Hey guys,
I'm sure you all have seen my posts. I've been dormant for the last 3 weeks because on April 10th, I saw a 3rd CRS preparing for LIS but he couldn't/wouldn't suggest it. He said that my fissure looked like it had healed from what he and the other doctor shadowing could see. At that point I had been using the diltiazem for 3 weeks from the last retear. So I left the office and reoriented my mind.
I decided to continue the 1/2 dose of Miralax a night and keep my fiber above average. I didn't go crazy with fiber becuase although my stools are on the harder side, I don't really have to strain and I have a BM everyday.
Well that has been successful until today :(. I had three pieces of stool and 1 was lumpier and larger than the rest. I bet it was that one that retore me. It didn't hurt but I felt some stretching down there than concerned me as it was passing. I wiped and nothing...phew. But as I wiped deeper I saw some blood on my TP. I was like noooo!
I don't know what happened. I've been keeping a diary of everythign I eat. I wonder was it the 1 cup of coffee that I had yesterday? I guess I'kk up my dose of miralax for the next few days and then drop back to 1/2 a dose a night. I just don't want to live the rest of my life taking miralax every night. I dont want to grow dependent on it, although it is what's been helping me heal.
I'm 26 and have been dealing with this since july of last year.

Oh, I should note that my BM was very smooth yesterday. I then excercised on a recumbant bike last night and got some burning after 40 min. I wiped and discovered some residue so that must have been irritating my butt without me knowing as I was pedaling. I wonder if that type of irritation caused this retear cuz the area was flared up??? I wipe cleanly all the time I wonder why I still get some residue as the day progresses.

Oh no, I'm so sorry to hear you've had a relapse :(
Probably a combination of irritation from the stool and the harder BM. Once a fissure heals it can actually take many months for the area to strengthen back up again, and even then things are really not the same ever again. Since you are jumping right on this relapse, hopefully it won't take long to get back to where you were before. Are you still using the diltiazem?

Yea, i hope so too. I was prescribed to use it 3 times a day. I have done so for the 1st 3 weeks, but after the doctor said it was healed I fell back to using it just once a day:/ (at night) and I probably missed one or two days last week. I figure since it was healed I'd let my butt air out instead of being greasy.
Yea, the only thing keeping me hopeful is that it does heal. I just cant seem to get past more than a month before things relapse. The only thing that I have done which has helped is take 1/2 a dose of miralax every night. I've been doing that for just over a month.

Since I have been seen twice (once in Dec and once in April) and told that my fissure is "healed" I guess my problem is keeping it healed? I don't know what to think. I seem to have problems staying blood free for more than a month.

Jax...
Yes, healing and re-tearing is really common with fissures. The reason is that wound healing is a gradual process that happens in stages over time. The wound is sort of like tissue paper for awhile, very fragile. Fissures are even more complicated in this healing process because the wound has to be able to be strong enough to endure the passage of stool every day. Complicating things even more is this has to be done within a muscle that is clamping around the wound. When a doctor examines us and declares the wound "healed" they should also be giving the warning that the area is going to be prone to retears for quite a long time. And actually, people who have a history of fissures are always at a higher risk for developing them in the future. Once the area has gone into full healing there will be some scar tissue. Scar tissue is never as elastic as the original was, so diligence with diet and keeping stools soft with no straining is a permanent change that needs to take place.

Yea. I think you nipped it on the bud, when you say permanent change is needed. :( I don't mind the high fiber, natural not processed food diet and increase in water intake but it's the 1/2 dose of.miralax that I've been taking every night for.the last month that I'm worried about. I don't want to do that for the rest of my.life. I'm 26. If I got the surgery would.that some how make the chance of recurrence less?

Unfortunately it's really hard to know that for sure. It could. But there is even disagreement among CRS about this. There isn't a lot of really long term data when it comes to fissure recurrence over very long periods of time following LIS. At least none that ive seen. It usually stops at about two years of followup. It would be difficult to collect longer term data i would imagine. More than likely the permanent changes in diet would still be a safer bet, even with surgery. There are probably people who get LIS and are never bothered again by fissures and people who are, despite the surgery. We've seen both on this board as a sampling.
It does seem logical, though, that your chances of not needing Miralax long term are greater with the surgery than without it. It seems like many people do wean from it eventually. But I've also heard plenty of people whose CRS has told them after their surgery to stay with the Miralax permanently, so who really knows for sure.

I was taking almost 3 doses of Miralax per day for almost two months.... I've been pain free & blood free for over a month now and am slowly working down the dosage. So far so good. I keep a steady high veggie & fruit diet, and measure out my Miralax by 1/2 teaspoons. Every 4-5 days, I cut out one 1/2 teaspoon. A very slow wean! All has been well, my ass has been able to adjust to more 'normal' stools, and if in the next few weeks something doesn't feel right I can adjust my dose back up by a 1/2 teaspoon. It's important to have enough time for your butt to heal before cutting back on the stuff though!
Good luck!