10 days ago my life as I knew it ended. I never fully appreciated how wonderful it was until acquiring an Anal Fissure.... or what I believe to be probably a handful of them.
I'm a 38 y.o. single mother of two - who is currently without health insurance. I think this fissure probably started out as something more managable in late June when I was finishing up my Business degree. I've been under a tremendous amont of stress over the past 4 months. This has wreaked havoc upon my bowels. First, my 9 year old was diagnosed with brain cancer and had a tumor removed, and then finishing up college sentenced me to spending hours on a kitchen chair in front of my PC. I think the combination of the three attributed to this condition. Plus, I just think I am anatomically predisposed. I'm certain that I have a hypertonic sphincter. But in any event..... I find myself thinking that I'd rather drive my car into the garage and just go to sleep. I just don't want to live like this any longer. I'm so utterly despondent and I find myself thinking that something seriously has to be wrong that requires more medical intervention - and then I read all of the posts on this forum and wind up feeling that I'm no different and this is just going to be my new lot in life. That this will be a cross that I may end up having to bear for years, and it just makes me feel even worse. I spend hours thinking, why me? What have I done to deserve this?
I've never been constipated in my life. I've never had to strain to move my bowels. I was regular, usually having 2-3 BM's a day. After the bout of diarrhea in June, I chalked up the blood on the TP and bowl to a hemmorhoid and treated with Prep-H. I achieved what I thought was a resolution to my symptoms. But in August, for no apparent reason, I started to see some blood.... then more blood, then lots of blood and I started to be plagued with this constant pain for HOURS after BM's. Finally, when I couldn't take it anymore, I broke down and saw my Primary Cvare Physician on August 16th. He gave me a limited external visual exam. Said he saw no sign of a fissure, just three small hemmorhoids. He sent me on my way with Hydrocortison suppositories, instructed me to begin taking a stool softener, told me to up my fluids, eat lots of fiber and take sitz baths. I barely made it through the weekend. By Monday I was now cold calling GI's physicians. One nurse took pity upon me and had me come right over to their office. Again, more of the same. A brief external visual exam. No rectal exam becasue of my level of pain. This Dr. made no mention of hmmorhoids and said it was def a fissure. He sent me on my way with a script for the .125% Nitro cream. Again, baths, fiber, water and stool softeners. he advised me that these things take up to a month to heal. I came home right after filling the script and was able to get two doses of the cream actually inside of me with my pinky finger. For dinner that night I had a large bowel of Shredded Wheat, thinking that this high fiber would create a softer stool. HA! What a joke! It was without a doubt the most tedious, excruciating BM I have ever had. I literally found my self SCREAMING on the toilet. I thought that I might pass out. It was horribly disturbing for my boyfriend who was left feeling totally helpless. It was horrendous. And then of course, 3 or 4 hours later I had to follow it up. I've never, in all of my life, seen that amouont of blood leave my body. The stool was streaked, there were clots on the TP and in the water... it was disturbing. The next day? More of the same. At this point I felt I needed to go to the ER. Where I received the "second-class citizen" treatment. They asked for a urine sample, which they then did NOTHING with after learning I had no insurance. It sat there unaddressed on the bedside table. No IV, no labs drawn. I was in excruciating pain..... my mother who accompanied me becasue I cannot drive, sat their sobbing right along with me. I haven't worked in a week. I can't drive, can't sit. Can't walk. So the hospital sent me on my way telling me I needed to be scoped. That they could not perform that in the ER. They gave me two percocet and told me to contact my GI doc. After contacted the GI practice, they informed me that if I was bleeding THAT much and in that much pain... that a scope in the office would never be humored. The nurse told me that I probably needed surgical intervention. She told me to go BACK to the ER to obtain a surgical consult. I haven't even bothered. Becasue I don;t have $20k for out-of-pocket ass surgery at present. I don;t knwo what to do. If would rather have a colostomy bag than have one more BM. I just cannot believe for the life of me that we can put a man on the moon, yet modern medicine cannot provide me with a solution that might alleviate the pain of having a BM. And this High fiber diet? WTF? My stools are bigger than ever, more traumatic than ever, and feel as if they are helping more than hurting!!!!!! I feel as if I am being ripped in two with each trip to the bathroom. I concede. I'm at the point where I'm actually thinking that I just WILL NOT EAT. I'm drinking as much water as a camel and the stool gets harder and harder. My anus is so swollen that I can barely even pass gas. there's no way to get my finger inside to apply the NTG cream so I am now accomplishing this with a q-tip covered in a finger cot. The other day I placed it inside of me and the blood from my rectum ran right down the finger cot onto my hand. Can this REALLY be the result of a fissure? What if this is a cancer?????? Why is it not a priority for any of these doctors to actually look or feel inside of me to find out what is going on?????? Can't they knock me out for the purpose of at least SEEING where this blood is coming from? I'm losing my mind. My family is watching my kids. I miss my kids. I want my life back. I don't know what to do. I just am groing more and more hopeless with each passing day... and to hear that there are people on this page that suffer with this for YEARS makes me think that I might be better served by just offing myself. I have no income coming in and am staring down the barrel of THOUSANDS of dollars in medical bills.
I'm sorry for this rant, but I needed to share this with someone. I need any advice, support, suggestions that I can get. I just don't want this. I just don't want this. I just don't want this.

