LOL, I've written things the way I say them without really thinking - I meant the night my surgery was due - I'm certainly not brave enough to do it the day I had surgery- ouch, ouch, OUCH! I could hardly walk that night!

Hey Andrea - my hubby does have brothers, but they're not nearly so great. I'll keep my eyes open for another one and let you know. :D
Val - you're still my hero

Thanks Hope :oops: and I am with you about Val too!!
She needs tellin as she doesn't know how great she is!!!
You listening Valerie x

Val is definitely awesome! :D
Yay Val! -

Thank u all for replying. The last 2 maybe 3 days I've been eating all soft and my Miralax.Stools been next to no trbl at all. The nitro still deadened spasm. Little to no blood last 2 days. Could I be healing? I took time to rest and really "baby" myself. Got a lil frisky this am,and gave it a go....felt nice to be close.And actually no pain. BUT I better not push it.

As a physician, I think that it is AWESOME! that this forum exists where people can share their personal experiences that many patients are hesitant or reluctant to discuss with their doctors.
I have suffered from chronic A/F for many years that heals and then get re-exacerbated from my marathon running. Even with the help from vaseline, the constant chafing after 10 miles makes the pain terrible, and I can't have sex for a few days because I get shooting pains in my anal sphincter with orgasm.
In these periods I use the 0.2 % Nitro ointment q8hrs and suffer through the headaches and anal itching until my condition rapidly improves withing 3-4 days of AF healing. This success and side-effect profile of Nitro is making me consider trying a nitro sparing treatment by combining therapies with a calcium channel blocker ointment. As with many other Nitro applications in medicine, Nitroglycerin has a tachyphylaxis (initial effect begins to weaken after 24 h of continued usage). I will let you guys know later how I fair with that.
I have been hesitant, about trying Botulinum toxin, but I am contemplating it.

hcarba,
Welcome to the forum! Can I ask why it is you are hesitant to botox?? And, why have you been suffering for 4 long years??!!! Have you found as a Doctor how difficult it is for us to be taken seriously??
Just wondering??

Welcome hcarba! It's great to have a physician here! I'm really sorry you are suffering, though - and for such a long time too! It would be great to learn about your combined therapy strategy. I tried Diltiazem for about a month, but it wasn't really working and the pain was too much to bear any longer, so I opted for the LIS, and now my fissure is gone.
Are you considering botox of LIS at all?

Depending how deep the fissure is will depend on if surgery is needed.
I am not a physician but I have clocked more research time than anyone should want to know about the backside.
Sorry to break it to you Doc ,but It sounds like you need the LIS and botox will just put off the inevitable.
What my Doctor did was Scheduled the LIS and during the proceedure determined whether the fissure was deep enough for LIS versus botox..
So I didn't know until I woke up which proceedure I was given...
I had the LIS..
that was 14 months ago..

Thank you fellow affected A/F members for your warm welcome. In reply to some of you, my CRS has offered me the Botox and the LIS procedure. My fears about Botox is that it can rarely over-paralyze an anal sphinchter nerve and cause fecal incontinence which will wear off within 2-3 months. My job description keeps me on my feet most of the day, so if by rare chance that did happen it would be terribly distracting. But hell, at this point I am going to try it together with the ointments because this thing has affected my sex life and exercise routine.
I have talked with my CRS about LIS and it can rarely cause sphincter incontinence. It would be a rare surgical complication but it is still possible and for some people surgical incontinence can be irreversible. I'm 36, so I don't want to have that rare complication at my age. If I was 60, I wouldn't care if I had anal leakage cause many of my patients that reach 60+ already have that problem anyways.
My CRS is conservative and wants me to be aware of the risks as much as the rewards of surgery. I have surgical training so I empathize with his thought process. So far, I seem to respond to aggressive topical treatment within a few days. However, Ouchtear, I agree with you. If medical therapy doesn’t cut it for me within the next few months, I will end up taking some time off work to get the LIS.
peace