Hey Everyone,
I've been viewing this board the last few months but never wanted to post, just keep reading it for information. However, the time is now to act for me.
I've had a anal fissure since June `10 or so I assume but never sought treatment until Oct `10. I wasted three months with my first Dr, who wanted to do surgery surgery surgery right off the start without trying anything. Jan `11 I saw a GI doctor who did a colonoscopy and at the end of that found I had 5 or 6 hemorrhoids internal that were grade 2 / 3. I had IRC laser three times on that. I started the fibercon / colace every day since that treatment.
Last week of Dec 10` to March 11`, I was on nitro .02%. I believe I healed it in March and stopped. When I had my 2nd IRC in April, I believe the metal pipe going inside me ripped the fissure open and I've been in pain since.
I have clear liquid leakage from the fissure, which I read is common. I eat correctly, no popcorn or any hard foods that could hurt.
I've tried the following: conservative treament for 5 months, two different times. Nitro .2% for 3.5 months. Nifedipine for three weeks but stopped 5 days ago as I had pain that lasted for 6 hours + after putting the cream on. I also tried analpram, lidocane cream etc. I have not done botox but from what I read, that is a waste and only temp relief.
Most of the time, I go to the bathroom in the morning, about 5am. In pain for 4 to 6 hours sometimes 8 on scale of 10, sometimes 4 on scale 10 and pain free the rest of the day. I will go #2 about 3 or 4 or 5 pm that same day, pain free. I don't understand it. How can I be pain free, same size poop in the afternoon but dying of pain in the morning?
I can't sleep in on the weekends as if I get more than 8 hours of sleep, the poop becomes super hard to push out and I pay for it in pain the entire day. Sighs. :( I'm off and on. I used to be able to have one good pain free day but now since April expect for rare fluke things that occur listed below, I'm always in pain.
I went to Europe in April for two weeks and get this crap, I was PAIN FREE the entire trip, but for 1 hour on 1 day, I had pain but other than that pain free! WTF? I couldn't figure it out. I ate like crap, McD's on some days, loads of twix candy bars... lots of crap food. No pain.
I came back, and had pain 3 days later. I thought long and hard about it had to be the water! I stopped drinking Dasani and Aquafina and went Zephyrhills water. I was ***PAIN FREE FOR 1 week*** but day 8, it came back with a vengeances.
*I'm currently on: Colace, Fibercon and Phillips Colon Health pills everyday. I saw the GI doctor last week and said I need to get surgery. I'm going to try the nitro cream one more time and keep with it once I'm pain free if that occurs again ever. I've had the nitro compounded but I want to try the Rectogesic, the prescription based.
I have two questions if anyone could help on:
1. Does anyone know where I can buy Rectogesic Online? I have an american prescription and I tried calling three places in Canada, and all of them said they do not carry it. I'm from the USA. If anyone knows a place that actually bought it, I would love to know please!!! The USA won't have it until Q1` of 2012.
2. I'm considering getting the surgery (LIS) in Nov `11 and would love to know if anyone know's any doctors that work at the Mayo or Cleveland Clinic that they would recommend? I've been looking at the US news and world report rankings today about doctors and hospitals and those are the best.
I'm willing to fly to meet a Dr now and get a consultation; Go back in Nov to get the surgery done and pay for a hotel stay for a week before flying back. (I'm not made out of money but I do not want incontinence for the rest of my life because I wanted to save a few dollars. I'd rather go in debt now and pay it off later.
The pain has greatly changed my life and I'm just tired of dealing with it. I used to be super active, doing triathlons (Ironmans's) and running marathons. All that has stopped since Jan 11`.
**I forgot to mention**. I supposedly according to the GI Dr, but than again he may be wrong, I have no skin tag. I thought skin tags were almost always with the fissure.**
I also have another GI problem. *I've tested it multiple times** For example, say I have sandwich with turkey and lettuce at 11am. Give it 6 or 7 hours later, that same lettuce I ate, I will poop out in strings but wetted down of course. My poop is yellow too, all the time. The DR believes I have another underlying problem but has no clue about it. Maybe someone heard about this problem too. :(
Thanks for anyone that can help!

Hi there.
welcome to the board. One of our boardies Cherylk goes to Mayo's. Hopefully she will come in and be able to recommend.
I had my surgery here in Florida and can't help you there.
I don't blame you at all for researching hospital, doctors, etc. So many folks have things done assuming and just going along with what there doctors say without questioning... I researched the hek out of this procedure and my CRS before having the surgery but in the end it was really just trusting my CRS and God. Plus talking to a couple of folks that I know personally off of here who had the LIS and no problems whatsoever, one being 25 years ago kind of put my mind at ease. It's really a simple procedure and incontinence is really un heard of. I've never saw a single post in this forum where anyone was incontinent.
I am not sure about the rectogesic online. I thought Nitro is rectogesic?

Hey Dawn,
I am also in FL too, Sarasota area. What CRS did you see? You can private message if you want. Rectogesic is Nitro but I always say, what if the person that is compounding it the nitro, does it wrong or forgets something? Sounds far fetched but willing to try rectogesic that is pumped out of a machine.

Yes I will PM you her name. She's awesome and located in Ft.Myers.
This Link may help you out too?!
http://anal-fissure.org/t2938-a-thread-for-doctors-info-region-recommendations#58860

My post disappeared! I'll try again. I would recommend Dr. John Schaffner in GI at Rochester Mayos if you decide to go there. They are very conservative at Mayos re: LIS surgery. Botox shots would have been the next thing I would have tried if the ointment (Diliatzem) did not heal me. Fortunately, it did. I have little confidence in GI doctors in my area after having been put through many tests b/4 going to Mayos. Good luck!

About Rectogesic, be warned all it done for me was give me an incredible headache! It is a common side effect! The one cream that is really helping me in Diliatzem also called Anoheal over here in UK. All creams in the world and painkillers don't disguise the intense pain of those dreaded spasms though! Good Luck :)

Thanks for the help. I found a place to order Rectogesic and placed it. Canada could not get it, so I found a UK shop that was willing to send it.
Thanks for the advice too!

Hey Lovetorun - I'm very surprised that you are having trouble getting the proper meds for your fissure in Canada. I live in Ontario and my doc presribed diltiazem for me no problem. I had to go to a compounding pharmacy, but that was the only obstacle. A good doc should be able to get you what you need. Is there a particular product you are looking for?

Hey hopetoheal,
I have had nitro compounded at my local pharmacy here in FL - US. However I wanted to give the made from the machine Rectogesic one last try since I've tried everything else but botox. I understand and know they are both nitro but sometimes I just do not trust compounding.
I did though make a appointment with a colorectal surgeon that Dawn recommended. About 2.5 hr drive but going to see what the Dr. view is and if I have any hope.

Ok - now I get it. :D It's great that you can see a good CRS! Good luck with the appointment. I hope it goes very well.