What is working for me

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What is working for me

Postby Guest » 23 Jun 2007, 12:08

I am a 48 year old male who is new to this forum. I also happen to be a physician, but my specialty is radiology. I developed an anal fissure July 11, 2006 ( I remember the date well. . . ) Since that time, I have tried NUMEROUS different therapies including various creams and mixtures which I will list below. I saw a colorectal surgeon and also had a botox injection last March. Here is a summary of what worked - and didnt work - for me:
1) I first thought I had a recurrence of my hemmorhoids; ythat was a big mistake as I started using Preperation H creams and wipes (witch hazel) which aggravated my problem at first. I tried several other steroid type creams (prescription and non-prescription types) as well.
2) Still thinking hemorrhoids, I tried various sprays and suppositories next. These worsened the pain and did nothing to help the fissure heal.
3) After diagnosing myself with a fissure, I tried the nitro and nifedipine creams. No help; the nitro gave me headaches that I could tolerate, but 6 months of use did nothing for me. I even went so far as to try the 2% nitro used for cardiac issues. Still no help.
4) I experimented with treatments suggested on various forums like Tinactin, lip balms and menthol-containing gels like Vicks Vapo-Rub. No help at all.
5) I tried softening my stools with homemade and medical concoctions including olive oils, metamucil, colace and mineral oil. These helped soften the stool, but some must have altered the quality of the stools significantly as lots of burning and pain accompanied my bowel movements.
6) The botox injection made absolutely no difference at all. I couldnt even tell anything was different afterwards. Whether the surgeon missed the spot or whether it just didnt work, I dont know.
Now, for what seems to be helping for the last week:
1) I take 2 Aleve before going to sleep around 11pm. I am very regular, and have bowel movements each morning at 7 when I get up. I think the Aleve helps to reduce pain levels and lets the sphincter relax.
2) I spray a small anount of Solarcaine on my anus when getting up; this has a good concentration of Benzocaine anesthetic and helps the sphincter to relax upon defacating ( usually 10-15 minutes later).
3) I am lucky to have a bidet in my home that I use after gentle wiping after my BM's. I use it on an all-cold setting. I think this further numbs the sphincter and prevents spasms.
4) After showering, I use Palmers cocoa butter skin treatment around the anal area. I believe this helps heal the dried, injured skin. I also spray a small amount of Walgreens aloe sunburn spray around my anal area once or twice a day if needed to reduce lingering pain.
5) I now take 2-1000 mg fish-oil supplements at night; I believe this has helped to lubricate the stools and facilitate voiding. Thanks to all of you on this forum for that idea!
6) Finally, I apply some Gold Bond Medicated powder to my anal area with a makeup brush before going to sleep. I believe this has helped healing as well.
I have now gone 7 days with nearly NO pain and NO bleeding for the first time in nearly a year. I truly think I have turned a corner in this arduous, painful process.
The items I note above are inexpensive, do not require a prescription, are unlikely to worsen things, and - at least for me - seem to be working!
I'd be happy to answer any questions that might help any of you. Thanks for all the great comments and advice that I have gotten from all of you, too.
Guest
 

Re: What is working for me

Postby Guest » 23 Jun 2007, 12:33

Thanks so much for taking the time to post and give us a run-down of what works for you. It was helpful and a very thoughtful contribution to the forum.
Welcome to our site and let us know how things continue to progress for you.
Take care!
Lecia
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Re: What is working for me

Postby mypoopyhurtsme » 23 Jun 2007, 13:49

Hey, thanks for the tips. Very glad to hear you're healing, and I wish you continued improvement.
I had one question...what's your diet like?
Thanks!
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Re: What is working for me

Postby Guest » 23 Jun 2007, 16:37

Since you are a medical profesional could I ask if you every considered LIS surgery?
Would you know more about the pros and cons?
Is your sphincter still tight but with out the spasms?
Do you take regular sitz baths?
I am so happy for you and your pain relief.
Thank you and continued health, Marie
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Re: What is working for me

Postby Guest » 23 Jun 2007, 21:05

mypoopyhurtsme wrote:Hey, thanks for the tips. Very glad to hear you're healing, and I wish you continued improvement.
I had one question...what's your diet like?
Thanks!

