Here I am posting on an AF board, as I'm taking the first step out of hell. It's been the worst 4 weeks of my life and I'm almost afraid to celebrate. Till last month I didn't even know what an AF was, yet I think I lived with it for two decades round, thinking it's just hems. What was I thinking ignoring it for so long? You know how it starts, hard stool, a bit of pain, but then it all goes away by itself, so why not just ignore it? Then the blood comes, who cares if there's no major pain? It got worse a few years ago, when suddenly I started getting fever a couple of times a year and it took me a long time to relate it to bloody stools. I was actually getting infected, still didn't do anything about it.
Then it got chronic last November when I was going through a stressful time, thus having 2-3 BMs a day. Only this time it never healed. It got worse when I got constipated for a couple of weeks and pushed it out without mercy. But still, pain would go away in a few hours and there was no spams. I didn't know what spasm was back then. Then I went on a diet, it's Easter fest anyway, and managed to get my stools back on track. Paraffin oil and flax seeds worked great for me.
Then end of March it has gone from bad to worse. I woke up in the middle of the night, about 4h after my BM. Spasm has entered my life and changed it forever. I didn't understand what was going on, why is my anus suddenly so tight? It would take another 3 hours before the pain would become excruciating and would last for another hour, but then it would go away. It took me another sleepless night to finally come to the realization that I have a serious problem and should ask for help.
Next day I was in for an emergency consultation and got the news: chronic AF 1.5 cm long, plus the hems I knew about. I've got a serious bashing from the doctor for ignoring it so long. He explained me the pain-spasm-pain cycle. Then I was presented the treatment options they had: ultrasound cauterization and botox (Dysport) combined with herbal ointment, sitz baths. No word about LIS and dilation. So I started with the ointment and got scheduled for cauterization one week later, on April 1st. Sitz baths didn't work for me, they would actually make my spasm worse for some reason.
The herbal ointment helped, but I just wasn't able to stick my finger up, so I made myself a thin applicator. The doctor insists that massaging the muscle on the inside is crucial to get the blood flowing and facilitate the generation of new skin. To me it makes no sense to traumatize an open wound. I felt I'm getting more healing by simply living it alone. So I just used the applicator and got better right away, I would still get pain but no spams for the next 2 BMs. Then the 3rd BM came just a little bit harder and put me back to square one.
On April 1st, the day of the ultrasound cauterization I barely got there due to the pain. Local anesthetic gave immediate relief and the pain after the cauterization was far less then the spasms. Next couple of BMs more or less pain free, no spasm. So I thought this was great, I'm healed. Little I knew that it would be short lived. I think what happened is that the cauterization closed the wound and generated a crust which fell off after about 5 days, so I was back on square one and worse: constant bleeding, painful BMs, spasm. Now I think it was a big mistake, it only made the AF worse, although my doc insists it burned the edges and made the AF from chronic to acute, thus facilitating the generation of new tissue.
On April 6th I was scheduled for botox, again got there in severe pain and the local anesthetic didn't help much. Getting the botox injection over this state surely didn't help my pain. What came after was beyond anything I could've imagined. If before, the spasm would top at 7-8h after BM, now I got a constant pain level 9 for 8 hours with very few moments of slight relief. I went from praying to cursing, screaming and crying. The pain was so intense for so long that it reduced me to tears. No painkiller helped. I wished for cure or death. Now I'm pretty sure the order was wrong. Should've got the botox first and cauterize after it has kicked in.
The next days went on the same, till my body refused to poop. Now I have a stool every 4 days, luckily it's still soft. I also noticed the very soft stool it's actually worse, as it burns the fissure. And the damn botox just wouldn't kick in. Doc wanted to cauterize again, I refused.
My agony topped last week when I got pain for 14 hours. Stool at 7 PM, bearable pain till 11 PM than a second soft stool put me back to square one. The pain was so big that I was contemplating in going to ER and having emergency LIS done. By 5 AM I was exhausted and fell asleep, but woke up every hour. Only at 9 AM I could fall asleep for good.
Then I got another episode when my hems got all swollen during spasm, but ice worked. Went to see the doctor the next day, he inspected the area and it hurt so much it send me back into spasm for the next 6 hours. Damn.
As a last resort I went on a (mostly) herbal cocktail of ointments and suppositories that is too long to describe here. However, 2 ingredients that worked great on my placebo were Balsam of Peru and Hyaluronic Acid. But the main thing was no touch and poop less. My doc still insisted in avoiding LIS. I also discussed balloon dilation, but it's not a practice here in Romania so the only alternative is manual dilation, which he considered too brutal.
Today though, 12 days after my botox I think it finally kicked in. I was also very careful with my pooping. I'm not pushing at all and barely opening my anus, just enough to release tiny chunks. However the result is that I didn't flush completely and now I feel like pooping again, but I'm just gonna hold it back and go to sleep. So more than 4 hours after the BM I have no pain, no spasm and the swelling is gone completely. So it's either the botox, either I didn't get a tear this time. I'm now confident to poop more often, maybe every other day, but I'm still gonna be careful not to open my anus completely, cause I feel that is when the tear happens.
So I think the door is now open for healing and what I'm gonna try next is Manuka Honey, I read it worked great for some of the members here.
Great board btw, learned a lot here