So I had 4 days of not bleeding and just a irritating level of pain, I was so excited and happy even though at the back of my mind I knew a setback was due. This morning I had that setback, I slept in which meant a delay in my BM and therefore a hard tip, I will be getting up the same time again from now on. I think that was the cause of the wee tear and blood. I did lie awake in the night worrying about a trip away to see my family who is all going to be in the same place since about 5 years so perhaps that stress added to the issue, not sure. I am worried about all the questions from my family about why I am eating like I am and them giving 'advice' of what I should be eating and their comments about my weight loss which I am freaking out about at the moment. I look like a skeleton. They will also be critiquing my parenting style which will be stressful. That's the worse case scenario anyway.
Writing here has put it into perspective, I need to breathe. I will try and talk to my mum about sticking to my diet which has been working a charm until this morning. I will be mindful and assertive and tell them I don't want their advice and critique.

I will heal.

You will indeed heal Hopefull. It just takes all the patience you can muster, I know. Hang in there and try not to sweat the small stuff. When is your trip?

Thanks so much msimon, definitely need patience by gosh. Felt like I've retorn all day, bah! My trip is just over a week away, it's all very last minute. I've not traveled since getting the AF.

Hopefull...i hope your trip goes well. I have read your posts and want you to know i am rooting for you.

A few thoughts...they may be "old" and you may have tried all of this...but just in case you have not...here goes.

You mentioned that you have poor circulation in general -- have you tried using a heating pad, hot water bottle or some sort of heater on your rear end while you are sitting. I have found that both soothing and i think quite helpful in stimulating circulation down there.

Also -- in terms of the hard tip....you can try and avoid that situation all together by taking something that softens your stool. Have you tried Magnesium Citrate...if not, get on it!! Start small...perhaps 200-300mg per day and if you need more perhaps up to 400/450mg per day. I had one nutritionist tell me not to use more than 450/day. Magnesium Citrate is not habit forming and helps both relax your bowel muscles and draw water in to your colon to help soften everything up. If you take too much you will experience watery stool...if so, lighten up until you find the right balance. If that does not work try Miralax...I am no expert on this one...many on this site use it and say it is also not habit forming.

You do not need to live in fear of the hard tip....i did for some time until i found magnesium.

So go and enjoy your trip...and likely once you start softening things you will find that you can eat a broader range of foods and it will not negatively impact you!

All best,
Canadabum

Thanks Canadabum. So nice to have your support and of others on this forum, it's a lifesaver :)

I take magnesium oxide, do you know if that has the same effect as magnesium citrate? I am currently taking 1000 mg/day although I think most the free magnesium gets taken into the breast milk. I am also currently taking Lactulose, I've never thought it to be that amazing at keeping the stools soft, I never have to push it flows out easily but I would like it to not have the impacted tip, TMI sorry ;) I just received some Movicol, it's called Movicol-half, I haven't researched what the 'half' means, perhaps half strength. I'm a bit nervous about making the transition from Lactulose to Movicol in case I take too much or too little, perhaps I shouldn't mess with my regime. I would like to add a bit more protein and carbs to my diet as loosing weight, at the moment my stools are quite bulky just because I am trying to stop loosing weight and so am eating more. I sit on a warm wheat bag whenever I need to sit for a time.

I talked with my mum about the trip, she reassured me about just eating what I want so I will send up a shopping list of high fibre foods for her to get. She has also said I can stay in the room with the ensuite bathroom that is such a relief since my bathroom time is so sensitive. I was nervous about talking with her, she always says things like 'you should have crunchy peanut butter....' and 'you should eat more variation', not sure why she doesn't understand the nature of the beast. I've tried to explain the balance between soluble and insoluble fibre and the challenge of keeping the stools soft enough.

I've just seen this post on the different types of magnesium explained, post107974.html?hilit=magnesium%20oxide#p107974, explains why I'm taking such a high dose, will get some magnesium citrate and see if it helps with the BM's before switching to Movicol.

So glad you found that...too add, my naturopath said the only form she recommends for people wanting to soften things up is Magnesium Citrate. I started taking 450mg per day - 3x 150mg capsule with each meal and found it too much...made things too watery for me. I cut down to 300mg 2x a day and still found it too much...now I take 150mg capsule in the morning and a powder version called "natural calm" where I can control the dosage and take 100mg at night. All that to say - I find for myself that 250mg day works well.

Very glad to hear that your mum will be helpful with the food and ensuite. Enjoy the family time.

Canadabum

I'm on my trip away to the family. Mum is being oh so supportive it makes me want to cry and no one is asking lots of questions as I have my soup in the evening.
Problem is I have developed what I think is a sentinel pile . The skin had started to get a bit squishy at the base of the fissure a few weeks ago. Last night I had nearly diarrhea as I didn't have the right measurement of lactulose and this morning's BM was a little more urgent as well with a bit more blood than is usual for me. I was so itchy afterwards and am still itchy now. I went to the toilet before and there is blood on the TP and I didn't have a BM! I think it's coming from around what I now see is the sentinel pile. It's a wee bulb down there the size of a pea. This is so depressing as I thought I was pretty much on the road to healing as the pain is so minimal and the bleeding had started to be only 70% of the time.

I don't know how to look after it, I dabbed a bit of sudocrem there. I have got with me the rectogesic and some medihoney and lanolin oil. I left all HC and coconut oil at home. Too nervous to apply HC there anyway.

Do not panic Hopeful, this too shall pass. I think it is pretty normal to form a sentinal pile, I had one from the very beginning. They will go down once the fissure heals. At the moment, I would keep it clean and maybe a bit of medihoney but I found keeping it clean and dry was the best thing when it as swollen. My fissure has also bled without a bm and this exact thing happened to me about 4 weeks ago and now it is a lot better so this does not mean all is lost. It does sound like things are not improving as much as you would like though, is it possible for you to get a different cream? I used rectogesic for a few months and while it did help for the first few months, it stopped having much of an effect and once I switched to Dilt things improved although I am now getting a bit sensitive to this as well! I really hope you feel better soon and remember nothing is permanant in life, everything changes and this will get resolved one way or the other.

Thanks Felix, that's encouraging to read. I'm back from my trip away. All went pretty well but dog tired now and sore. It was a 7 hour drive with a 6 month old so hard work. The sentinel pile is painful and incredibly itchy at times. I have a skin tag/sentinel pile from what I think is perhaps another fissure from a past life. When I was using HC initially for the hemmies the old skin tag started to get smaller, I've just connecting the dots to this so perhaps I could try HC, just so nervous.

I'm going to take your advice and others and try and get Diltiazem. So far two surgeons and a doctor I have talked to are not familiar with it but will try the major cities for the specialists. I've never felt any different down there from using Rectogesic, didn't really get headaches or anything. I wonder when people have used GTN did they actually feel their sphincter relax?

I'm also going to start weaning for sure this week. I've had this for 6 months and that's enough. Sometimes I have a pain free BM and sometimes there is no blood but generally it's not changing much. I need a plan of attack I think. First call around and find Diltiazem, then if that doesn't work, not sure how long to use it if I can get it, then try Botox. I'm yet to read up on Botox properly but I have a feeling it has mixed reviews.

I'm going to throw money at it also, there goes my savings but hopefully here goes my life.