Hi Everyone,
I've lurked on this site for a short time but I need some advice....I'm a new mother with a 4 1/2 month old baby. I had a fissure last spring before becoming pregnant, it went away very quickly and I didn't have any problems for over a year. About a month after I delivered I got constipated from antibiotics and now I've suffered with a fissure for over 3 months. This time around has been so bad that death feels like a better option....the pain is unbearable for hours a day. How I've managed to still breastfeed my baby is beyond me.
I do have a CRS who has tried everything to get this thing healed, Nitro, Nifedipine, and 2 shots of botox, nothing is working. He finally discussed Lateral Subcutaneous Internal Sphincterotomy with me at my last visit. I think I have to do the surgery, I have no life, my husband is so wonderful I am very lucky. He basically takes care of me and the baby and works from home. I just want my life back.....I'm just so terrified of incontinence. I've had some incontinence with the botox. I don't know where else to turn for advice.....all I do is search the internet which is not always a good thing.
Any advice would be greatly appreciated....sorry that was so long.

hi canuck mom and welcome.....
well it is understandable that you feel a lot of anxiety and hopeless since you seem to have tried everything.....
i didn't read in your posting if you have adjusted your diet to a rich fiber diet and if you are taking any other types of medication that may be causing you constipation at this time.
seems like your fissure is relatively new like your baby so i am rather hesitant to advise getting LSIS until about a year so you have had time get everything in sync with a fiber diet.
i am impressed that you have already done botox in canada.
i am interested in hearing about your current diet, newmom. and what do you drink all day - just water, coffee, tea, etc. and how much. do you have any supplements such as fish oil, flax seed oil, vitamin e, etc?
i am sorry you are in a lot of pain right now. i know i don't wish it on anyone especially a new mommy who should be enjoying her new baby.
fwiw, i think i would rather have incontinence if it meant that i would no longer feel the horrible pain in the butt!!!! i am sure a lot of us would.
cheer up....and write back. there a lots of mommies on board here that will chime in to help soon....
gareth

Hey new mom. Welcome. I am sorry to hear that you're in so much pain! You've come to a great place though. There are many fissure sufferers on this forum who are either healed or still fighting. I hope you find comfort and support here. Kudos to you for still taking care of your beautiful baby while suffering with this ridiculos ailment!
Like happy questioned, have you changed your diet at all since you got the fissure? Are you careful with what you eat and are you having regular BMs now? After coming to this forum ages ago, I learned a lot about what I should and shouldn't be eating. You should be careful with anything hard (nuts, nacho chips, chips period, etc.). I still eat this on occasion (especially the nuts because they're nutritious). But you have to make sure to chew it all down to a paste so that it doesn't come out and irritate your fissure.
I've tried several things for this fissure and have had it for two YEARS! I actually have two fissures. I feel frustrated because my skin is sensitive so sometimes diltiazem has helped me but it causes rash other times, nifedipine causes big headaches, etc. just from reading the board it seems like botox usually just lasts 2-3 months... So I've also booked myself for the surgery.. I was scared of the incontinence too! But trust me... It's worse to live like this... & still, many post-LIS people say they didn't experience incontinence.
Take care and welcome again.
sh

