I thought I'd start a diary because my journey to AF-dom is a bit different from any other person I've encountered yet on this forum or the web, and if my story can help another lady in my shoes to feel a little less alone, I'm happy to help. I know there have been many times when I felt (and still do) so impossibly alone on this pretty miserable journey.
In truth I have probably had issues with hems/fissures for many years (I'm currently 31)- but it was never anything debilitating, and I never thought twice about the bloody streaks that would occasionally appear on the toilet paper after wiping.
Things started to change rapidly last year. I suffer from Polycystic Ovarian Syndrome (PCOS), and this means that, for me, I don't have regular periods/menstruate/ovulate. In the past, I've actually gone over a year without having a period. Nothing cooking in the ovarian kitchen. Nada. Anyway, my husband and I decided last summer to start visiting a fertility specialist in the D.C. area to see if having biological children was a possibility for us. Fertility testing and treatment is, by all accounts, grueling (not to mention expensive!), and more so when you respond poorly to the medication you are given. My reproductive endocrinologist prescribed Clomid for me; many of you will have heard of Clomid, as it's been around for decades and is considered widely tolerated and highly effective. Not for this girl. Cue the hot flashes, night sweats, mood swings, insomnia. And, worst of all, constipation. When I could move my bowels, the stool was rock hard. The stool was so hard it would clog the toilet- without the aid of toilet paper. I never knew that the straining could give me an anal fissure... Well, as we know, it can and does! More on that later.
I took Clomid from August through December, suffering from the side effects in the hopes of ovulating. As it turns out, there's a fraction of women with PCOS who are considered poor responders to the drug. Instead of ovulating, all I grew were big fat cysts. I'm pretty good at that! And then a diagnosis came in December during a transvaginal ultrasound: I had a mass attached to left ovary. The fertility specialist halted treatment and referred me to a gynecological surgeon. Five days before Christmas I had a fist-sized tumor removed from my ovary. Thankfully, the diagnosis was the best that one could possibly hope for: the tumor was benign, and the surgeon was able to save my ovary.
Recovering from the abdominal surgery was, in hindsight, a piece of cake. The Percoset I was prescribed for pain didn't do much harm constipation-wise because my abdominal muscles had been cut and straining wasn't an option. I was able to resume fertility treatments in mid-January, this time with injectables (Gonal-F).
Then came the bum tear heard around the world (literally, I think!). I went grocery shopping one day and, as I was squatting in front of the fridge to put vegetables in the bin, I suffered a catastrophic rectal tear. I could feel the tearing, and the immediate spasms... You'll know about those. The feeling of being violated by shards of glass or a fire poker. I called my husband and told him, "I think I just tore my a--!" Unfortunately, I was right.

The initial spasm subsided (thank God!), but the fissure wouldn't heal. I oozed faint pink blood for two months before the bleeding worsened and the spasms resumed. Starting in March, I halted fertility treatment. I'd get up from the ultrasound table and leave blood on the tissue paper from how badly I was bleeding (and the wand they used for the ultrasound only reopened the wound... fun when you're getting ultrasounds four to five times a week, eh?!). At this point, I had been using an injectable (Gonal-F) that is known to have constipating side effects. The same is true for a progesterone supplement (prometrium) I had been taking in massive quantities. I stopped taking the meds and contacted a CRS.
On April 29 I had LIS and a fissurectomy. My spasms were constant and severe. I was spending as many as five hours a day in the bathtub. Nothing I tried provided me with a modicum of relief. And I tried it all! More on that another time, I suppose. :o
Recovery from the LIS has been slow. At first, I was despondent that the surgery didn't work because I was still suffering from spasms (they take weeks to go away for some people, so if you're in the same boat hang in there!). The actual post-op recovery wasn't bad- no incontinence, very minor rectal bleeding only the first day, and no incision pain after a week. But the fissure has been taking its merry time to heal, and at times I still worry the LIS didn't work. I travel everywhere with a memory foam cushion (my little life saver... I was actually able to fly to Japan this July because of it!). It took me a couple months before I could lay on my back in bed or not sit side saddle on the sofa.
A few weeks ago I would have said that I felt healed. No fissure pain whatsoever. In the past week I've experienced an inexplicable setback- I'm thinking maybe it's a histamine intolerance/blood vessel issue. The fissure has been stinging and the sphincter has been occasionally spasming. But no constipation, straining, or blood. Yippee! So we'll see. I'm getting back on antihistamines to see if there is any correlation between that and fissure pain. For a few weeks, I was taking Claritin regularly and experiencing no fissure discomfort. We'll see. Fingers crossed!
As for my infertility... I don't know if I can bear to go back to the specialist. The plan, when I was feeling better, was maybe to go back in January and try it for another six months. I'll keep you posted on that. What I worry about it, if I can get pregnant, is how I am getting to deliver a baby. I think at this point I would elect for a C-section. Having had abdominal surgery, I can say that recovery from that was a breeze compared to life with a fissure.
I think that's about it for now. Thanks for being such a supportive network for me! The members of this board have kept me sane more times than I can count, and your support means so very much to me.