8 weeks post-fissure - whats worked so far

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Re: 8 weeks post-fissure - whats worked so far

Postby healthybutt » 17 Mar 2017, 14:26

FromCroatia, yes it has been a struggle, but luckily I havent lost my mind yet. Also luckily, it really only hurts during the BM. I never had spasms so I thought surgery didnt seem appropriate for me, but I am going to talk to the CRS tomorrow to ask about it.

Hope the surgery went well and you are recovering quickly. I feel your terror about missing a BM, although the LIS means your sphincter muscles are less tight, right? So hopefully your BM just slides right out! Can you take a laxative or a glycerin suppository post surgery? Anyway I hope you heal quickly :)
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Re: 8 weeks post-fissure - whats worked so far

Postby healthybutt » 17 Mar 2017, 14:39

Day 5 --

Yesterday's good diet (minus the candy and cookies) paid off in poop. Formed yet soft poop. I did find myself clinching a bit again since I am super vigilant about exacerbating the wound and I feel any expansion beyond say the size of a carrot will do that. 800mg of Magnesium at around 11 pm last night. Did the ghee in soy milk at around midnight, which I hadnt done in a while. I could drink a pint of it, it is so good. However it didnt make me go any sooner or really seem to affect my BM. This am, I also took a triphala capsule with warm water at around 6:30 am (I didnt go till around 8 am); triphala is also supposed to help soften stool and is a good blend of herbs in general. I did feel a little bloated after taking it though. Then I got to work and ate my apple sauce with chia seeds, chai tea with only a little black tea (i went caffeine free for a week prior to all this -- it made no difference whether I drank a cup or tea of green or black tea a day, and i stay extra hydrated when I do. Now I am eating my cauliflower and kale with my veggie patty that I really like (costco for the win!). I was tempted to eat italian food today because my sister has a groupon, but there is NOTHING on the menu that sounds butt-friendly. It has worked -- I dont crazve those foods anymore because I associate them with pain. If only sugary foods would do the same, but whether or not I eat chocolate, cookies, etc seems to not matter much to my gut.

My fissure feels like it is healing quickly. In fact today's poop was not unlike poop from a week ago, and while I felt a little irritation it was fine. The sitz w/ coconut oil, nitroglycerin, bottoms up balm, and my healthy diet I think are really speeding up the healing time.

One thing I noticed yesterday was that it can feel a little dry there -- not sure if it is from wiping because i'm at work and cant use my travel bidet, but i feel a weird sort of dryness. maybe it is always that way and i am just now aware of it. maybe having it dry out down there has contributed to the re-tear(s). anyway i plan to religiously use coconut oil, tamanu oil, and calendula oil up there even after it heals. i stopped using tamanu because i figured that would be good for the scar tissue later on, but wanted to limit the stuff i was putting on it now to avoid irritation.

anyway, i am happy things are improving down there in such a short time.
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Re: 8 weeks post-fissure - whats worked so far

Postby healthybutt » 18 Mar 2017, 02:43

I had another loose-ish BM at around 3 -- no pain.

Had another coconut oil and lavender infused sitz, put the bottoms up balm with calendula oil on (i had used the nitroglycerin oil 2 x today already)...note to self to make a cheat sheet for fiber intake. ate pretty well today -- veggie patty, caulifflower and kale, basmati rice with thai curry (carrots only), brusselsprouts and butternut squash, a few pieces of pesto bow tie pasta, then of course had my sugar fix of frogen yogurt with strawberries and brownie chunks.

Anyway I put togetehr a long list of questions to ask the CRS tomorrow. I'm a little anxious so I was reading up posts on the forum and had totally forgotten about botox. Hm. However, that is only temporary -- I want a permanent fix.

Also I looke dup more on manuka honey, and was considering it for a bit, but there isnt much posted here on it and while I would be fine to try it on a minor cut on my arm, I am a little leery of smearing it up my arse. And also the clean-up involved every time! I also am still considering ghee, which is cheaper and which I try to keep in stock because it tastes so damn good. Tasty wound healers.

I took my 800 mg of magnesium, drank some tea with chia seeds, and am now onto my cup of warm milk witha tsp of heavenly ghee mixed it. it is chilly/windy here tonight and the ghee milk tastes even better.

