hey guys, I basically have been dealing with the same symptoms for 5 years now. Finally figured out 3 months ago that I had a AF. I went in for surgery and they found that the AF was'nt bad enough to remove and that I also had 2 large internal hemmeroids which they did remove. I also had botox done as well, but its been a month later and I have had no relief. I have been taking miralax and metamucil to keep my stools soft, and I have no pain during BM but my pain starts about 20 mins after and continues for 8-10 hours! I also have other pain just from moving around as well. Also, while my fissure is in spasm I have painful/urgent urination. Another thing, which hopefully isnt inppropriate..I have pain after intercourse, it feels like my bum is going into spasm as it would after having a BM. I had a post op appt the other day and the nurse said my fissure was healing and that the hemmeroid removal is causing the pain but it feels just like it did before? So i dont buy that. I think my next step will be another surgery. The nurse also brought up pelvic pain syndrome, but would wouldnt the fact that an AF is present be what's causing my pain? thoughts? Thanks in advance.
Mike

Hi Mike…..I could have wrote your post….same problem as you. I did not go the Botox route. However, I did do everything else including the Nif cream, I will say that I went from a 10 out of 10 pain wise to a 2! However with that said, after a week or so, bad BM right back to a 7 and then a week of the pain game. I was going to win this thing…well after months and months….game over…this little ______ won! I went to two different CRS and both said if you somewhat heal and re-tear, there is a 90% chance it will never completely heal
There comes a time that you just say screw it, I want my life back and you want it fixed once and for all. This has taken over my life in many regards. I use to be involved in many physical activates….had to stop. Use to do anything and everything with my kid…put a stop to much of that. Oh and it so very enjoyable when I have to travel for business and I cannot sit. I had one meeting that I told everyone I screwed up my back and had to stand most of the meeting…I’m done….finished…I refuse to live this way…..
You live in a major area. Unlike some where they have to travel hours to see a CRS.One thing you might want to investigate rather than a LIS is a new type of Anal dilatation. There are not many Doctors that perform this. I was lucky that I found a CRS who does. In fact, he was award top doctor in NY two years in a row.. He has performed over 300 LIS’s and after learning this new technique, he will no longer perform a LIS. He went on to tell me that he gets about the same results with no chance of any infection simply because he does not cut anything. This is a big thing for me because someone I work with had an LIS and got an infection and it was not pretty. Also, the healing time is much less. I had the opportunity to speak with some people in his waiting room and wow, many well feeling great in a few days. I spoke with two people who had the AD on a Friday and was back to work on a Monday. I am having this done the beginning of next month. I will keep everyone in the loop on how it goes. I just want to get to a place where I can get back to the way I use to be like watching the Yankees beat the Red Socks next year. Right now I could not make the first 5 min of the game!
Again I am not saying do not get a LIS, all I am saying is do your research and see what is good for you. Given what I found out about this new AD and speaking with others in this Dr office….for me it’s a clear choice which way I want to go….
http://anal-fissure.org/t3936-thinking-of-a-lisread-this-first

Hey Mike,
Sorry to hear you are still in pain. I think I've read where others have said it can take months to recover from hem surgery. It seems hit or miss as to how well Botox works for folks. I have heard that getting spasms with hem surgery is pretty common, so it's really hard to say if your fissure or having the hems removed is causing your spasms .... I'm just really curious as to how the fissure is healed if you still have spasms?!
I would definitely consider a second opinion if you aren't feeling comfortable with what you're being told. I would also consider LIS if it were me. Apparently the CRS you are using now thought it was necessary to do Botox so he/she must have thought that area was too tight, and by now that has definitely worn off.
Sorry and I hope things get better soon!

Wecc,
I have tried to research controlled anal dilation and there is very little information. I found one study from the Doctor you mentioned and one out of Turkey?!

Hi Dawn…..the link that I sent was from the CRS who perfected this new standard AD. He performed over 2000 with no complications and a very high success rate. In fact, it was about 1% less than an LIS….but there is no cutting or chance of infection. As I said prior, I had the opportunity to speak with over 7 of the Dr. patients of different ages and all were doing just great. He had done a hundreds of LIS and said he would never do another one if he can help it simply because of the results he has with the standardized AD…
I do not know how much is out there about this.....
Many people that had problems with an LIS is the area which was cut and that has to heal as well. Outside of the U.S most of the AD uses a balloon with great success. On one of my posts, Val in Germany had this done with good success? I also work for a Germany owned company and am there 4-5 times per year. One of the people I work with husband is a surgeon and they had me over to their house for dinner. I can tell you most Dr there would never want to do an LIS, not because it does not work, simply because they can achieve about the same results without the cutting. Again, I am not saying that there is anything wrong with an LIS. I am just saying I would rather try something that seems to be just as effective that is much less invasive which less chance of compucations I would never have the old AD where the CRS puts his fingers inside of you and rips you apart. The fact is, most develop countries do not have the form of AD anymore. Also the fact is…..just because that medical community here would rather cut does not mean it’s the best way. Everyone has to make what they believe is the best discussion….

Hey Wecc,
Call me naive, but I have a hard time understanding why this isn't practiced more in America??!! From what I have read if done in a controlled manner it can achieve as good of results as the LIS. I just don't understand why it wouldn't be the surgery of choice in America and everywhere else if that's the case Please don't think I'm questioning your choice because that's definitely not my intentions!!
I have tried to research and there's just not much to find on the procedure. I keep finding the same two pages over and over...
Who knows what the future holds and where things may go as far as procedures and cures for fissures. Nothing but good can come of a better choice or more choices. Thank God they don't do the Lords stretch or whatever it's called!! OMG, that sounds horrific
Hopefully you and Val will stick around and keep sharing your experience :)

thanks for info wecc, nice to know of another option. The doctors I have spoke to around here haven't spoke of that procedure, maybe I will bring it to light on my communication with the nurse. Good luck next month, hope it works out for you!
thanks for the feedback, dawn. I don't understand it either. the thing is, this pain I have now is the same I had from before the surgery, I have good days and bad days depending if I have a BM! My Bm's are all soft as well, no straining at all because of the miralax and metamucil. The nurse said I should be seeing some relief at this point, and after a quick exam she said the AF was healing and that it must be the hemm removal. But no relief whatsoever at this point. Another crappy thing is the line of communication with the CRS nurse has been tough, I may go see my GP and get a referral outside of boston. I really dont want to wait around anymore with this problem. Thanks again.
Mike

Fact is Dawn; many countries have socialized medicine, which I am not in favor of. As you can see in many posts, people waiting for months to see a CRS or any doctor for that matter. While our health systems needs to open up for all, the fact is I can see any doctor within a pretty good time frame for $40.00 on a co-payment.
However with that said, our medical community is for profit, just look at how the same prescription is 40% less outside the U. S. The fact is CRS are indeed surgeons and just maybe there is more money when a CRS performs a LIS rather than an AD. Simply because there is more involved. In addition, while a LIS is most likely taught school, this form of AD may not be. Meaning the CRS would have to go out and get trained.
This CRS that I found in NY who performs this new AD, had performed over 400 LIS's saying he would never do one again given the success rate he has ad with hardly any complications and a very fast healing rate. By the way, this is not some small town CRS. He is affiliated with two major hospitals in NY and he has been voted top doctor by a well know magazine that comes out with this once a year. So what I am saying, while it very well seems not to be mainstream, I feel pretty confident. I will let everyone know how it goes. Perhaps if more people went out when speaking with a CRS and said they were interested in the new AD, just maybe it would become more mainstream. By the way, I found out about this on this website from an old post and doing my research. This site is so invaluable!!!