So I have an AF as you all can guess as I have a copious number of posts under my belt here.
Probably had it for at least 9 months. And had it at least twice before that over the last couple years. But have only known it was an AF for the last 4.5 months and treated it accordingly.
Not sure how I got it. Probably a large BM or two, but can't remember. Probably has something to do with the extensive episiotomy scar I have from a forceps delivery, although 3 CRSs have thought not. Probably has something to do with stress. Wish I has a smoking gun to point to, but I don't. Not plagued by spasms, just hurts when I BM and then sore and twinging the rest of the time. Just don't want to live with it forever, but scared that I might have to.
Well I was doing really well, had days with almost no discomfort at all, but then for the last few days have been feeling twinges again. Nothing great though. But this morning there was blood again. Hadn't had that in over a month, so feeling pretty blue and scared.
To put it in perspective though. I can sit on any old chair without too much discomfort. So compared to previous setbacks it is still mild, I guess. Not as much inflammation.
But I am just so sick and tired of it ruling my life.
I think the dilation was helping, but now I am unsure. Did I not go big enough with the dilators??
So I am going to bite the bullet and go see the local TCM guy. Initial consultation is free, but could be quite costly if I decide to go that way, as insurance won't help.
Botox with the second CRS I saw will cost $400 and may or may not be partially reimbursed by my health insurance. Honestly I would pay more if I knew it would help. But it would \"yangtze fluid\" me off if I paid money and it didn't help. Like all the money wasted on this and that miracle cure before this.
so after I get the consultation at the TCM clinic the choices are;
Botox with the second CRS I saw,
or the herbal remedies of the TCM clinic.
(part of me wonders if I shouldn't do both...)
and/or should continue dilating?
or like my first CRS thinks.... just live with it. :(
any thoughts on this? Sure would appreciate some other thoughts to help clear my muddled mind.
-Tanya
p.s. sorry to be such a downer.

Hi Tanya...
Sitting here in the same quandary with my multiple fissures, wondering what to do. Having tried it all as you have too, and then some. I think it's all such a personal decision on where to go next and there is no one easy answer for anyone. You could get just as many varied responses to the question as there are people posting here. And as we all know, different doctors have different approaches too. For me personally, surgery is still not on the table. Even if I could find a surgeon to do it, going this much against my gut feel against it, and against the advice of doctors i trust and who know me and my history, seems foolish on my part. Botox has always seemed a temporary fix, if a fix at all, for me personally, as relapse rates are pretty high, and I think would be even higher in someone who has had fissures before as in my case. So, this fissure heals and the Botox wears off (in the best case scenario) ... then what?
I like the TCM approach a lot, and if I could swing it, I would go that way. Much more about root causes than about a mechanical fix. But that's just my opinion.
Dilating at home does for me provide pain relief and does relax things more, but I think unless you can build up the diameter of the dilator with time I don't think it will heal the fissure. Medically controlled dilation under anesthesia is a whole different game from trying to dilate at home. If I could swing that, I would consider that route, but it's just not going to be possible for me to travel for it.
So for now, it leaves me with the "live with it" option. Some days I manage that better than others and becomes as much of a mental discipline as a physical one. in addition, I'm tweaking my diet more and more to get smaller, softer stools, rather than bulkier softer stools, just to see what that does.
I wish there were great words of wisdom I could share and a one size fits all answer for fissures, but everyone's situation is different and while we can all share our experiences and what has and hasn't worked, it's also obvious there is no one answer for everyone.
We do have to keep trying though. Keep searching, hoping, and sharing.

