Thank you for sharing how you talked to your supervisors. I think that will give people courage too.
I hope your supervisors will somehow be able to let you keep your same schedule considering what you are dealing with.

Lecia,
One more thing. I found that telling appropriate supervisory staff also minimized the stress aspect because I knew they would be in a better position to make sure others could pick up the workload, if necessary. I know that that is not feasible in all work situations, but my place can hire a temp to fill in, if need be, and re-distribute where appropriate. Some places may require a physician's note, which none of us would have any problem securing.
Queenofpain/AgonyAnn

Hi Guys,
Haven't been on for a couple of weeks, as I was waiting until I had my first appointment (yesterday) with second CRS. In short, the CRS seems just what I've imagined from the brief information I put together on the web: he's seasoned (30 years experience), sensitive, and listens well. He even jokes with me, and said I made my first CRS mad (because Metamucil and sitz did not work, and I was dismissed). He totally accepted what I said about supplementary fiber turning my stools hard. He did an external exam (to my relief) with a resident, and said he should be able to see the fissure from the outside. The only thing is, he didn't palpate the area like the first CRS, but did some stretching, which put me in mild pain, and, I believe, caused me to re-tear later. Can you win for losing! (I had been relatively pain-free since midday on Halloween, almost three weeks.) At any rate, he said there are two fissures. I heard him telling the resident that one is anterior (I know anterior ones are often found in women because of the weakness of the tissue there). I was so concerned about the exam, that I forgot to ask him about the location of the two, and about Ultram. I had questions written down, too, and didn't get around to them. But, the good news is, he communicates well, so I should have no problem in the future. I'm not surprised I have two fissures, because it seems I've felt pain in front, too, and just couldn't seem to localize my pain. It had crossed my mind many times, but I thought, "No way." I guess I went to the two for one sale.
At any rate (sorry, I'll get to the point), he prescribed nitro (yikes), and said it has the highest response rate of the creams. If it causes headaches, I can email him, and we'll switch (he said it tends to cause headaches for only about 10%, and applying it only on the outside is advised). He said my sphincter is real tight (I heard him tell the resident that it is thick, and like a rubber band), and said he's never seen someone with a sphincter that tight who didn't end up in surgery. He didn't want to prophesy gloom and doom, but that 's what his experience has told him (he's a specialist in sphincter reconstruction, too). He asked if it was always that tight, and I told him I've had a loose bowel for a number of years (that stopped with the fissure - don't understand why). We think the muscle possibly may have atrophied a bit from the IBS. I told him that I'm not surprised by anything he's telling me - I did my homework, thanks to this invaluable message board - and he replied that he can tell. He also wants me to take an OTC stool softener called Sufac (?), but neither the pharmacist nor myself can read the writing. I am quite sure he said 'Sufac', but I can't find it online.
At any rate, I think of you guys often (sorry, I'm busy at work), and pray for you by screenname. Thank you for all the information you've given me. I will keep you posted on the nitro (it scares me - I hope it doesn't affect the heart). I still want to work with the MD with the natural emphasis (mentioned in previous posting). Maybe by eating certain fibrous foods, there is a way to stretch that muscle.
You guys are great. Happy Thanksgiving!
The Lord is my helper, and I will not fear what man shall do unto me. Hebrews 13:6

So glad you finally found a doctor who listens and works with you. That is so crucial to your confidence and comfort level. He seems to respect you too!

Thank you for checking in and I will continue to pray for you and that a resolution can be found to end your pain and get you on the road to healing from this terrible ordeal.

:happ3: to you too!

Ouch!! two fissures...yikes
Hope you start to feel better soon, it sounds like you have found a good surgeon :)
Good luck with the nitro.

Yes, good luck with the nitro, I sure hope it heals you!! I am so happy your found a reasonable CRS...in fact he seems pretty cool by your descriptions!!!
let us know how it all works out!

yes. let us know.
apparently, I too have a remarkably tight sphincter, and I have healed from the fissure and the surgery (abscess drainage). I am in the final stages of healing a hemmie turned fissure. I found that a lot depends on diet and on managing the poo. (personally, I would prefer to wean myself from laxatives then go in for surgery.) The diet recommended to my by my TCM is to eat cooked apples in the morning and cooked, soft foods for meals. managing to poo is only possible for me through upping the fiber--glucomannan (grain fibers don't work for me)--and taking a non-stimulant laxative (these are harder to get addicted to). My gold standard is Milk of Magnesia, but I have been using Mineral Oil lately. These keep my poo super, super soft, so that there is no reinjury.
I think the healing time may be greater for people like us, but it is still possible to heal without surgery, provided you prevent reinjury by keeping the poo super soft.

Hi Lecia, Kim, AA, and BG,
Thanks for your thoughtful replies (and prayers, Lecia). Like you BG, I still have hope there will be natural healing with dietary management. Strange things happen, and doctors don't know everything. After all, there has been an improvement over the past 14 months. But, if I need surgery, I'll just have to deal with it. My sphincter could use loosening, after all. About having two fissures, AA - it really is funny when I think of it. I mean, it just kind of sums up the year I've been having! Thanks again, guys.
Have a happy Thanksgiving!
Blessings,
QueenofPain/AgonyAnn

Hi Guys,
I've started the nitro treatment this past weekend, but I'm gradually easing into it. I'm supposed to apply it externally twice a day, in the morning and the evening. I'm only applying in the a.m. for a while to see how I respond (headaches or whatnot), and then, if all goes well, I will apply twice a day. I think I'm not applying enough because of fear of how my body will react, but here are my questions:
1) Is it okay to apply the cream with a Q-tip, or is this not advised? I mean, the fibers from the Q-tip will not cause infection, will they?
2) I've been wearing a glove so that the nitro is not absorbed by the finger, as well, but it's hard to get a sense if I am applying things right. Is it okay to get nitro on your finger?
Thanks.
Queenofpain/AgonyAnn

I think the glove is a good idea, it probably will absorb into the skin on your hand. It wouldn't hurt you per se, other than to give you an unneeded and ineffectual dose delivered to the wrong area. Certainly wouldn't reduce the headache risk, either.
I have heard others who've used the nitro with good results say they used their finger to cake it up into the canal a bit. Gently....
Hopefully you'll be one of the lucky ones who don't get bad headaches from the cream!