oh Chrisser27...please dont feel so hopeless..I do know how you feel though as I felt the same some days before I had my fissurectomy. I am soooo sorry you are hurting so much and that you are not getting the help you need. I totally understand the physical pain. And the shredded wheat thing too..they send us on our way and say to eat more fiber which only makes us poop more and hurt more! I spent a few days with just liquids...chicken soup broth, frozen fruit bars, jello, ginger ale, protein shake with a small amt of fiber. that way it gave my ass a break . We do need to have reg. bms so we dont get constipated, so you do need some fiber. Right now, 4 months after surgery, I am still on a pretty boring diet. Cheerios in am, soup and canteloupe for lunch and protein shake for supper. I also have miralax..(muvicol in UK) in chamomile tea in am and in pm..plus 1 stool softener in am and 2 in pm. I wish I could help you! I really do know how you feel. I was depressed and losing my mind too for the months before surgery . Please find a way to get help. i care about you..i will be praying for you...big big hugs! Maureen

I am so sorry that you are in so much pain . People really don't know just how ghastly this can be until it hits them.
I am not a doctor, so my advice just comes from my experience in my three years of having this, and I hope some others will chime in.
You should see a Colon and Rectal surgeon. They do not just do surgery, but are experts in this condition...be it hemorrhoids or fissures. Don't mess about with a GI doc.
I don't know what the situation is without insurance, but presume you are in the US. (We have 'insurance'. I put the inverted commas there as we land up having to pay for most of the damn treatments, and have spent a lot of money that do not have for this.). So, if you can go to a CRS. It is awful when you are in pain and cannot get someone to help.
When it comes to food, personally I have cut down on the amount of food that I eat, but worked out the calories I need and I take vitamins too. I just work out what I need, through trial and error I have to say, to have a formed BM. I drink water, enough of it and take fibre - probably about 20g.
Do you use anything to help things go through? Like Miralax or Milk of Magnesia (I take MOM)? The more you strain, the worse it becomes. So, you need something to help you, and as most people have success with Miralax, I would go with that. Again, you need to tailor the amount. Don't stop eating! Will just make things worse coming out, though soups and things like that can help for a few days.
You are reading other people's posts, and that is good, as there are some great ones on here, from people who have been just where you are now, and got through it, out the other side and on with their lives. We have all been in that desperate place, in pain, not knowing where to turn, so hang in there. Say at the ER that you need to be seen by a CRS. Nobody should have to be in pain without having it sorted. And rather sooner than later.
Thinking of you.