Hi Mom ! It seems that you are prone to fissures and the fact that you got your fissure after you had baby and not during delivery only points to one thing - you have very tight sphincter. Constipation and diarrhea can cause fissures but they are supposed to heal fast as your first one did. Once they "linger" - something is preventing them to close. It is most often the sphincter that goes into the spasm due to pain during bowel movement and that pain than lingers for hours . You tried it all and if you have soft poop and still not healing with creams and Botox - LIS is next thing to conceder. You can wait up to a year until you decide to have surgery - after that a lot of scar tissue forms and healing is slower even after LIS. Your CRS and you know the best when it is time to have LIS. If all conservative treatments (diet, stool softeners, soaks, creams, Botox ) do not give you even the smallest relief :( , than staying in agony forever is not worth it - in my opinion. I tried it all but I did have periods of healing, feeling better and than would rip open again - so I waited 5 months before I had enough of it all and had LIS.
If your CRS never had a case of incontinence in his practice - you can be very confident in him and not worry about it at all !!! When they talk about incontinence they usually refer to "gas incontinence" and even that is transitory . Sphincter tends to regain some of it's strength after LIS, so much actually that mine regenerated and I needed a SECOND LIS to make it loose. Even with second LIS I am FAR from being incontinent. I think that you should pray that he "cuts enough" and not worry about other way around. CRS's are very careful not to cause any problems there, not only because they care about their patients but about their reputation too !!!
I am so sorry that you are in so much pain :( - we all understand you and we all thought that death would be better than this suffering, so we really DO understand and care.
I wish you best of luck Mom, don't despair, there is the end to it all, it just takes time and a right approach - you will be fine - you will see !
Hang in and take care

newmom
I can relate to everything you write her, as can all of us here on the AFSF
You've found the perfect place to discuss your fissure problems, and the best place to get comfort and support.
I fear incontinence too, but I have decided on having it if my CRS will do it on me. As Happy says, incontinence must be better than buttproblems 27/7....
We all want to give up, but we cannot do that - don't give up
Corsica

Welcome to the team. It is such a painful condition and can really keep you from enjoying life as one setback can tip things off again. That is great you have already tried the creams and botox. It can take 3 rounds to really make a difference so don't give up.
Are you taking baths? They are a wonderful tool for healing though not easy with a baby unless you put her in her carseat or bouncy seat or do it while she is napping.
I take magnesium supplements to soften the poop and relax the sphincter so I can go better. Also flax seed oil or fish oil is great to eat to help lubricate the poop so it comes out more easily.
Congratulations on your new baby!

Welcome, new member! You can find a lot of support in this forum (and answers to questions about what worked and what didn't for many people).
Cheryl

New mom
Many congratulations on your new baby :#uck:
I am sorry you are suffering this pain and the demands of a newborn
The botox studys do show that repeated botox injections 2-3 claim the higher healing stats but if after 2 shots you do not feel any improvement whatsoever then that is the time to consider the LIS , There is nothing left to try if we have exhausted all other treatments we just have to bite the bullet in order to gain some control back into our lives… ….Don’t let this take away anymore precious time than it has already !
Listen to our wise Fissy ref your concerns about incontinence , I haven’t seen one case of that on this board yet ….
Goodluck !

Thank You for all the replies and the warm welcome....with this condition it gets pretty depressing and lonely.
Some of the things I am currently doing include metamucil twice daily, fiber-rich diet, about 4 liters of water daily. I rarely eat meat (never red meat) only fish and chicken. I have a BM every morning at about 8:30 am and I'm then in the tub for a warm soak. I have 3-4 baths daily. I also take a small dose of MOM every night before bed. I've found that on the really bad days my BM was to soft/loose or I've had to go twice. I haven't tried the fish oil supplements yet.
My CRS is young and seems up to date with things, he was very hesitant to discuss the surgery in the beginning but at my last appt he basically gave me the option of more botox or surgery and I opted for botox. I recently had a CT scan to rule out any other problems as per my CRS but haven't received the results yet. I have a second opinion on the 11th also per my CRS. I did see a different CRS at the very beginning of this problem but I don't feel as comfortable with him, just a feeling...I don't know why.
Basically my days consist of sitting on a heating pad and my husband doing everything.....I barely even lift my own baby. I think incontinence at this point would be better than what I'm going through now.
Thank you all again for the support....this is the worst thing I've ever been through.
Tamara

Tamara,
Maybe you could try to sit less? Are you constipated? It seems like you are doing many of the right things. I think this forum will help you. The mental attitude is very important. I agree. I think having an AF is the worst. Docs probably have never had one so cannot really understand all of the mental angst that goes with having one. I am taking an anti-depressant (Lexipro) which has helped my mental outlook a lot. I also use the diliatzen cream/ointment when necessary. Good luck.
Cheryl