Hi Desperate-
I just wanted to say that I am so sorry you are having such a hard time and facing a second surgery. Dawn mentioned me- about the Dr. mentioning my sphincter was really tight and "very spastic". This was actually when he talked to my husband after the surgery. The CRS seemed surprised in my husband's opinion- I don't think he thought things were that tight until he got in there. I do think Dawn has a very good way of thinking logically about things and finding out how tight that is before hand would make sense to me. Before my surgery, I could easily have talked myself out of it because my symptoms after almost a year had become so much less and I worried I was doing something I didn't need to do. But hearing that afterwards really made me realize it probably wouldn't have changed for good without the surgery. Maybe go back and read the threads from the ones Dawn mentioned that had success after a second surgery- like Fissy. It is terrible to be where you are right now. Hang in there!
Bambi

Alpine, Bumbutt, Dawn and Bambi,
THANK YOU for replying! Your advice and support means a lot!
No, no incontinence issues. I think on the weekend I'll get off the nifedeprine to check out tightness. Before when my fissure was bad, it hurt to put the nifediprine in. Not at all anymore. Does putting cream up there bother anyone else? I just had my 8th painless BM in a row! No pushing, nothing. I can't remember the last time in my life when I had 8 painless ones in a row!
It is just so hard to know what to do as my osteitis pubis is acting up again and my whole pelvic region is a mess. I'm getting pulling sensations in my groin along with aches in my pc muscles. In addition to the pressure feeling described above. I know I am supposed to do kegels according to my physiotherapist who did pelvic floor work on me. I went a total of 22 times, to no avail. But I blamed the fissure for it not working at the time. She instructed me to do kegals but I can't as the muscle just feels like it gets tighter and tighter and cannot release. Does it hurt for you girls to do kegals/cause pressure with your fissure (not a stinging pain though)? Also when I sit down it feels like a rod is being stuck up there and actually makes my stomach hurt. Doctors have told me that that is muscular. When I checked the fissure today, it looked like a white line of about a cm (it is on the inside, I really have to stretch to get a good peek, lol). 2 weeks ago I could see an actual fissure (loop/pitted in the skin). I'm wondering if it is healing...... or maybe I'm looking at the old incision site from LIS #1. It is actually the same site where my thrombrosed hemmeroid was lanced in JUly. However, that was what was bleeding after I left the hospital last time in February when I was supposed to have surgery this last time.... So confusing!
If I decide to get the surgery, I'll have to put off resuming physio again for a while. I only waited 2 months last time as I couldn't handle the pressure anymore. As I live so far away it is a difficult decision considering I need to go back to work soon as we are so broke! Do you think after 2 LIS's I might develop painful scar tissure that will hinder physio?
Thanks for listening!

As far as putting ointment in there, if you had asked me two months ago if it hurt, I would have said yes, but today, it doesn't. Two months ago I was really swollen after every BM and had to wait to put in cream, but today... it's almost like normal (i do have small fingers though - LOL!)
Still, my fissure isn't healed. I think it's just in a different stage. Maybe it's healing... I don't know yet.
I think like Dawn said in another's post (I think it was Dawn... or Alpine), that LIS is the option when you have chronic pain that doesn't allow you to live your life on a daily basis.
I guess you are wondering whether you are healing or not... I think this whole dang process is just sooooo slooowww that it is so hard to tell. I think that the changes (if they happen) happen almost on monthly time scales, and it is so hard to live that way. When did you have the first LIS?
I'm not sure about anything with the scar tissue - but there are a few people from the forum that have had 2 LISs. That would be a good question for the CRS though. If it would put your mind at rest... you could possibly just call the CRS to discuss some alternative with them... such as going in and using your March 4th appointment to talk to them, ask them these questions and to get a feeling for how tight your sphincter is... then reschedule the LIS for a little later (late March or April). Would that be possible??