Hi Jr et all,
Well I went to the TCM clinic, which is called the NATCM clinic;
http://vannatcm.com/about-us/vancouver-branch
and shelled out $1000, which is the going rate for one 'problem', be it a fissure or a hemorrhoid or fistula. They said that for another $600 they would remove the scar left by the lopping off of a sentinel in late 2010. But said the scar wouldn't effect healing or leave a weak area for re-tearing, so I opted to be cheap and leave it.
I am to avoid fish, red meat, lamb, spicey foods, alcohol, stimulating food. I am also not to do more exercise than an strenuous, half hour walk.
The initial exam was rather brusk and so I am a bit more sore than when I went, but I don't feel any damage from the 'herbs' they applied. The doctor (Dr. Jou) who applied the herbs was more gentle than the initial lady who examined me.
They said I need to go there every day for the herbs to be applied, for 15 days, by which time I will be healed.
Ideally the herbs should stay in place for 8 hours/ day.
I hope this works. They guarantee it will for at least 3 years or the next session is free. And if it takes longer than 15 days to heal, the additional days are free.
I feel a little light headed, but I think it is because it is over 2 hours since I usually eat lunch and I am alway a little freaked out when going to anyone for my AF. I have always had to do it on my own, while my hubby works and my daughter is in school.
well anyway, I will keep posting as this treatment progresses. I will have to lay off the dilation in the mean time.
It was nice for a change, to have someone take my 'problem/af' seriously.
Hope everyone else is improving!
-Tanya

Oh my gosh, Tanya, I didn't know you were going so soon. It sounds like a really good appointment though. I'm totally excited to hear how this progresses for you and am so hopeful for you that this will be successful! If nothing else, just to feel like you're doing something new must be nice. But I totally understand the anxiety about even having the fissure looked at. Geez, one stretch just a bit too vigorous and I'm in agony for days, sometimes weeks.
I am keeping my fingers and toes crossed for you every second...

, I'm away from this forum for 2 days and soooo many new developments around here!!!
Tanya, I'm really sorry to hear of your set-back, I know that you were on a slow, but somewhat smooth path there for a while, and I know all to well that taking what seems like a few steps back can be emotinally devastating .
As I read your post I had never heard of TCM so I did a search of it. I'm really intrigued by the thought of a natural approach to try and remedy this condition. I know it's a whole heck of alot to shell out for this treatment, but I'd have to say if there's another course of action to take, before surgical means, then that's always a wise consideration. Have there been others on this forum who have tried this that you know of? Are there stats on this?
I'm still not sure what's in store for me and my 2nd fissure, so any additional info I can get is greatly appreciated...my state of mind at this point is to remain optimistic, but realistic...so I'm looking to be armed with as much amunition as possible to take this thing down forcefully if it refuses to go peacefully !
My thoughts and prayers are with you that you will soon join the ranks of this forums success stories !!!!!
Best Wishes, Angel

Thank so much Angel,
I won't know what to think of the treatment til I have a few days under my belt. It was kinda uncomfortable today though. The stuff they put up there and the cotton wedged between my cheeks. But no pain or irritation. Just a bit sore from all the messing around down there.
I am trying to keep optimistic too. Sure is hard some days though
Have you read the potato theory here?
http://anal-fissure.org/t1849-i-have-an-af-what-should-i-know
scroll down to the bottom for what Arsets says.
I know it sounds weird, but she had an inside fissure as well...
http://anal-fissure.org/t3653-all-healed-and-much-happier
I guess I remain skeptical of the TCM treatment because I smeared so many other things on the fissure that helped a bit but ultimately didn't cure.
But we shall see what we shall see...
I will miss my walking though. It is how I manage my anxiety. I will have to try reading more.
Sending you healing thoughts too Angel!
Jr,
I don't know, I worry this won't work because it is a mechanical thing. But I am a worry wort. :roll:
I need to not worry so much.
-Tanya

Tanya,
Yes, I totally get that. I think for any treatment, surgical, topical, dilation, or otherwise, we have to get our minds aligned with success to give any treatment the best possibility of success. Fissures seem to be such complex things with no one answer working for everyone, so the best we can do is keep trying and keep our heads aiming in the healing direction. In addition to my usual meditations, I've started journaling to see if it might help to get all the negativity and despair out of my head and onto the paper. Maybe it will help? I don't know yet.

Hi Tanya,
Just checking in to see how things are going...how are you taking to these herbs overall? Do feel any different as of yet? If you don't mind, what exactly is the process? Is it something that you have to pull out at some point each day? Just unclear about the procedure, but am very curious.
I do hope your feeling some relief and continue to keep you in my thoughts and prayers.
Best wishes, angel