I should add, for those healing without surgery thus far! I am finally, finally, having a relief in pain after about four months this time (plus another five weeks before a month off and then I retore), so five months of daily hell. It's not that I didn't consult professionals, I did. And both traditional and naturopaths recommended the conservative approach for starters (they didn't seem to count the first five weeks before major re-tear). So, just as I was being seen to go to the next level (surgery, or maybe botox), I was seeing improvement. I was mostly seeing improvement by tracking my pain levels. I rate every day using the max number (so let's say I have a BM and rate it a 7, I rate the day a 7). Because there has been so much up and down (including retears along the way), it has been difficult to know whether I have been healing or not). I could only appreciate it by calculating my average rating over the week and then looking across weeks. Sure enough, slow gradual progress. Two steps forward, one step back. More like, three steps forward one step back. This week I'm down to low pain levels everyday and I'm finally feeling a little hopeful that I'll heal. Realizing never to let my guard down. I'm curious whether other AF sufferers have tried this approach and how helpful it's been. My naturopath did say to me, "it's all about the pain". Thoughts?

Hi JPT, I tried this approach for a while, but the Botox has helped me. I re-tore just a few weeks ago at week 10 on Botox. I visited my CRS yesterday and everything looks good so far. One monster is dead and the other is getting there. I know other members have healed naturally, but this wasn't working for me. Botox is my new best friend, and I plan to have more if needed! I hope that you can heal soon, keep going.

Sorry forgot to say my pain was at 10plus every day. Now it is on average 1-2 some days a 3. Hopefully 0 soon!

Good idea, JPT, which I think I will have a go at myself. Thank you!

Thanks for the encouragement and sharing, Rachael. I was scheduled to meet with a CRS surgeon to discuss botox or other surgery a few weeks back. I cancelled because I was seeing reasonably good improvement in my numbers. Plus, I'm changing health plans. For example, over the last three months, the first month pain levels averaged 7 to 8 (highest daily rating was a 9), the second month they averaged 5.7 to 7 (highs of 8 ), the third month 2.6 to 5.5 (highs of 6 to 7). Or, if I look back over the last four weeks, average pain levels are: 5.5, 5.3, 5.1 & 2.6. :) I still have some discomfort (some days post bm minor spasm pain) but it is so much more manageable than it has been. I was curious about others' experience with this. I felt it gave me something to do and more objective data than my roller-coaster like emotions. A negative could be just too much focus on the pain. Let me know, Savaici, if you find it helpful!

Hi Pain,
I'd not plotted my recovery to the extent you have but your approach makes complete sense and it is a great way of keeping a record, as yes, setbacks, can completely throw you off track because they can be so random and unexpected and convince you that are slipping further back in your healing than you actually are!.
I took things more month by month and used my period as a guage to my progress, which sounds a bit strange - but I would always think at that time, so how am I compared to one/ two/ three month(s) ago?? and sure as houses, month by month, I noticed much improvement (slow but steady progress) In the same respect, I'd always do a monthly shop in a certain supermarket and again at this time, I'd progress track by the month until I reached a point that I knew I was substantially better because instead of gripping the trolley handle tightly and bending forward slightly to easen any pain, I actually found myself walking more upright and barely holding the handle - more like just pushing it lightly!!! These were my little pain monitors in the same respect and they helped a lot!
Keep going Pain.....To me, (I healed naturally after 1 year, 5 months) you sound like you are heading the right way!!..Even a week prior to confirmed full healing, I had, what I felt was a big setback and it scared me a lot, but given I was confirmed healed only a week later, it just goes to show how a fissure plays havoc with your brain and can lead you to believe the worst, even when you're actually doing incredibly well!........Patience and acceptance that natural healing in a chronic fissure is slow, are key......

Just 'Pain' Tired, I also kept track of my healing, Im like you have the worst during the first 4 months of the fissure, then with on and off major set back until month 6 as I could not no longer use the nitro cream, that is when my CRS offered the surgery, then after month 6 I actually got a hold on my fissure routine and started to control it, a few more months of mild set back never as bad as it was in the first few months, then everything started to get better and better.
It is light at the end of the fissure tunnel if you are willing to wait and see.
Occurs if the fissures set back are as painful as in beginning after months of treatment then is not reason why to keep suffering anymore.
But if you can wait and see I guess is worth it, at least is was worth it for me. :D

Thanks, guys!  Today was not a good day.  Pain spiked to 6 after being at a 2 or 3.  Then had a bad time of spasm.  Thank God I was at home and could use more ointment and heating pad.  Just shows me how fragile I am!!!!  But I'm going to take a longer view and use my data.  If I really go way back, then I have to opt for botox or surgery, it would only make sense!  :(

Hey, Sunshine here  
Ive just been reading this blog of yours and am interested in how you are now?
I too have been keeping a total diary for the last two weeks, of basicly everything I eat, drink, pain relief needed each day, sitz required, BMs and the pain level. As I though that i may find some pattern to pain levels, or may see things getting better.
At the end of every day, I also mark the day by either drawing a sad face and writing, painful or achy day, or a HUGE smiley face followed by FANTASTIC day!! Which would be a non broken galss day and no pain killers required. When its a good day, i finish it with THANK YOU :D  Well, I figure someone up there is helping me out, and grattitude is the way forward  
Bum Club Diary.....now theres a business thought!!! haha
 X

Realizing never to let my guard down.

Bingo!! Just 'Pain' Tired:    That's it.
I love your intuitive approach my friend. Its a certain mind set that we must get in to successfully battle these little monsters, and it appears you are in that mode where you basically have "had it up to here" and your thinking.....
"gosh darn it, I'm not going to take it anymore".  
That's the way you do it Just 'Pain' Tired, just keep coming up with different ways to attack these cowards. I see you've crunched the numbers on this that would make a mathematician proud, and the theory sounds "rock" solid. Pythagorean has nothing on you.:D 
As I continue to read about these devastating re-rears in here, it appears many if not most of them are preventable, by simply keeping the stools soft (I know mine were).
And it saddens me to hear of some who may say I can't seem to heal
when in fact they could if only they take the time to learn the secrets of keeping stools soft, not straining on toilet among other things.
Time and time again I'm seeing when a person does this, like your doing, that's when things usually start really improving.
Botox, LIS and the like will always be totally necessary for many in here, but I will continue to wonder, what % truly could have avoided this and healed naturally.
So, keep it up Just 'Pain' Tired, your bound to discover yet other ways to successfully combat your assassins even if in the end you go the botox or LIS route.
GL