I should also note that I started taking turmeric again a couple days ago, after running out of supplements i just made my own and also put a lot of it on my cauliflower. i was also considering using it mixed with ghee to apply topically, but again, the mess it would make just isnt worth it to me when i have other good options.

well, hope the appt goes well. tomorrow hope to get up early, have a pain free BM, wash, sitz, and hope the CRS says good things about all this.
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Re: 8 weeks post-fissure - whats worked so far

Postby FromCroatia » 18 Mar 2017, 05:21

I feel so sad when I read all of this. What a nightmare we are living. Our world is ruled by poop and that should not be like that. Go to see your CRS because if this is NOT your first fissure it probably will re-tear because evwry time it heals it is making a new scar tissure over the old one and skin looses its flexibility. That was excatly what happened to me. And my fissure was made by doctor during examination for internal hemorrhoids so imagine...
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2nd trip the CRS

Postby healthybutt » 18 Mar 2017, 18:54

Thanks FromCroatia!

I just saw the CRS this morning.

My fissure is almost healed. This one healed very quickly -- usually it took closer to 3 weeks, but this one wasnt as bad as the others. Also I think eating wealthy, using the nitroglycerine and the balms/oils helped. I have been pain free since Day 3.

So he checked me out, I had mentioned a couple things he said previously: that my anal canal wasnt "that bad". He was like, yeah, it isnt. He said, it is a little tight, but no surgery. He said, the people with chronic fissures cant get theirs to heal because their inner sphincter muscle is so tight the blood wont flow there. Thats why even the nitroglyc doesnt work with these folks.

He also told me that the inner sphincter is beyond conscious control. He said, when you feel like you have to poop, you contract your external sphincter muscle is that one that holds it back -- the clinching action i talked about. The inner sphincter will do what it does -- I cannot control it. So I understand more now why people do self-dilation.

However he said it isnt the tissues themselves (i.e. scar tissue etc) he said it's the inner sphincter muscle thats the cause. This meant to me, that if my sphincter muscle were less tight, it wouldnt matter if i had previously had fissures.

Also when I told him I retore when I was taking like 7-8 g of fiber supplemenets everyday (psyllium), he said that was overboard. I wish he had told me the correct amount when I saw him last. I told him I basically followed the directions on the bottle. He said 2 capsules at each meal and be sure to drink water. He said that enough water was a must and he seemed to think that I re-tore with too much fiber not just because I took too much, but because I didnt have enough water. I seem to recall I was dehydrated the day before I got the fissure and I was dehydrated with this one, so I can agree with him there, that water is important. So I will be having to pee every hour now since I'm gonna drink lots of water again!

Also the magnesium came up again because he mentioned over time, if my poops were too watery, the inner sphincter would begin to tighten. I asked him, well this is what I have been going through the past few months -- he didnt seem to think that was the cause of this one or had made things tighter for me. He just said use it to soften not to get things watery. Easy to say when you dont have fissures! LOL. But now that I have the hang of it I am dosing the magnesium correctly, since my supplements come in 100mg increments (the one I used for 5 months only came in 500 mg capsules -- so it was either no effect or diarrhea...and when I tried to break up the capsules to get half doses it didnt work so well).

anyway, i again aske dhim about the surgery, almost baiting him, and he was like nope, you dont need it. he said, people get surgery so theres can be as open as yours is -- so it's normal. he said mine is normal, albeit on the tighter side of normal.

i will say i have had fissures dating back to teenage years, but they were few and far between, never this bad (like glass), and i usually never felt them after 1, maybe 2 days, even with shitty diet etc. So I know my ass is probably just tighter by nature. LOL. however getting them so frequently is still worrisome.

Oh CRS also said that the small sentinal tag I have and the small hemmie are not problems and do not affect the fissure formation or healing. Yay! God forbid I need surgery on those -- have read about the pain here and dreaded that.

After being probed, I treated myself to some vegan pizza! I was gonna get real pizza, but whole foods had vegan that looked good so i said why not, and aso my friend who owns a pizzeria and makes vegan pizzas said vegan cheese is pretty good. I tried it -- yum! It was delicious. Vegan cheese is pretty delicious -- tastier than mozz. I also splurged and got guacamole on sale and am gonna eat some with carrots since I stopped buying tortilla chips to prevent unhealthy binges.

I think turning my diet around as been the only good part of this. I feel much healthier and look my body is healing itself faster. Even my psoriasis is better.

