Thanks for that Val :D As for work, well supposed to go back monday? I know I am being unrealistic! I haven't been able to go out at all for a few days! Just the thought of the dole queue frightening me! We will see...

I remember a thread a while back and someone suggested codeine for the spasms. Never tried it myself - and it is VERY constipating, but with stool softeners, it might be worth a try?
Monday?? Ugh! Best of luck with that...........!

Dawn wrote:Itpainsme,
I never read of anyone on this forum becoming incontinent and like I said before I would NEVER use a CRS who wasn't 100% confident this wouldn't happen. Incontinence just wasn't my biggest fear after researching. I was more afraid of not healing than anything.
I am sure folks heal with Botox as they do with just the ointments. I hope you guys can post a positive, healing experience with the procedure because I have found by reading this forum over and over that most folks that had the Botox ended up having to get the LIS and that really turned me off (personally) against the procedure. If I had seen a trend where folks were healing from it then I may have had a different view... There has to be a reason so many CRS's are doing it. I'm thinking it has to work. I was never offered it and statistically LIS had the better healing % so I just went with that.
I hope your CRS is right and I totally support your decision. NG said he had awesome results the first three months of his Botox and I believe he said eating crappy and getting brave could have caused the re-tear. There have been folks who had LIS have problems from eating un-friendly fissure foods. I think the key is diet and if the muscle can stay relaxed long enough to heal. I noticed some of you guys mentioned not having too bad of spasms, that may be a factor with your healing being better with the Botox. I had horrific spasms the whole time with my fissure

Incontinence will definitely always be my biggest fear for LIS or any other type of surgery in that area :D If lookng at risks, that would be my number one on the list. I guess it really depends on where you are at in the process of healing. I was in deep excruciating pain for a while before the nifedipine and sitz baths and all of the laxatives and fiber kicked and I started to heal. I was at the point of not having much pain at all anymore. I went in to the CRS for a follow up and was told that I had a fistula and would need surgery for that. My CRS also thought that the fistula could be keeping my AF from healing all the way because of the location of it. At that time he also recommended the Botox to help heal the fissure. Like you, I would never use a CRS who wasn't 100% confident about what my course of treatment should be. I even drove to another city, 3 hours away to get a second opinion. That second opinion CRS told me the Botox/fistulotomy would be the best option for me too.
What I was trying to get across in my original post was that Botox is a good option for some, just like LIS is a good option for others. Everyone is at a different place in their "long ordeal" of dealing with an AF. Treatments are not a one size fits all. I said in my original post to you that it is hard for me personally to read posts that say LIS is the only thing that will heal a chronic AF when I am using other treatments that seem to be working well for me at this time. I guess I felt the need to defend my treatment because to me it is not a waste of time and LIS is not the only option for a chronic fissure.
You may be onto to something when you mentioned the spasms being a factor, because I personally don't think I have ever felt spasms. I also feel like the amount of Botox and the location of Botox are other factors that play a role in the sucess. I didn't get stastistics from my CRS, but he told me that he has had a lot of success with Botox.
I am just glad we can all learn from each other and support one another dealing with our AF's and treatments :D

I get your post and I agree we all may want to take different approaches. I don't think it's a waste of time. It's a chance I didn't want to take. I read the medical literature and saw that LIS is the gold standard and has a 90 something % chance of healing fissures. That was my deciding factor along with the post I read on here.... I think we need a Botox/ Fissurectomy Poll, a LIS/ Fissurectomy Poll to go along with the LIS and Botox Poll. As for wasting time,I spent 8 months using Diltiazem that didn't work and IMO was a Huge waste of my time but no one could have told me to have the surgery until I had enough and came to decide on my own..,Lol. You made a good point when you said Botox is temporary and I think that should be a point folks should take into account. It's effects will wear off and your sphincter will return to it's original strength..... I would love to see some more long lasting- positive results with the Botox. One thing I've noticed is the results can differ and recovery depending on the procedures. Hopefully others will get a better idea of options and a more positive view of the Botox than I have. I realize that it's more common to see negative than positive on these procedures as we have discussed before about the LIS and healing. Most folks who heal and do well go about their lives and never post in a forum and the ones who may have a bumpy road or aren't healing are more likely to be here for support. I would love to see more positive healing stories with any procedure. That's why I stayed in this group. I wanted to share my experience as positive and not just disappear because I had a very uneventful surgery experience. It was all pretty much up-hill pretty quickly and I really had no reason to be here for support( Thank God)!!
I have no doubt procedures other than LIS work. Look at Cherylk! She healed with the Diltiazem and never had surgery or Botox.
Yes Ma'am we are learning from each other and I hope I didn't offend you :)

