Thanks Hayley & SavaIci for the reply and encouraging thoughts and advice -I really appreciate it more than you'll ever know!

I definitely had my mind running rampant due to my fissure being located off side. I believe it's called a unilateral fissure? Not sure...but yes, I don't have any abdominal pain, diarrhea, or mucus so far. I do have some spots of blood covering my stool after a painful BM and maybe a tiny bit on the tucks pads that I use to wipe. I am too scared right now to get a flex sig/colonoscopy/anything really due to the pain and fear of worsening it.

Update:

Last night was bad.

After painful BMs, especially the past few days (on a scale of 1-10, I would say it was a 10 two days ago and maybe a 7-8 yesterday)....I realized my prolapsed hemmy started to swell again. I think that's what it is...it is a little pink ball on top of my old skin tag outside of my bum...my GI had said that it was a residual hemorrhoid so I paid it no worry as it had shrunk a lot since I got it about a little over a month ago when all of this started. I feel like the painful BMs irritated it. It was kinda the last straw for the day as it led me to a breaking point as I had to now worry about this hemmy and worrying whether it was bad internally as well. This, on top of my usual high anxiety over next day's BM just really pushed me over the edge where I really felt like I was going crazy and just wanted to die and not live anymore. It sounds so dramatic, I'm sorry...but I was losing it.

My question is can I use both Prep H and Nifedipine/Lidocaine at the same time to treat my fissure and hemmy? Are there any side effects to this? I'm really hoping it's nothing other than a hemmy that will shrink on its own...

Didn't sleep at all last night, not really due to pain, but due to my stupid worrying and anxiety!!! I hate myself that I can't keep myself calm. I felt pins and needles all over my body from the anxiety and felt like I couldn't breathe - all night long. I had to hold tight onto my pillow just to stop myself from feeling like my chest was going to blow up. I seriously considered going to a psychiatrist over this...but I don't know if that'll be of any help. I don't want anxiety medications or anything to produce unwanted constipation at this stage.

I am back at work today after being off for a week due to my pain, and it is kinda nice as it keeps me distracted. But at the same time, I was not able to take my sitz bath and had to go at work and am in quite a bit of pain. The BM took a few minutes and was painful, but not a 10, maybe a 7. I cleaned up with wipes and tuck pads and then put on the Nifedipine. I usually don't feel too much stinging and pain afterwards unless it's a painful 10 BM, but today I am STINGING and hurting...I wonder if this is because I was unable to do a sitz bath right afterwards.

Also, for all the ladies out there, do you find that your fissure or BMs are more painful when you period is about to come?

This is truly the hardest thing, and I would never wish this on anyone. The only good that has come out of this is the fact that I find beauty in the smallest of things now and really enjoy every little good moment life has to offer me. I find that things I once complained about are trivial and nothing compared to this and really want to be a better person and be more thankful for things in life going forward.

Thank you for the support...I don't know if I'd be functioning right now if it weren't for you guys.

Preparation H is useless. Try to get something for your hemorrhoids from a doctor. I am not convinced that is what you have, as your pain seems very much the sheer awfulness that is an AF. You can, of course, use both.

When I was truly in agony - before I started dilation - I got a very mild muscle relaxant from my doctor as needed to have at least some time that I could sleep. I had 0.5 mg and it was heaven to be away from the pain during the night.

By the way, you do not need to aim at being 'a better person'. This is a hellish thing to go through. I lost 40lbs during it all, so I was also in a dreadful state. Do not take note of anyone who tells you that you need to 'buck up' etc. This is bloody painful and we are all individuals in how we cope. However, if you really feel you are not coping with it all, you need to see a decent GP at least, who will listen to you.

We are here for you

One final thing, try to stay on the one post as it makes it easier to see what's going on for you. And to be able to more easily help. It will come right in the end, though I know it's the proverbial pain in the arse right now.

Sorry about that, SavaIci!! I will try to stay on one post. I just created a new post, but not sure if it should be under here. I do apologize as I am unsure and hope I am doing this right. Feel free to let me know whenever if I'm effing up!

