As promised, I'm reporting back after my visit with the CRS today. He was very familiar with the issue and said it's the most common among individuals in their 30's and new moms--due tot he stress of pregnancy and postpartum on the body. Anyhow, he explained that the main reason these done heal is due to the restricted blood flow to the anus, which can be caused to a tight sphincter muscle. This is why they typically prescribe nitroglycerin ointment (.02%). This helps relax the muscle and allows for optimal healing of the fissure. However, this doesn't always work for everyone and that is when surgery becomes the go-to option for folks. That all being said here is the plan he gave for me, I'm going to try the nitro again for 6 weeks. He said the fissure I have in the back is already on the mend so more than likely this will do the trick. He is going to have me come back in 6 weeks to see how things are going. If it doesn't look like the fissure is healing all the way then we will talk seriously about LIS surgery. For breastfeeding moms, my OB did say that nitro should be fine to use while breastfeeding as you aren't ingesting it. However, there hasn't been any study done to prove it's not harmful. It's a personal risk outweigh the benefits decision really.
Here is what the CRS explained about the surgery. He said it takes 2 minutes to complete. You will be knocked out he will go in an do an examination...by the way he did not do an internal exam at my appt. as he didn't want to further tear or irritate the fissure. Okay, so he does the exam while you are under, if he feels the area and the muscle is tight he will go ahead and make the small incision in the muscle to relax it. If the exam indicates the muscle is not tight, he will not operate as it isn't necessary at that point. If he does operate then you are released within a few hours of surgery being completed. He said that the pain is not terrible during recovery and should only last about 3-4 days. He said going #2 will feel sore because he played around back there but nothing compared to the horrific pain of a fissure. My surgeon has done 450 of these surgeries and said only one instance did one of his patients have a problem with incontinence afterward. The surgery has a 95% success rate. My advice to all would be to have this consultation with a CRS if you have exhausted everything. I started at a GI doctor to determine it wasn't digestive related. Once that was ruled out the CRS made sense. I'll keep everyone up-to-date on my progress. As of right now I've been pain free for a week with just the high fiber diet, lots of water, a little petroleum on before going, and wiping with a gentle cleanser and water .
Oh! The CRS said absolutely do not use wet wipes of any kind. They are the worst thing you can use. He said stick with water. My dermatologist also recommended using Aquanil gentle cleanser to wipe with, followed by wet tissue, then blot with dry tissue. This seems to have worked. Also, another thing to note is do not use hydrocortisone ointment on your fissure as it slows down the healing process. Last, he recommended taking Fiber Choice tablets everyday.
Sorry for the long post, but I hope this helps someone.

Thanks for all the info, NDMK213! Are you still doing well?