This is pain...

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This is pain...

Postby ben2013 » 09 Mar 2013, 09:16

Hello all. Sorry to hear all of the awful experiences you have been through. I thought I knew what pain was, but this last couple of days I have been to a whole new level of distress. After a very long time putting it off - not sure sure exactly how long, but months possibly years - I finally saw my doctor a while back. She diagnosed a fissure and sent me to a specialist, who confirmed this. I have been prescribed the GTN ointment, which I have used for two days. The pain was very very bad before I started GTN, but since starting it, my pain has been excruciating and persistent, lasting for hours and hours. Does anybody else have experience of increased pain and symptoms after starting GTN? I am really desperate to treat this problem now, I can not concentrate on anything whilst the pain is present, and going to the toilet has become a daily ordeal. I don't think it is possible to convey the levels of pain and distress caused by this problem to a person that has not experienced this; hence joining the forum. Anyway, be good to hear from anybody that has any useful information...I'm truly desperate to solve this...it's miserable...
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Re: This is pain...

Postby delasama » 09 Mar 2013, 12:34

Are you taking miralax? I take a cap full morning and night. My crs wouldn't even give me that cream. He said miralax forever.it took a whole month on miralax to notice difference. I'm hoping after another month that it will be even better.how long have you been using cream? Some people take a week or more to notice a difference. It might hurt more at first because gtn increased blood flow? I was wondering if your able to take miralax because gtn won't work if your stool isn't soft...
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Re: This is pain...

Postby PIA » 09 Mar 2013, 20:26

Hi Ben, If the pain is not being eased then you might need to better define the type of pain you are experiencing.
I find that I experience a few different types of pain.
The intense spasm from the tightness of the sphincter which usually comes on shortly after a bowel motion (BM) and can last for hours. The sharp burning pain of the open wound of the fissure when passing a BM. The oppressive pressure of a descending stool on the fissure and sphinter.
This is relieved for me by nurafen (ibrufren) before a BM, Vaseline around the anus to aid a smooth passage of BM, cleaning with witchhazel soaked baby wipes (not toilet paper) warm to hot baths immediately after each BM (and when whenever the spasms are not relieved), Movicol (Miralax) one sachet in the morning, 3litres of water a day, Prune Juice, Oatmeal, GTN ointment and more recently Botox injections.
I also experience an irrisistable urge to scratch the area which I have relieved with a cortisone cream.
When using the GTN I experienced pounding headaches and throbbing at the fissure site. Both due to increased blood flow to the area. I dealt with this by applying a much smaller than recommended amount more frequently and making sure I could sit or lay down for a while after application.
Does any of this help? I hope so.
If you find the pain is the same after GTN it may not be having affect. But if you find that the pain if due to increased blood flow you may need to reduce the amount slightly and take some analgesia to offset it.
The secret to healing is a combination of many things being understanding the process of the infliction,diet, ointment, analgesia, water, stool softeners etc.
It is also vital to take control of you thoughts. Practise some relaxation techniques. try to take things one step at a time and look at things logically without worry.
we have all been at the place you have been and can reassure you that it does get better.
Healing wished to You. XX Pia Image
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Re: This is pain...

Postby ben2013 » 10 Mar 2013, 06:39

Hi Pia. Thank you so much for your reply. To know other people understand this situation is a great relief. Yes, I experience each of those types of pain - as well as the associated psychological difficulties (I'm full of anxiety at the moment whenever I'm not in pain, and I'm living in fear of the next BM) - so your advice and empathy really resonate for me. Thanks again. The pain I was referring to yesterday was the first you described: the intense spasm, lasting for hours, shortly following BM. I am so grateful for your advice and support, and I will try building all of that in to my routine. I have started taking Movicol and addressing my diet; I am very much in the early stages of actively trying to address this, so all help and experience is gratefully received. Thank you once again for your advice and understanding. Ben.
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Re: This is pain...

Postby PIA » 10 Mar 2013, 08:35

You are more than welcome Ben. Everybody's experience is a little different but AF rates as one of the most painful afflictions. Take advantage of the wisdom and support available on this forum by reading other people s experience. Keep us posted as to how you are going. XxPia.
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Re: This is pain...

Postby JHH » 11 Mar 2013, 12:11

Dont think my pain worsened the first couple of days on nitro, but I sure wasn't improving. I do remember it was very disapointing. Since then I have had some OK days once in a while, with only few hours of pain, and even the pain seems to be going down in intensisty. Its now 3 weeks since I started.
The things I have learned so far is:
1. Keep your stools soft and easy to pass.
2. Beeing on nitro is a rollercoaster. One day you think you are way better, and the next you are back to scratch.
3. Dont work out. I tried to bike and was punished.
4. Be patient. This WILL pass. 75% heal on nitro, and if you are not in the lucky group, LIS will do the trick.
- Fissure developed in Jan '13
- Started rectogesic in Feb '13 and diltiazem Apr '13.
- Got botox Jun '13
- Healed by Okt '13, although I still had some irritation for about a year.
- New fissure April '22, healed June 2022
- New fissure 24. December 2023
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Re: This is pain...

Postby delasama » 12 Mar 2013, 16:17

You said 75% heal on nitro. Is it the same with nifedipine ?
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