My diet was typical American - lots of red meat, occasional pastas and pizza and some seafood once in a while. I always have eaten lots of salads, though. Since this started, I've tried to add fiber-containing fruits and vegetables, along with lots of bran cereals. I've also added lots of water throughout the day. I do believe the diet changes have helped - if for nothing other than to make me more healthy - but in all honesty, getting the fissure to heal has taken MUCH more than that for me. I also must admit to a love of potato chips and snacks, which the fissure seems to hate about as much as I love them!
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Re: What is working for me

Postby Guest » 23 Jun 2007, 21:26

pillow wrote:Since you are a medical profesional could I ask if you every considered LIS surgery?
Would you know more about the pros and cons?
Is your sphincter still tight but with out the spasms?
Do you take regular sitz baths?
I am so happy for you and your pain relief.
Thank you and continued health, Marie

Absolutely I have considered the surgery. I consulted 2 experienced surgeons, both of whom claim that it would be a "piece of cake" and that I'd be back at work in 4-5 days. Unfortunately, as a physician, I do know that there are no 100% guarantees with ANYTHING surgical. Even with a very small chance of failure, my personal feeling is to avoid surgery until ABSOLUTELY necessary - like when the pain and or bleeding becomes intolerable for a majority of the day ( my worst days were bleeding after a BM and spasms for around 8 hours afterwards).
The pros and cons are well documented - quick relief of the spasm and pain with a lower recurrence rate than other treatments vs. a slim possibility of incontinence. You also always have the risk that the "cut" is not enough and there is always the chance of a post-op infection. I simply could not bring myself to accept that risk at this time of my life. Also, in all honesty, the concept of making a second cut to heal the first one just seems crazy, though the medical efficacy of the procedure is well accepted and has proven , by far, to be the best solution for chronic fissures. Many studies in the medical literature substantiate this. My STRONG advice would be to consult a colorectal surgeon with considerable experience in the procedure if you deem it necessary.
My sphincter does remain tight; but I have had NO spasms for a week now. The spasms are what causes the pain; mine were bad enough that I could not pass even the slightest amount of gas for 4-6 hours after a BM. I truly believe that the sunburn sprays (especially the Solarcaine) have had the most impact on the spasms. Believe me, it is worh the $6-7 gamble to try it out.
Yes, for a while I would take 3-4 baths per day, for 30-45 minutes at a time. They certainly help relax the sphincter, but again I had no real improvement over 10 months until I tried the regimen discussed above. I now take one 30 minute bath before bedtime.
I hope this helps; best of luck to you, Marie.
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Re: What is working for me

Postby Guest » 24 Jun 2007, 09:07

Wow Doc,
Ten months, I am sorry for your pain. I have had this fissure since dec 06 on and off pain, but ever since the first week of May 07 I have been having trouble lots of pain. Now its the end of June. I take baths 3x a day and I use my creams. I also have changed my diet and eat healthy with lots of water. But when do you draw the line? How long should one suffer with this AF pain before surgery??? All this pain and stress on your body can't be good either.
I know this is tough for all of us. My life has pretty much stopped for 2 months. Like I told Lecia on the good days I would do as much as I can just to catch up on simple household chores and grocery shopping. God I was even excited to do a little dusting thats sad.
I have since started nefedipine. I was good for three days and now for the past 3 day I have been in pain for the past 3 mornings. All this is very frustrating. But I hope we all get better soon. Thanks for listening.
BBG
Patty
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Re: What is working for me

Postby Guest » 24 Jun 2007, 16:57

burnbutgrl wrote:Wow Doc,
Ten months, I am sorry for your pain. I have had this fissure since dec 06 on and off pain, but ever since the first week of May 07 I have been having trouble lots of pain. Now its the end of June. I take baths 3x a day and I use my creams. I also have changed my diet and eat healthy with lots of water. But when do you draw the line? How long should one suffer with this AF pain before surgery??? All this pain and stress on your body can't be good either.
BBG
Patty

Patty,
I really believe the decision to have surgery is an independent one. The surgeons I have spoken to are conservative and suggested non-surgical therapy for as long as I could tolerate the pain and bleeding. As I noted above, it was nearly a year before I detected any improvement at all. I really can understand why people opt for the surgery, though, as the pain really got terrible for a long while for me. Stress clearly has an adverse effect as well.
I hope the nifedipine works for you; I really didnt get much effect with it myself.
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Re: What is working for me

Postby Guest » 24 Jun 2007, 17:04

Doc,

Thanks for the response. I hope the nifedipine works too because I really don't want to try nitro. I will try to go as long as I can before surgery. I just don't like when I have the spasms because my blood pressure shoots up (most likely everyones does)but I feel that can't be good for you either. I work in a medical office and I have the nurses check my BP every week. But I am willing to try as may non-surgical methods first. I may have to give up my summer but thats ok. Thanks again..Good luck to you too..:)

Patty
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Re: What is working for me

Postby dano » 24 Jun 2007, 21:29

im currently on the 2% nitro cream..its powerful stuff,if you have headaches on a lower dosage,2% will really send you in a tizzy! noticable difference in the spasms as well compared to the 1%...the 2% has been helping,im on it for 3 months.....i dont know what is after that though,seems its a long road to recovery using creams.fortunetly,my spasms arent too terrible,i know they are there,and i can feel it,but its not like i have to stop and sit down,or take a bath,though i did have a slight relapse the other day,and spasms are worse than theve been in months,but seems to improve quickly,usually a few hours in the morning then thats it till a bm in the evening,then again its short lived
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