They inject about 1 cm up the anal canal in the intersphincteric space. It is really close to the opening and no anoscopes or anything are needed. My CRS used a really small needle and I would have had no problems if I didn't give myself a small roid in the area a couple days prior.
I didn't worry about the injections because I have had several needles poked in the area with no ill effect. When I had the abscess surgery in Feb, I had the numbing shot and a couple of stitches, so I figured one super small needle injecting me in a couple of places could be no worse.

Another update:

Three weeks since the injections and still no fissure pain. Yey, Botox!!

I also think I figured out what was keeping the roid somewhat irritated (besides the poo that is)--my sitzbath! I thought it might be because all the lit says to not sit on the toilet for too long if you have a roid, and i was sitting on the sitzbath, which is "on the toilet," for 20 mins 3-4 times a day. So I cut those down yesterday to a quick soak and wash and have felt improvement in the roid. I also started taking Rutin, a bioflavanoid which is supposed to promote vein health.

It's so weird. Treating this is almost the opposite of treating the fissure in terms of heat and soaking.

Hey Buttgirl,
I am so thrilled you aren't having any more fissure pain and have figured out what may be keeping your hemorrhoid from healing. You could even try using a really warm/hot washcloth and keep unfolding it as it cools.
I take Rutin too and have for several years to help with vein health. You could also look into Diosimin/hesperidin complex too.
Lecia

Thanks. Me too. I'm still in disbelief and every monring when i am getting ready to bm, I am afraid this will be the day I reinjure myself. Then after the bm, I am thrilled and shocked that there was no pain and no reinjury. you mentioned fissure fear before, how's this--after bm, I have even thought to myself that I might have reinjured the fissure so bad that I just couldn't feel it right away and i have braced myself for the pain to set in. Geez, this condition can really play with a gals' head.

I'll take a look for that at the Health Food store. Thanks yet again Lecia.

LOL! I know what you mean. Pain and fear can really mess with your head. Yeah, you almost have disbelief that you are getting better. I have always had a problem with "waiting for the other shoe to drop." Like I am fine today but something will happen to screw that up. So instead of enjoying being relatively pain free I start to worry about what if the next day it gets worse!

Oh. I forgot to mention for the gals:
This was period week too, and still not cramps/spasms!! Super yey!!

One last update, since I haven't done so in a while:

Fissure pain still gone. I've eaten chunks of cheese twice over the past week and no retear, extra soreness, nothing. Of course, I'm not overdoing the cheese and still doing the fiber water thing. But still super duper yippee!! yey botox!, though I still feel like I have to knock on wood.

Mini-roid pain steadily decreasing. I can sit on a heating pad again without the area throbbing. I also found that lanolin (stuff used by nursing mothers for nipple chaffing) works wonders on cutting down the irritation and burning of the roid. I also noticed that a soap I have been using makes the area sting, so I stopped using that. Also, I can't remember who posted about a yeast infection, but I figured it couldn't hurt to add a little miconozole to the lanolin. Whatever the case, I'm not totally roid-burn free yet, but I am to be improving.

Yesterday, went to see the CRS who Botoxed me. He checked me out, but not with the anoscope because he did not want to risk retear. He said the spasms are MUCH better than when he saw me the first time (duh!). And he also said to come back in 2-3 mos if the roid is still bothering me and we'd do something then. He is reluctant to do anything now because he doesn't want to probe me and injure the fragile new scar over the fissure and thus negate the progress on the fissure. (Interestingly, he's the first one who had cared about not reinjuring me. All the other drs I've seen have been like, "let me jam this device up there and take a look-see.")

Anyway, yey Botox!


P.S. I know a numer of people on the board are considering Botox. Even though my experience with Botox has been positive, I hear that it is not so for everyone. According to the medical lit, it only helps about 50% of patients and there are several patients who need to go in for a second dose three months after the first for complete healing. I have also read in the medical lit that the percentage goes up to about 80% when GTN is used in conjunction with the Botox, but this doesn't seem to be widely practiced. At any rate, though it did work well for me, it is not a miracle cure. Still, I think it's one that should be considered.

Thank you Buttgirl for sharing your journey with us. You are our botox babe here and it is so good to have someone who can document the process and help others who are considering taking this road.
Hope the mini-hemmie behaves and resolves soon. That is interesting about the lanolin-I used that when I was nursing but never thought to apply it down there. Good to keep in the back of my mind.
Thanks again and hope you continue to do well!