Chrisser27,
First off, I'm really glad that you found this forum, and that you have shared your story here with all of us. Please don't apologize for ranting. Everyone here understands completely your level of pain and the despair you are feeling.
Okay, now, as for what to do. I know it seems impossible right now, but there are some things that can make a difference for you. But before getting to that, you really need to start calling around to colorectal surgeon's offices and explain your situation to them. Believe it or not there are doctors out there who are willing to set up financial arrangements for patients with no insurance that will work for them. If you aren't able to make the calls yourself, have a family member do it for you. Look to the websites of your local hospitals to find a list of colorectal specialists in your area. Just be totally honest with them.
On to what you can do in the meantime. First and foremost, don't stop eating. It will only make you worse. It will impede your ability to heal, it will deepen your depression, and it will just constipate you.
But you do need to learn what to eat. Diets high in fiber will bulk up your stool, as you are discovering. And in particular, diets high in insoluble fiber. The shredded wheat you ate is insoluble fiber, which is probably why you were so miserable with the BM you had from that. Soluble fiber is generally much better tolerated by folks with fissures. Fruits and vegetables have a good balance of soluble to insoluble fiber, and should be the main emphasis in your diet. Grains such as wheat will be far harsher, but oatmeal is a good, soft source of soluble fiber. Always drink plenty of water when you are eating fiber in your diet. Without enough water your stools will be bulkier and drier. Emphasizing fruits and vegetables, and avoiding foods that generally cause constipation such as cheese, red meat, etc. is a good idea. Chicken and fish are generally well tolerated.
Stool softeners. Most people with anal pain of any kind need to find the right combination of stool softeners. Colace is one option. Miralax has been a godsend for many people on this board. Some people are on it for life. Prunes work for some people, as does a tablespoon of olive oil before bed. You really have to try out different combinations of things to find what works for your body. You want your stools to be the consistency of soft serve ice cream and with absolutely no straining.
Stress.. So so important. It is vital that you engage in some something to help you manage your stress. Whether that means listening to soothing music, watching your favorite movies on t.v., reading a good book, meditation, prayer, writing in a journal about your feelings, doodling, anything at all. It makes a HUGE difference. Do not underestimate how important stress reduction is.
Depression. It is totally understandable that you are feeling so hopeless about your situation right now. Left unaddressed, your depression will only impede your healing. I totally understand there are barriers to counseling because of the cost issue, but there are counselors who work on sliding scales, even some organizations that provide counseling for free. Nowadays there is even online counseling available.
Cancer. Try not to worry yourself with this. Anal cancer is actually pretty rare, and yet hemorrhoids and fissures are very common. And yes, anorectal conditions like hemorrhoids and fissures can make for what looks like a lot of bleeding.
Please know we're nere for you. Read through lots of postings here, ask any and all questions, rant and rave and cry and vent. We get it. The people here are awesome for support and information.
Take things one breath at a time. You can do this. I promise you, you can.

So pleased that jr2 came on too. Full of great advice there for you Chrisser27. We are all thinking of you, believe me.

Thankyou for taking the time out of your day to reply with such thoughtful advice. I'm happy to report that I went right out and bought some Miralax today. :) I am hoping that I am as successful as so many others who have taken it. I will CERTAINLY be backing off from my high intake of insoluble fiber. Went out and bought some pears and Oatmeal today as well. I also struggled through a second BM this evening.... which makes me think that my bowel habits are at least returning back to a more normal routine. It was painful as all hell.... but with less blood. So I am encouraged. I'll take whatever victory (real or perceived) I can get at this point - no matter how small. I believe that having been off from work for a week and staying home concentrating on nothing but the pain only contributed to the feelings of desperation. I asked a girlfriend to join me tonight for a cookout and I have my children for the night so as I write this I am in a much better place than I was this morning. Again... my thanks for the great advice. I will try to remain as optimistic as I can be (considering).
But I still think that this disorder is on par with the 7th Circle of Hell. My hat if off to ANYONE who has managed to live with this as a Chronic condition. Truly.

