Hi all,
I'm new to the forum and have just registered after reading many of the stories and experiences over the last 2 days; AF is new to me and I'd like to share my story (so far) in case there are any wise words for me from you experienced folk out there.
So, I'm 38 years old, have always eaten pretty well (I do have the odd takeaway, McDonalds every now and then) and enjoy sport - a lot. I do Triathlon which requires much training and most of my spare time is either out running, biking or swimming.
On 5th February (I remember the date!) I can recall the fateful BM; it was in the evening, I strained, it was hard, it hurt and it bled. To be honest, I wasnt really worried, and thought "oh well, it'll sort itself out"; how wrong I was going to be! I said in my intro that I eat well; well on this weekend, my parents decided to take the kids off our hands, so my wife and I decided on a "slouch" weekend (which doesnt happen often!) whereby we sat watching tv all day, had pizza and junk food - we enjoyed ourselves. What a price to pay, an AF!
Anyway, that first week didn't seem all that bad when I look back. The first few days there was still blood on the outside of the stools and on the TP and there was slight discomfort, but didnt really affect me that much. As it went on for days, I decided to make an appointment with the GP. I saw him on 14th February but the couple of days leading up to that appointment, the discomfort was getting worse. He diagnosed an AF right away and told me not to worry, it would clear in a couple of weeks and to use a cream after each BM and last thing at night (it wasn't Rectogesic, I cant recall what it was, but it was useless, did nothing!) Anyway, after a couple of days, the pain really kicked in. Now I have always been good with pain, quite stoical, but this pain was different. After a BM, it was hell. It was as if the devil had taken residence in my back passage with all his tools and was having a field day. Nothing I could do would relieve it; lying down, walking, lying on my side and sitting was a no no. I don't need to tell you guys any more about the pain as I know you understand. I have a very busy job, I'm a Director of a business and I still had to work. The worst thing for me was driving. That was pure agony. I don't know how managed to sit through customer meetings with that red hot poker rammed up my butt! I made another appointment with the GP. I remember sitting in the waiting room sweating with the pain. He then prescribed Rectogesic, the nitro cream. I saw him on the 24th February and started the cream right away. I also asked to be reffered to a specialist right away, as I couldn't bear that pain any longer and needed help, now. Luckily for me, I have private health cover through work, so could get an appointment arranged pretty quickly. Now for me, I am focussed on my sport and had a 10k race planned on the 26th February. I have to say, the cream worked well. It reduced the pain back to the uncomfortable feeling (although the first couple of hours after a BM were painful) so I did the race on the Sunday. I was fine running, I even managed a PB on the day! I thought I would pay for it that evening, but I didn't.
I carried on with the cream, was careful with my diet, ate plenty of fibre, drank a load of water, had lactulose twice a day and it kept my stools to a nice consistency. I did feel like I was healing and was gonna kick this AF in the butt. I did have hot baths each evening (I have no time for any more than one!) but stopped after the first week as I felt I was on the road to recovery.
I had my first visit with the CRS on 28th February, 2 days after my 10k race. He inspected me, confirmed the fissure, told me to carry on with what I was doing and come back in 2 weeks. I was in there no more than 5 minutes. I wasnt worried, the pain was diminishing, I was beating this thing!
The first week after my visit to the CRS was okay, mild pain after the BM but then nothing for the rest of the day, a zero on the pain scale. The second week and leading up the 2nd appointment, I wouldn't have even known I had an AF. I was mildly aware of it, just being there, but it didnt bother me.
I happily walked into the CRS office confident he would give me the okay and send me packing. When he inspected me and said it hadn't improved in the last 2 weeks, I was flumoxed. But I've had no pain, no blood? This depressed me somewhat, but even leaving the office, I thought to myself, okay, it's still there, but I'm not in any pain, I can carry on as normal and give it time. He did say the first thing to subside when it was starting to heal was the pain. We planned another appointment for 5 weeks time.
The next morning (my birthday!) I went for my usual BM and it was slightly painful and there was blood! What is going on? I had a 2 hour drive that day to see a customer and it was an uncomfortable journey to say the least; probably quite dangerous to drive in that state! Even sitting in the 2 and half hour meeting I was concious I was squirming around. The 2 hour drive back wasn't fun either. Did the CRS poke around too much to cause this? We had scheduled a revisit for 5 weeks time, he told me not to worry and carry on as I have been.
So that is where I am up to, but having ditched the pain for a whole week, and the week prior to that not being bad at all, I feel I'm deteriotating. This week has been "uncomfortable"; I can feel the stool "scrape" on it's way out, have a burning for a couple of hours then eases to an uncomfortable feeling. It's now just gone 1600 hours and it's settled down somewhat but I am really not enjoying this yo yo ride. Yesterday was worse, nearly back to the pain levels in the initial week but not quite.
One question I do have and I've not found much information on this is whether I am doing a diservice by continuing to train. I run around 20-25 miles each week, swim 3 times a week, and bike a couple of times a week (one of them being a long 30 mile bike). I have not biked much (sitting in a saddle with an AF - not appealing!) but continue with the rest. I swam 60 lengths this morning and although I was aware of the AF in my butt, it wasn't painful (uncomfortable after though). Does anyone have an opinion on this?
I have another 10k race tomorrow and I also have a half marathon planned for the week after. I'm also away on business for a week on a course after the half marathon to Holland and am dreading how to manage my food intake as the food will be supplied for the group; there is a tendancy to drink a lot at these affairs so I am dreading my excuses already. "Not drinking? Why??!"
A long post, so I apologise, but I feel better already offloading. Perhaps my case is not as bad as others but this AF is really getting me down. Having to watch what I eat, the nerves of that first BM in the morning, will it be hard, or too soft, will I be okay to drive today? It can rule your life! I decided it wouldn't rule my sport, I have 5 Triathlons booked in for this year, so really want to knock this thing on it's head. Oh, and I developed a cough yesterday which is really fun! Every time I cough, I feel the AF dancing in my butt. Thanks Devil!
Looking forward to some advice; am I on the right track? Will nitro work for me (been on it for 4 weeks now - I am concious some of you state if it doesnt work by 6 weeks, forget it - the thought of surgey scares me to hell...) It seems to me, the real key to all of this is keeping that stool soft, so a retear doesn't occur allowing the AF to heal. It's tough watching what you eat, but perhaps the most important thing of all to beat this thing. Oh, one final question; I am trying to do a bath every evening with Epsom salts mixed in. I was told a hot bath. How hot? Should it be as hot as I can bear (I can take it quite hot) or just warm, or warm to hot. I don't want to end up "burning" or aggravating the AF!
Thanks all.

