Sorry you're also having a rough day mamafizz. I have the burning most often, but the internal sphincter is clearly very tight - my physio has me doing some gentle massage and I can feel how tight it is, and I have lots of trouble having a bm. It could be I'm just used to the "tightness" feeling by now or that the pain is overwhelming it.

Honestly, the Botox did help that, going is pretty easy. It's just after ward the tightness of the connective muscles that I am dealing with. I was told the goal is to decrease the inflammation and the muscles will relax, the deep burn ache and tightness will ease and eventually go away once this is accomplished. Good vein and anal health is key.
Not inflaming the area further, (how the heck do we do that?) procedures, exams, inspections, normal going to the bathroom disturb the area and creates more inflammation, muscles tighten more etc. each time takes longer to get back to normal. Meds seem to make things worse. Trying to find the balance. Prayers help in this spiritual journey, something good has to come of this.
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GG can you tell where the tightness is coming from? Does it feel like its the muscles surrounding the sphincter ? do you have any pulling up feeling, since I am wondering if the muscles have shortened and thickened and how to remedy this.. I have appt Monday with Physio so we will see.

I have tightness at the actual sphincter mostly and right around it. Sometimes I feel a golf ball feeling in the rectum but not often. It does create a sort of pulling up feeling, as if I am clenching the anis without trying to.

I would say from what I have been told and from what I know about muscles (way too much lol!) that you likely have some muscles in the pelvic floor that are hypertonic - overly contracted. This may mean that at their "resting state" they're more contracted than they should be - maybe that's why you are feeling them often. The physio may help you to be able to relax them with some manual work. In my case, manual work is not effective, that sphincter muscle is just too stubborn - thus surgery.

Let us know how the physio goes. I hope they will be able to give you some answers.

I think so too, I'll see what she says next week, and share any new info that might be helpful...

MPB, just wondering if when you have internal hems it gives you a full feeling as though you need to go along with a deep ache higher up?

GG, just wondering Overall I still feel as though like you my muscles are way too tight, how do they gauge how much to cut if the fissure is healed? And if the surrounding muscles are also hypertonic, how would they relax since they are only cutting the one? Also does the surgery injure the nerves? Seems as though they are so disturbed aleady...jus curious what you were told.. Did you decide to schedule that?

I have my appointment on Friday to discuss LIS. I can ask some of these questions then to confirm, but this is what I think:

- they will likely be able to feel the relaxation of the sphincter right as they cut it (ie the surgeon can just feel the tightness with a finger). I'm assuming they will use this as a gauge.

- once the muscle that is NOT under our control (internal sphincter) is relaxed, I believe the others will follow suit, simply because the IAS is likely the source of the tightness. If this doesn't work, physio will help with that. I've been able to relax the surrounding muscles quite successfully in our sessions, just not the sphincter.

- nerves are everywhere, so surgery will for sure cut through some. BUT I believe when you're referring to "damaged" nerves, you mean hypersensitive nerves - nerves that send pain signals more easily than they should when stimulated. This is a different case than the surgery - the surgery will result in a small incision that will heal (nerves and all) like a papercut on the hand. The hypersensitive nerves, if present, are probably the result of the pain cycle, and of the tight muscle continually compressing the area. That's how I see it...sorry if I've made it a bit confusing

Will let you know how things go on Friday!

Meanwhile trying to get bms and stomach pain under control. This constant stomach pain is debilitating, as bad as the fissure at this point.

OOH, soo sorry that dreaded stomach thing, Dealing with pain really stirs things up also, digestion and all.

Yes thanks let me know what you learn. I have to figure out if mine is the IS or the surrounding muscles. I did read that muscles take a little longer to heal then say a bone injury per se. I just cant wait until this aching soreness goes away.... Hopefully we will both know more by the end of next week. I am thinking mine is the surrounding muscles. I have no problem going to the BR. I actually took 2 advil and went for a little walk in this little village with rocks and water, very serene. Would have enjoyed it more without this horrible ache but at least I got some fresh air for a bit. Now back to laying on my side again... OH Lord I cannot wait to feel like my old self....Sooo ready:) I would like to know what healing feels like?? Prayers for all who are suffering in this journey, we will be better soon!!!!

Mama and GG,

Keeping you both in my prayers. No updates on my end but I am continuing to try everything possible.

I have a good feeling about LIS for you GG, please keep us updated.

Mama, do you think the Botox was worth it at this point? That's the next step my doctor wants to take.

I appreciate both of you and I know we will all eventually heal!