It's been a while since I've been on the forum so I had to register again using Ring of Fire2 as my user name. I was Ring of Fire before ;) You can search for my previous posts with that user name if you want to see my past history including my experience with physical therapy for my chronic AF. I am a 38 yo female who has suffered on and off since my teen years. The pain became unbearable 3/4 years ago while living overseas and developing a thrombosed hem. A surgeon in Spain removed the blood clot and attempted a LIS. Pain persisted on and off worse than ever since that fateful day.
I am two days out from Botox, tag removal, and cauterization of my chronic fissure. Dec 20, 2013 I went in for the procedure in an outpatient center. My surgeon wanted me to do an enema in order for her to do a sigmoidoscopy but she was cool with it if I did not. I chose not to put myself through the pain of an enema so we skipped the scope. She did ultrasound to see where the LIS was and SHE DID NOT SEE ANY EVIDENCE OF IT HAVING BEEN DONE. This explains why it did not work for me and why recovery was soooo painful and didn't work at that time. She thinks my current fissure is actually the attempted LIS site. So the ultrasound was clean showing a strong and TIGHT muscle.
Was very scared and reluctant to go through with this because I have been pain free for over a full month. But the cycle has been that way for so long no matter what I do. The internal muscle is simply too tight. The physical therapist confirmed that with me for the several months that I gave that a shot. The ultrasound also confirmed that.
Day 1
I had IV sedation so felt and heard nothing. I lay on my stomach and they did ultrasound, 4 botox injections (30 units on either side of the fissure area and 2 20 units top and bottom), numbing injections, burned the fissure to "promote healing" and cut off the associated skin tag. I woke up mostly numb but could feel a little pain. The sedation was totally fine - no nausea or anything. Went home laying on my side in the front seat and ate a chicken sandwich. Took two advils on the way home. Took one Nucynta 50mg for pain an hour later. Rested and tolerated the pain pretty well. Mostly just a burning sensation the first day. Very sore. Felt like a hot curling iron in there. Dreaded first bowel movement! Kept on top of the pain with the prescribed pills, hot baths and rest. Doubled up on my Miralax to 2 full doses a day. Very helpful Miralax and Balneol cleansing lotion!!!
Day 2
First BM in the am. Hard and very painful. Lots of bright red blood. Pain persisted for 6 hours and was intense but no worse than a bad fissure day. Continued with pain pills every 4 hours and double miralax. Balneol cleansing lotion is helpful. No rubbing, just dabbing and then a hot bath. (Also using good bathroom habits of relaxing, knees widespread.) Another bm that evening with very little pain. Third bm that evening with almost no pain. Ate dinner laying on the couch, watched a movie and felt decent. Slept good. Only took one pain pill at 11 pm. Did not need one during the night.
Day 3 - that's today!
Took pain pill in am, as well as Miralax in coffee. (I also take a good probiotic and Vitamin D daily.) BM in morning was softer but the pain really hit afterwards. Not as much blood. Took a long hot bath and an extra pain pill. Put lidocaine 5% and Vaseline and sat with hot pad while laying on my side. Pain is there but tolerable. I am eating a plate of kale with feta cheese and typing right now. When I put the ointment on the area, it felt tight and lumpy. Hubby looked and said it doesn't look bad but there is some bruising just to the side and the area where the skin tag was cut looks raw. I was really hopeful last night (day 2) that the botox was doing the trick but today tells me it hasn't kicked in yet.
Does anyone know when the Botox should do its thing? When I asked the surgeon her answer was "I honestly don't know." I might be a guinea pig for her! If anyone has advice/knowledge please post! And if anyone has questions, I'm happy to answer. I honestly am not sure that I'm glad I did this just yet. I am glad for the ultrasound and in the end I'll probably be glad to be rid of the skin tag but I went in with NO PAIN and I now have pain. Ugh.