Diary of pain

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Diary of pain

Postby bgd » 29 Apr 2013, 12:21

Since I'm not making progress as fast as I'd like too, lots of trial and error, I need to go more scientific and log my actions and BMs.
Last edited by bgd on 29 Apr 2013, 14:02, edited 1 time in total.
bgd
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History

Postby bgd » 29 Apr 2013, 12:50

Long history of constipation in childhood and adolescence. Problems started when I was around 19, small hem popping out. No severe pain. Constipation got better in my adulthood, with only rare episodes. Enough to cause problems anyhow. I didn't know what a fissure was, so I self-diagnosed myself with hems and continued ignoring.
Symptoms went from irritation, to mild pain that would stop within hours, bleeding after BM. It would all go away within days using suppositories and ointments. Ignore.
On occasions I would get massive bleeding, but no pain. Then fever up to 38.5 C. It took me a while to relate fever episodes to blood on stools. Treated with antibiotics.
End of Nov 2012 (age 39) I had some mild diarrhea, 2-3 BMs per day and I started getting the symptoms again. Only this time it never went away. One day I had to go home from work and lay down. Symptoms got milder. In Feb/Mar 2013 I got very constipated. Started watching my diet, taking flax seeds and dry prunes, but it was too late. Even though I resolved constipation, pain started waking me up at nights. But had no spasm yet.
Mid March got to another level of pain, I learned the hard way what spasm was. It would start 4h after BM, grow in intensity for another 3 hours climaxing with excruciating pain that I've never felt before. I just didn't understand what was going on. Then pain would subside. I found out later that it was pain level 8-9.
After 2 such sleepless nights I realized I need to seek help. I called in the next morning and got an emergency appointment the same day at a private clinic, specialized in rectal problems.
Last edited by bgd on 29 Apr 2013, 15:10, edited 6 times in total.
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First appointment

Postby bgd » 29 Apr 2013, 12:51

Mar 25. Diagnosis: internal and external hems, chronic AF internal, large, 1.5 cm long, located in the back, starting close to the anal opening and going up.
Treatment options offered: herbal ointments, cauterization, botox. Scheduled for cauterization 1 week later.
Last edited by bgd on 29 Apr 2013, 15:11, edited 2 times in total.
bgd
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Treatment pre-cauterization

Postby bgd » 29 Apr 2013, 12:59

Ointments worked, first 2 BMs (every other day) pain free. 3rd BM slightly harder (Bristol 4), sent me back into spasm.
Vegetarian diet. Paraffin oil twice a day prescribed by doctor.
Last edited by bgd on 29 Apr 2013, 15:00, edited 5 times in total.
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Sick leave - week 1

Postby bgd » 29 Apr 2013, 13:05

Apr 1st - painful BM on the day of cauterization. Anesthetic gave immediate relief, no pain during cauterization. No significant pain afterwards. Scheduled for botox 5 days later.
First 2 BMs great, no pain.
Apr 5 - 3rd BM very painful, botox (Dysport) the same day, all hell broke loose. Pain level 9+ for 8 long hours, in bursts. Would subside to 7-8 than go back to 9+. Cursing, screaming, crying, begging, agonizing.
Last edited by bgd on 29 Apr 2013, 14:05, edited 4 times in total.
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Sick leave - week 2

Postby bgd » 29 Apr 2013, 13:10

Agony continued, reduced BMs to one every 3-4 days to cope with the pain. Unable to do the self anal massage nor apply ointment. Anus very tight and painful, like raw flesh. Used an applicator, but realized later I wasn't hitting the fissure site. Bleeding, which I didn't have prior to cauterization. I felt it made my situation much worse. Spasms longer lasting and more intense. Doc reassures it goes worse before it can get better.
Botox (Dysport) wouldn't kick in. Doc reassures it usually takes 7-10 days.
Spasms so bad, nothing would help. Cold bath would contract the muscle more, hot bath would cause inflammation, therefore stopped baths completely (big mistake). Anesthetic gel would cause more burn. Painkillers have no effect whatsoever. Found out lifting legs on top of a pillow stack and spread legs open would slightly decrease pain from 9 to 8, but still unable to sleep.
Getting major swelling during spasm episodes.
Despair made me hoarding and mixing all sorts of herbal ointments. Good for moisturizing, but nothing seems to reduce pain.
Regretting cauterization. Contemplating colostomy and LIS.
Last edited by bgd on 29 Apr 2013, 15:13, edited 3 times in total.
bgd
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Sick leave - week 3

