Hi all,
So I thought my fissure was calming down for a while, but lately it's been acting up again -- some pain and bright red bleeding during BMs (relatively minor but consistent and noticeable) has returned. I'm not sure if it's acting up due to recent dietary changes (more junk foods) or drug regimen changes (I stopped all nitro/nifedipine ointments for a week and have been reducing my Valium dosage because I noticed that I'm becoming dependent on it), but whatever the reason, it's got something to do with the sphincter muscle, which is noticeably tighter to the touch than it was weeks ago.
Anyhow this has got me to thinking about more aggressive therapies, and all that's really left on the table is Botox and LIS. I've been seeing two colorectal surgeons, and one suggests Botox and the other suggests LIS. So I can choose either.
I've been looking through the archives and can see that Botox hasn't been terribly successful for folks who have tried it. Looks like maybe 1 or 2 success stories out of all the people here. My question is this: has anyone ever ended up WORSE off after trying Botox? Right now my symptoms are relatively tolerable, so if the worst case is that I end up getting nothing from Botox, then I think I'll give it a try first. But if there's some risk then I think I'm getting to the point where I'm ready to stop screwing around and just get LIS.
Thanks for any feedback. I've got a suspicion that the Valium was keeping my sphincter loose for a while, and the reduced dosage is causing the spasm to come back. Reason I'm so positive is that I've definitely noticed other systemic withdrawal symptoms after reducing my dosage. This stuff is about as addictive as anything I've ever encountered so if I don't give it the boot now, I think I'm going to end up with a Valium problem on top of everything else :)

I don't think eating junk food is helpful. I know of no one that was made worse with Botox. That would have been my next step.

Thanks Cheryl, I'm going to lay off the junk food for a few days. The bleeding has been worse recently and I wonder if the junk food plays some role. It did help me put on about a pound or so though.
I'll probably look into Botox, was making some progress with the ointments but it seems that the improvement wasn't lasting.

are you taking miralax? why'd you stop the ointments? stopping that AND the valium probably freaked your sphincter out.

Hey juney,
Chalk this one up to overconfidence (or maybe just plain ol' foolishness and cockiness) on my part. I stopped the ointments and Valium because I thought I was well on the road to recovery. I did continue taking the MiraLAX along with a high fiber diet and thought that would be enough. Apparently I was wrong :(
This week I've realized that I have a Valium addiction, though. It was surprising to me considering the relatively low doses and short duration of my Valium use, but I've confirmed it over these last few days. I'll get serious anxiety and inability to concentrate, along with muscle tightening all over my body and some mild flu like symptoms, and it all goes away within 20-30 minutes when I take even a tiny dose of Valium. So now I'm trying to wean myself off it and am reluctant to take any higher doses. Guess it did help with the fissure but I ended up picking up a habit unexpectedly in the process. Go figure.

Hi, NeurpathicGuy so sorry you're having a rough time. How many valium a day were you using. My CRS gave some to me to but it was limited to only 2 a day and only as needed and it kind of scares me because valium is easy to become dependent on. I also take ibuprofen and it does seem to help. I've heard kava kava sold at the health food store has the same effect as the valium does on your muscles. Have you ever tried it. Boy just when you find something that helps another problems arises. Hope things works out for you. Give it time because while you're weaning yourself off the valium all your muscles will spasm. The good thing is that shouldn't last too long. Best of luck, Suzy

Hey Suzy, at my "peak" I was taking two to four 5 mg Valium pills a day, so 10-20 mg daily tops. I took that for a maybe just over a month and then dropped to 5 mg per day. It wasn't until after I stopped the 5 mg cold turkey that I felt any withdrawal symptoms. I've got an appointment with my CRS tomorrow and will ask her about doing Botox during my next visit and also giving me some 2 mg Valium pills or maybe liquid Valium so that I can wean myself off of it in smaller increments. Since I have the 5 mg pills right now, I can only cut them so small with a pill cutter, and I'd like to decrease in smaller increments to be safe. I'd rather not go through any kind of acute withdrawal unless I really have to. The stuff definitely helped my fissure but I don't think it's a great long term solution given the addictive potential.
I've tried kava kava before a long time ago, and it does make me feel mentally relaxed. I can't say if it does anything for the sphincter spasm though.
Thanks for the well wishes, I don't think my Valium dependency is really all that serious compared to most people out there, so I'm not too worried about it. I think I just need to get some in lower doses and follow a gradual dose reduction schedule and I'll be fine. It just kind of caught me off guard, and of course I'm a bit bummed that the fissure is acting up again now.

How long have you been using the nif and nitro before you stopped using it?I feel for you NG it seems you got some things to deal with.Hopefully you can control the bleeding sooner rather than later and kick the valium habit as well.

I think you know what my adivice would be...
Very interesting on the Valium..I've always joked that I could use some as I am quite the Type A personality, but man, I sure wouldn't want to get addicted..that was FAST.
I know I would like feeling calm for once in my life, though - probably too much. LOL

Hi, wow you were taking a pretty high dose of valium. My doc would only give me the lowest dose. I didn't think it would help but it did. I think they use it to break the cycle of the spasms. I was told if the spasms were lasting hours and hours then I should take one along with a few advil and it should help stop the spasming. It did a pretty good job too. But I had to use the nifedipine ointment too. I'm not a big pill taker because I can't swallow them. When I'm really stressed out I still like my glass of wine. I already had LIS a year ago but it seems things have tightened up again and I still get some spasming. For me that's the worst, because it can last so long. I wonder if a second LIS would help me. Suzy