Current supplements:
- Fish oil (~2100 mg EPA/day)
- Vitamin D3 (1000 mg/day )
- Turmeric (2-3 caps a day, I think each cap is ~500 mg, plus use in cooking)
- Psyllium (1 capsule (the equivalent I think of 0.5 g fiber) with each meal if I feel I dont have enough fiber in that meal)
- Just received glucosamine / msm supplement -- going to take 1-2/day, dont know the dosage since I'm away from what has now become my pill shelf. Had read people recommending MSM.
- Mg (800 mg/day)

Also got my coffee bean silicone tray to make suppositories with -- gonna do that later. I was joking to myself I should make suppositories for people like me and call them "butt lozenges"

Well it's a beautiful day! Helps that I had a glorious, nearly normal, and pain free poop this am and that my broken butt is almost healed. ALso helps that now I dont have to make the decision about whether to have surgery -- the surgeon was pretty emphatic about me not going under the knife. I guess I could get a 2nd opinion -- when this happens again, but hopefully that doesnt happen.

TL;DR: CRS said I dont need LIS, that I am normal but on the tighter side, and that I can take magnesium and psyllium to manage it. Basically, he said it's a management issue for me. Which makes me happy and sad at same time!
Last edited by healthybutt on 19 Mar 2017, 14:37, edited 1 time in total.
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original post here from december 2016

Postby healthybutt » 18 Mar 2017, 19:07

I wanted to keep all my notes in one place -- esp as it relates to CRS advice.
---------------------
Hi everyone,

I've been reading on here for the past 6 months when my fissure wouldnt heal, and I didnt quite understand why, as they had always healed within a couple days in the past. I tried a bunch of things, but after a few weeks found that Magnesium (Mg) was the best, although occasionally it would result in 3-4 trips to the bathroom the next day...but at least it didnt hurt. Constipation has never been my problem, but hard stools resulting from lack of water and possibly lack of fiber and overdoses of stress.

Like many of you, you feel healed after a few weeks, start to get complacent, then BAM. Fissure returns. I finally decided to go see a CRS and got nitroglcyerin ointment. He told me to ease off the Mg and add fiber (psyllium). This was the interesting thing he told me. He said that if I continued having runny poops on the Magnesium, my sphincter muscle (cant remember which) will not be able to expand as much as it had before -- I guess it begins to atrophy. He said adding fiber would help restore the muscle's function and so once I was healed, I'd be able to pass normal BMs once again without tears -- whereas if I constantly used Mg and then stopped suddenly, I would probably get a tear because my muscle wouldnt be able to expand to handle it (he did a nice demo of the spincter muscles and anal canal by opening and closing his fists). He said I could slowly add fiber and wean myself off Mg (I was taking 1000 mg/day at this point)...and he said my sphincter muscle wasnt "that bad" and not something he would consider requiring surgical. My fissure had almost healed at this point and I wasnt in pain, so I felt pretty good and relieved after seeing the CRS finally. (Word of advice: Go see a CRS. I wish I had done this back in the trial and error phase in the first few weeks). I felt I didnt even need the ointment at this point, and used it only for a couple days then went about my pain free way for 3 weeks.

I followed the CRS' advice, afraid that I would always need a huge dose of Mg and possibly loose stools for the rest of my life if I didnt add more bulk to my stool. Added only about 1 tsp of metamucil a day first, then 1 tsp in the morning and 1 in the pm. I eventually got down to about 500 mg Mg a day with the fiber and was impressed by my poops, the way only people with a fissure can look triumphantly at their poop when they have a pain-free BM.

But one day I upped my fiber content (at this point i had used up my metamucil and switched to psyllium pills from Costco, so I was taking about 9 g of fiber pills a day (half in am and half in pm)) and didnt drink enough water. I got complacent and even drank coffee that day. I took Mg as usual, but I think the culprit was not drinking enough water. It wasnt a full blown pass out from the pain kind of tears I'd had earlier this year, but it was enough for some blood and panic. I kept up my fiber regimen and stepped up my Mg again, and even added a dose of good old miralax just for the hell of it. Started using the ointment again, too. Headaches :(

The 2nd day of the recurring fissure -- again another bulky poop to start with (it wasnt overly hard, but not soft and clean like the days of yore), followed by the deluge resulting from the Miralax and Magnesium...they dont call it "the runs" for nothing! I had a lot of water the previous day along with the Mg and Mlax, so I was outraged on top of my pain that my poops were still well formed initially, perhaps the dreaded initial firmer plug that some people get (it was real, not just because my sphincter was tight). Fine then, I took 1500 Mg, determined to really make things soft and loose (I gave the miralax a break this time. Also noteworthy -- my CRS said it is fine to take Miralax daily everyday for those worried about that). I did a sitz bath, continued w/ ointment, drank water, about 8 g of fiber, lots of fruits and veggies...

