Hello everyone, thought I'd give a brief update, and to ask some advice.
As a reminder, this is my second AF. My first I got after the birth of DD1, I had it for 9 months and then had botox which was successful first time (though I did keep drinking lactulose for a further 9months). This time, I got my AF after the birth of DD2. She turns 1 in a couple of weeks, so that's how long I've had this! After the GP giving me bloomin' hemmy cream on multiple occasions, I finally saw a CRS in April who told me to stop using the cream as it could make things worse, gave me diltiazem cream and laxido (movicol). He couldn't see anything, but because of the spasming from the digital examination he thought it was likely I did/do have an AF. He said he would see me in 8-10 weeks.
Three months later, I phoned to check they hadn't forgotten me to be told of long waiting lists (I'm NHS). Luckily, I'm finding the diltiazem plus movicol to be working and making things manageable. I've finally had an appt for my review come through for 30th August, so I will have had the AF for over a year, by then.
On the positive side, things are getting better. I've recently been able to reduce the movicol from 2 sachets/day, to 1 in the morning, and whilst that has affected the consistency of my BMs, it's not retearing. I daren't stop using the diltiazem, though, as I didn't for a couple of days (I know - what was I thinking??) and I did retear then, with fresh blood and pain, etc. I am concerned, though, that when I see the CRS again, he won't find anything and declare me 'healed'. Last time, I *know* I had 2 tears - one internal and one external, and he couldn't find either. Now, I think I still have the external AF, or at least it's not totally healed, because I am very conscious and aware of everything that happens when I have a movement.
I don't know what to expect when I do see the CRS, or what questions I should ask/what I should be saying to make sure I am treated appropriately, itms.
As an aside, I saw the dentist today for a check-up, as my maternity excemption certificate is about to expire. He asked if I had been grinding my teeth, I said I don't think so, so he has fitted me for some guard to wear at night as that's when most people who don't know they grind, do. It occured to me on the bus home, that when I have a BM I clench my teeth together with the pain (or the expectation of pain, as I'm not in actual pain as much atm). Another side effect of AFs is worn-through teeth. :roll:

hi Bernie! I would wonder if the next step in the treatment process, if the Dilt doesn't heal you, would be botox again, since it worked before. Of course, I would you be a candidate for an LIS? Are you having spasms too or just bleeding and discomfort during BMs? If the doc doesn't see a fissure, but you feel like you have one, maybe they could do a manometry test (to test anal resting pressure)? I've read a few cases on this forum where docs didn't see the fissure, but it was definitely there!
I always go to doctors with a list of my symptoms, since they always ask about that, and how BMs are going and sometimes even what I eat. Anyway, I would ask about every possible treatment option. And if the doc doesn't see a fissure, I would ask about other or examination methods to either detect the fissure or identify a possible different problem (like pelvic floor problems).
I would also grind my teeth during the dark days of fissure pain. I'm surprised I didn't break a few teeth! :D

Well, I do still have the AF as I've started bleeding again. Fortunately it hasn't come with the searing pain, but I'm going to start taking the movicol twice a day again.
I'm not having spasms atm, though I was before I was on the movicol & diltiazem combo. And the pain would last from hours to all day.

Aw Bernie, I'm so sorry the fissure's acting up again. :(
Do you think you should use the Dilt again, just to make sure the spasms don't start up again? Are you taking warm baths? I'm so glad there's no searing pain! I really hope you beat this one before it gets nasty on you.

I haven't stopped using the Dilt, just reduced the movicol.
DD2 turns 1 on Monday, so I'll have had this a year then. Happy Birthday, AF!
(OK, so technically I don't know if that's the exact day it happened, but I didn't have it before birth, and the day after knew I was constipated so started on the Fybrogel, not that it helped much. :roll: )

Sorry you've been dealing with this for so long Bernie. Movicol has been a life saver for me too. I don't what I'd do without it. My fissure has been here a long time too and am also struggling with the NHS wait times (and the doctors who can't see a fissure and prescribe hemmie cream lol) so I can really sympathise.
I hope you beat this one too :)

Well my appointment has been postponed until 7th September, so will be 1 week short of 5 months since my last CRS appt (assuming it doesn't get cancelled again). I'm still concerned that I will wrongly be declared healed, though.

Oh no, Bernie! I'm so sorry your appointment got postponed :( It sounds like you don't feel healed yet. Are you bleeding or is there an uncomfortable area in the butt? If you doc declares you healed, maybe you can ask him/her why you still feel like you have a fissure. I've had to deal with some frustrating medical situations and I've learned not to let doctors off the hook. They need to be pushed into giving us some idea of what might be going on. If you are politely assertive, hopefully your doc will appreciate what you saying and not just fob you off.
Good luck with your appointment - I really hope it goes well!