Thank you for your kind words. I was able to have my GI prescribe me Proctosol-HC 2.5% yesterday and I applied it after the Nifedipine/Lidocaine and it seems to have somewhat shrunk the hemorrhoids (at least the one on the outside, prolapsed?). But still experienced the same pain this morning during BMs and surprisingly a lot more blood in my stool the past few days. Frightening! But last night I was able to get more sleep than the night before. Working from home today so that is definitely a plus! :) Trying to stay strong~

Hang in there, it does get better. Continue with your routine and keep your bowel movements soft! The hemmy you describe on the outside of your bum sounds more like it could be a sentinel tag associated with your fissure. I know a lot of doctors misdiagnose them as regular hemorrhoids since they look just like them.

When I had a horrible bm my sentinel pile would swell and feel very sore. If hemorrhoid cream doesn't work then it's probably a senteniel tag which can't be treated since it's a symptom of having a chronic fissure and will only reduce in size and pain when your fissure does. Even now my fissure is feeling loads better I stil have the tag but it mostly doesn't hurt or produce any sensation anymore.

Oh and Recto cream is good stuff, I had to stop using it because it gave me headaches and heart palpitations. I switched to Diltiazem instead but they are both the same kind of thing. It takes weeks for them to make a difference and you are going to have good days and bad days for a while. It's the nature of the beast. You know you are getting somewhere when you start having prolonged periods of good days inbetween the bad ones.

Hi Hayleyw,
Thank you for the reassurance. Boy oh boy are the good and bad days thing so true. Being patient with an AF is incredibly challenging...ahhh. But I must hang in there!! Yes, I definitely am starting to think it is a sentinel tag rather than a hemorrhoid so I have stopped using the Proctosol-HC cream. It seems to shrink quite a bit overnight or when I am in the least pain. Seems to somewhat swell after a BM, but yes definitely the nature of the beast!


Update:
The past few days...not too much change although I do think the overall pain of a BM is I guess somewhat better? Really don't want to jinx. I can't be too sure. I am still suffering badly from the plug effect aka initial little pieces of stool that is tough to get out followed by normal, formed stools. The first part is what is painful (currently about a 7 out of a scale of 10) and then the following stool is only like a 2 on the pain scale. The thing is...I think my stool is quite soft so I don't know why the initial pieces are hard to get out and also the most painful. The bleeding seems to have stopped for now. I just started Miralax this morning (half dose) so we will see how that goes. I will also continue to take 100 mg of Colace as I have been for the first few days until the Miralax kicks in. I am thinking of stopping Citrucel as I get plenty of fiber throughout the day and I am unsure if Citrucel is actually making the hard tip/initial stools worse.

I am trying to eat a little more each day to gain some weight back...but still get scared. Like I said, I'm a fairly healthy eater, but lately due to this problem I've been craving things that I don't typically crave such as PIZZA, CHICKEN WINGS, chocolate chip cookies, etc...all the bad things!! But I haven't dared to try and won't.

Otherwise sticking to basics every day:
Oatmeal/quinoa mix with blueberries for breakfast
Ezekial cinnamon raisin toast with peanut butter
Fruits such as seedless green grapes or raspberries, etc.
Lots of soups..such as lentil soup, minestrone etc. (although a lot of these have tomatos in them and i can't tell if they irritate the AF worse or not)
A little bit of rice + lean fish such as salmon or tilapia with mixed green salads

Still on the Nifedipine and have my two-week follow up (since I started the medication) with my GP on Wednesday.

Hope you are all doing well <3

Good to hear you suspect some improvement. I know what you mean about jinxing things. I'm cautious about admitteding things are going better. It'll take time.

As far as diet is concerned I have never changed my eating habits. I'm a junk food addict and that hasn't changed. I guess I don't really believe what food you eat really matters. Poop is just poop to me and if I have a laxative that draws water in the bowel it's soft. I can personally say I haven't noticed a difference from a day of eating healthy foods compared to a day of eating takeaway food.

Lots of people on this forum do stick to a diet and think it helps them so i'm not saying they're wrong. It's what works for the individual I guess.

