Hi!
I am new to the forum. This is my first post. I am a 28 year old female and I have had my fissure for a year.
I got my fissure after a bout of constipation when my son was one month old. After a year of being misdiagnosed with internal hemoroids by my OB doctor, family doctor, and GI doctor (after a colonoscopy), I went to a CRS a month ago and was diagnosed with my fissure. She put me on .2% nifedipine cream. The cream heals my fissure fast, but does not stop any muscle spasms. I get reoccurring fissures; it heals and comes back. My bum has too much anxiety about going to the bathroom and spasms. My CRS says the only way to cure this is surgery. She says I don't need surgery; people live there lives managing their fissures. She says it is up to me to decided if I "had enough" of my problem. To be honest, I have had enough. I am not scared of surgery in general, just the fact that this surgery can leave me uncontrollable gas and feces leakage. How common is this problem? I have read so many horror stories!
Please tell me your stories! I am leaning more towards the surgery, but need some advise! I am so scared about the possible side effects!
Also, has anyone had any of these muscle spasms that went away without surgery?
Jen

Dear Jan,
First welcome to this forum : ) ! I hope it will help you in many ways. You will find a ton of information as well as friendly and caring advices and support in whatever you decide to do.
I don't know where you read so many horror stories : ( - I think that they are misleading since all studies point toward different outcomes. I saw 4 CRSs and all of them said that they never had a single case of incontinence in their practice (all were working from 20 to 35 years in this field) so, it mostly depends of CRS expertise.
I had LIS 2 month ago and I don't have problem controlling ANYTHING, including gas !!!! Not even close to not being able to control !!!! My fissure closed by now, and I think that advice that your CRS gave you "to just live with it" is completely insensitive , to say the least. Fissures can cause abscess formation and fistulas , not to mention that they themselves can cause incontinence if they form too much scar tissue.
If I were you, I would find more competent CRS as soon as possible. In the meantime, read as much posts as you can - you will find info about many ways how members manage their pain and it might help you. Also, some members found relief of spasms using Botox - but again, you have to find very competent CRS who would know right dosage and right place to administer it to have full success.
All the best !!!

Hi Jen,
I think a year of suffering is way too long, and that your CRS is an insensitive idiot! How can you "just live with it"? it makes me really cross when these doctors say this-its not their butts that are hurting. I was absolutely terrified of incontinence too, but I think most of it is just horror stories. Obviously there is a risk with any surgery-in fact living each day is a risk if you think about it! But you have to weigh up the pros and cons. None of us have had any incontinence problems. I would definately reccommend the LIS, but get a good surgeon who you feel comfortable with and who knows what he's doing and understands the pain you are in. It stops the spasms immediately.
Good luck!

Jen, there is a rsk of incontinence with the LIS, in anywhere from 1% to 5% of cases depending on the source you are reading. I didn't let those low odds deter me from getting it, when at last I had decided I could not take it anymore. Pretty much what my general surgeon had told me. He'd have let me "heal" the rest of my life.
The muscle spasms can go away if the fissure heals, but it would have to heal completely and it sounds like you are constantly re-tearing.
To be honest, we have had no horror stories here on this board, but in one or two cases people continue to have problems despite the surgery. Most of us have healed up quite nicely and our fissure became thing of the past.

Thanks for all your replys! It is great to talk to others like me!
I guess I was not very clear with my post...I REALLY do like my CRS. She didn't mean for me to "just live with it". She was giving me options and leaving the surgery up to me...She is more than willing to do surgery on me, but it is a personal choice that everyone with a fissure has to make for themselves. She said people can and do live with these because they don't want surgery.
Well, here is my problem....I really want the surgery...I am about 90% positive. I don't think I can have it done because of school. I am in a nursing program and I graduate July 2009. All of you said I need more than 4 days to recover. I can not get that much time off. Nursing school has no breaks, and if I miss more than 16 hours in a class, I get kicked out. I have worked my whole life to get where I am. It is very hard and competitive to get in this RN program. I guess I can schedule my surgery for July 2009, a week after graduation (I am not kidding). I have already lived with this for a year...I guess I have to do another. I am so bummed. I wish my problem was diagnosed sooner, as I just started my school. I had almost a year to get it done prior to school. I was told I had hemrroids by several doctors prior to my diagnosis and unfortunatly, I believed them.

That's a terrible choice to have to make, waiting so long. It took me a week and a half before I was able to return to work and I was very weak then. Now, some people just bounce right back and act like, what is all the fuss about? But a minimum of four days recovery -- my CRS told me 2-3 weeks.
Yes people live with fissures for years even decades but I know I couldn't last seven months!

Jen,
I am wondering (being a nurse myself), could you possibly explain to the administration or the head of the nursing program that you need to have an outpatient procedure done that may take some time to recuperate at home? Could they possibly make arrangements for you to take home the work for that week (or2) and maybe you can keep in close contact with a friend in the class while you are home. As long as you do not have clinical I don't see why this can't work out...what do you think?
I do know that my friend had the surgery on a friday and was back to work that Monday, but this does not seem like the norm, but you never know.
Good luck!

Jen - are you managing to keep your BMs soft and small? This can help a lot with the pain. As can warm baths and lots of ibuprofen.

I'm not sure about the muscle spasms, i don't think i've ever had the common spasms people talk about. I've just had pain all day after a BM and sometimes during the actual BM. (My dr said that can be spasms also, that everyone's pain experience is different.) I've had 2 LIS surgeries and neither one worked. But if you're having noticeable spasms chances are the LIS will stop those. Since you've been dealing with this for so long I think surgery would be a good option for you. But if you really can't take the necessary time off maybe you could try botox in the office, or any of the prescription creams (i used nitro for 6 weeks). A few people on the board have had success with botox, and i'm even considering it for myself in the near future.

Once I realized my 2nd surgery hadn't changed anything as far as my pain, I started using MOM regularly. This keeps my stool extremely soft, almost liquidy sometimes, and I have no pain at all for the first time in over a year. Maybe you could try a saline laxative like this, in additon to stool softeners and the "fissure diet" to keep your stool soft.

As for incontinence issues after 2 LIS surgeries, I've had none. If your rectum has already been compromised giving birth or something, you might have to worry about incontinence, otherwise i think it's just something drs have to mention.

i'm sorry you're suffering. good luck in making a decision.

I agree with motherlunch, talk to them. They are nurses, they'll understand I'm sure. I know that my job did . I recently graduated from nursing school and only started work for a month and a half before the fissure flared up and I was really scared to ask for time off or even tell them but, they were so understanding.
Good luck

hi there....
well i decided to "live with it" for almost four years and then finally gave in. but since i had received a diagnosis that i also had a fistula, i really freaked out and i went to try macrobiotics.
along the way i added aloe vera juice, flaxseed oil capsules, and the omega 3-6-9 capsules.
the macrobiotics helped me make a remarkable improvement in about 30 days time that my fistulotomy and LIS were cancelled but opted to keep my colonoscopy anyway.
***
if worse comes to worse, i would first try to modify your diet and possibly that your nursing program is so demanding that you must be very tense most of the time, whether it be physical, emotional, or mental and this definitely has an impact on your bowels and their movements.
any competent CRS will advise you of diet modifications along with other behavior changes to care for your butt - i also began to squat on the toilet seat and this provided immense help in having BMs with ease and no longer putting pressure on my fissure.
it's been a year since the colonoscopy and i am still fissure free and have really just returned mostly to a higher grains, veggies diet but i am not as macrobiotic as i was (stupid work travel) but i wish i was.......
take care and best wishes with your decisions.....