I am a 26 year old female, and developped my first AF during the birth of my son (First Child). I had a horrible delivery. I pushed for 3 hours, they gave me an enema during pushing and then finally had to have a second degree episitomy and they took him with forceps. 90 stitches :( Layer by layer. Recovery was horrible. I developped an infection in my uterus and episitomy and was allergic to the stitches they used. This was seven months ago, and am now just starting to get passed it. However, I kept telling my OBGYN that I had this horrible pain during BM's. I would bleed and it would be like knives scraping my insides. He said it was all part of the healing process. I had to see him for three months because of my healing. He then said it was hemmorhoids. He gave me HC cream to try. It did not work. I went to my family doctor and she gave me...suprise surprise..another cream.Proctomycin. That didn't work. I felt like it was getting worse. I tried Tucks, creams, anusol, suppositories, sitz baths... I had aching heavy pressure in my bottom all day long. Finally I went back to my Doctor and threw a world class hissy fit, complete with tears. She thought I had Post Partum Depression and I said "NO I have a pain in the a**" She referred me to a CRS. I went and saw her and she said right away it was an AF. I had never heard of this before then. She gave me Diltiazem cream (I cried, because I was sick of using cream) but she said this would work to help relax the muscle. It didn't work. I was so constipated and still bleeding. Finally, a month ago I had 3 injections of Botox and had a skin tag removed that stayed behind from hemmorhoids. I felt great for a week and then all hell broke loose. The pain came back witha vengeance :( I went back to my CRS and she gave me more Ditiazem. She said that, plus the botox that did get into the muscle should help. I may have to have more injections when I go back in three months.
I really decided to get serious about this. I started taking two stool softners at night, lactulose in the morning, I drink 8-10 glasses of water a day, eat healthy, walk lots with my little man. I use the Diltiazem once a day before a bowl movement...I find it burns a little. and I continue with baths and epsom salts. I haven't bled or hurt too too bad in 6 DAYS!!! I know it's probably nothing to brag about, but I take any good I can get. I must say also, to mothers who read this...I was strictly breastfeeding my son and just stopped completely 2 weeks ago. It has drastically improved my BM's. I no longer feel constipated. I was just too dehydrated while breastfeeding. I am finally starting to see the light at the end of the tunnel, and even talking about having more children (I was convinced for awhile that I would never do that again) It sounds cheesy and lame, but attitude and positive thinking are really powerful and sorta make me feel better, even just for my well being. It's nice to know we're not alone.
One question I do have though that I hope someone can shed some light on is...now that my sphincter muscle seems to be more relaxed, my anus is super itchy..I could take a scouring pad to it all day long (too much info) any suggestions on how to calm this issue down???

Wow, sorry you're suffering so much, that sounds awful.
I think that awful itch could be a sensitivity to the diltiazem, I had that myself. Could you get a prescription for Rectogesic instead, it doesn't seem so irritating, although it does give really crashing headaches.
The best thing to heal it up permenantly would be LIS, as the longer a fissure is there, the less likely it is to heal up with creams - although not impossible.
You've found the right place here for advice and support

Thanks! I think you're right about the sensitivity to the Diltiazem. Surgery is not an option for me because my CRS said that because after the extent of my episiotomy, I no long have a lot of muscle to work with and it would just cause me problems later on. I am ok with not having surgery because my fissure is starting to heal after I had botox. I was hoping to hear of anyone who had itching because of some sort of healing that was happening. Like I know when you get a cut on your hand for example, it sometimes itches as it's healing! I may have to have a second round of botox in three months, but we'll see!

Well, it does itch when it's healing, so it could be that - hopefully! It's not such a bad itch as the diltiazem causes - that itch made me want to tear myself to pieces!
Shame you cant have the surgery, but it sounds like the botox is helping, which is good news.