Boy as the pain been bad today. Worse than ever, blood everywhere, and im still confussed as to why i feel the pain 'way up'. i nearly passed out with the pain earlier...will this nightmare ever end??

Idol, I'm on my 2nd AF, and this time has been far worse than the first. I'd start by getting sharp pains letting me know it was "time." Then, as I had my BM, it felt like someone was hammering a railroad spike up there. My legs would shake uncontrollably, and I once almost fell off the commode. Like yours, I felt the pain way up inside (why I mentioned a railroad spike). Then, anywhere from fifteen minutes to an hour later, the spasms would come along and I could be guaranteed of at least another four hours in agony.
I too had much blood, at times to the point where I could feel it running down my butt check and dripping into the toilet. It would look like I'd just taken a dump into a big bowl of Kool-aid! The bleeding has gone on strong for up to ten minutes or so, with spotting still happening the next day.
I know exactly what you say about the pain. I even fully considered suicide one evening it got so bad. I just wasn't sure if I had enough pain killers left to take me out, and I didn't want to just get more ill. The only thing that I coulld think of that would be worse than my AF pain would be sitting in the locked ward at the hospital on suicide watch, with a narco hangover and the fun of just having my stomach pumped out.
Now, the good news (or at least in my case). This is my 2nd AF, it has been much more intense than before, and I am now just over two months into it, so my CRS has scheduled LIS for the 27th. I've read a few stories about painful after effects of LIS for some, but I figure that nothing can be worse than what I've gone through. I've been grazed by a bullet, stabbed in the arm, had a complete tear of the medial collateral ligament in my knee, arthroscopic surgery in the other and Carpal Tunnel Release on both hands. Oh yeah, I also broke a leg sliding too hot into a turn on a racetrack riding my old RD350 Yamaha. NOTHING hurts like this!
So, follow the diet advice of those on this list, make MiraLAX your best friend, and start hounding your CRS to take this monster away through surgery!
And, if it gets so bad, you can't sleep at 2:00AM, and your ready to punch holes through the walls, sign on, and hopefully one of us will also be in said frame of mind and willing to talk each other through it. Good luck and take care.

Awww thank you for the encouragement rasmith3530. I am in the uk, my doctor today was talking about dilation not LIS:( but i have to try the nitro for 8 weeks first. This too is a new fissure and my second one which she said is big Is your fissure internal too?, where is it located? Great news for you on the 27th!!!

Gosh, I wish I could find a doctor who would do dilation here. Is it the controlled dilation? Or the old fashioned 'finger of god' kind?
I've only read good reports of controlled dilation.
You can look at Wecc's information and there are some reports on the Yahoo anal fissure group.
Just use the above search and search for 'dilation'.
I'm so sorry about your pain!
Hope it eases up soon. Have you tried an electric heating pad? Not much I know, but it helps.
-Tanya

My fissure appears to be internal and posterior. In fact, when they examined me at the Immediate Care center back in November, they initially diagnosed me with internal hemmies, and as such, proscribed Norco 10-325s and Hydrocortisone suppositories. I think they might have made it worse.
Before, my wife had looked at my rear end and saw nothing remarkable, and the doctor didn't see anything externally as well.