Also the first erm..plop being the hardest is very normal. As long as you keep up with the laxative use and go when you need too (don't hold it in if you can help it) it should get easier. Exercise is great for helping your poop on its journey. Moving around helps to dislodge hard stools.

Thanks Hayley! I have been slowly eating a little bit more. I had some thai food the other day (just some vegetable basil rice) and the next day my BM was still about the same level. I think Miralax has been helping a lot. The "plug effect" has somewhat gone away since starting the Miralax. I still apply a little bit of Vaseline before as well. I'm just really wondering if I can have a slice of pizza (been craving it soooo bad) without having to pay for it. Still been too scared to try that! But it's good to hear that you personally haven't noticed a difference from eating healthy vs. takeaway food. You are so very lucky in that regard!!!

Update:
Dare I say it? I have felt a little bit better in the past few days except for a slight retear on Friday night. My pain level has gone down a lot since starting the Miralax. I have cut out the Citrucel, but now taking 1/2 dose Miralax daily with one 100mg Colace. It seems that I have to be on a strict schedule of taking these daily around the same time, along with a good diet in order to avoid pain and retears.

On Friday, I went a little off course unfortunately. There was a Halloween potluck at work and right after work there was a party I could not get out of. I stuck to just a salad for the potluck so that wasn't too bad...but wasn't able to take my Miralax till I got home that night, which was around 1am. I immediately took my sitz bath and was exhausted and went straight to bed. The next morning, I felt more pain than I had felt in the past 3-4 days prior. I also felt the retear. Afterwards, I felt little stings all day and it was quite uncomfortable I rested up a lot and then went back to my regular diet with the Miralax & Colace around 6pm, which is when I typically take it. Since then the pain has gone down again.

Is this what life will be like? Just having to live so strictly on a schedule? Not being able to eat whatever I want or feel afraid to go out because you have to worry about how you will pay for it the next day? It was hard enough not being able to drink while everyone else around you is eating and drinking, while I make excuses for why I can't.

Still on the Nifedipine...currently on week 3. I still can't help but constantly have fear in the back of my mind that all of this will only ever be temporary and I will have to live this way forever. It's so true that it completely lowers the quality of your life, where your life revolves around a strict schedule with multiple sitz baths, medication, certain foods, etc. Not to mention, and this may be TMI, but I feel like it has affected my intimate life with my husband as I am scared to have sex. I also feel gross as I always have medication or some type of cream up there. Keeping my fingers crossed and hoping for the best.

Thanks guys..x

I was suffering with pain just like you are until a couple of weeks ago. It sounds like you have really been going through it and I'm sorry to hear it has had a knock on effect on your state of mind, anxiety etc.

I think Miralax is the same as Movicol which we have here in the UK. I started taking mine 2 weeks ago today and tomorrow is the 2 week anniversary of the last time I had a painful BM followed by excruciating, debilitating for several hours afterwards.

I started taking a full dose (2 half doses) morning and evening and this has worked for me. I don't tend to worry about the exact time I take them, I just take them when I can and try to make sure it's as soon as I get up, and just before I sleep.

Have you considered increasing the dose slightly to be absolutely sure you are getting enough water in to your stools? I'm not a medical expert and everyone's body works differently but I am just saying what has worked for me. To clarify, my stools are really soft and mostly formed, and just 'fall out' of me, no straining and absolutely no pain.

Also I'm not sure a late dose would have impacted on your bm the following morning, as doesn't it take 36 hours to pass through your system?

Hope this is of some help. Keep your chin up and fight this(as hard as it feels sometimes), you will get through this!

Im sorry that you are going through this. I skimmed through quickly with the time i have. Honestly, i tried everything. LIS surgery was the only thing that worked. It changed my life. I may have missed it, did you mention that as an option?

I'm right with you on the anxiety part and mostly on the fissure part as well. I have severe anxiety and panic before and after a bowel movement even though my fissure has mostly "healed" (although I still have some aching when stool is not completely soft). I too am looking for answers to the mental part as it seems I have the physical part in hand as much as possible (lots of water, fiber from veggies and fruit, exercise). But at least I know I'm not the only one struggling with more than just the physical symptoms.