Wounded Bum and Infertility Warrior

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Wounded Bum and Infertility Warrior

Postby Ceeteefeebs » 02 Sep 2013, 13:33

Hi guys,
I thought I'd start a diary because my journey to AF-dom is a bit different from any other person I've encountered yet on this forum or the web, and if my story can help another lady in my shoes to feel a little less alone, I'm happy to help. I know there have been many times when I felt (and still do) so impossibly alone on this pretty miserable journey.
In truth I have probably had issues with hems/fissures for many years (I'm currently 31)- but it was never anything debilitating, and I never thought twice about the bloody streaks that would occasionally appear on the toilet paper after wiping.
Things started to change rapidly last year. I suffer from Polycystic Ovarian Syndrome (PCOS), and this means that, for me, I don't have regular periods/menstruate/ovulate. In the past, I've actually gone over a year without having a period. Nothing cooking in the ovarian kitchen. Nada. Anyway, my husband and I decided last summer to start visiting a fertility specialist in the D.C. area to see if having biological children was a possibility for us. Fertility testing and treatment is, by all accounts, grueling (not to mention expensive!), and more so when you respond poorly to the medication you are given. My reproductive endocrinologist prescribed Clomid for me; many of you will have heard of Clomid, as it's been around for decades and is considered widely tolerated and highly effective. Not for this girl. Cue the hot flashes, night sweats, mood swings, insomnia. And, worst of all, constipation. When I could move my bowels, the stool was rock hard. The stool was so hard it would clog the toilet- without the aid of toilet paper. I never knew that the straining could give me an anal fissure... Well, as we know, it can and does! More on that later.
I took Clomid from August through December, suffering from the side effects in the hopes of ovulating. As it turns out, there's a fraction of women with PCOS who are considered poor responders to the drug. Instead of ovulating, all I grew were big fat cysts. I'm pretty good at that! And then a diagnosis came in December during a transvaginal ultrasound: I had a mass attached to left ovary. The fertility specialist halted treatment and referred me to a gynecological surgeon. Five days before Christmas I had a fist-sized tumor removed from my ovary. Thankfully, the diagnosis was the best that one could possibly hope for: the tumor was benign, and the surgeon was able to save my ovary.
Recovering from the abdominal surgery was, in hindsight, a piece of cake. The Percoset I was prescribed for pain didn't do much harm constipation-wise because my abdominal muscles had been cut and straining wasn't an option. I was able to resume fertility treatments in mid-January, this time with injectables (Gonal-F).
Then came the bum tear heard around the world (literally, I think!). I went grocery shopping one day and, as I was squatting in front of the fridge to put vegetables in the bin, I suffered a catastrophic rectal tear. I could feel the tearing, and the immediate spasms... You'll know about those. The feeling of being violated by shards of glass or a fire poker. I called my husband and told him, "I think I just tore my a--!" Unfortunately, I was right. Image 
The initial spasm subsided (thank God!), but the fissure wouldn't heal. I oozed faint pink blood for two months before the bleeding worsened and the spasms resumed. Starting in March, I halted fertility treatment. I'd get up from the ultrasound table and leave blood on the tissue paper from how badly I was bleeding (and the wand they used for the ultrasound only reopened the wound... fun when you're getting ultrasounds four to five times a week, eh?!). At this point, I had been using an injectable (Gonal-F) that is known to have constipating side effects. The same is true for a progesterone supplement (prometrium) I had been taking in massive quantities. I stopped taking the meds and contacted a CRS.
On April 29 I had LIS and a fissurectomy. My spasms were constant and severe. I was spending as many as five hours a day in the bathtub. Nothing I tried provided me with a modicum of relief. And I tried it all! More on that another time, I suppose. :o 
Recovery from the LIS has been slow. At first, I was despondent that the surgery didn't work because I was still suffering from spasms (they take weeks to go away for some people, so if you're in the same boat hang in there!). The actual post-op recovery wasn't bad- no incontinence, very minor rectal bleeding only the first day, and no incision pain after a week. But the fissure has been taking its merry time to heal, and at times I still worry the LIS didn't work. I travel everywhere with a memory foam cushion (my little life saver... I was actually able to fly to Japan this July because of it!). It took me a couple months before I could lay on my back in bed or not sit side saddle on the sofa.
A few weeks ago I would have said that I felt healed. No fissure pain whatsoever. In the past week I've experienced an inexplicable setback- I'm thinking maybe it's a histamine intolerance/blood vessel issue. The fissure has been stinging and the sphincter has been occasionally spasming. But no constipation, straining, or blood. Yippee! So we'll see. I'm getting back on antihistamines to see if there is any correlation between that and fissure pain. For a few weeks, I was taking Claritin regularly and experiencing no fissure discomfort. We'll see. Fingers crossed!
As for my infertility... I don't know if I can bear to go back to the specialist. The plan, when I was feeling better, was maybe to go back in January and try it for another six months. I'll keep you posted on that. What I worry about it, if I can get pregnant, is how I am getting to deliver a baby. I think at this point I would elect for a C-section. Having had abdominal surgery, I can say that recovery from that was a breeze compared to life with a fissure.
I think that's about it for now. Thanks for being such a supportive network for me! The members of this board have kept me sane more times than I can count, and your support means so very much to me.
Ceeteefeebs
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Re: Wounded Bum and Infertility Warrior

