Hi everyone i hope you are all feeling better and one step closer to full recovery. So as i mentioned before in my introduction i have been suffering from an AF for some time now due to constipation which was a result of a large hernia. Now that the hernia is dealt with, Movicol is amazing and a fiber/liquid rich diet is ensuring soft BMs with little to no strain at all when in the bathroom.
The only problem i have now is the AF, the pain is fairly new to me, it started getting this intense around two months ago, i had some blood two weeks ago, but now i don't see any blood at all but the pain is there none the less. Sometimes it lasts for an hour or two, other days it takes me 5 to 6 hours.
My manager is getting angry and he never does, but they need me at work and forget going to work if i had a BM in the morning. Is my fissure going to heal or do i need surgery? The blood is gone, the spasms are receding now i only have them post BM for an hour or so. But the pain is destroying my professional and social life, i can't go out, i rush home from work to start my daily routine of pain, sitz baths, and obsessing about what to eat so it wont hurt me on its way out.
What kind of testing/diagnosis is the CRS likely to do? last time he just checked me with his hands, no tools what so ever and he said he can't do anything because the muscles are too contracted. Will there be any tools (or approaches) used to find out how serious my AF is? Does it hurt? Can i ask him to apply some sort of local or even general anesthetic so it wont hurt? I am really worried but i need to get this over with, i don't think it will heal on its own, the pain hasn't decreased on the contrary. The only difference is that i am having soft BMs now and no bleeding.
Please, let me know what i should do.

Ink,
Your fissure is chronic if it's over 6 weeks old. The chances of healing without surgery can be pretty slim once a fissure becomes chronic. Your CRS may or may not be willing to do LIS . Some CRS's aren't quick to do it and others will do it as soon as the fissures chronic.
If your CRS has visualized your fissure already then there may not be any reason to use a scope. If you were too tight at the last exam then your sphincter was probably in spasm. I don't really think the size of the fissure determines if you can get LIS. How long you have had the fissure usually determines this. Since yours is chronic by medical terms, you should be able to get the LIS if your CRS is willing to go ahead with it.
If you have an exam with a scope- lidocaine can be used to numb the area. I was told by one of the CRS's I seen that I could get anethesia in a hospital to be examined if I wanted that. I never did it though. I saw another CRS who saw my fissure without a scope. She was the CRS who did my surgery.
If you are having spasms and pain then your sphincter is probably too tight and could benefit from LIS. There was another boardie on here who had LIS and only bled twice with her fissure having it for months. Some folks bleed a lot and others don't always have that much. I don't think it really means that a fissure is healing just because you don't see blood. If you have the pain and spasms then it can be a matter of time before you see blood again(re-tear).
I think the fact that you have figured out how to make the perfect poop and still have the pain speaks for itself that you still are tight down there and in spasm.
Those soft bm's work much better after LIS without spasms and since you already have that figured out, you will be ahead of the game if you get the surgery.

I had my surgery 6 days ago, doing better, but still healing. I too was very tight, so much that I could hardly get the prescribed creams where they needed to go. I tried every option I could, every cream, nitroglycerin, calcium blockers, stool softeners etc. I would swallow 6-8 Aleve daily to get into work, some days I would have to leave because the pain was so bad that I needed to go home to soak and lay down. Many days I was brought to tears. Bottom line, I wanted to get my life back. I tried everything. My surgeon said I would be happier. So here I am today, 6 days post surgery, no more spasms, still some discomfort, but nothing like before. I feared the worse going into surgery. I was so scared, but it wasn't as bad as I thought. I stayed off my bottom and lounged around for a few days. I only took three of the prescribed pain pills. I managed with Advil afterwards. I plan on trying to go to work on Monday. You will know when your ready.

Dawn thank you for your reply, most likely i am going for the surgery i will tell my CRS that on Sunday. The pain is just too much to handle with painkillers and i don't want to get a warning at work, i worked too hard to lose this job now.
Sandi my surgeon talked about a laser surgery that is supposedly faster and less painful, but on the off chance that he suggests a more conventional approach (LIS) which i learned here is the golden solution that everyone recommended, how would you describe the post surgery pain, like is it the same as spasms and the pains we get after BM?
Also is one week enough for me to recover and go back to my work? (Office job)
Thank you all in advance

My surgeon numbed my surgical site with Novocain, so when I woke up I felt nothing. Once I got home and the Novocain wore off I began to feel some pain, as instructed I took a percocet and was comfortable. I was soar, but it was a different pain, manageable. I only took three of those percocet pills the entire time. Otherwise I kept pain at bay with Advil or Tylenol every 4-6 hours. Believe me, I was scared. I was crying the day before fearing the unknown. It wasn't as bad as I thought. Days before I kept my diet light, not to fill up my intestines. I had a BM the morning or surgery and kept my diet light for two days after surgery. I was instructed to take mineral oil for the two days after sx. That did make BM slide out, again I wasn't eating much so not much to come out. You will make it through. The pain is a soar pain, not sharp and intense like those awful spasms. I am on my way to recovery and so looking forward to getting my life back.