Quick question - please help

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Quick question - please help

Postby Okaybum » 23 Nov 2018, 04:08

I've had a small fissure that hung around for 4 months. For the last 9 weeks I've not had a retear. For several weeks I kept my BM so loose it was mostly diarrhea. It was the only way to prevent a retear. I did not feel the fissure at all. It would get sore from time to time but not during a BM.

Well, this past week my BM have been more solid (still super soft) and every time I go, I can feel an almost pinch or a stretch where it feels like the fissure is one step from ripping open. It only happens at the start of a BM. My sphincter automatically tenses to slow or stop the BM. After this, the bm proceeds as normal, no more feeling like it will retear.

I have zero pain afterwards and no pain at the fissure site. I can wipe. No pain at all

So I went to the doctor. Just a general practitioner. I was going to get a referral but she said she couldn't see anything. She could see where it had been but it was healed now and had been very small/superficial.

The thing is I keep feeling like my fissure will pop open at the start of each BM which makes me terrified to have one. My mum thinks it's just nerves on the healing skin.

It's never sore to wipe or after anymore so what's causing that feeling at the start of my BMS? I should say it's not painful but it's unnerving and terrifying. Is it from making my BM too soft for too long? Or am I close to retearing? I hate this. This fissure is so different from the others. I kept retearing despite stool softeners
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Re: Quick question - please help

Postby patience_and_healing » 23 Nov 2018, 09:49

I've had this feeling too and my PT said it was because of tight muscles in the area. One thing that helps me is to contract and relax the muscles 10 times in succession, but slowly. So sitting on the toilet, breathe out and contract for 5 counts, breathe in and relax for 5 counts. This fatigues the muscles and makes them less resistant to starting a BM. I understand the fear you feel, but fear also makes things tighten up unconsciously. Try looking up, breathing deeply, let your diaphragm do the work, and let go of fear before a BM. Watch some funny videos in the bathroom if you have to, to distract yourself.
8/16-12/16: Fissure due to antibiotics
5/17: Botox to sphincter, fissure healed
9/19: Trigger point injections and pudendal nerve block
11/19: Botox to pelvic floor
8/20: Botox to pelvic floor in new location.
Currently in pelvic physical therapy
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Re: Quick question - please help

Postby Abu » 23 Nov 2018, 10:14

Okaybum, how do you make the stools so watery?
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Re: Quick question - please help

Postby Okaybum » 24 Nov 2018, 03:37

Thank you patience and healing. You're likely spot on, that's probably what it is. Tonight felt more scrapey but I relaxed and it didn't feel like it was going to retear. I think at 9 weeks the skin is definitely still healing. I'm going to keep up my routine and be strict about my diet for another 4-6 weeks. I just need to relax and be patient.
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Re: Quick question - please help

Postby Okaybum » 24 Nov 2018, 04:05

Abu wrote:Okaybum, how do you make the stools so watery?



Happy to share. This tiny pain has not agreed with fiber supplements or anything like that so here's my tricks:

Morning I take 1 dose of movicol/miralax.
I eat yogurts and fruit for breakfast. Or oatmeal or whole wheat toast.

Lunch salad. I used to have veggie sticks like cucumber and capsicum aka bell pepper but that's too much fiber and I'd find I'd get bad gas all afternoon which would make the fissure sore. So I found if I haven't had yogurt, then I could eat my salad and yogurt or add in chicken or leftovers into my salad.

5:30pm: I take another 1.5-2 doses of movicol.
Dinner is chicken/fish/lots of veg/rarely beef.
After dinner, I take a dose of docusate sodium.

Now don't start on that much movicol. I've been on it for 5 months and I really believe that you build up a tolerance. Each retear, I had to increase the dose to stop the cycle.

If I haven't had an evening BM I would drink warm prune juice. It triggers a BM in 2 hours for me. However, this has been full on diarrhea so this week I've been letting my body take control. It's honestly been anxiety filled as I prefer my super loose stools. My stress levels were unnaturally high anyway as it's been a stressful week at work and home.

I had to keep everything soft as simply sitting on the toilet would cause the tear to pop open. It is right on the outside. I no longer have that now but now I need to retrain myself to have a more normal bm. Thankfully, I've not needed my prune juice this week. I took it last night as I was too stressed to go naturally and that was a terrible mistake and my stomach was seriously not happy with that. I ended up clearing out my whole system and then not going like clockwork today. But I'm about to see a dietitian as I think I have ibs that swings from diarrhoea to constipation in a single day.

Also worth noting apple cider vinegar cloudy apple juice has even a more powerful laxative effect.

Best recommendation, try things, see what works. Gradually increase medicine. If you suffer a retear, make sure you jump on that straight away with slightly more medicine.oh and lots of water. Lots and lots of water
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Re: Quick question - please help

Postby Okaybum » 01 Dec 2018, 00:04

patience_and_healing wrote:I've had this feeling too and my PT said it was because of tight muscles in the area. One thing that helps me is to contract and relax the muscles 10 times in succession, but slowly. So sitting on the toilet, breathe out and contract for 5 counts, breathe in and relax for 5 counts. This fatigues the muscles and makes them less resistant to starting a BM. I understand the fear you feel, but fear also makes things tighten up unconsciously. Try looking up, breathing deeply, let your diaphragm do the work, and let go of fear before a BM. Watch some funny videos in the bathroom if you have to, to distract yourself.



:thanx:

I just want today this has been working like a charm! I still need to let go of my fear in the afternoon but the moment I started doing this in the morning, everything was perfect. Fantastic advice. Thank you.

I have spoken to a dietitian who has help sort out that my "constipation" is mostly stress related. The fissure began with serious stress and a job interview and every flare up has been due to stress. Even with all the stool softeners, I still get big BM with stress. So far the breathing is helping and I'm working on my stress. I'll meet with her in 6 weeks to see how I'm going and if I need to see anyone for anxiety/stress. So far so good. 10 weeks healing. I tried to stop the GTN cream yesterday, but I got twinges of general pain, not at the fissure site. Tomorrow will mark 6 weeks of GTN so I'm going to continue it another two days then try to stop again. So far, so good


Thanks!
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Re: Quick question - please help

Postby sean530 » 01 Dec 2018, 12:50

can you elaborate on the breathing thing? i couldnt understand sorry
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Re: Quick question - please help

Postby MarkM » 08 Dec 2018, 18:02

How many weeks will be safe to say healed ?

Why does retear happen, even BM is soft?
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Re: Quick question - please help

Postby Abu » 08 Dec 2018, 23:23

We can hardly talk about weeks here. It's months or years till you can consider lucky to be healed...
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