Botox or not?

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Botox or not?

Postby William2 » 04 May 2017, 06:04

It's been three-and-a-half months since I first got my fissure, and it's still not healed. It seemed to be almost healed, until a bad BM incident last week that resulted in blood for the first time in over a month. I got into my CRS that day, and he said that after the three-month mark it's probably time for Botox. So, I got scheduled for next week.

Since the BM incident, I've had more stinging and burning, and sometimes more discomfort while sitting than before. However, there are other times when I feel totally normal and can actually sit with less pain than before. It seems almost random. There hasn't been any more blood or any significant spasms since the BM incident, and I can function more or less normally (except the sitting part).

I started using a refill of the nifedipine on the day of the incident, and have noticed stronger side effects from it (so it may be more potent). That may explain some of the feeling better.

I guess my dilemma is: is having Botox an unnecessary risk at this point? Should I cancel it and try to heal a bit longer? Or, is it time to do it? One benefit would be that he could clean up the fissure so it could heal better. But the procedure may cause other problems.

Anyone have advice?
8/09 - 12/10: fissure, cured by LIS/fissurectomy
1/17 - present: fissure/hemms, healed but pain remained, 3 CRSs (nifedipine, infrared coag) were no help, cold dilating >= 1" helped but still have pain when sitting
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Re: Botox or not?

Postby Jamesscott96 » 04 May 2017, 06:14

William2 wrote:It's been three-and-a-half months since I first got my fissure, and it's still not healed. It seemed to be almost healed, until a bad BM incident last week that resulted in blood for the first time in over a month. I got into my CRS that day, and he said that after the three-month mark it's probably time for Botox. So, I got scheduled for next week.

Since the BM incident, I've had more stinging and burning, and sometimes more discomfort while sitting than before. However, there are other times when I feel totally normal and can actually sit with less pain than before. It seems almost random. There hasn't been any more blood or any significant spasms since the BM incident, and I can function more or less normally (except the sitting part).

I started using a refill of the nifedipine on the day of the incident, and have noticed stronger side effects from it (so it may be more potent). That may explain some of the feeling better.

I guess my dilemma is: is having Botox an unnecessary risk at this point? Should I cancel it and try to heal a bit longer? Or, is it time to do it? One benefit would be that he could clean up the fissure so it could heal better. But the procedure may cause other problems.

Anyone have advice?


hiya i have had my anal fissure for about 7 months i was originally to go for botox but i felt the pain was to much for a hit and miss as have heard the percentage is same as the cream so i begged for lis, waiting till 10th now

i get the discomfort feeling also, if its not that its the stinging / slight burning ( tbh idk whats worst lol ) but i would beg for lis if the pain is really getting you down , i read on your profile you previously had lis . did you continue with the diet you are at now ( loads of water 25g of fibre a day etc ) maybe stress cause you retore , it is possible i am sure ( as im a very stressful person also ) but i would recommend advanced anal flaps. have heard thats normally next step if lis doesnt work ( something about the wound needs healing etc from the lis surgery )
but yea how was your lis? did it help
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Re: Botox or not?

Postby William2 » 04 May 2017, 06:47

After the LIS, I had six years without any fissures. I was under the impression that any new fissures would heal quickly because of the LIS, but my current one clearly hasn't.

I definitely blame this fissure on stress. Although my diet has continued to be pretty good, I was drinking heavily and very stressed out for the two months prior to getting it. Stress has probably interfered with the healing as well.

The thing is, this fissure isn't horrible like the last one. The main thing that I can't do is spend much time sitting. Spasms and blood have been very rare. In general, it seems to be getting better, although slowly and with periodic setbacks. My CRS saw it clearly in my first two appointments (said it was superficial), but now has difficulty seeing it. My main concern is that the long healing time may lead to poor healing that is easily retorn.
8/09 - 12/10: fissure, cured by LIS/fissurectomy
1/17 - present: fissure/hemms, healed but pain remained, 3 CRSs (nifedipine, infrared coag) were no help, cold dilating >= 1" helped but still have pain when sitting
William2
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Re: Botox or not?

