Since my failed Botox injections I have discussed it With many people, my best friend works for an eye specialist who uses Botox ALOT. He told her to tell me the problem was really that I only got two injections, one on either side of the fissure, I've read on the self help page that most people get four in each quadrant of the muscle. Dr J says because they only did one side, it wouldn't stop the entire muscle from spasming and probably caused more pulling on the fissure as the non paralyzed side would continue to spasm and try to compensate for the side that wasn't. Makes sense but I guess Botox is expensive and in Canada everything seems to b done conservatively because of cost(?) just guessing.... Yesterday my new niece was born and I talked to the doc who delivered both my girls and she assured me she has sent many patients to my CRS and that he is brilliant at what he does. For the last year I haven't found him very brilliant tho as I've been in pain for so long but I must admit that 4 yrs ago he banded my chronic hemmies and I thought then he was a god... My only hope is that he's as good at LIS as he is at getting rid of roids...it couldn't hurt to ask where the Botox will go and how many shots there will b. The shots themselves hurt like hell but as I've said before, afterwards I had 12 solid hours of NO PAIN which was the first time in a year. I did have some leakage when coughing or sneezing, if u feel this coming on after Botox just sit while coughing that seemed to keep it all in. I refused any more Botox and insisted on LIS which is in one month, I am also planning to try the sufrexal cream from Mexico which the doc down there told my mom heals fissures within WEEKS....I'm skeptical but willing to try anything at this point. After 30 yrs of misery(!) I'm sure u would too. Good luck I hope it works for you I know it has worked well for many.

Well, saw the doc today, he tried the finger exam but luckily for me gave up quickly saying the muscle was still too tense. So now he is going to send me to a surgeon who will decide if they give me the botox or surgery. This will take some time though it seems, like a month at least. In the meantime there's not much I can do except endure the pain and he gave me a fresh tube of nifedipine :(

Ok I'm seeing the surgeon in a couple of weeks. In the meantime I've had a re-tear (well the chronic tear was still there, by re-tear I mean it got bigger) with some blood involved. Not much, but it was there. Normally my chronic AF doesn't bleed (hasn't bled in months on end for example).
But one strange thing: I always have two BMs in the morning when I wake up. They are not VERY painful, but about 1h after the pain starts and lasts until 2-3 pm, peaking around 11am. I guess it's spasms, because I can feel the muscle being REALLY tight. Then the pain subsides and in the evening the muscle is REALLY loose, like no AF at all.
What's even stranger is that if I have a BM in the PM (which is rare, but happens), even if there is a bit of blood, there is no pain AND NO SPASMS after that. It's like the muscle only spasms morning through afternoon, no matter what.
Anyone got a clue why this might be?
ps: nifedipine is used in the AM and PM, but doesn't really help, tried a few days without and it's pretty much the same, tense in the AM, ok in the PM.
pps: also weird, in the PM, even if the BM hurts, the pain goes away almost instantly and doesn't come back. Probably due to the muscle being relaxed?

hi Dexterdude - wow! you sure have been through a lot! I have a similar experience. The mornings are the worst. After I have a BM I'm in agony for at least four hours. But the evenings are not so bad - I just feel a bit raw and tender. It does sound like you re-tore, or tore a bit more. I've developed a second fissure, which isn't as deep as the chronic one, but it bleeds and hurts like a ^%$&%&!!
Are you going to get the LIS?
I see my CRS on May 10 and I'm really hoping to get the surgery (well, I think I'm really hoping!). In the evening, I think 'maybe not'. But in the morning I'm practically screaming 'cut me or kill me!'. I guess that means I want the surgery!
I'm just thankful for the relative relief in the evenings!