Chicken or the Egg

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Chicken or the Egg

Postby StlMom475 » 22 Jun 2017, 12:03

Having spent a lot of time on this forum looking for answers and learning from other's experiences, I thought I should start this diary before I go forgetting anything about my journey...which is really what having a fissure is.
Chapter 1: Mine started in January with a bad stomach bug and a lot of diarrhea. By February I knew something wasn't right back there mostly due to acute pain during bm and made an appointment with a local proctologist. He diagnosed a fissure on the posterior side and also did some other painful stuff for some internal hemorrhoids. I drove back to work with the worst pain yet -- I think this may have been when the spasm started. I did some cort steriod enemas for the next week at his direction - the result was terrible cramping the first night and no benefit at all. I also got a nifedipine ointment and started applying externally. I did this for the next month with no improvement.
Last edited by StlMom475 on 22 Jun 2017, 12:40, edited 1 time in total.
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Re: Chicken or the Egg

Postby StlMom475 » 22 Jun 2017, 12:03

Chapter 2: About a month after the visit to Dr. Proctologist, I was about to make a follow up appointment when I "Bing" searched him to find his phone number. What hadn't shown up on Google the first time I looked him up was a criminal record. Turns out the guy was a former cocaine dealer. I decided to see a different doc and got a referral to a Colo-Rectal Surgeon from my PCP. My first visit to him, he said my hemorrhoids were no big deal (just something literally everyone has). Because I'm 36, he thought I was too young to have LIS surgery. He recommended Botox, and I went forth with that a few weeks later.
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Re: Chicken or the Egg

Postby StlMom475 » 22 Jun 2017, 12:08

Chapter 3: The Botox procedure itself went ok I suppose, but I experienced terrible pain that evening until I pulled out the packing (which the doctor gave me zero direction on) while in a sitz bath. Long-story-short: the Botox unfortunately did not help me at all. I went back to the doctor a month later in exactly the same condition as before the procedure (minus some money). I still experienced the painful muscle aches/spasms about 10-15 minutes after a bm and continuing for an hour or more depending on if I had multiple bms. I tried taking stool softeners as recommended, but I found that resulted in too loose/frequent bms that just exacerbated the pain.

During this time I tried concocting my own suppositories with coconut oil, calendula, and a small amount of tea tree oil. They may have helped some, but were certainly no miracle cure.

The CRS offered to perform a flap procedure or just continue the nifedipine ointment. Having researched the flap surgery on this forum and elsewhere, I decided I was not ready for that. I switched to applying the nifedipine internally with a slip-tip syringe multiple times a day. It didn't help a whole lot either.
Last edited by StlMom475 on 22 Jun 2017, 12:38, edited 2 times in total.
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Re: Chicken or the Egg

Postby StlMom475 » 22 Jun 2017, 12:16

Chapter 4: I left the CRS office the day of the follow up in tears. I did not want another surgery and I was frustrated. I hit this forum heavily to try to find answers. I had yet to have anyone address why I was getting the pains post-bm. I started to read some posts about pelvic floor issues and I wondered what part that was playing in my issues. it was around this time that I was also disturbed by my inability to feel like I was completely emptying my bowels sometimes when I would have a bm. At some point it was like a light-bulb went off and I started splinting (I didn't know that was what it was called, but I put my finger in my vagina to assist in emptying my bowels during a bm). I read about the rectocele condition and it sounded like I might have one. I purchased "Heal Pelvic Pain" by Amy Stein to see if it would make any difference, and I made an appointment with my ob-gyn.
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Re: Chicken or the Egg

Postby StlMom475 » 22 Jun 2017, 12:23

Chapter 5: At this point, my husband is pretty worried about this problem and he accompanies me to my ob-gyn appointment. I LOVE my ob. She delivered both of my children (ages 4 and 6 and yes, both vaginally so that's probably part of my problem too). She is honest, sincere, caring, and everything I needed and wasn't getting from my drug-dealing procologist or too-busy CRS. She confirmed what I thought - I had a rectocele. She said it was possible that the rectocele caused the fissure, by maybe causing a constipated pocket. I think it definitely could have contributed in that I know I was pushing to try to empty my bowels before I started splinting.
She said I could have surgery for this (as well as for my partial uterine prolapse and cystocele). But I teared up when she mentioned surgery and she said we should wait on that. Instead she referred me to a local pelvic floor physical therapist and said she may be able to help some, although it wouldn't fix the rectocele completely. I at least felt like I was on the path to understanding this thing for once, even though there was no easy fix.

At the same time, my husband pushed me to take some time off work so I could also focus on general relaxation. I decided it was probably a good idea. I also needed some time to figure out if I should modify my diet. I've discovered that eating what I thought was a good diet - Lots of fiber, vegetables, fruit - was probably doing my butt more harm than good. Of course, fried food didn't help either. The days I was having loose bm's I would also have more bm's and that was the worst for my pain. I rethought my diet and tried to focus on very neutral white grains and non-greasy proteins and hoped my waistline wouldn't be growing too much.
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Re: Chicken or the Egg

Postby StlMom475 » 22 Jun 2017, 12:32

Chapter 6: I finally got in to see the pelvic floor physical therapist. I explained to her what was going on and then she did an exam. She put a finger in my vagina and had me do some tightening/relaxing to see what was going on. Then she put a finger in my rectum and I did more tightening/relaxing (I will also note she was much more gentle with the insertion than my CRS...why is that?). She described my pelvic floor as having a good foundation and good strength, but compared it to an elevator: My elevator goes from the 1st floor to the 10th okay, it goes back down a little slower, but when I'm resting it wants to hang out on the 3rd floor. She gave me 3 "exercises" to work on getting my pelvic floor to hang out on the 1st floor. The first is just deep breathing. The second is a "contract/relax/bulge"...like a Kegel but with an extra focus on pushing at the end. The third was a deep squat. I had to do reps of these three times a day and see her again in two weeks. She thought she would see me a total of 3 or 4 more times. Wow, I felt significantly better about the prospects of this. About this same time I took a little while off work to try to relax and focus on getting better (yes I am very fortunate for the ability to do this).
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