I kid you not.
He said that my fissure was only a little bit better and to continue with the nifedipine salve but at a higher ratio (0.9%). I was using 0.3%.
He reiterated how difficult it is to heal an anterior fissure on a woman.
When I asked 'what if it doesn't heal with the nifedipine', he said then I am SOL.
He said that in his opinion the LIS doesn't have a good enough success rate for anterior fissures to warrant the risks of surgery, unless your situation is more dire. He didn't know about standardized anal dilation and didn't know anyone in the area that did it. He did say that botox might be something I could try, but didn't seem to think it would be worth it.
All in all it was utterly depressing. I was feeling kinds anxious when I left for the appointment but all in all in a pretty confident mood. I definitely feel better than when I saw him the first time.
But man, did I have a good cry when I got home!
I don't want to live the rest of my life worrying about my BMs. I mean, I eat pretty well, just less than I used to, with more veggies, metamucil and now olive oil. I fear any change in my diet though. Like eating later, or skipping lunch or breakfast, or eating out, or changing my vitamins. I will have to change my vitamins as I can't get the same brands here as I did in the states. I fear traveling, and staying at other people's houses.
ANyways, sorry to be such a downer. I guess I will get used to it. I mean it is surprising what a person can get used to.
Who knows, maybe the upped dose of nifedipine and staying the course will do the trick.
FYI I will post the reasons for the dietary restrictions on my other topic "no caffeine -ugh!"
-woi

woi -
What is the difference between an anterior fissure (versus a posterior fissure -- I just found that word, looking on google) . . .
BTW, tomorrow I'm going to ask my crs about this (what your crs said, with regard to LIS doesn't have a good enough success rate for anterior fissures to warrant the risks of surgery)- and see what he says . . .
I mean, I thought an AF was just an AF. Now we have classifications of them . . .
Well, I hope my crs is up to speed with all of this. Gads!

BTW - I hope you can get through this okay.
I mean, what does a person do, when the doctor says to just stick with the cream and hope for the best??
Well, I am totally hoping that cream helps you.

me too Sweet. Thanks for the kind thoughts.
Anterior means it's on the side closest to your front. Posterior means it is closest to your backside. Usually AFs are one or the other, sometimes both.
Yes we are getting an education we didn't really want.
-woi

So, if I understand this correctly, an anterior fissure is deeper, while a posterior is more easily seen, because it's closer to the outside anal area?
Sorry to ask, I'm just trying to figure this out.

No, actually I am talking about the sphincter like it is a clock.
and we are moving around the circumference of the anus like the hands of a clock. When the hands point up (Towards your front), it is anterior. When the hands point to 6 (towards your backside), it is posterior.
Wish I could draw you a picture
-woi

I think I got it . . .
Hmmm, well, I would think that it wouldn't make a difference (with regard to how it's treated), but I guess it does . . .
Such a seemingly small thing can really be a big problem, too.

Sorry for the news woi. I have read on here many have had LIS on an anterior fissure. Maybe, you should look up another CRS and get another opionion!!! I don't think I have ever heard anyone say their CRS told them they are SOL!!! I would run to another one.

Sue, I think I would definitely seek another crs's opinion, too.
Well, we'll just see what my crs says tomorrow . . .

BTW SB, anterior is towards the vagina and posterior is towards the butt. I am sure you will make out just fine. You seem less stressed today :D