Hi Everyone,
I just wanted to first start off by saying how great this forum is. It has really helped me over the last couple of months (and scared me some as well)
Just to let everyone know where I am coming from-
I was originally diagnosed with an AF back at the end of August. I went through the usual route of trying to cure it with sitz bath's and a change in diet habits. That did not work.
I went to my doctor and he gave me nitro cream. Boy did that stuff suck. It did resolve the pain issue but left me with pounding headaches, at that point though I would opt for the headaches over the pain. After two weeks I began to get used to the nitro and it was becoming less and less effective. A month later I ended up making an appointment with a CRS surgeon at a hospital near my work and he diagnosed me with a chronic AF, and gave me .2% nifedepine ointment to try for three weeks and told me to start taking Konsyl (boy is that stuff nasty). Anyway, three weeks pass and I feel like the nifedepine is not really doing anything. At the recommendation of my wife and family, I was luckily enough to get the name of one of the top CRS surgeons in the state of MA. I learned a heck of a lot from that visit. #1- .2% nifedepine is very weak stuff, he wasn't that surprised that it didn't work. He prescribed me 2% which only after a week, I could feel a huge difference. #2- He said the success rate of Botox is anywhere between 50-70% and he did not want to jump to surgery especially if the nifedepine was working. So I went in yesterday for Botox. According to him, the usual dose is 30 units? He gave me 100 units. Anyway, I did not go under general anesthesia or get any sort of numbing agent. It hurt but not as bad as I thought. So onto today, I am still pretty sore at where he poked me and the fissure is about a 5 out of 10 on the pain scale. I will report back by this weekend when hopefully the botox has taken affect.
Sorry for the novel, but I just wanted to thank everyone so much for sharing their stories.

Hey Rusty,
Your trajectory to this point and mine share many parallels :)
I also developed a fissure back in early summer, and have went through 0.2% nitro, 0.2% nifedipine (still currently using both), and one round of Botox. The Botox helped for about a month but that was about it in my case. I did it without anesthesia as well -- not the most fun I've ever had but certainly tolerable. My rear was sore for a few weeks too. I haven't tried stronger ointments than 0.2% though.
I'm also trying to avoid surgery, because my fissure no longer causes the supreme pain it once did. Now it only causes mild-moderate pain during bowel movements with occasional bleeding, so I've been lazy about getting it taken care of.
Keep us posted on how you do with Botox. I've been thinking about going back for another round but have just been busy with other stuff lately. It's on my to-to list though.

Welcome Rusty!
I had fissures on and off for years, and finally had one decide to stick around for 6 months. I also tried the creams, sitz baths, diet changes, etc. Some worked, some not so much. It took some searching, but I found a CRS who said that LIS would help me (unlike previous drs. who thought it wouldn't due to other issues).
I can honestly say - it was the best thing I have ever done! My pain scale has been a zero - a zero! - when it was sometimes a 10 or 11. No bleeding, no incontinence issues. If the botox doesn't work, go back in and see if the LIS is a viable option for you. I feel like I have my life back finally!
Good luck ~ this is a great board to search through, bounce ideas off, and get some solid support from super nice people!

welcome mate to the board. theres loads of info on here, which am sure some you will find helpful
as busynum said
"Good luck ~ this is a great board to search through, bounce ideas off, and get some solid support from super nice people!"
again welcome and dont be afraid to ask anything whatever it maybe.