Postby Jamesscott96 » 04 May 2017, 08:21

William2 wrote:After the LIS, I had six years without any fissures. I was under the impression that any new fissures would heal quickly because of the LIS, but my current one clearly hasn't.

I definitely blame this fissure on stress. Although my diet has continued to be pretty good, I was drinking heavily and very stressed out for the two months prior to getting it. Stress has probably interfered with the healing as well.

The thing is, this fissure isn't horrible like the last one. The main thing that I can't do is spend much time sitting. Spasms and blood have been very rare. In general, it seems to be getting better, although slowly and with periodic setbacks. My CRS saw it clearly in my first two appointments (said it was superficial), but now has difficulty seeing it. My main concern is that the long healing time may lead to poor healing that is easily retorn.


sorry for late reply, at least u had a good 6 years fissure free (y) i know its thrustrating and annoying i cant wait to feel normal again tbh and if anything the fissure has taught me to grow up lol im 21 was 20 when had fissure but was still immature in the mind slightly, didnt eat veg wasnt drinking alot etc i smoke alot of ganja which i find helps when im feeling low as hell with the pain or cant sleep but i find whenever i bm i just tear and in discomfort still. allday :( but u gotta keep strong i take gabapentin daily which helps alot but its always there yano.. for me atm
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Re: Botox or not?

Postby William2 » 06 May 2017, 18:44

I decided to postpone Botox. I'm constantly second-guessing my decision, but I just wasn't convinced that it was the best thing to do at this point.
8/09 - 12/10: fissure, cured by LIS/fissurectomy
1/17 - present: fissure/hemms, healed but pain remained, 3 CRSs (nifedipine, infrared coag) were no help, cold dilating >= 1" helped but still have pain when sitting
William2
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Re: Botox or not?

Postby William2 » 07 Jun 2017, 11:42

I was doing better and better and feeling that all I had was a hemmy (one that thrombosed around May 11 and has been shrinking since). After today's BM, which was slightly delayed, I saw blood and now have a sharp, worsening sting. I really hope it's the hemmy and not a fissure, because I don't think I can take dealing with that any more. However, I'm pessimistic. I'll wait until tomorrow to call the CRS to be sure. If it's a fissure, I might as well put a gun to my head right now.
8/09 - 12/10: fissure, cured by LIS/fissurectomy
1/17 - present: fissure/hemms, healed but pain remained, 3 CRSs (nifedipine, infrared coag) were no help, cold dilating >= 1" helped but still have pain when sitting
William2
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Posts: 129
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Joined: 27 Jan 2017, 08:33
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Re: Botox or not?

Postby patience_and_healing » 09 Jun 2017, 23:18

Life is precious and worth so much more than to throw it away for a fissure. You can get through this and whatever the problem is it will heal. It's a benign condition and treatable.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
On and off in pelvic physical therapy
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Re: Botox or not?

Postby William2 » 10 Jun 2017, 19:02

Sorry, when I have a setback I feel like I'll be handicapped by this forever and go down a grim emotional path. I'm doing a bit better now.
8/09 - 12/10: fissure, cured by LIS/fissurectomy
1/17 - present: fissure/hemms, healed but pain remained, 3 CRSs (nifedipine, infrared coag) were no help, cold dilating >= 1" helped but still have pain when sitting
William2
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Posts: 129
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Joined: 27 Jan 2017, 08:33
Location: New Hampshire
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Re: Botox or not?

Postby patience_and_healing » 10 Jun 2017, 23:00

There's a great book that might help you called 'You are not your pain' that addresses the problem of 'secondary pain' which is all the thoughts and feeling associated with pain, besides the pain itself. I found it to be very eye opening and it's changed the way I react to pain. It's not a magical cure but it may just help to reduce the stress associated with pain.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
On and off in pelvic physical therapy
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