Hello,

Well, I’ve been working really hard to get my stools right…but I still managed to F it up and here I am. The somewhat larger than normal stool got ‘stuck’, and had to move through an opening too narrow. Torn again. Searing pain and blood upon defacation, but thankfully relatively beningn/unfelt during the daytime.

I’ve had three separate issues of chronic anal fissures—the first time 3 ½ years ago, was resolved within a few weeks with medications; the second, resolved within a week on its own; the third (current), has been on-and-off for the past year and a half.

I’ve been on Miralax for the past 9 months, and I don’t want to continue. I know that Miralax is supposedly safe and can be taken for the rest of your life, but I just can’t believe that. I don’t see long-term use of Miralax as a solution. And, anyway, it isn’t exactly a 100% solution for me either.

At this point, I am considering both Botox and LIS. I don’t have ‘spasms’ as many describe, but the sphincter is just chronically tight it seems. I am hesitant to do botox, since its effects wear off and I am trying to resolve the muscular problem more than the fissure itself.

The problem is that I cannot hold my current job and undergo either procedure (I think). I have to be able to swim and wade through rivers and natural pools. I don’t see how I can do that with the risk of infection. I love this job, don’t want to leave on bad terms, and the job only lasts a few months. If I pursue botox/LIS, I am moving back in with the parents.

I am afraid to postpone treatment of the muscular tension. Trying to heal has already consumed my life for the past several months. I can’t have this be a lifelong daily struggle…

So here is what I am debating:
a) increase the pharmaceuticals (which scare me) and get through the season (which will make me happy)
b) abandon the job, seek treatment immediately (which will be reassuring), and move back in with my parents (which will be depressing)
c) the magical third way, or, somehow get adequate treatment (reassuring) AND keep the job (happy)

Any ideas, folks? I could really, really use some advice right now.

Isn’t it unfortunate that I seem to be deciding between psychological health and physical health? They are interrelated after all, and neither realistic scenarios provide both.

Botox would get you through the season... It lasts around 3 months...... Then you could go for LIS if that didn't do the job?? You could still keep working after Botox no problem, just take a few days off after the injections.

Good luck with whatever you choose!!

OMB x

I've seen so many posts about Botox and infection, though. How could a few days off possibly be safe enough to start jumping in rivers again?

In my very, very humble opinion I would do LIS after the job ends depending on how long a "few months" is, how much pain you're in currently and if you think you can manage the pain. I am 13 days from LIS. Never had botox. I also suffered for over 1 1/2 years and my muscle tone was just very high. Triple the normal tone.

Ultimately, as you know, the decision will have to be something you're comfortable with and only you can know that.

The job only last a couple of months the fissure could be with the rest of your life if you don't take care of it. I had to decide between LIS and BOTOX I chose Botox. Given the choice I did not want to risk permanent side effects from LIS (incontinence). Botox has side effects but not permanent.

See a board certified Colon Rectal Surgeon and follow doctor's advise.
LIS worked like a charm for me.

ut_outdoorsman wrote:I've seen so many posts about Botox and infection, though. How could a few days off possibly be safe enough to start jumping in rivers again?