Postby bgd » 29 Apr 2013, 14:17

Anus starts to feel more relaxed. No BMs first part of the week.
Apr 15 - anal massage performed by doctor upon checkup sends me back into moderate spasm for the next 6h
Apr 18 - very careful with the BM, not the slightest push, just let out what comes naturally, therefore I was left with a sensation of fullness. However didn't get spasm. Botox has kicked in.
Apr 19 - BM same as before, feeling great, no spasm. 4h later major diarrhea (Bristol 7+) kicks in and ruins it all. 4 BMs in 2h. Back to square 1. Stopped it with 2 imodium pills. Moderate spasm for 2 days, constant, hard to sleep.
Last edited by bgd on 29 Apr 2013, 15:14, edited 5 times in total.
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Back to the office

Postby bgd » 29 Apr 2013, 14:25

Felt OK on Monday, but realized I have to reduce BMs in order to reclaim my life and cope with my job. BMs every 3-4 days, pain for 7-8h, sometimes moderate, sometimes severe. Schedule BM to 7-8PM, go to bed afterwards, hoping to fall asleep around 1AM. Feeling OK the next 3-4 days till next BM.
Ordered Manuka Honey, no solid opinion yet. Seems to promote healing, but maybe it's just placebo.
Last edited by bgd on 29 Apr 2013, 15:07, edited 2 times in total.
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ROUTINE

Postby bgd » 29 Apr 2013, 14:27

I feel controlling tear and spasm is like walking on a rope, the slightest mistake can take you back to square one. After lots of trial&error I established myself the rules below. This board is Godsend, many thanks to all board members. This is a puzzle I've put together from things I've learned from other members. Can't believe pooping has now become a discipline. The price I'm paying for totally disrespecting my body for 2 decades long.
DIET
- vegetarian, bread, liquids, paraffin oil twice a day (doctor prescribed). Nothing else.
- dropped flax seeds, making stool too soft. Will reintroduce once I start eating meat again.
- only lost 2-3 kilos
BM
- Bristol 5-6 ensured by diet, every 3-4 days - only way I can function and work. Can't afford 8h pain everyday
- schedule BM to 7-8PM, not to spend the whole day in pain. Hope to fall asleep 2-3AM
- bath 38-39C before BM, relaxes sphincter
- plenty of vaseline before BM, make sure to cover the fissure with a thick layer
- painkiller and anti-spasm pill after BM
- no push, let it flow naturally
- do not open anus completely, that's when tear happens. More here: http://anal-fissure.org/t6597-how-not-to-tear-vaselinecontraction#88352
- if it comes too fast try to slow down by slowly contracting the anus
- getting lots of swelling during BM, but no major pain
- no toilet paper, use shower
- bath right after BM, temp is crucial. 38-39C seems to work best. Cold contracts, hot inflammates
- if pain is great, no ointments after BM, they just irritate more and trigger spasm
- if pain is moderate ointment or anesthetic gel might work, otherwise it just burns more
- lay down after BM, legs up on pillow stack
- if spasm starts kicking in, go back to the bath tub, watch temp
- passing gas seems to break spasm for a while, as it slightly opens the muscle
MEDICATION
- magnesium, 1 pill/day
- painkiller and anti-spasm pill before BM
OINTMENTS (twice a day)
- initially started with a mix of herbal ointments and smashed suppositories (containing Balsam of Peru and Hyaluronic Acid), eventually kept only the one given by the doctor, which I found has the best cooling effect. It contains: oregano, blackberry leaves, blackwort (comfrey), fallkraut and pot marigold
- Manuka honey
- using applicator (thin 1ml syringe), lube with Aloe gel. Try to hit the fissure with the tip of the syringe and release
- release some excess ointment in the rectum as well, it will build up and mix with faeces, keeping them soft. It's OK as long as it's herbal
ANAL MASSAGE
- crucial for relaxing muscle, increasing blood flow to the area and prevent fissure from folding into itself, thus scaring incorrectly (according to my doctor)
- wouldn't work before botox, anus tight and painful
- try to insert the tip of the finger at least
BATH
- twice a day and before/after BM 38-39C
- no salt for me
- initially neglected the importance, but crucial for relaxation and blood flow to the area
Last edited by bgd on 03 May 2013, 12:46, edited 6 times in total.
bgd
Proctosphincteranalogist
 
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Re: Diary of pain

Postby bgd » 01 May 2013, 02:02

Apr 26 - BM close to midnight after 3 days, couldn't hold it till next day. Bristol 5-6, but for some reason I tore pretty badly. Vaseline didn't hit the right spot and I forgot to slow down stool, so it came out fast. Felt the tear all along the fissure, going deep inside. Pain peaked at 6-7, still better than 9+. Was able to reduce pain with several warm baths. Fell asleep 7AM.
Starting Manuka Honey.
bgd
Proctosphincteranalogist
 
Posts: 214
Topics: 11
Joined: 17 Apr 2013, 16:00
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