This is a new pain in my...

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This is a new pain in my...

Postby StressedOutGrad » 31 Dec 2013, 21:07

Well, I'm glad to have found this page but it's unfortunate that I've had to.

After years with IBS, recently I have been battling hemorrhoids and now I believe I have a fissure. I say "believe" because I am an uninsured graduate student/teacher with a very small stipend. I am unable to go to the doctor or a specialist, lucky for me that the internet is here!

I believe I had a fissure rear its ugly head... The burning is unbearable for over an hour after a BM, I cannot stand up straight because I feel like half my colon is crawling out of my body, and there is no comfort with sitting, lying down, etc.

I was in so much pain after my 3rd BM for the day that I was sweating profusely, crying, and I couldn't walk for about ten minutes. I just stood, buckled over, for a bit until I could wobble to the bed for more misery. Now I feel the spasms which make me have the urge to go non-stop.

It doesn't hurt as much on the toilet until I wipe and try to stand... Then it gets AWFUL.

I'm in my 2nd sitz bath for the day (which really do help alleviate the intense burning, I have been applying coconut oil and Vaseline extensively to the external surrounding area, so any other suggestions for the poor, uninsured Would be beyond appreciated!

Happy New Year!
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Re: This is a new pain in my...

Postby jr2 » 31 Dec 2013, 23:31

Hi there! Welcome aboard! I'm so sorry to hear about your pain, but it's all too familiar what you're describing. Unfortunately, a proper diagnosis can only be performed by a physician, preferably a colorectal specialist. If you have any family members who might be able to donate to at least one evaluation, it would be a good idea.

If your fissure is new, you are in the best possible phase to get it to heal naturally. Another reason a visit to the doctor would be helpful is a colorectal specialist can prescribe you an ointment to help relax the internal sphincter spasms and assist in healing the fissure. Ointments such as nitroglycerin, nifedipine, or diltiazem.

At home, there is a lot you can do to help your fissure heal. First and foremost you need to make sure your BMs are regular, soft, and that you never strain. If you can accomplish that with diet alone, great. Most people, however, find a stool softener or something like Miralax to be a godsend in keeping the stools soft and easy to pass. With diet you'll have to experiment a lot with levels of fiber to see what woks for you. Keep in mind that too much fiber can actually make stools too bulky and a lot of fissure sufferers find that the constant stretching of the sphincter by bulky stools just keeps re-opening the fissure further. Also, if you do increase fiber you have to increase your water intake to prevent constipation.

It's important to keep the anal area clean, but be careful about the way you clean up after a BM. Never drag dry toilet paper across the anal area. Use moistened tissue and blot gently. Following up with either a hand held shower or a warm bath can help both with cleansing and with pain relief as the warm water will help relax the sphincter muscles.

A blob of Vaseline applied before a bowel movement can help to reduce the irritation of stool passing by the fissure site.

Some people find it soothing to sit on a heating pad (make sure it's on low) or a hot water bottle. Ice can also relieve inflammation and pain, just don't apply it directly to avoid tissue damage (cushion it in a soft cloth) and apply for 10 to 15 minutes at a time and then remove it.

Ibuprofen can at least take some of the edge off the pain in some people.

Lots of warm baths, lots of rest, no straining, healthy eating, soft stools, and focusing on relaxing the muscles in your anal area that you do have control over. Though the main problem is with the spasming of the internal sphincter, most people are also unconsciously clenching other muscles in the area as well. Deep breathing, filling your lower abdomen with your full breath will help you relax these muscles.

I hope you start to feel relief soon. Keep us posted on how you're doing. Everyone here understands the pain and the desperation of this affliction, so you're definitely in the right place.

:wel:

:smilyhug:
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Re: This is a new pain in my...

Postby StressedOutGrad » 01 Jan 2014, 00:35

Jr2, thank you so very much! I'm trying to follow as much of the advice I'm reading on here! I may have to crack and go to my doctor if I don't get a little relief after a few days. I really appreciate your advice and wish you an amazing New Year!
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Re: This is a new pain in my...

Postby Scientist2516 » 01 Jan 2014, 02:03

Dear Grad,
The university I work at does give grad students health insurance, so you may actually be covered - have you checked into that?
Also, do you have a Student Health Center where you are? I believe they are cheaper than a hospital.

jr2 gives most excellent advice. I think that by following that advice, you can really reduce the pain levels. It does take time, because the internal anal sphincter is slow to heal, so be patient, and don't give up. It may take a few weeks to get your diet and laxatives sorted, and your stools soft enough to allow healing. I know that sounds terrible just now, but you will get through it, and it's important not to despair if you don't heal right away.

Gentle heat, and ibuprofen are cheap. Actually, if you can get a prescription for nitro, that's pretty cheap too, though I suppose that depends on insurance and your pharmacy - mine is only about $15, and it lasts for months.
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: This is a new pain in my...

Postby StressedOutGrad » 01 Jan 2014, 12:08

Dear Scientist,

Thanks for the help & advice! I appreciate it!

Yeah, we're able to buy into the student insurance plan for $2600 a year that only covers 60% of our costs. To me, that's a recipe for being even more broke! I only make $6000 a year on my stipend... TN isn't one of the states where being a Grad Asst. is appreciated nominally. We have a student health center, as well... I went there once... Once. Haha! They only needed to draw blood for my varicella immunity titer and both nurses on duty failed. They couldn't draw my blood at all.

Luckily, some of they physicians through our med school donate their time/resources to students so I've been able to receive occasional treatment for my RA. I don't know about this, though.
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Re: This is a new pain in my...

Postby Scientist2516 » 01 Jan 2014, 23:31

Wow, I can't believe your insurance is so poor. That's terrible. At Vanderbilt, we cover our graduate students' health insurance and the stipend is a lot more generous too, at least for the sciences. I don't know what it's like for other colleges. It really makes me angry that being poor means you can't get good health care.

sigh.......

See if you can get prescribed nifedipine, diltiazem or nitroglycerine. At Vanderbilt medical center, they regard nifedipine as state-of-the-art, and will only prescribe nitro as a last resort because it can cause headaches. It may be the same in other TN hospitals, I don't know.

Good luck, fellow Tennessean!
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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