So this morning was expecting nothing short of Niagara, only to have another relatively bulky difficult passage resulting in minor pain, which I think I lessened considerably by assuming a semi-squatting position and vigorously jiggling my ass cheek and kind of moving my pelvis back and forth while still seated in a semi-squat -- yeah it sounds weird, but I think it helped and also it was a nice little 2 min cardio workout to keep a steady jiggle, almost like i was trying to push it along with my ass cheek. Then after I got to work, the waterypoopworks turned on from all the Mg, but even that poop seemed firmer and bigger than usual.

My only conclusion is that I was taking too much fiber. I generally eat healthy but go on occasional cheese binges, which also happened the day before the fissure returned. Perhaps I added too much bulk too fast. So whenm your CRS tells you to add fiber, dont go nutso with it like I started to do after 2-3 weeks. Especially if you already eat a decent amount (altho I think I probably dont come close to eating the recommended daily dose even tho I have a few servings of veggies/fruits a day usually).

Anyway, so I'm back on the path towards healing -- nitroglycerin cream, Mg, maybe Miralax if things get dicey, sitz baths, hot water bottles on my bum at night, and after reading here again am gonna try to lube the area before a BM with vaseline to see if that helps while the wound is healing. I am only taking 3 g psyllium a day now, as I dont want to risk the bulks. I am meeting with a naturopathic doctor in 4 days regarding this, too, since the CRS cant really help with nutritional advice and am wondering if there is some way to speed up healing with diet and even acupuncture? Havent looked into it, but thats the ND's job!

Best of luck to all of you and happy holidays. <3
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Re: 8 weeks post-fissure - whats worked so far

Postby FromCroatia » 19 Mar 2017, 07:16

You will see with time. I am 7th day post surgery so I'm using laxative to make my BM watery. It hurts incredible. What do you think, am I going to be too tight again because of it?
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Re: 8 weeks post-fissure - whats worked so far

Postby healthybutt » 19 Mar 2017, 14:29

Hi FromCroatia,

No, not at all. You had an LIS right? That will definitely take care of any tightness, permanently. Also, 7 days of watery poop is not something I would worry about even if you hadnt had an LIS. I was having watery poops for weeks between may and nov, on and off for 6 months, and the CRS did not seem to think this was an issue. Granted, I had some normal BMs for a couple weeks before I retore and was back to watery poops again, so it was very cyclical, but I do recall there was a 3 week stretch before I went to the CRS the first time in mid-Nov where things were watery almost every day. However usually there was some "body" to the BMs and it wasnt pure liquid, so I did give my sphincter a little workout I guess.

I would say you have nothing to worry about. Happy healing!
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Re: 8 weeks post-fissure - whats worked so far

Postby FromCroatia » 19 Mar 2017, 16:19

Yeah, I had very big anal fissure together with huge sentinel pile ans inner mucose polip. My doctor cut off edges of fissure so it may heal by itself. Also he cut off sentinel pile and polip. All together. Nothing hurts now but inner polip place. God it hurts so much that I'm asking God to take me in heaven every time I have BM. It is breathless pain. Than I take ibuprofen 600mg and I'm pain free. I just hope to be normal soon because I miss my job soooooo much. Im teacher and I miss teaching and classroom. That's my whole life. ❤
How have you been today? How's your fissure? All the best, blessings from Croatia.
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Re: 8 weeks post-fissure - whats worked so far

Postby healthybutt » 19 Mar 2017, 23:56

Wow FromCroatia I am so sorry to hear you are in such intense pain! I am glad though that the iburpofen helps with that. I thought you originally had an LIS. It sounds like you had a lot done; glad there is only 1 spot bothering you. I have a small sentinel tag and external hemmie and the doc said no need to remove it, thankfully, because I have heard that is more painful than a fissure! I hope you are able to get back to work soon. Hopefully 1 more week of healing? It is a good sign though when you can manage your pain with just ibuprofen.

My fissure is pretty much healed and I had a nice, fiber-rich day! Haha. I am still using the suppositories I made though to keep that area lubricated and to hopefully aid in making the scar tissue less of a problem. Thanks for asking!
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