I got a last minute call yesterday when the crs I was referred to for a second opinion had a cancellation. It was super yucky weather, which is probably why they got the cancellation
Anyways,
This CRS, dr. phang (pronounced 'pang') is very nice. He too seemed to think it was no big deal, and not something he could really help with. He thought it would heal on it's own. Of course he asks if I've ever been constipated or get constipated. I say no, and that's the end of the conversation.
It's like they are at a loss as to cause if it isn't constipation. Which I suppose they are.
He didn't really seem to want to spend time with me, like it isn't important. He was very nice about it and answered my questions, but always with that 'one foot out the door' feeling.
Mind you, I can't remember the last time i didn't get that impression from a doctor... about anything.
He said it was hard to see the fissure because of the sentinel. But he could see a bit of swelling. No sign of infection. He had me squeeze his finger and said the muscle felt good.
SOooo, according to him;
having a baby or a forceps delivery does not mean LIS isn't an option. He didn't say whether he thought LIS would help.
He figured I might as well not do the topicals since they make my period so heavy and seemed to think I would still heal without them. But he didn't actually say it.
He didn't think the episiotomy scar could be a factor as the fissure is superficial and on the inside of the anus, so not near the scar.
He didn't think I would need any 'work' done to the fissure itself to help it heal, like fissurectomy or abrading the edges.
He thinks controlled dilation isn't really controlled, because it involves tearing of the muscle and you can't predict where the tearing will occur.
He thinks self dilation might help because it is gentler and can work like a massage. He said it is good for spasms.
He said botox is an option but didn't seem to want to do it. He felt I should continue trying to heal the way I am.
It is true, that here in Canada, you have to pay for the botox which is $300-$400. I have supplementary insurance that would probably refund part of that.
So basically I would call him and set up the appointment to inject it. Make sure the pharmacy would have it ready that day. Then go pick it up and bring it to him, on ice. He would have to inject it within 2 hours of my picking it up.
kinda nuts.
But he said he would be happy to do it, if I made that decision.
So I guess I am kinda where I was at before I saw him. I need to keep up the fibre, metamucil, olive oil and prune juice with plenty of liquids. And start self dilating.
I was feeling better yesterday, and today is good too. It's just the uncertainty that gets you down.
There's still that NATCM clinic to try as well. I emailed them last week about fissures, but haven't heard back.
I plan to call them after the March break and hear what they think too.
I still have an appointment to finally see dr. Pezim, the first CRS on the 29th of March. I may go, I may not.
-sigh-
Tanya