Saw my 4th CRS last week

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Saw my 4th CRS last week

Postby sotiredofthis » 27 Mar 2014, 11:42

I saw my 4th CRS at the Cleveland Clinic last Wednesday. She was wonderful and very knowledgeable. Renowned in the CRS field and works with very tough cases. I've had this fissure problem since Sept. 2012 and my main problem is sitting. Here is what she told me:

My fissure had healed over and all she could see was scar tissue right now. She had trouble doing a digital exam and knowing that I have IBS she had me do the anal pressure test. Not terribly unpleasant. Then she did another digital exam and that's when she could feel the scar tissue.

The result of the test showed I have extremely high anal resting pressure. I think triple the normal pressure. She said that is partly because I have IBS and tighten my muscles more than others. Definitely true. She said she would do the LIS surgery if I wanted but wanted me to be well aware of the risks. She says the incontinence in women is more of an issue especially as we age. Our muscles tend to relax much more then. She said not so much of an issue right now maybe but could possibly be an issue in the future. Also, most prevalent is gas incontinence. Having IBS complicates the issue.

I have high blood pressure and take meds for it so she said I could try another med that relaxes muscle. It's a calcium channel blocker, nifedipine. She said I could try that for a month or so and see what happens. She has had success with it before. I started the med this Monday and today had some constipation which is causing a little stinging in the fissure area. Constipation is a side effect of this drug unfortunately.

So, now I'm sitting here wondering what in the world to do. I definitely don't want to get constipated. That's what started this whole thing to begin with!!!! But that darn incontinence scares me to death. I'm wondering if my resting pressure is this high would that help with my incontinence?

Any advice?

Thanks!
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Re: Saw my 4th CRS last week

Postby Savaici » 27 Mar 2014, 12:42

I can only reply to the resting pressure. I have very very slight anal incontinence (for all I know I have had it for years but now that I follow what happens down there with the same obsession that I watch Downton Abbey I notice it). I have a very tight muscle, and a bit of stenosis, which I solve by soaking on a Sitz bath on my loo in order to easily poop...not always easy. :groan:
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Re: Saw my 4th CRS last week

Postby sotiredofthis » 27 Mar 2014, 17:05

Savaici,

Did you have LIS?

Thanks for replying.
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Re: Saw my 4th CRS last week

Postby sotiredofthis » 27 Mar 2014, 17:06

One more question, Savaici, what exactly is your slight incontinence? Having to wipe again later, gas incontinence or actual stool loss?

Thanks!
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Re: Saw my 4th CRS last week

Postby sotiredofthis » 28 Mar 2014, 07:35

Unfortunately, more pain on BM today. I obviously tore some again yesterday. I'm sure it's from the blood pressure meds as like I said it does have a constipating effect. I was hoping with my IBS that wouldn't be an issue but I guess not.

Any advice for me? I am terrified of the incontinence but I don't know if I can go on living like this either! It feels like one step forward and two steps back all the time! Damn incontinence fear!!!!!!
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Re: Saw my 4th CRS last week

Postby Jbl22424 » 28 Mar 2014, 09:38

Are you applying the nifedepine topically or taking it orally? You could try the topical option which I would imagine would not constipate? Have you tried nitro?
Developed fissure from constipation due to breastfeeding 7 weeks after delivery (Jan 2014)
Nifedepine
Colace
Magnesium
Miralax - godsend
Nitro - some improvement
LIS (May 2014) - cured for 3 months then setback
Diltiazem
Feeling better for now
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Re: Saw my 4th CRS last week

Postby sotiredofthis » 28 Mar 2014, 11:39

It was the oral Nifedepine. I've been using Rectiv since December.

Thanks!
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Re: Saw my 4th CRS last week

Postby sotiredofthis » 29 Mar 2014, 14:45

Definitely a new tear. Pain and bleeding today when having a BM. I haven't bled for over a year. I guess my only choice is surgery but I can't begin to tell you the fear I have of incontinence. Having IBS as well just about makes me go crazy with fear. All I can see in my future right now is never being able to leave my house again for fear I'll poop my pants. This just really, really sucks.
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Re: Saw my 4th CRS last week

Postby Rachael 1984 » 31 Mar 2014, 12:33

Hi STOT,
I am in the same boat as you... Although I haven't actually been offered any surgery yet..... I will do though when I hold a gun to the CRS head next week! Seriously, my first CRS just gave me Botox and kept saying he didn't want to cut me because I'm a woman and the fact I have IBS. Now he has referred me to another CRS in his team. I am in real bad pain again and I'm convinced the fissures have never healed, although he said everything looked fine. So maybe my situation is the same as yours... My muscle is tight.... Although he said he didn't think it was because he inserted the Anuscope okay?. How would he tell without a pressure test?? This is so annoying, just want my life back. I do hope you can come to a decision on this as it's god damn awful living in fear and pain all of the time. Sorry you have a new tear, please keep us posted. Xx
Hem Banding sept 2012
2Fissures
Nitro- Effective short term
April 2013-Botox-Effective short term
Diltazem-No effect, developed Rash
July 2014-Diagnosed High Resting Pressure
LIS performed on 17.9.14
Ongoing pain/re-tears. Awaiting pressure test results.
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Re: Saw my 4th CRS last week

Postby sotiredofthis » 31 Mar 2014, 12:45

Thanks, Rachael. I think of you and pray for you often as we are on the same track it seems. I do so hope you get offered surgery. I'm waiting for my CRS to call me so I can schedule mine. Probably the end of April as my husband will be off and can help me with our little ones. Right now that seems like an eternity away though. Just absolutely terrified but I can't live like this anymore. I thought I was doing okay until last week. But really I guess I was just one bad bm away from another tear anyway.

I don't think they can tell pressure without a test. I've had the anoscope inserted before as well but the pressure test showed a lot of pressure.

Just want my life back, too.

Thanks again
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