by Ever the Optimist » 04 Nov 2013, 15:42
Hey Sugarspice,
Calm down poppet! & a few deep breaths......Stress makes things so much worse but I do understand that it's so hard not to feel the way you feel right now because I was there once too (although I didn't get the Botox treatment - just the Diltiazem)
The problem with fissure recovery, whether it be through Botox or cream or whatever, is that it doesn't happen overnight as much as we all want it to. It really does take some time as you will read in people's healing diaries. Fissures are unpredictable & relentless at times and your healing can't really be monitored on a day by day basis - it's better to look at things week by week or sometimes month by month, depending on how quickly you seem to be healing.
It's best if you can try to get yourself to look at things that way because then you won't feel so disheartened and down if you do have another bad day or two in the meantime. The main thing is as long as your pain is reducing gradually then this is always a good sign. Perhaps keep a diary of your pain levels & symptoms & of everything you eat along with your BMs ? - this may enable you to see some patterns and make some connections with what you eat?
It's often easy to think that after one bad BM that you have retorn, but this isn't generally always the case....yes, you probably irritate things again somewhat and suffer more discomfort but you can be still healing - it doesn't mean you go back to square one again. This happens to an awful lot of us and a few days on, you realise it was just a "blip".
At times like this, try really hard to shift your focus off your bottom (again - difficult I know) but it really helps if you can "lose" yourself in other distractions - whether in your children or music or films or inventing new fissure friendly foods (that was one of my faves!)....Dealing with a BM alone is hard enough at these times, so if you can shift your focus away from your bum when you are out of the bathroom, it does help.
Your diet sounds absolutely fine to me too - I never had an issue with bran flakes myself but I get even better results with porridge oats, so what OMB has advised is a great idea for breakfast. I sprinkle oats with cinnamon and pour honey over them and it's delicious - Soft tinned figs mixed with Bio yogurt are also yummy too. The one thing I did note was your Cottage pie however - I have a few issues personally with mashed potato (possibly due to the mixture of milk & butter when I make it) so I tend to steer clear - That with the minced meat, is a bit too binding on my system creating the soft but hard "ploppy" stools you described, so the combination does not work for me - I also try to substitute minced meat for Quorn these days because it's much lighter on my digestive system.
The main thing is you seem to be doing OK with your diet but it's always good to keep experimenting to see what improvements can be made. Please check out the website for fissure friendly recipes & tips because there's loads here that will help you - Also, if you haven't already, check out the Bristol Scale on stools that JHH has posted because this gives you a great idea of what you need to strive for at such times!
As far as your stool softeners go, I would just say be careful right now because you do need soft stools. Lactulose is fine to continue to take regularly and I'd say persist right now - just be careful with Senokot. That's a stong laxative & not recommended for ongoing use. I think you might be thinking of Milk of Magnesia - it contains Magnesium Hydroxide and although is effective again, is not a laxative to be taken all the time.
A lot of people here (including myself) supplement with a regular Magnesium tablet once a day, which helps me personally maintain soft stools & you could try using additional Olive Oil, which is natural & safe. You can add loads to food or even take a spoonful orally. Other than that Miralax (Movicol) comes highly recommended but you might need to experiment with your dosage a bit....
You just need to experiment generally right now using some of the great tips on this site to see what works for you but the main thing is to stay as calm, strong & as practical as you can about it all too. Stress really does not help.....
Don't fret too much about going every other day either. Maybe that's just you...We all have totally different BM patterns. The main thing is the quality of what we produce is far more important than the quantity of times we have to go!
Take care Sugar & stay calm.....you will figure out what works for you for sure but please use this site to your advantage. It is undoubtedly the best place to be on the net with an anal fissure!!! x x
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups