by dmcff » 22 Mar 2016, 08:37
Still having problems managing the pain, which comes and goes without apparent cause. I recognize that I have a big fear of surgery. Called the CRS's office, but when it came to actually making an appointment chickened out, said I wasn't sure about the date, maybe it should be after Easter - secretary was naturally impatient - in the end I had to say "Sorry, I'll have to get back to you later."
As a sign of my indecision, I re-started Diltiazem this morning, and found that it doesn't sting me any more. So perhaps that's the way to proceed, after all my rude remarks about Dilt in the past. I also found that a Proctosedyl hydrocortisone cream with lidocaine didn't sting and burn as much as I thought it would, so perhaps I'll persevere with that, too.
I need to stick to one plan of treatment - either conservative, with creams and ointments, or surgical, which will mean bothering the CRS I already saw last year, and braving the consequences.
Part of the reason for my indecision is some remarks by my GP at a recent consultation. When I mentioned Botox and LIS I said "they'll probably have to knock me out for those", and my GP said "No, they probably won't because of the risk involved." When I asked him what he meant, he said: "The risk is that you might die on the operating table, and no surgeon would want to take responsibility for that."
I found these remarks strange. My GP seemed to be implying that because I'd rejected Diltiazem I had left myself with only the surgical option, and being a reasonably healthy 71-year-old that option was likely going to be denied to me because of the afore-mentioned "risk". Or was this my GP's sense of humour? If so...
I also currently have a problem with medications: four weeks ago, when I first got the new fissure, my GP prescribed 5mg zolpidem (ambien), something he has also done in the past. When the pain got bad recently, I started occasionally taking one zolpidem in the daytime, as it killed the pain and relaxed the muscles "down there."
But now the GP says I have to come off the zolpidem altogether, and switch to Seroquel (Quetiapine) 25mg. This is a sudden change, and I'm not sure I can make it at the same time as I'm juggling with the conservative methods/surgery dilemma. Seroquel is a powerful anti-psychotic, and its off-label use as a sedative/hypnotic is frowned on by some in the medical profession.
One thing that's sure is that this condition definitely contains a psychological as well as a physical dimension. The worst aspect of it is the nagging, constant pain, which makes it hard to take cool and rational decisions, and leaves me, at any rate, in a state of indecision and semi-crisis.
2014 Anal fissure
2015 CAT, EUA, sigmoidoscopy, 2 MRI
2016 Pain severe then moderate to low
2017 Moderate pain
2018 Physical therapy, pain management
2019-20 Living with it
2021 Still AF
2022 Therapy, meditation
2023 Pneumonia
2024 CT scan, MRI, ERCP