Possibly back again? Hem or AF?

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Possibly back again? Hem or AF?

Postby back(side)again » 26 Oct 2014, 18:03

I am possibly back again to this board. I am hoping and praying not. My old diary is here: from-botox-to-lis-t8093.html

Iwent into the CRS a number of weeks ago, because I had some unexplained bleeding, but no pain and no pain with bms. They did a thorough examination and found a very small tear and a grade I internal hemorrhoid. He said that the bleeding was from the hemorrhoid, and I shouldn't be concerned about the tear. He said they don't typically do anything for grade I, but he does offer cortisone meds to those who want them, but they don't really do too much.

Immediately after the appointment, I had some pain from the prodding. This pain has built up over the past few weeks. I still don't have any pain with bms, but as the day goes on, pain underneath my tailbone builds up. I can't help but find it reminiscent of the muscle spasms with the fissure. However, my fissure hurt with a bm and seemed to be a constant throbbing, particularly when sitting down, and standing/walking relieved it.

With this, the pain slowly starts after a bm (pain-free during bm), and works up to a throbbing, dull ache by the evening. Even walking can irritate it. For those who have had both AFs and hems, is it possible it's a really mean grade I hem or perhaps working its way up to grade II? The CRS did give me meds, and I have been using them. I did have some itchiness a couple of days ago, which seems to be more common with hems, too.

I have myself in such a tizzy about this, and I know I just need to relax, as the stress is doing nothing for me, but I have a once-in-a-lifetime (expensive) trip abroad in three weeks, so I am seriously stressed. If it's a hem, I don't know how much they can do if I am leaving in three weeks, and if it's a fissure, I really don't know what to do. This would be my second one, and I've already had LIS earlier this year for the other (which did fully heal).

To add to it, with my AF in 2013, they immediately diagnosed it as the GP as a hem, as did the GI doctor. It wasn't until months later when I went to the CRS, that he told me there's no way that internal hem could cause that much blood and pain... UGH... Thoughts and prayers are greatly appreciated!
Pain began in Feb 2013
Diagnosed with AF in June 2013
Conservative treatment with nifidepine lidocaine June 2013-Oct. 2013
Botox & tag removal in Oct. 2013
Botox in Dec. 2013 (provided pain relief)
LIS in March 2014
Fissure healed in June 2014
back(side)again
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Re: Possibly back again? Hem or AF?

Postby Jbl22424 » 26 Oct 2014, 23:18

Sorry to see you back again. I did re-tear after LIS but it was very clear to me that I had a new, milder fissure. Everything was the same except the severity. Diltiazem and miralax have healed it for now. Are you taking miralax? I took miralax, colace, and mineral oil on a recent trip across country to try to prevent any issues. Hope this is just a temporary thing for you. I also worked myself up when I re-tore but it turned out to be not as bad.
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
Nifedepine
Colace
Magnesium
Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
Feeling better for now
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Re: Possibly back again? Hem or AF?

Postby back(side)again » 27 Oct 2014, 16:31

The CRS told me at the last appointment to stop taking Miralax and increase my fiber to two tablespoons per day. I haven't had any problem going and movements aren't painful, like with the fiasure.

Regardless, I scheduled another appointment. The pain, though moderate, is enough to annoy me and radiates through my entire bottom. Standing, walking and running are now bothersome for more than 15 mins or so. It seems lt seems like my whole midsection is super tense and there's nothing I can do to relax it- kind of like the spinchter is clenching. Perhaps it is a learned response to pain down there?
Pain began in Feb 2013
Diagnosed with AF in June 2013
Conservative treatment with nifidepine lidocaine June 2013-Oct. 2013
Botox & tag removal in Oct. 2013
Botox in Dec. 2013 (provided pain relief)
LIS in March 2014
Fissure healed in June 2014
back(side)again
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Re: Possibly back again? Hem or AF?

Postby Scientist2516 » 27 Oct 2014, 20:42

back(side)again wrote:It seems lt seems like my whole midsection is super tense and there's nothing I can do to relax it- kind of like the spinchter is clenching. Perhaps it is a learned response to pain down there?


I asked my colorectal nurse two or three times over different visits, and using different phrasing, if there was a way to learn to relax the sphincter using biofeedback or similar technique. If people can change their blood pressure or heart rate using biofeedback, why not the resting anal pressure?

She always said she didn't know of any such technique. It's frustrating because I know that my pain is often caused by stress and anxiety. I am learning to relax, but that's just conscious relaxation of the bottom area and the external sphincter. We need to learn to relax the internal sphincter, which is not under conscious control.

The nurse said to try yoga and meditation, and that would probably help a bit. It might help more in your case, if it's your whole midsection that's clenching. It could be a learned response to pain. Alyssa has posted quite a few links to pain-management sites recently. Have you checked them out?

Good luck!
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: Possibly back again? Hem or AF?

Postby back(side)again » 27 Oct 2014, 21:18

It's funny you mention yoga. I did start to do some cow and cats, which feels great, along with child's pose before bed. I haven't see her pain management links; I'll have to take a look.

Do you or anyone else have any recommended yoga poses that help relax that area? It's been awhile since I've done yoga in a class, seeing I've been super self-conscious about flatulence due to the LIS... But, I suppose worrying about things like that are what keep getting me into this predicament...
Pain began in Feb 2013
Diagnosed with AF in June 2013
Conservative treatment with nifidepine lidocaine June 2013-Oct. 2013
Botox & tag removal in Oct. 2013
Botox in Dec. 2013 (provided pain relief)
LIS in March 2014
Fissure healed in June 2014
back(side)again
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Re: Possibly back again? Hem or AF?

Postby Jbl22424 » 29 Oct 2014, 23:40

I go to yoga all the time post-LIS... No unexpected slips yet. I highly recommend it!
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
Nifedepine
Colace
Magnesium
Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
Feeling better for now
User avatar
Jbl22424
Proctosphincteranalogist
 
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Re: Possibly back again? Hem or AF?

Postby rockybalboa76 » 30 Oct 2014, 10:05

I ended up temporarily on anti-anxiety medication and it really helped. My primary care physician prescribed CITALOPRAM (aka CELEXA). I visited a therapist for all the mental issues I was having related to a fissure. She suggested I ask my primary for anti-anxiety medication. I did. He agreed and it was a real turning point. Your CRS usually doesn't handle such things. Perhaps you should visit your primary care physician instead. Explain the situation and see if they'll prescribe it. Once you take it, it takes a little while for it to build up in your system, maybe a couple of weeks. Once it's going, it does help relax and release the tension. Then, once my fissure issues were healed, I was able to come back off of it. Hope this helped.
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Re: Possibly back again? Hem or AF?

Postby back(side)again » 01 Nov 2014, 14:05

Thanks, all. I am actually taking a tricyclic for some other nerve pain, and it seems to be helping.
Pain began in Feb 2013
Diagnosed with AF in June 2013
Conservative treatment with nifidepine lidocaine June 2013-Oct. 2013
Botox & tag removal in Oct. 2013
Botox in Dec. 2013 (provided pain relief)
LIS in March 2014
Fissure healed in June 2014
back(side)again
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