Chrisser,
oh, i'm so glad to read you are feeling a little more hopeful, and really glad to read you had some time with a friend and you will have time with your children. We really all do know how desperate and hopeless it can feel, and you've already started to turn things around for yourself in really significant ways.
Miralax will take some experimenting. For some people it takes several days to see an effect, for others there is an overnight effect. Also, you have to experiment with the dose to find what works for you best. Some people need significantly less than a full dose, others need the full dose or even more than a full dose. It will also vary depending on your diet on any day. Some people do better dividing the dose between morning and evening and some do better with a single dose either in the a.m. or p.m. If you experience gas, stick with it for a couple of weeks. Usually it's just an adjustment your internal ecology needs to make.
Celebrate the little victories with big celebration. You didn't do anything to deserve this pain. Your body needs your gentlest thoughts, care and compassion, which you've already begun giving it. Oh, and keep in mind that during this whole ordeal, setbacks are really common. The idea is to keep at the diet and supplement stuff for awhile to give the area plenty of time not only to heal but also to get some strength back in the tissues.
Oatmeal and pears sounds wonderful. remember lots of liquids, preferably water :)
Please keep us posted.

I have been where you are. I think my fissure is healing, but it is such a slow process, setbacks are inevitable.
I know the kind of pain you're talking about. I drive a lot in my job, and the pain was so bad I was literally screaming, constantly lifting myself up in the seat, having to stop every 5-10 miles to let the spasms subside. Sometimes the spasms were so bad I couldn't even stand still, and had to roam the streets during the middle of the night, walking it off. Hell, pure hell.
Through much trial and error, I discovered 3 things that seem to have really helped me.
1. Go very easy on the insoluble fiber. Shredded wheat, Raisin Bran, celery...they may be high-fiber, but they caused agony for me. Put a heavier emphasis on soluble fiber. I take Metamucil fiber capsules with every meal because it's mostly soluble. Fiber-Con caused me nothing but problems.
2. Stool-softeners are a must. You must get your stools to a soft consistency. I never had much luck with laxatives, the stools were either too hard or too runny. Wal-Mart has two store-brand stool softeners. For me, the blue-bottle version (Colace) was not effective. The green bottle (Compare to Peri-Colace) works well for me. Four tablets every night.
3. Eat soft foods. I have learned to avoid things like corn, peanuts...seems no matter how well I chew them, they create problems coming out. I even do better with egg-salad and pimento cheese sandwiches rather than lunch meat.
God bless. You have friends here.

Chrisser,
Just to wish you all the best and show my support for you too x It's horrible but it is temporary! You WILL get better again at some point you must believe that.
Every response to your post has provided you with some invaluable information and some great advice for helping you heal....... :)
Stick with the soluble fibre intake & soft foods for now, loads of fruit, soft-cooked veg, bioyoghurts, brown rice, soups, purees....WATER WATER WATER......
Prunes are helping me with stool softening as well as a big tablespoon of olive oil before bed.
Use a generous dollop of vaseline around your anal area before you go to lubricate it all so it pops out more smoothly.
Use a shower head to clean if you can straight after a BM and then sit in a hot bath to help healing & pain relief (if you're not already doing so) Some people use a cool hairdryer setting to dry off if it's just too painful to touch. Never wipe but dab!...I used Aloe Vera/ Sudacrem/ Witchhazel and Dilitizem cream to help heal it, which is what I suspect you need at this stage (that or Rectogesic)
Like you, I couldn't figure out why it all started for me as my BM's were never an issue but the one thing we do have in common is the stress element.
I got my fissure after a quick relocation & house move coupled with having to change jobs pretty quickly and a different lifestyle. That was exciting but hugely stressful. It also meant my exercise was reduced and my lifestyle more sedentary.....
As you say, you have been under HUGE emotional stress for a long time now by the sounds of it and it could be your body's way of showing the stress taking it's toll. Far better this than anything far worse. Honestly. I hope your 9 year old is recovering well. That must have been horrendous to deal with.
I truly hope you find someone that is able to help you through all this both psychologically and physically. I'm in the UK, so we have a very different system here.
ALL the best to you with it all, and don't hesitate to pop back for further assistance and reassurance xxxx