Hi Everyone,
I need your advice. As I posted in a previous thread, I've had AF over Christmas 2010 and it since healed 2-3 weeks later. It was brutal, glass pain, just horrible.
Now for the past 2 weeks, I've had a re-tear, with set backs, including the CRS's tear it open again during inspection. I've been trying to heal for the past week since then.... overall, it is getting marginally better.
However here's my question... My pain this time around isn't as bad during the bowel movement (it's painful with the "stretching" going on) but not glass pain. However approx 40 mins later, I get crazy spams pain... that lasts for about an hour or two with Nitro ointment applied. At times the pain from spasms is so bad that I have to "grunt" and am breathing weird due to flashes of pain.
Does this mean based on all my reading of the various posts that I would be a good candidate for LIS? I of course want to try to let it heal more over the next few weeks but just curious if my symptoms (spasm pain) is probably much better suited for LIS than others?
To Add: Anyone recommend a CRS with top LIS skills in Phoenix, AZ area? Apparently my current CRS does 2-3 LIS a week... wondering if I should check with others too.
Thanks

Definately read the thread..."I survived the surgery" and the first "sticky" in this surgery category. Lots of good info.
I had the razor blade pain for two months or so of my onset...now it's not the same pain. I seem tomake it through the BMs but feel alot of pain after for hours sometimes.
The mean and nastiness of this thing (one of them) seems to be that sometimes you think you are healing and then the next day it's back with a vengeance. Its sucks!
I never had spasms but I know a lot of folks here do and I never used Nitro so I can't speak to those questions.

I never had pain during BMs but the spasms that you are experiencing 40 minutes later are exactly what I had. Botox injections stopped the internal spasms and I was able to control the pain with a Sitz bath and lidocaine cream. The pain started to come back about 4 weeks after the injections, which was when my CRS opted to do the LIS.

How about now? Did the LIS "fix" things? Did they do an "open" or "closed" LIS?
I have a life where I travel a lot for work - I need to either heal OR get LIS and heal. I'm obviously going down the NTG route and trying to heal... my diet is strict right now as is my 'softness'.
Last time I had a fissure, it did really heal (in 3 weeks) - to the point where I zero pain/feeling whatsoever... I ate and drank everything. Now 2 weeks ago, i re-tore due to a hard bm.

Unfortunately, I don't know which technique was used but I'll ask at my follow up on Thursday. I'd say that I'm about 95-100% better and going up.
You are basically where I was at in January (treatment wise) but I used Nifedipine 0.2% cream instead of NTG. The nifedipine didn't really do anything. I also took plenty of Sitz baths, which definitely soothed the pain, and used lidocaine cream. I also ate very high fiber foods and took lots of stool softeners.
How long were you pain free? In my case, the pain would go away for 3-5 days. I thought I was healing but it would come back again. In hindsight, I don't think it ever would have fully healed on its own.
I had enough after Day 1 and I would have gone in for surgery right away if my doctors didn't insist that I explore all medical options first. Sitz baths/Nifedipine ointment didn't work. Botox stopped the internal spasms but I still needed to take a Sitz bath and use lidocaine cream immediately after using the bathroom.
You're problems seem pretty similar to mine. Most CRS will recommend Botox before surgery and I think that they are right to do so. It apparently works for 60% of patients. It didn't work for me but I was able to live a fairly regular life after the injection, at about 60-75%.
If Botox doesn't work, go for the LIS. I still don't understand how another tiny cut can provide so much relief but it really did work and I started to feel better within a few days.

From what I have read on this forum...the conservative methods seem to work when the fissure is acute (not had it long...I think people say 4-6 wks.) and you can heal with creams. That may have been what you went through at Xmas. You may get lucky and the creams will work again. I didn't find this forum 'til I was 4 1/2 months into fissure hell and I think it was too late because even w/ soft stools and diltiazam cream I still have the da*n thing.
The driving thing sucks. I have terrible pain if I have to drive very long with a sore fissure.

Why waste time with Botox? If LIS is so successful in reducing relapse to less than 10%, that seems more valuable than anything else!
I just don't want this again, period. I will do my diet bit - but don't want to be home bound and in fear of life.

Botox made everything worse for me, it felt like I was in permanent spasm till it started to ease after maybe six weeks. I wanted surgery but doc insisted we try Botox first, he wanted to do it again for my follow up but I lost it and demanded surgery. It's a year I've list on this! Don't suffer any longer than u have to. Your life is waiting! 12 days to go until my LIS, I'm nervous and eager at the same time. Hope u feel better

Oh and frustrated, have u a heated seat in your car? If not get one of those wheat filled magic bags, it has made driving marginally better for me.

I totally agree with you ss...why waste time on Botox if you don't have to? Some surgeons push people into trying it first, but mine didn't. I didn't want to have to deal with it anymore either...the high chance of a recurrence, followed by more uncomfortable doctor's visits, anxiety, pain, etc.
There's something to be said for just getting it over and done with, and the surgery is not that bad. At least it wasn't for me.