are sentinels permanent without surgery?

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are sentinels permanent without surgery?

Postby soothe88 » 13 Jun 2012, 18:36

Hi all,
I've got a nasty sentinel that is very painful. I have been taking nitro for about 4 months (Di before that but couldnt handle the itching side effect) and the sentinel is STILL there. The actual fissure has healed somewhat...maybe 15% but the nitro doesnt seem to be shrinking the sentinel pile. Is this normal?
Is the sentinel there for the rest of my life if I don't have surgery?
Other than nitro what are my topical options? Botox? How effective is that for a sentinel?
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Re: are sentinels permanent without surgery?

Postby workingonit » 13 Jun 2012, 18:57

My CRS said that sometimes the sentinel goes away, and sometimes it doesn't. It won't go away though til the fissure is 100% healed.
Botox won't do anything for the sentinel directly.
I had a TCM in Vancouver get rid of my sentinel. I had had one cut off a couple years ago and that just caused me further problems I think. Can't say for sure, but I think it made my current fissure so slow to heal. Plus the second sentinel was at the same place as the one I had had cut off.
I found my sentinel most painful when the tissues down there were more inflamed. As the fissure slowly heals the inflammation went down a lot and the sentinel wasn't as 'sore' all the time.
Whether or not having the TCM get rid of the second sentinel has caused healing to finally occur with me, I can't say. It is still very slow, and I made other changes to my diet and my stress levels as well.
4 months sounds kinda long to be on nitro. I've read in other posts here that it loses it's effectiveness in just a couple months.
What did your CRS say about the sentinel and what treatment to explore next?
-Tanya
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Re: are sentinels permanent without surgery?

Postby soothe88 » 13 Jun 2012, 19:54

sorry but, what does the acronyms CRS and TCM mean?
I have an appt tomorrow to see my surgeon in ontario. I am thinking he is not as "special" as I need him to be. He did not give me a full exam when I first saw him, only poked "here..here..here" and I said ouch, and his reply was just "yeah, you have a fissure". I tried to explain to him the "growth" (by this time I wasnt familiar with the term sentinel pile, which I discovered online), and he just blew me off and prescribed some nitro.
And yeah I am noticing that the nitro doesnt really do anything for me anymore. However the SENTINEL is far far more painful than the fissure ever was. I saw a medical diagram once that had it all laid out and said a specific group of cells around it sends out those pain signals like no tomorrow. I dont even know if I still have a fissure but that sentinel is a PAIN! It is hard on the end of it near the 12 o clock position. I have thought that if the sentinel is there, then the fissure must still be.
Thanks for telling me about the botox. Hadnt heard that it was ineffective against sentinels. Now I am at my wit's end trying to figure out what route to take..aloe vera..emu oil..or what? If the nitro didnt cure me what will? Is aloe a waste of time?
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Re: are sentinels permanent without surgery?

Postby workingonit » 13 Jun 2012, 20:24

Yah,
I am used to being blown off by doctors too. Sucks.
CRS= colorectal surgeon
TCM= traditional chinese medicine
If you are in Ontario, there is the main office of the NATCM clinic that I have been seeing in Burnaby.
They are in Markham.
Here's the thread I have been writing about my experience there;
http://anal-fissure.org/t4349-chinese-medicine-in-canada
I wonder if ice would help your sentinel pain?
You could ask your doctor about nifedipine. It works better over long periods than nitro.
-Tanya
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Re: are sentinels permanent without surgery?

Postby soothe88 » 13 Jun 2012, 21:52

I havent heard of nifedipine. I wrote it down and will ask the gen surgeon tomorrow if he knows anything. Am reading that link now..very interesting :)
I am reading the chinese-medicine thread and I keep thinking of the X-Files guy, Mulder. He was on Letterman few years back, telling Dave a story about his doc that couldn't help him cure his problem so he went the chinese medicine route. His chinese doc kept saying to him, "Not pain! EXPERIENCE!" LOL
Update: ok, after reading that thread, just to be sure...the chinese doc did say that the sentinel WILL in fact heal/go away eventually...? Or did I misread that?
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Re: are sentinels permanent without surgery?

Postby workingonit » 14 Jun 2012, 07:19

hi,
Actually, Dr. Zhang said that the fissure would heal eventually with or without the 'procedure' to get rid of the sentinel.
It's hard to be sure, because of the language difficulties, but I think he thought the sentinel would get smaller eventually, but not go away. He kept referring to it as the scar which confused me for a long time.
I wouldn't expect Chinese medicine to be a miracle cure of anything. I tried it for getting pregnant when I was younger, but it didn't help. Quitting my stressful job did the trick ; )
Of course there are probably some better TCMs than others, like any profession.
-Tanya
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Re: are sentinels permanent without surgery?

Postby soothe88 » 14 Jun 2012, 13:20

Went to the doc today and mentioned the asian medicine route and he kind of laughed actually. He said $1000 was way way too much unless you had some kind of guarantee. of course I didnt expect him to be unbiased since he is a competitor with him, haha.
Am going to get a referral to see a different specialist from my family physician (different guy than the one i saw today). Next step is either niph or botox. Interesting thing he said though, was that a botox injection was more successful in his patients than nitro. I had heard the reverse in some uk study once: 25% better for botox and 50% for nitro. Who knows.
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