:hi: everyone,

I just had an expereince today that I thought I should share with you folks. So far, it has been much better and more simple than I ever expected (knock on wood). We'll see if that keeps up.

I GOT BOTOXed.:!:

It was a really simple procedure. I basically went in to the CRS, told him about my troubles over the past year and a half (including the fissure, the healed fissure, the abscess, and the gigantic cut). I also told him that the nitro and the nifedipine did not help me while I had period cramps, and that the cramps were really detrimental to my healing process.

He did an initial exam and saw that I did indeed have a fissure (like anyone would lie about such a thing!) and then said he explained that Botox would probabaly not be the panacea I was hoping for. I responded that I fully understoof that I would not be healed immediately, but that I was looking for something to cut through the pain of the sphincter tightness and give me an edge on the healing. He returned that that was reasonable, but I should also be forewarned that there is the possibility of incontinence and infection. To which I queried, "isn't the incontinence something that would wear off in 6 mos max?" and "has anyone you injected ever got an infection?" His answers were "in most cases, but not all. Still there's less of a chance of incontinence with Botox than LIS" and "no, but I don't do this on a daily basis."

I said I understood all of this and he said he would be right back with the Botox. :pale:

Needless to say (but I will say anyway), I was a little surprised by this turn of events, paniced more like. After all, I was expecting this to be a preliminary visit to see if I was a candidate for Botox. Also, I had been asking for Botox for so long that I thought I would have to return for a procedure! I debated about putting my pants back on and running out the door. But then I checked myself and reminded myself of yesterday's tear filled afternoon!

The dr. asked if I wanted something to numb my butt for the shots, and then reminded me that the numbing shot would also be a shot. I said no and braced myself for the pain.

But there was some, but not nearly as much as during my daily bms. There was no need for a scope during the procedure, as the injection sites (one on either side of the cut) were about 1/2 inch tops from the outside in the bottom verge of the internal sphincter.

Afterwards, I thanked the Dr., walked downstairs, got in the car, and drove myself to my lunch meeting. No pain afterwards. Maybe a little, tiny, tiny bit of tenderness at one of the injetion sites, but that could just be my imagination. And my sphincter is noticeably more relaxed, though not completely relaxed, which I guess is a good thing.

Post-op care is sitzbaths and pantyliners. So for me, absolutely no change in routine.

Well, I am definitely rooting for you! Sounds like you got more attention in one visit than most of us get throughout the course of our AF! If you play your cards right and stay on the diet and manage not to get too stressed, who knows but you might actually see the fissure healed as a result!
Just keep us posted and let us know how you handle it, and how well it manages your pain over the next few weeks!

Post-op care is sitzbaths and pantyliners. So for me, absolutely no change in routine. Right, keep up the routine, now more than ever!
Good luck!

Congrats on taking a big step toward healing. It was probably good that he just did it right then so you didn't have much time to worry about it plus that saves you some time having to come back for a separate visit.
You will have to keep us updated on how you feel, and any side effects you notice.
Thanks for the run-down of what happened-that will really be useful for others thinking about the same thing.
Great job, Buttgirl!

Thanks for the support. I will. And I will keep posting!!

I saw a new CRS today and he actually seemed to listen to me and pay attention. I think I'll stick with him even though he is nearly an hour drive away.

Wow-you will have to pass on his name. I know we are all looking for good CRS doctors. What part of the country are you in?

I'm in Southern California. He is at the Lakeview Kaiser, and his name is Anil Bahadursingh.

you go butt'botox'girl!
and what a trooper to get the shots without numbing!!! :-)
not to freak you out, but make sure you are clean back there after every poop because there is a high incidence of the site of botox shots to turn into an opening of a fistula/abscess.
just a precaution.

Hi,
thanks for the warning. and thanks to everyone for the encouragement.
it is day two after the botox. Having heard stories of incontinence, roids, abcesses and pain, I think I have had a good experience. I am having a minor problem with a roid, but the roid itself was from my mishap the other week (blood but not from the fissure). since the injection site was right next to the roid, it irritated the roid a bit. It throbbed yesterday after poo #2, but it is fine this morning and stings only when I think about it. that has been the only downside so far.
i am making sure to keep extra clean and take my sitz baths religiously. I also wash with an antibacterial soap while sitzbathing, and I have decided to take the last of my metroniadazole (flagyl), which I was given after my Feb anal surgery. I am also applying neosporin to the area as well as monistat (dont want to kill too much bateria and leave room for yeast to grow).
Now, on the plus side, I have had no spasms, even when the area around the sphincter seems to want to spasm, the actual sphincter hasn't. Yippee! Most of the tension (what the CRS called my rock hard sphincter) has receeded, though the muscle still has tone. And BEST OF ALL, it has not hurt to poo for the past two days!! I have had a quite soft stools as a side effect from the flagyl, but even then, the stinging soreness that I would usually get is no longer. I was worried about incontinence, especially with the really soft poos, but I have had no problems. It is easier to fart though! (something my significant other fails to appreciate, but he just can't understand how nice it is to fart without pain). Also, when applying the ointments, even when pressing on the fissure area, I can barely feel it (it's still there I know, but the pain is very much reduced).
All things considered, so far and knock on wood, the experience has been a good one. and if i am not completely healed in by the time the botox wears off, I would definitely go in and ask for another couple of shots.
And really, about the shots, as someone who hates needles and often passes out from shots/blood draws, the shots in the rear were not bad at all, especially compared to what was the daily pain of pooing everyday.
I'll keep posting on this subject and let you know if there are any developments, good or bad.

Awesome. Really glad to hear the botox is working well for you so far. Thanks for posting your update...and would definitely like to hear how you're doing in the coming weeks/months. My doc mentioned botox as a possible next step if the nifedipine does not work.
Be well!
steve

Thanks for the update! I am so happy to hear that you are going to the bathroom without pain and no major complications from the botox. That is wonderful news-thanks for keeping us in the loop with everything.
Have a great weekend,
Lecia