First off, thank you for creating this forum and a diary section. There is so much trial and error to get this problem under control. I need somewhere to document what works, what doesn't. I come to the forum daily since my AF seems to have taken over every thought , so what better place to write everything down?

Brief history:
- Asked GYN about a strange lump a few years ago. It would occasionally itch, maybe a spot of blood, but no pain or real impact. She said it was "just an anal fissure." Hooray - not an STD! She told me to apply cortisone if it ever bothered me. Sometimes it would itch, the HC took the itching away immediately and would shrink it to nothing.
- I had to have a hysterectomy in 2012 despite completely changing my lifestyle to avoid it. Afterwards, I suffered chronic constipation even though I ate healthily and exercised often. Added nightly metamucil, which fixed that. I am very prone to scar tissue. My theory is my abdomen is full of scar tissue again, which slows down my digestive tract. Just my theory...

- Last month, came down with strep throat, requiring 2 rounds of antibiotics to kick. We were on vacation during the second round. Not sure if it was the meds or vacation, but I got terribly constipated despite my metamucil.
- June 6...worst pain of my life. I instantly knew it was a fissure. I started applying HC since it was the only thing I had while camping. Went into research mode on the way home.
- I started doing the following June 9th and the days that followed:
...Drinking tons of water, 2-3 liters/day
...Started 2 Colace stool softeners at night for a few days - didn't notice any change
...Stopped using HC because I read how it can thin the skin there and prevent healing, switched to Triple Paste zinc oxide cream - didn't help
...Lidocaine ointment - didn't take away pain
...Added 3-4 sitz baths/day - very uncomfortable at first. Felt like sitting there was putting too much pressure on my AF area. Discovered that leaning back, relaxing my back against the toilet seat helped tremendously.
...Switched to applying coconut oil - my CRS actually laughed at that one. But it felt the best of anything, besides the HC.
...Added ZMA supplement to aid in softer stools - pretty sure this is working
...Started tracking my food/water in My Fitness Pal app - huge help!
...Switched to Benefiber instead of metamucil - big difference. My stool is not as large, and it's much more pleasant to take.
...Making sure I'm getting about 30g fiber every day. I've only had bleeding twice, and both times I'd had closer to 40g the day before.
- June 16...first visit with CRS. AF confirmed, but not where my old sentinel pile is. This one is new and posterior. I'm hopeful it means this will act like an acute fissure and heal more easily. Prescribed Proctofoam HC and Nifedipine, to use both twice daily. FYI any newbies reading this - nifedipine has to be compounded and isn't available at most pharmacies. I really wish I'd known that instead of driving 30 minutes home only to turn around to drive 30 minutes again and beg another pharmacy to get it made before they closed.
Proctofoam - I don't like this. It burns a little and I don't like the applicator. May use it for a week to see.
Nifedipine - Pretty sure it's working. havefaith posted on here, "He said to apply it as you would smear toothpaste in the crack of cement. It just needs to get in there." My prescription didn't come with instructions, and this was the clearest description for me on how to apply.
- June 17...added wheat grass powder to my diet.

Today - had my usual 2 BMs. Both were soft and much less painful than a few days ago. My spasms passed way quicker. I'm doing laundry, able to interact with my kids, basically, I was able to get into my day and my mind off my pain earlier today. I have hope.

Something is working! My BM was much softer today - definitely reached the recommended "toothpaste" consistency. It's less bulky, which I don't know if that's caused by switching to benefiber or what I'm eating. Either way, I'll worry about that down the road. I tried the squatting method. I moved a wide footstool in the bathroom to place my feet on. What a difference! I had zero pain during and only minor pain afterwards. I did have to strain slightly, but I didn't have to grab the doorjamb in pain. I really hope I'm on the path to healing.

It still feels weird to discuss such private matters in a public forum. But I am so thankful for all the openness and support I find here. I figure my details may help someone else in the future they way everyone here has helped me.

Today was my best day yet. Almost no pain with BM and very little afterwards. I started using a travel bidet instead of wipes. It's definitely less irritating. I also stopped using the proctofoam on the 19th. There has been a little more pain without it, but ibuprofen alleviates it. I decided to apply my nifedipine 3x/day instead of twice. That seems to be the most common frequency prescribed, and I figure it can't hurt. I feel like I've maybe got a handle on food/fiber. My stool has been just right the last 2 days. I only took 1 tsp of benefiber tonight to get me to 30g fiber. Fingers crossed...

