I wanted to mention one other thing-maybe take some pain meds before you go to your appointment. And really the exam itself takes probably less than a minute once they are in.
I'll pray for you too!

Thanks, Lecia. Maybe I can request that they numb the area, if possible. But, then I'm afraid of any injection in that place, too. It's probably better than a scope, though. Maybe the CRS will agree to examine me externally only at this point, and prescribe the cream. That way, they can do the exam after the sphincter is relaxed down the road from the medication. Yeah, like I'm really going to tell them what to do!
Queenofpain/AgonyAnn

Well, I think you should tell them. It is your body and I think your plan makes sense to me. Try the cream and then see if that will loosen things up. The lidocaine cream is a great idea too.
I know one of the boardies took an anti-anxiety pill before which works as a muscle relaxer. It really does help. Maybe a low dose of valium or Xanax.

Okay, thanks, Lecia. I totally just dread it. Having had this thing for 13 months, there is no way I want more damage and pain.

Hi Guys,
We entered our busy season at work (that's where I have access to a computer), so it's harder to get to the board (will be that way until Spring). I finally made an appointment with a CRS this morning (after quite a bit of searching), but the earliest available date is November 19. I'm thinking of going to see the MD with a natural emphasis in the interim. I mentioned this before, but having experienced a fissure himself, he said he would prescribe nifedipine, and help with diet. What's kept me from going to him, is the prospect of too many examinations. I need to see a CRS in case I have to go the surgery route, and I'd rather have a CRS, with all his experience and, hopefully, access to a child's anoscope, do the exam. He could then just relay the info. to the MD. (Lecia, I couldn't find Julia Chen's listing - maybe her name changed). I just hope the pain situation remains stable in the meantime. I was doing better last week, and things deteriorated Monday morning at work, for no obvious reason. I really disagree with my former CRS about the pain being related to the bowel movement alone. I didn't even have a bm that day, and have only had one small soft one since. Yet, I continue to be in pain for the most part. I think sitting on this chair at work puts my sphincter into spasm. Sometimes I'm in more pain when I don't have a bm, in fact. I know that doesn't make sense, but there seems to be some correlation, as if my sphincter doesn't know what to do, so it goes into spasm. Anyway, I miss you guys, but it's just so busy here.
Queenofpain/AgonyAnn
O satisfy us early with Thy mercy; that we may rejoice and be glad all our days. Psalm 90:14

We miss you too, Ann.
I think that if your fissure is in the "wrong" location around the anus, that sitting in a chair directly on it could indeed irritate it and set off the spasms. Why not?
I would get spasms out of the blue from just kneeling down sometimes!
Gareth once said that figuring out a fissure is harder than a Rubik's cube. He was right!

Yeah-sometimes there is no rhyme or reason. I could do the exact same thing one day as another and have completely different results.
Maybe a cushion like this could help with sitting:
http://www.icnsales.com/?command=goto&file=DailyComfort-ChairCushions.html
My CRS said she normally doesn't need to do a internal exam to see the fissure. That you can have the patient bear down while down there and usually that presents it. And there have been times when although not comfortable at the time it has helped loosen things a bit down there after an anuscope exam.

Hi Kim and Lecia,
Thanks for your input, guys. I'm glad I'm not the only one who has seen how erratic a fissure can be. I would think this would be common knowledge among doctors. Maybe you have to have firsthand experience with it like us in order to see that it's not something that is solely related to bowel movements. There are some basics to try to keep in place (attempting to have soft stools, of course), but beyond that, it's anyone's guess. I've just received some unrelated and unexpected, bad news today. I have a flex schedule at work (approved years ago) that allows me to work four long days, with a fifth day free. I have especially been grateful for this schedule with all the pain I have experienced at work, knowing that I only have to get through four long days. Well, it looks like the policy is going to change, and those working flex hours will have to work normal schedules. I can't quit because I obviously need income and insurance. I don't want to go anywhere else with all this pain either. At least, I know what to expect here, and my bosses are aware of the situation. I'm still in shock, but maybe something will work out. It's better than not having work at all, I know. Thanks for your support, and I will check out the cushion website, Lecia.
Queenofpain/AgonyAnn

Ouch, that stinks. I wonder if they could make an exception for you since you have a medical condition.
I know there are others that deal with having to work with this. Can you tell us how you were able to tell your bosses? I know there are people on here that are facing that issue.

Hi Lecia,
I just came out and told the top supervisor directly (and privately) of how I developed the fissure (through fasting two out of three meals and drinking Diet Coke for a few days), and the pain I was in. The workload was going to pick up in a few months, and I was concerned I would be out with pain and surgery. So, I guess it was anxiety about being off during our peak season that motivated me to tell the director. Fortunately, she was very understanding, and said health comes first. I then told the manager directly over me, and she understood, as well. I figured there would be speculation if I needed to take off, so I thought it was better to be direct about it. I've also told some of my co-workers (the ones that don't talk about others). It's actually a relief that key people know. One person shared their pain with me, as a result. So people can be pretty understanding and sympathetic. One supervisor (new) recently joked with me about having two chairs. I then went to her office, and used that as a springboard to explain my situation. She understood, too, and said I didn't even need to tell her the specifics because health is a private matter. So, I guess I'm fortunate at the office when it comes to this fissure thing. Others take off for surgeries and medical appointments, so why not us? I guess it all depends on the particular workplace.
I just wish I did not have to deal with the flex schedule thing on top of it. It seems to be coming from the broader organization, though, not the immediate office. I don't know if it is an option to shave off a day's hours and be part-time, and maybe find outside work (flexible) to compensate. I would have to pay a lot more for insurance, though. This is all a nightmare! I almost feel like I'm going to wake up, and realize this didn't happen today. I'm just in that surreal "this can't be happening" mode. Thanks for all the support.
Queenofpain/AgonyAnn