OK- here is my newest report after SF CRS examination today.
Fissure is not visible by the eye but when she is touching an ex- fissure site she can feel some indentation - tiny one at the base of my famous skin tag.
Fissure can heal different rate on different parts of fissure.
My sphincter is tighter than it should be for fissure friendly environment.
Removal of a skin tag in this condition could lead to possible fissure forming.
Suggestion: Round of Botox + skin tag removal by cauter (sp. ?) Cauter is electrical device that would seal the wound and it will not bleed. She is not putting sutures - open wound is less likely to get infected in her experience and puncture wounds for sutures are extra trauma for the area. They can brake and make more injury.
Healing time - for me it would be about 4-6 weeks in her opinion since I am a slow healer ( I do not agree with it - my LIS closed in 2 days strait and fissure closed in 8 after fissurectomy that usually takes 11 weeks for healing). For "normal person" it will take 10 to 14 days for skin tag site to heal.
I have app. for second opinion Wednesday, but I already made an app. for surgery this Friday at Noon So, unless second person says something completely different - it would be IT ! I will not wait for "laser guy" for app. on 19th - I am just tiered of this and want it to be over with.
Any input is greatly appreciated
:linus:

Fissy,
See what the second opinion says. So this means you will be getting Botox and Cautery? The Botox will help with the tightness, you will notice that in about a week. Cautery I am not sur about. So see what that second doctor says. Good luck I think you will like the Botox.
Patty

It is so nice that you have a doctor that can do cauterization. I wonder why more docs don't do that if it makes for a closed site.

Is this the lady doctor that you liked or the one that did the operation?

It sounds like a sound plan to me. Glad they could get you in so quickly. I hate just waiting around. If I am going to be in pain it might as well be from healing!.

Keep us updated!

Years ago I had a small fissure that was cauterized and healed completely. This, unfortunately left my skin tag, but...you are having it to remove the skin tag, so it sounds like a great idea to me!! I say "Go for it"!!

Thank you all for fast replies !!! I am pacing in the house like lion in the cage . One part of me is telling me that pain that I have now is "manageable" - at least I can function normally :roll: , the other part is telling me to go ahead and help it heal completely ,hopefully :( . I know that something is wrong - how is it possible to be in less pain just a week after LIS than now ???!!! I also had long period of no pain in the anus whatsoever until 3 weeks ago . Just crazy !!!!
Patty - she will cut the darn tag out with a scissors and than just "seal" the edges (not together) - each for itself to stop bleeding. I don't know if it now sounds any better She was against removing it at all - she hates any cutting there period. It was me that think that this tag has to go since in my opinion it is on the way on the exit and over-stretches the anus when poop comes around since it is hard and bulbous - not regular skin tag
How much Botox hurt ??? Do you have any swelling ? She will give me some topical lidocain and some subcutaneous before the Botox - how they do it for you ?
Lecia- it is the lady from SF, not my original CRS that did LIS. She is very nice, but always tries to shy away when it comes to any cutting even though she herself suggested removal 3 weeks ago, and that makes me always nervous - I can never figure out why - is she concerned or had bad experiences or she just does not believe in cutting period ??? :pale: Than why she suggested it in the first place??? She also said that if I need LIS again it is customary that "original" CRS does it again - like she does not want any responsibility for his "screw up" - I don't know how to explain all of that. I always forget to ask some questions since once somebody is "in my butt" my brain just goes in some self induced coma.
Motherlorch- thanks for the encouraging words - makes me relax a little.
I am more nervous about this "superficial" procedures than LIS - am I crazy or what I think I am just scared to death not to make things worse because I hardly survived all that pain for 5 months - I really, REALLY wanted to die :( :( :(
Thanks again for all the input - it means a lot to me whatever you suggest.

:hi: Fiss,
It sounds like your Dr. has a plan to prevent future fissures from forming by using the botox during your procedure. It is scary to undergo new surgical procedures but it sounds like you need to get this taken care of so you can heal.
My Dr. from Mayo suggested cautery and botox for me if I continued not to heal.
You will be in my thoughts and prayers, for quick healing and for reassurance to know this is the right thing for you.
Hugs to you
:truebud: ,
Jo

What exactly is cautery? I have never read about that treatment method?
Fiss - Is the CRS Dr. Million? I saw her profile at my clinic here is Sin City.

Thanks Jo , it is nice to hear that other doctors have same approach, especially at Mayo. It sounds as a good plan - maybe I just need to calm down and trust my doctor. It is so hard when you have bad previous experience with other doctors :flush: .
I hope that you are feeling better and that you will not need any of the mentioned procedures

Hey Jen
Yes, her name is Dr. Million. Cauter is kind of electric wand that "burns" tissue instead of cutting it, so it is in some respect close to laser - it cuts and seals at the same time. I once found video clip of LIS performed with cauter , I am so sorry that I lost the link.
How are you doing ???

Fiss -
I don't think you have anything to worry about with Dr. Million. The doctors at the CRH clinic are very concervative (as you pointed out to me when I first went there). If she wants you to have this procedure, she must be very comfortable and confident it will be your savior. Get your second opion and try to relax - your on your way to being pain free - Look how far you have come!!
I am doing pretty good. Thanks for asking! :) I have had 2 RBL treatments done and I really notice a big difference. Alot of pain that I thought was fissure pain was actually hemmie pain. No more blood, no more swelling, and no more pressue. I never had prolapsing hemmies - but the swelling was horiffic! Since the swelling was happening around my fissure area, I thought it was the fissure getting infected. In my personal opinion, I think my fissure was popping open due to the hemmie swelling occuring in the same spot. I am still having occasional issues with my fissure (itching and a pinching feeling), but hopefully they are a sign of healing. I am still on the nitro (for 6 weeks now). I have been thinking of getting on a stronger dose as well. I do not think I am healed yet - but I am doing a hell of a lot better. I have an appointment on Wednesday and will keep everyone updated! :)
Jen