by rasmith3530 » 07 Feb 2012, 11:44
Sorry to hear of your discomfort and negative reaction to treatment. I'm on my second Anal Fissure in little over a years time, and this bout has been much worse than the first.
I was originally misdiagnosed and given a treatment that is counter to what works for AFs. My GP prescribed 2% Nitro, and my CRS moved me to a more common 0.3% formula. That had to be custom formulated by my local pharmacy BTW. He has me applying it four times per day.
I didn't get as bad a reaction to lidocaine as you report, but it also did not provide the numbing feeling which I had assumed it would, having much experience with novacaine from dental work.
I got some great advice and picked up a number of good tips from reading the posts of there here on this site. It has been a Godsend to me. A couple things that have helped me some include, limiting diet, and by this I mean both eating less and eating more carefully. Remember, the less you put in, the less you have to quite painfully let out! Stay away from red meat, uncooked veggies and anything with whole seeds (such as my favorite multi-grain bread). I had already been using soluble fiber, in the form of Metamucil, due to Type 2 Diabetes, but one of the miracle elixers I learned of here is called MiraLAX. It is a stool softener, and most that have used it had to find their own personal comfort level. With an AF, diarrhea can be as bad as constipation. I've experienced both, and neither are any fun.
As bad as a bowl movement is, what can be even worse is the spasms that come afterwards. This is the burning, crunching pain that comes on anywhere from fifteen minutes to an hour after your movement and can last for hours thereafter. That is when you start asking why they only shoot horses to put them out of their misery. It's when you begin to think that self-immolation may be a realistic pain relief! I have read that some folks have had decent luck with a cream called Dr. Wheatgrass to relieve this, but I have as yet no personal experience to share. You will wonder at times where that merciful God went and what you did that was so bad to deserve this.
My first time out lasted about twelve weeks and was cured using the Nitro ointment and some feeble attempts with Lidocaine. It was also far less painful than this last bout. This time around, I've been suffering for a bit over one month now (or so, time gets cloudy when you're having such fun). I have experienced BMs that had my legs trembling so uncontrollably my feet were coming off the ground and I almost fell off the toilet once, I was in such pain. My GP has me on Nucynta ER, an extended release Category 2 narcotic, somewhat akin to Demerol (stronger than Vicodin), and at times it just takes the edge off the excruciating pain I've experienced. I have experienced BMs that were so bloody the blood was streaming down my bum and dripping into the toilet. I hope you are not experiencing anything near this gut-wrenching.
I am former military with a service connected disability. I've also raced both cars and motorcycles, and have had bad encounters with each. I grew up on the wrong side of the tracks. All this is to say that I'm no stranger to pain. That said, I have never experienced anything quite so painful in my 58 years as this last AF. I've seriously thought of suicide, just to escape the agony.
I have one good bit of luck, a very good CRS. I found him during my last bout when it was suggested that I should have a Colonoscopy due to my age. He has a good grasp of the intensity of this tear. On our last visit, he said we'd give it two to three weeks longer, and if it weren't greatly improved, begin looking into surgery (LIS). I am still bleeding and in much pain with my BMs as I prepare to see him later today.
I sincerely hope that your experience is nowhere near as intense as what I've lived through these past weeks. From what I've read, LIS has the best success rate for bringing closure to Anal Fissures. You asked how long you should wait and the only answer I can think of is a question. How long do you want to remain in pain?
Good luck and God bless.