Itpainsme,
I am rooting for you and we got to have faith in our Drs. They surely know more than I do
I want to see you heal and be a Botox success story!

Here's a very positive find on Botox combined with Fissurectomy.
http://www.ncbi.nlm.nih.gov/pubmed/17262202
Botox:
http://www.ncbi.nlm.nih.gov/pubmed/19266207

The reason I wouldn't have considered botox - not that I was offered it - is because I'm a big baby and scared of surgery and with botox it seems like it usually has to be repeated, or maybe even have LIS in the end anyway. So I wouldn't have wanted to keep going through surgeries when one would do! Also, when I was here all those years ago, botox hardly ever worked for anyone - there seem to be more success stories with it now.

Dawn,
I am not questioning why you chose LIS. I know that you made the best decision for yourself at the time. I also know from my research and my CRS's that I made the best decision for myself with the Botox at the time. Thank you for the links to the studies. I have looked at those before too. I know the effects of the Botox are temporary, but it should in theory last long enough to let the fissure heal before the sphincter goes back to the original strengh. I lived with my sphinter at it's original strength for 39 years before getting this fissure. I got my fissure from constipation and having a really hard bm. If I heal my fissure with Botox I don't plan on being in the situation again that caused the fissure to begin with. I was only 3 weeks post partum and breastfeeding my baby exclusively (AF not caused from childbirth because I had a scheduled c-section). I was not on fiber supplements or stool softeners and was most definitely not getting enough fluids. This AF is a very hard lesson learned. I will probably always take a psyllium fiber supplement for the rest of my life now. I will also not be breastfeeding another baby, because he is my last baby. I will always make sure I drink enough fluids to not get dehydrated and I am staying on Miralax and stool softeners indefinitely :roll: I know that it may be easier to retear once healed, but that can happen after LIS too. After reading posts here it seems that the retearing is fairly common, unfortunately. I remember telling my CRS at my first visit that the AF was life altering for me, at the time I just didn't realize how life altering it would become.
Thanks for rooting for me. I do have faith in my doctor, he is very experienced and seems very positive that I will heal. I also know what you mean about people healing and disappearing from the forum. I can understand why, but it is nice to have them around to share their experiences and offer advice to those of us who are still trying to heal, so it is a good thing that you are sticking around :D

val wrote:The reason I wouldn't have considered botox - not that I was offered it - is because I'm a big baby and scared of surgery and with botox it seems like it usually has to be repeated, or maybe even have LIS in the end anyway. So I wouldn't have wanted to keep going through surgeries when one would do! Also, when I was here all those years ago, botox hardly ever worked for anyone - there seem to be more success stories with it now.

I would be happy to have more Botox injections over being cut any day lol. I was numbed, but not sedated for mine and honestly, I didn't feel the Botox injections. I hope that I don't have to repeat the Botox, but I will do it to heal my fissure if I have to. My CRS made me feel really positive about the Botox. I go back in three weeks for a follow-up, I guess I will see how the healing is doing at that point. I will keep you posted :D

Hi itpainsme how are you doing after all these years having only had botox my story is just like your ie weeks after baby hard bm fissure I've had mine on an off for 3.5 years looking into fissurectomy and botox