new here! needing advise

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new here! needing advise

Postby New mum » 31 May 2010, 20:56

Hi everyone,
I have had my beautiful daughter 3 months ago and 2months ago i have the joy (NOT!) of having my first fissure. My question is Do they heal a little and then come back is a few weeks or does the pain hang around till you get it fixed???? For me it seems to reopen for 2weeks then go away for 2 weeks.
Thanks
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Re: new here! needing advise

Postby NeuropathicGuy » 01 Jun 2010, 12:27

Hey mum,
Congrats on your new baby!
Fissure pain can cause all kinds of different patterns, and the patterns can even change with time. It's unfortunately quite an enigmatic problem at times. I've had both patterns myself: times when the pain was constant and unrelenting, and times when the pain would come and go. My fissure even healed completely and reopened, which isn't uncommon either.
Are you currently doing anything to treat the fissure? If it hasn't been around too long and is coming and going then it's possible that some of the conservative treatments (stool softeners plus topical ointments) can still work for you, assuming you're not trying them already.
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Re: new here! needing advise

Postby New mum » 01 Jun 2010, 18:04

I have seen my gp twice about it and she gave me some cream called proctosedyl, i am not sure if it helps all that much but i dont want to use anything like rectogesic because i am breastfeeding and my bub comes 1st.
She gave me a referal to see a colorectal surgeon, i am terrified to go see him not knowing what he is going to do! have you seen a surgeon about yours? if so what did he do?
My gp recommends getting surgery if the surgeon thinks its a good idea so it will never come back. but then i read other peoples posts saying that it still may reopen.
thanks
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Re: new here! needing advise

Postby NeuropathicGuy » 01 Jun 2010, 18:15

Hey Mum,
Yeah I've seen all sorts of doctors about mine. I tried the following things in the order listed.
1. Nitroglycerin (i.e., Rectogesic)
2. Nifedipine
3. Botox injections
4. Diltiazem
5. Lateral internal sphincterotomy
I also took stool softeners the entire time. The Botox injections allowed my fissure to heal completely for a while. But then I re-tore it.
Proctosedyl from a quick search just looks like hydrocortisone plus dibucaine. Unfortunately if you have a fissure, neither one is going to do much except possibly alleviate a tiny bit of the pain very temporarily. Nearly everyone on this board has been given hydrocortisone for their fissures by an uninformed doctor. I had the same thing happen, and it only made things worse because it delayed proper treatment of the fissure.
I can understand the breastfeeding concerns, but I think you should at least consider a stool softener. Miralax (Movicol in some parts of the world) is pretty popular here and I love it myself. According to Thomas Hales' book "Medications And Mother's Milk" the ingredient in it passes only through the colon and is not secreted in breast milk at all. I've checked a bunch of stuff in that book because we had twins last year and my wife had some anorectal issues while she was breastfeeding.
Also the surgeon will probably just do some kind of rectal exam, either with his finger or an anuscope. If the pain is intolerable with an anuscope, be sure to let him or her know. While it's easier to visualize the rectum with an anuscope, it should not be 100% necessary.
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Re: new here! needing advise

Postby NeuropathicGuy » 01 Jun 2010, 18:18

BTW I have a copy of last year's edition of "Medications And Mother's Milk" (it's considered the Bible of medications and breastfeeding here in the States -- not sure if it's known in your part of the world) so if you ever want to know what it says about any particular fissure medication, I can have a look and let you know. Obviously I'm not a doctor and it won't substitute for your doctor's advice, but at least maybe it can give you a high level idea of what's feasible to consider and what isn't.
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Re: new here! needing advise

Postby New mum » 01 Jun 2010, 19:01

Thanks for your advise!
I have now booked in with the specialist but its a 2 & 1/2 months wait! I am not sure if i should see if i can find one that i can get into sooner. I am worried that if i leave it that long it will get worse. I guess if he is booked out for that long he is a good doctor!
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Re: new here! needing advise

Postby Fissulyna » 01 Jun 2010, 21:39

Good luck with your new appointment !!! I wish he could see you sooner Image .
My CRSs used finger and anoscope and if a surgeon is gentle and uses lidocaine as topical anesthetic , exam is not that horrible. It also depends in what position they do the exam and what kind of speculum they use. If you go to a younger CRS in a modern facility - you will be examined laying on the side and with plastic disposable "tube" that is inserted gently and with a ton of lubricant and local numbing agent. If you go to some old brute - you might be examined kneeling and with metal speculum : ((( - that HURTS !!!!!
I had them both Image , and although I thought it would be impossible to go through the exam and stay alive and not scream, I survived many exams and honestly - they were never worse than a BM - actually some were MUCH less painful !!! Image
Yes - some people had a LIS and still have some problems , but 98 % have NO problems and they do not post ; ))) !!!!
Best of luck with it all !!!!
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