I recently spent a week up in Portland, Oregon working with Dr Brett Hubbard at the SE Sandy Blvd Hemorrhoid Clinic & I'm really happy with the results. I'd seen him in the beginning of January when my pain was off the charts & I was almost completely incapacitated- the work he did there got me back on my feet & feeling alot better. I went back up for a follow up & am feeling just about 100%. He's a naturopath & they use special methods for dealing with hemorrhoids (I still had a few) as well as shrinking papillas & a technique called 'Fissure Repair" where they remove scar tissue & reshape the fissure so it can close naturally. Not a completely painless procedure but no worse than some of the poking & prodding I suffered at the hands of my CRS. They work in conjunction with a local hotel for out-of-towners and the entire process including bills, air fare, hotel and car rental was still half the cost of my disastrous Botox shot. There's even a mall and a Fred Meyers nearby for entertainment & groceries. They see people from all over the USA & I really can't recommend him and his staff enough. If you can get out of town for a week and you don't mind staying in glamorous Clackamas, Oregon- it may be worth checking out. When I win the lottery I'll send every person on this list to go see him!! Peace y'all- Ed
http://hemorrhoidhelp.com/index.htm

Hey Ed,
Thanks for the tip! That's terrific that you are doing so well. I was wondering what you were up to.
So how is 'fissure repair' different from a fissurectomy?
And also, I think I have an enlarged papilla, but won't know for sure til I see my crs next week. But how does this guy deal with those??
I made an appointment to see a TCM guy for the week following my crs visit. Just in case I leave the CRS's office feeling like a 'rudderless boat in a storm' again.
Can you give me some more details??
anyways, this is awesome news!
-Tanya

Hi WOI-
Yeah- I wish everyone could go see this guy!
My understanding of the fissure repair is that they remove the scar tissue that surrounds the edge of the fissure (assuming its been open long enough to scar) and then, depending on the shape of the fissure, they actually open it up a little so it can lay down flat again and close up. They don't actually cut out the fissured part like in LIS. I can't say if that's exactly how it's done but that's my understanding. The day of the repair procedure it can be pretty sore but by the next morning I was already feeling alot better. They use topical anaesthetic during the procedure & can prescribe vicodin if you want. I passed on it since it tends to constipate me & it didnt hurt that bad. Us fissure veterans are pretty tough! I think the papillas were taken care of via injection- which sounds horrible but really it only hurt for a second.
When I first saw him in January I had like, 7 papillas, 3 hemorrhoids (including a thrombosed one- ouch!) and the fissure so no wonder I was hurting. This time I just had 1 or 2 hemorrhoids (which they treat electronically) and just a bit of the fissure left.
I can't speak definitively on what their procedures are though and I'd suggest anyone considering going there call first for the brochure that they can mail out to you and read it thoroughly.
Right now I'm just focused on eating right and staying "calmly active & actively calm" as they say. I know these things are hell to deal with- don't ever give up hope! The Creator has a master plan! ed

That's great Ed,
Thank you so much for all the info. I think I will call them. I used to live in Portland, and wish for my butts sake that I lived there now ; )
I am curious if the TCM guy I have an appointment with will deal have similar success with papilla. I honestly don't expect much from my crs. From what I've read here on the board, they just cut them off! ick!
So you were there a week, but the proceedures themselves were accomplished over a couple days, and then recovery?
Thanks for the words of encouragement, been pretty down the last couple days. It just sucks when doctors look at you and just shrug their shoulders and look at their watch.
-Tanya

Yeah- for alot of doctors it's just their job and they're probably really sick of staring up people's butts but for us it's like "My god this is my life! Help!' Yaknow?
There's actually 2 doctors at the clinic- I met Dr Gardiner as well and he was cool too. I went there on Tuesday morning & saw Hubbard that afternoon then saw him once a day till Friday. I flew back on Sunday because plane tickets were cheaper and I wanted at least a day after the repair to chill out. Last time I flew back on Saturday and was a little sore going thru the airport & sitting on the plane ect.
It was just nice to be someplace where they understood what was going on. The offices have these elevated tables that you lay on your side with a heating pad- as opposed to my CRS office where you have to kneel over in front of this window that faces an office building!
I know everyone's situation is different but he really helped me out, I would be overjoyed if even one person on this list gets better from this recommendation!
Also, I've really cut back on sugar- I was eating a chocolate bar/bear claw a day & I think it was messing with my pH.
Hang in there! It may take a little while but someday this will just be a distant, unpleasant memory!

Hi Ed:
I'm glad you're feeling better!
I have a question about the Botox injection you had: did your CRS say why the Botox injection caused you to have a thrombosed external hemorrhoid?

Hey there- My CRS never even saw the hemorrhoid- when I went in for a follow up he just barely looked up there at all & said I was fine. I was like "Are you sure cuz it hurts like crazy" & he said to give it a few more days & take a Vicodin. Hubbard saw the hemorrhoid when I first went to see him. My understanding is that it can happen from the needle- somehow if they mess up the injection, it can cause a thrombosed hemmy. I first heard about them thru this article- which is a pretty interesting read in itself-
http://www.ambiguous.org/quinn/medical/fissure.html
I hope this helps. cheers- ed

Hi Grateful Ed,
This is similar to something I posted a few weeks back - my CRS told me that sometimes he likes to 'tidy up' during Botox or LIS. He said its not actually fissurectomy but more a clean up.
Basically he removes all the thickened edges of the fissure and leaves them clean cut to allow things to heal quicker. If healing has started to take place but things are slightly out of line he will release the incorrectly healed bit in order to relax the fissure again so healing can re-commence properly and in line.
Davo

I also went to the Sandy Clinic a year ago, on recommendation from a friend. I am from Montana, and I had fissures for five years not knowing what they were, except that they totally wrecked my life. Toward the end, I somewhat healed the fissures myself with diltiazem cream and a SUPER-soft vegetarian diet, but Dr. Cranford helped me with some other problems I had. He got rid of my internal hemorrhoids completely painlessly, and also gave me virtually painless treatment for anal stenosis. Thank God I went there, and saw someone who actually knew what to do. I clicked on your "best doctor in the USA" thread because I knew you must be talking about the Sandy clinic. My fissures are now a thing of the past, though I still am still careful about what I eat, etc. -Jake
P.S. My favorite part about the Sandy Clinic is the brick wall with the huge round window in it.

Hi jake
I have been dealing with a fissure for almost two years now. Last year I had 2 LIS surgeries but my pain never went away. I'm really at my wit's end and I read your post on the sandy clinic in Portland. Could you give me some more details of the procedure you had there and the doctors you saw? I understand that your experience was great but could you tell me more about it? Did you have a surgery? How long did it take for you to get back to normal?
I live on the east coast so I wanted to get as much information as possible before deciding to head to Oregon.

Thanks
SSK