I've relied on the wonderful advice on this site for some time now, but after a few bad days, think it's time to share my store to get some more personalized guidance. Here it goes... I gave birth (vaginally) to a wonderful baby boy in September. The fissure pain started two weeks after he was born when I didn't take Benefiber for a few days and had a hard BM. It was excruciating and I had no idea what it was or whether it was normal postpartum pain. After suffering for a week with pain escalating to the point of bringing me to tears with every BM, I went back to see my midwives. Unfortunately for me, the new woman in the practice had the first available appointment and she wasn't experienced or savvy enough to identify my problem as a fissure. She took a superficial look, told me I had a hemorrhoid (I'm still not sure whether what I have is a hemorrhoid or skin tag from the fissure), and sent me on my way with a hydrocortisone cream. I got very little to no relief from the cream and at my 6 week postpartum check-up, another midwife knew immediately, based on my description of my symptoms, that I had a fissure before she examined me. It was a such a relief to have a proper diagnosis. She advised me to liberally apply vaseline or A+D ointment before going to the bathroom to protect the fissure. This did help some, but not enough.
A month later, I saw my GP. He examined me and prescribed me Nifedipine with lidocaine. Around that time, I added Miralax to my regimen. When I apply the Nifedipine, I can tell it has done its job in relaxing the sphincter. I still take Miralax nightly and had just been congratulating myself on a month without bleeding when the fissure tore open again this week. It almost feels like I'm starting back at the beginning. My GP told me that if the Nifedipine didn't work within a month (it's been nearly three), surgery was the next option and gave me the information for a CRS. I've been reluctant to even have a consult with a CRS because I'm unwilling to pursue any treatment options that would impact my breastfeeding relationship. It's entirely possible she'd have ideas other than surgery, but I've been afraid to even ask. Right now, baths are helping relieve the more acute pain, but I've been taken back to a place where I fear going to the bathroom. Every BM is like razorblades escaping from my body. It's amazing how something so tiny can cause so much pain and the daily re-injuiry just feels so unfair. It's far worse than giving birth (unmedicated!). I would love some advice regarding treatment options that are compatible with breastfeeding, particularly from others who have suffered with postpartum fissures.