Another good day, thankfully. I was worried most of the day because my BM this morning was much less than usual. I had to go again in the evening - thankfully it wasn't hard or painful. I'm nervous about the next few days. Flying across country by myself with my kids to spend 2 weeks with family. If I could cancel, I would in a heartbeat. One whole suitcase is dedicated to my footstool and various trusted things. My dad is going to think I'm crazy, I'm sure, but oh, well.

My trip didn't cause any major setbacks. Each day was a little better than the last, with the exception of my travel days. I expected that due to my schedule being off. I'd had no pain or discomfort for the last few weeks. I honestly felt completely healed. I continued the nifedipene and diet, but had stopped the baths.

Then, last week happened. We went to visit family for a birthday. I had 2 beers and a small piece of ice cream cake. I thought it would be fine since I'd been feeling so great and maintaining my diet otherwise. No such luck. Diarrhea the next day and a re-tear. Just from wanting to feel a little normal around my in-laws. The pain is even worse this time. This feels hopeless.

MM, Sorry you had such setback. Its getting to point where it may becoming chronic. You probably need a trip the CRS to say what he says. You may want to take next the next steps. Hope you feel better. good luck

Thanks, Apes. Botox and LIS have been on my mind a lot this last week. I'm hopeful that I can rest and get this healed now that my kids are back in school, though. This morning was just slightly better than yesterday - I'm so thankful for that, at least.

Note to self: don't add shredded coconut to smoothies. It's a bad, bad idea that comes back to bite me.

This morning is a little less painful than yesterday. I'm back to only eating known foods that won't hurt me. It's boring, but I like them, so I'm ok with it. I added a vitamin C supplement yesterday. I read this on a medical site, and I figure it shouldn't make things worse, at least : "As an important factor in collagen production, vitamin C is useful in wound healing of all types. From cuts and broken bones to burns and recovery from surgical wounds, vitamin C taken orally helps wounds to heal faster and better."

Yesterday was really bad, mentally. I feel like I've had nothing but problems since my first pregnancy. Everything has been pregnancy-related, and I feel too young to be going through all this. I hate having my husband and young kids seeing me like this. I feel like a walking Petri dish trying different things to see what makes me feel better or worse. I hate all the obese people I see eating crap fast food and smoking and seeming to have no problems. I'm at a healthy weight (almost too thin since my AF, which is another worry), I eat extremely well, and walk or run almost everyday. So, WTF?!

The last 2 mornings have been a little better. Still painful and needing 2-3 motrin, but the broken glass feeling is mostly gone. The pain is mostly afterwards, and baths help a lot woth that. My BMs are still bristol 5 or 6. Before my retear they were consistently 4s with no pain during or after. I've been home a week and I've gotten my diet back on track. Hopefully the consistency will return, too. I wish I'd noted when I switched from ZMA to regular magnesium supplements. That and the vitamin c are the only differences I can find in my diet pre- and post-retear. ZMA had 300mg where the other has 400mg. I think I'll only take 200mg for a few days and see if that helps. I dread switching back to ZMA, but if I have to, I will.

Pain during and after BM is definitely decreasing - around 2-3 the last 2 days. I think I've finally gotten down to only going twice a day, again. I'm hoping to get it back down to only once. That's when I felt the best a couple weeks ago. I'm still taking 500mg vitamin c in the morning and taking 150mg magnesium citrate at night. While I'm not back to Bristol 4s yet, it's not as loose as it has been.

I walked 4.5 miles with my friends this morning. It was too much, too soon. I had a lot of bleeding after my 2nd BM, which has never happened before. There wasn't a lot of pain, but I jumped in the bath just in case. I'm going to stick with half that distance until this heals.

I'm starting to be more open-minded about LIS. I'll give the nifedipine 12 weeks, but if I'm not pain-free, I'll go see the new CRS to discuss options. I'm just ready to be normal. Two years ago, my husband's birthday and our anniversary were kind of ruined by my hystero. This year it's the AF. I'm so thankful he's so understanding.