thanks! I am still waiting to hear back from the GP on the lab results.

starting my prep for the second round of Botox on Monday. I am hoping the second round works. I remain hopeful, as during the first round, I had a tag removal and terrible rash, which probably only exacerbated things down there. I am running low on vacation days, so I am hoping I feel better the next day, as the doctor has promised.

post-Botox round 2:

The first day I was in quite some pain. First, he didn't use a local anesthetic, because he thought I may have gotten my terrible rash from the last prep. After a number of hours (and some painkillers), the packing fell out and I had instant relief. It must've been rubbing against my AF! Anyhow, the doctor thinks I am healing now from BOtox, despite two weeks ago when he said he didn't think I responded...

First actual BM was the following day. No blood.
Second BM that day there was light blood. Both were a 5.

Today, both BMs were pain free, but there was blood with both, which is concerning. He said there is blood after Botox, but I am afraid my AF tore again during the op. He said that can happen, when I talked to him in pain post-op, but said as long as I don't get constipated, I will be fine.

Here's the thing, I never get constipated. It seems that even a perfect bm can cause that sucker to bleed. Anyone else have a similar situation?

He wants me to continue half cup of Miralax at night and increase to two tbsps of fiber in the morning. It seems to me that it would make more sense to split up the fiber, but he said to take it all at one time when I asked.

A week post-second Botox round:
Bleeding subsided after two days. The doctor said some blood was normal after Botox injection. Very little pain during or after bowel movement. This is all GREAT news. I remain optimistic, seeing during the first round I also had a tag removal, which I'm afraid may have complicated the recovery more than necessary.

I'm so glad things are settling and going so well for you...... Lets hope this time it fully heals!!

OMB x

Thanks, OMB!

Very light blood today with second after a tough first bm (4), but wasn't as "regular " as I normally am the day before. Upped the water and veggies today. Hoping it's just a small bump in the road. Felt fine the rest of the day. No pain. Continuing to use nifedipine lidocaine, 1.5 tbsps of fiber in the morning, colace after meals, and a half cup of Miralax before bed. Two sitz baths.

Two weeks post second Botox
Very little pain and blood, if any. This is leaps and bounds ahead of where I was a month ago with blood and pain lasting immediately following a bm and for the next hour.

I felt scar tissue, I believe, a few days ago, which was weird, but good. Unfortunately, i think it's gone. It seems like any bm with any pressure would remove any scar tissue pretty easily. You need to win the bm lottery to heal an AF it seems like!

Still at two probiotics, one and a half tbsp of Metamucil in the morning, and a half cup of miralax before bed. With colace after meals.

I am now having two bms a day. Usually an hour or two after the first. I think my body has trained itself to split up the pain I used to have. Then, sometimes exercise or nerves cause me to have a third. It's frustrating, but as always, I feel it's better to empty than to let it sit inside you. I gained nearly 10 lbs since getting my AF. I always have to laugh, sadly, when the doctor asks me if I am losing weight and then tells me it's good that I am not. I just haven't been able to run (makes me have to go) and outside of running,, I have a fairly sedentary lifestyle. UGH!

Wondering if you had success with the Botox? I just had it 7 days ago and updated my diary for anyone else out there pondering whether or not to do it. Hope you are great!

Hi Ring of Fire 2, I'm so sorry for my delay in responding. I was trying to avoid the board for a bit, as sometimes I feel it got me more worked up.

I did my first round in early October, and didn't have much luck. However, they removed a tag at that time, which limited my healing, I believe. The CRS highly recommended a second round, as a last ditch effort before LIS, and I had A LOT more success with it. Even upon going in for the second round, he mentioned I was already looking better. About two weeks in, I started bleeding quite a bit, but I went home for the holidays, ate like crap and drank, and ended up being better off. Since then, I have removed raw vegetables from my diet. I try to just do walking for exercise and do my best to limit BMs to once a day. It seems my fissure was acting up from more of the high end of the Bristol scale (diarrhea) than the low end (constipation).

I end up going three weeks or so without any blood. I have had some very minor bleeding when wiping every once in a while, but the pain is almost gone when I go the bathroom. I do have some swelling sensations that started recently, so I'm curious as to what this is. The pain has also gotten slightly worse, but still no bleeding. It might just be the Botox is wearing off.

My follow up appointment post-second round of Botox is Tuesday. I can hopefully provide a better update on the success then.

I just wanted to officially close out this diary.

Unfortunately, the Botox was not successful for me. The second round was fairly successful with three painfree and blood-free weeks, but unfortunately, I had a setback a day or two in week 7 before my follow up. He said botox usually kicks in week 2 (mine was about week 3), but at this point, a third round of Botox wouldn't be very useful. He recommended getting LIS at this point. It has been a year this February since I developed my fissure. I have tried all conservative methods: ointment and Botox.

I will be going in for LIS soon. Before LIS, I will meet with the GI doctor one last time to make sure there's not a bigger issue at large, such as IBD, due to my "overactive" intestines when exercising or when I'm nervous.

As much as I am nervous about LIS and the risks it carries, I am very anxiously awaiting closing this chapter of my life and getting on with my normal activities!

I hope to start an LIS diary after my surgery, as i hope these records are useful to others experiencing this problem.

Best of luck to all of you in your recoveries!

I look forward to reading your post lis recovery diary!!

Keep us posted on your up dates

OMB x