I don't think running is doing any good for you. Gentle walks maybe, but strenuous exercise isn't good when you are trying to heal.
Just take your bath comfortably hot, you don't want to burn yourself. Some have said, and that is my experience also that too hot water can sometimes trigger a spasm.
If you are afraid of surgery you might want to do some research on self dilation. I have been doing it with very good results - hopefully the dilation will keep me from retearing in future, as this was my fourth fissure or so.

Thanks Baba; makes sense with the water. I have a feeling I may have had it too hot in the beginning. Live and learn! I'll have to keep an eye on the running; it doesn't seem give any bad effect (for me anyway) but I guess I need to monitor pain levels etc for the period after and day after. I have a half marathon to run next week (running for a charity so don't want to let them down) so may lay off a while after this to give it a rest.
Self dilation sounds interesting; not heard of that. Will look it up!
JT

Hey deepfissure,
As far as training goes, I had to make a few changes before I got better. I limited rides to 1 hour (20 mi) and trained on a recumbant bike instead. Swimming never really upset my fissure, but running anything over a 5k did. The burn can be debilitating. I had to take a month off of running and that was depressing. But don't give up. I replaced running with lower body lifting (squats, leg presses, etc) and I actually think it helped with my recovery.
There will come a day when your 100% again. (I'm around 90% back to normal and running again). Ultimatley this will make you even tougher mentally. In the back of my mind now, when fatigue starts to turn to pain, I tell myself "No, I remember what REALLY hurts, and this ain't it. I've run this distance with razor blades in my rear". Lol. I'll be praying for ya.

Thanks TOTI; swimming so far has been fine. I managed a 5k run this morning and stopped at that so not to aggravate it. I'll save myself now for the half marathon on Sunday and will expect some payback on Sunday night/Monday. Will probably ease off for a while after.
Good to hear you are 90% there; I'm looking forward to that so I can get training back to normal again.
Question, didn't squats hurt? Just the thought of loading weight on my shoulders and "stretching" Mr AF makes me wince!
JT

I had some discomfort when I first started and sweat alone could cause irritation. I wouldn't recommend doing them in pain. Probably best to wait until there is no visible blood in the stool or on toilet paper.
I also use a freemotion machine at the gym, not a barbell. Yeah, even at 90% I don't want to risk reinjuring the fissure if something went wrong using the barbell. Not sure what you have access to, but I started out gradually just doing wall squats. I think getting blood moving and muscles rebuilding in the pelvic area helped a lot.