Postby Ceeteefeebs » 02 Sep 2013, 22:12

I think I'd also like to use this diary as a space to post observations about what has/hasn't worked for me in case it can be of use to others. Entry one:
Epsom salt. You know what expression about pouring salt in open wounds? Yowza! On my second attempting at taking an Epsom salt bath, salt came in contact with my open fissure. I leapt out of the bath and writhed on my bed screaming and bawling for half and hour. Maybe that was medically a good thing... Like cauterizing a wound with gunpowder to fight off infection. But holy hell. That was THE most painful 30 minutes of my life. So my advice: bear in mind that Epsom salt may sting you like the absolute devil.
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Re: Wounded Bum and Infertility Warrior

Postby Scientist2516 » 03 Sep 2013, 06:35

Hi Ceettfeebs, thanks for telling us about your experiences. They sound horrendous. I can only imagine dealing with infertility and an anal fissure at the same time.
I hope so much that you will be able to have a baby one day.
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: Wounded Bum and Infertility Warrior

Postby Ever the Optimist » 04 Sep 2013, 15:37

Ceetee,
You are truly a tower of strength!
Dealing with infertility as well as the fissure must be incredibly tough on you emotionally and thanks for sharing your story. I was touched!
I also hope that you overcome this very soon and that at some point you are able to conceive too. That is the hardest thing for someone who is so desperate to start their own family.
Having also had a history of ovarian cysts (one the size of a large golf ball removed) some years ago, I was extremely fortunate to conceive my daughter 6 years ago naturally (and it was very unexpected!) - so I really hope that this might just happen to you too.
If I were ever to get pregnant again, I would NEVER consider a natural birth after all this anal stuff. I would get a C-section booked & ready!!! There's lots of women in this situation too.....
All the VERY best to you in whatever you decide to do & I pray it works out for you x x
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Wounded Bum and Infertility Warrior

Postby Ceeteefeebs » 05 Sep 2013, 22:48

Thanks for the kind words, Scientist and EMO! I draw every ounce of positivity and support that I can from this board and channel it right back into the good fight. So I'm sending a big hug right back at you. Image 
I can't tell you how relieved I am to hear another AF sufferer share my thoughts on a C-section. I know I'm putting the cart waaaaay before the horse, but I can't help thinking about what happens if I can have a baby (gotta get that wee one out somehow). I worry thinking that a doctor will be dismissive about my request or that my health insurance would somehow refuse to cover an "elective" c-section, or that it's shameful in some way (I have so many friends and family members who are adamantly pro-natural birth to the point of judging others who don't... or can't... go that route).
I was hoping that my latest fissure flare up was a histamine response. I've been on anti-histamines for a few days now, and although my seasonal allergies are under control, there hasn't been much improvement in the fissure department. That's a bummer. I hope it's just scar tissue acting up and that the fissure itself is healed. The only way to find out for sure is to go back into the CRS, and I'm definitely not chomping at the bit for a rectal exam or sigmoidoscopy! I'll update on the antihistamine theory over the next couple weeks on the off-chance it proves helpful (you never know!).
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Re: Wounded Bum and Infertility Warrior

Postby Ever the Optimist » 06 Sep 2013, 15:41

Hi Ceetee,
Yes please update!
I hope it was nothing major too and as you are probably well aware by now, flare-ups are part & parcel of the fissure healing process. Scar tissue does come along with its own issues, but in my experience, nothing nearly as bad as an open fissure! It would be interesting to get a follow-up though, just to see how healed you are?
If it reassures you, when I discussed getting pregnant again after my fissure healed with my GP, he was the one that actually advised me that I could elect for a C-section and based on what I'd been through, this would not be a problem at all.
I would have no hesitation to go this route and as far as I'm concerned, other's opinions are irrelevant!! It's my life and as long as I deliver a healthy happy baby, who cares which way it has to be done! I know C-sections are not always a walk in the park, but after having experienced a natural birth, I know for sure that prolonged pushing would more than certainly reopen my old tear and potentially create another, so NO way!!!! :) 
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: Wounded Bum and Infertility Warrior

Postby omyrear » 12 Oct 2013, 08:47

Hi Ceetee - I am with you on so many of your points! I developed my fissure last November and then was officially diagnosed with PCOS in June of this year and referred to a fertility specialist. I, obviously, want to get rid of this stupid fissure before doing anything fertility-wise though. I had LIS in mid-August & am still not healed. I had 1 great week & then have experienced pain/spasms off and on since then. It hadn't been as bad as pre-surgery though, until this past week, and then I had blood this morning for the first time since before surgery. Ugh!! If I'm ever able to heal, I worry about putting my body through all the necessary medications/treatments to get pregnant and then through a pregnancy. Forget about the delivery - I will definitely opt for a c-section! I've had major abdominal surgery twice and, like you said, I'd put up with that pain over the fissure pain any day! At least you know the surgery site will heal unlike this stupid fissure!! Anyway, just wanted to let you know you're not alone. Dealing with the fissure and infertility has been horrible. I'm almost 32 too, so I feel this major time crunch on top of everything. I hope you are continuing to heal and that your recent set back hasn't turned into anything major!! Best wishes to you!!
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Re: Wounded Bum and Infertility Warrior

Postby omyrear » 13 Oct 2013, 01:21

I should have said that I'm almost 33...I guess you know you're getting older when you forget how old you are. Ha!!
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