I wouldn't do Kegels right now if someone paid me. They just wind up making the crazy sphincter even stronger and that isn't a good thing! That's got to be hard when you need to do Kegels to fix one problem, but they might be aggravating the other; I suppose it might be possible to learn to isolate the muscles when you contract them, so that you're not contracting the sphincter muscle at the same time. When your PC muscles get achy, does sitting on a heating pad or in the bath help?
I know what you mean about feeling like something is jammed up there when you sit down. I get that feeling occasionally, I used to get it more when the fissures were worse. It's painful to sit down, like I'm sitting on an orange or something--it's probably just because of tight rectal muscles and/or swelling, I'm guessing, since there's not actually an orange up there. When I get like this, sitting on a heating pad does help.
I can manage to get ointment in without hurting myself...the nitro has helped me SOME, my original fissure site stays healed now 99% of the time, and it's starting to look more healed, but I've developed another that seems more superficial. The only reason it's not torn open is because of taking Miralax....and I have days of wondering whether if I just took Miralax for a couple of years and let everything heal really nice, would the sphincter eventually relax on it's own? But no way am I backing out of the surgery.
It does sound like you might be healing the fissure...it is a VERY slow process, and there are other members here whose rule of thumb is that you should wait one year between LIS's to let the tissues get back to normal. My CRS did say that when he's had to do two surgeries on someone, it's usually on the order of several years later.
I'm not sure why your CRS says no to botox? To me that doesn't make sense, since it does what the surgery does, only more temporary. It seems like an easier alternative than committing to the surgery too.
But try not to worry about the incontinence thing too much. I know it's hard when they say that women who've given birth are at the most risk for it--I'm right in that boat with you. But there are plenty of women here (or were here at one time) who had the surgery more than once and didn't wind up incontinent.
Let us know what you decide! We'll be thinking of you--

Well 1 week until the knife...again....
I spent a good part of the morning with my hand mirror and flashlight, my new best friends! I've perfected the technique on how to inspect your own anus, what a skill! I couldn't see my fissure like I normally can.
I went to my gp today and told her this. She insisted on taking a looksie. She looked but couldn't see my fissure. She then inserted her finger up there, and it was uncomfortable ( sore and moderate stinging sensation when she pressed on the left side). I am confused though as the bm's are not that bad (only a little uncomfortable or not at all uncomfortable when passing but no shards of glass feeling anymore). This is also the first period when I've had over a week with not so unpleasant bm's. I told her I was thinking about backing out of surgery as I think I'm healing as I've never not been able to see my fissure from the outside before. She told me she thinks it could be an internal fissure and that I should just do it. Anyone had one of those before? Would they hurt less than external ones?
Levator ani can cause muscle soreness on the left side too. Aghhhhhh..... See if I get the surgery then pt will be delayed by another six months and then I'll have to take time off from work again and I think there is currently a lack of sympathy for me from my superiors as this seems to be a never ending problem for me and I have students that depend on me.
I want to call the surgeon but I'm scared he'll just be unsympathetic and cancel the surgery because I'm being indecisive and probably annoying to him. Last time I went in in February, he didn't use an anascope! Shouldn't that be protocol? Do I need a prep for that?
I also got the results of my most current bone scan showing my pubic symphysis being lit up like a Christmas tree.... Everytime my son gets into trouble when he's older, he's going to hear my horrific never ending pain stories over and over, lol. I can't believe I'm still suffering, he's almost 2!
Bottom line: I don't know if I'm suffering from muscle problems (too tight/knots in rectum which is levator ani), or fissures! My skin/muscles are still sore from the freezing last month. The thought of him doing it again for nothing, or just doing a LIS to "shut me up" scares me.
Feeling so down today. Thanks for listening.

Painless BM # 12..... Finding the Ativan helps mildly with pressure/ and or spasms.
Called my CRS today, the secretary thinks I still need to proceed, but managed her to book me in for a pre-op discussion (again) on Wednesday. I'm really nervous about only a 7 month gap between surgeries. Hopefully that will be enough..... I've had nightmares about pooping my pants all weekend, lol. I guess it will all depend on what the surgeon says. Thanks for all your support and wish me luck!

In all honesty and I like to be truthful with people, I'm inclined to agree with you being nervous about there only being a 7 month gap between surgeries (I'm on the verge of being 7 month post-op) and I feel that it's too soon to be considering more surgery even though I'm still not healed, more time for healing is required sometimes for a minority of people (me included) and I'm prepared to stick it out until the 1 year post-op then consider surgical options, all I'm saying to you is, can you really cope with the way things are now and give more time or is it just too much to bear, if the latter then you must proceed.
Best wishes and good luck with your decision.

I think that was a wise move to have the pre-op consultation. Good for you! I'll be thinking of you on the day of your visit!
Just have a little list of questions prepared and anticipate the CRSs response - I find that helps.
And Steve's advice sounds right on to me....

Thanks for the honesty guys, appreciate it!

You're very welcome dh... I really hope things work out for you, whichever path you take.