my renewed focus on health. I wish I could eat all of the things, but instead I had a mashed sweet potato with guacamole and an apple. And, of course, stool softener!

Breakfast was oatmeal with dried cranberries, flax and chia seeds, and almond butter.

Time to get back to work and drink more water!

By the way, any advice on this new fissure issue, while I wait for the crs office to open tomorrow?
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