Did you call him back? Has he agreed to do the injection?

So the receptionist suggested that I write the doctor an email, which I did a week ago and have not yet received a reply. In the meantime, I am now again on a 6 day streak without finding any blood, and had my 29th treatment today. I figure I'll at least let this streak run out and wait till the inevitable day of misery when I see red with the BM again to call back the office and plead for the steroid procedure...

Hi asdf,
Keep going, you are doing the right thing. These damn Fissures lead us into a false sense of security. They keep doing it to me too.... It messes with my head! Keep us posted. Xxx

Update: I'd appreciate some advice from my AF support group friends- I have now gone 16 days without finding blood, but I still have delayed pain after a BM- usually what I'd rate as a 3-4 out of 10, and which is only bad when I do something butt-clenching, like coughing, sneezing, laughing, etc. etc. It's very depressing when you are out laughing with your friends and every laugh feels like you are getting knifed in the ass...after 2 years. So I have done 38 treatments of HBOT, 33 of which are at full depth and duration. I proactively also scheduled another surgery, the kenalog/dilation/clean-up treatment for June 4...thinking that if my wound has not fully healed by then, it's time to try something new again. However, now I am second-guessing myself thinking that maybe I should stick with HBOT for even longer in light of not finding blood for over 2 weeks... The HBOT people seem to keep pushing the goal posts on me, first saying to give it 15 treatments to find progress, then 20-25, and then 40, and are now saying some people (not AF people, just wound people in general) get a total of 60 treatments, and THEN still take a few more additional weeks to heal after the treatment has stopped. If I committed to that, then that would mean at least another month of treatment, and then giving it a few more weeks, it'd be the end of July. I don't know if I have the mental capacity to wait through that, with my exercise/work/social life all on still on pause, especially since HBOT isn't exactly a sure-thing for this type of wound. The Kenalog thing, on the other hand, is supposedly (assuming you trust a doctor's word, which I certainly do not), quick acting, and so far, highly successful- virtually 100%. The doctor said, of the 119 patients he's done the procedure on, none have reported control related problems, but he has had a few 2-3 who had post-op infections, 1 of which required an additional surgery. He said 2/3 of his patients report to be pain-free in 10 days, and the rest have taken as long as 6 weeks. He said the only patients the procedure did not heal on were 2 patients who decided to just go ahead with LIS within 10 days of getting the kenalog procedure done, I guess out of pain, so there's no real way of knowing if they would have healed eventually. The idea of being pain-free in 10 days is SOOOOO enticing, but have I committed too much to the HBOT to quit at 40 treatments, without noticing any blood? I am leaning GO for surgery, because 40 treatments seems like a lot for such a tiny tiny wound, and I am *seriously* considering a mental institution because I can't believe so many fucking things, first Hemmie surgery, then creams, then 4x botox, then LIS, then YV Flap, and now almost 40 HBOT and I am still not healed...I had a life (albeit a shitty one) before all this, and I want it back before I am too old to enjoy it. Suggestions?

Asdf, I'm so sorry you are still having so much trouble. You have been through to much. It's a very tough decision, if you think the Kenalog is superior to HBOT maybe that is the way to go. You have certainly given the HBOT a lot of time. I can only wish the best and hope whatever you decide works out.

ASDF,
I am sure that you are in another league than the other 119 patients that have done Kenalog. Of the 119 how many have done 4 X Botox, LIS & YV Flap? I would bet zero. If you are improving and you think you can heal with HBOT, and you currently have no bleeding and less pain and no side effects, keep going. You can reschedule your Kenalog surgery. If my LIS does not work, I may follow you in doing the Kenalog. Weight your options and make the best decesion with the most upside to help your body heal. Wish you the best.

Asdf,
If it were me, I'd just give the HBOT the full recommended time..... Then think about the next step.
Roidsfizzman makes a very good point, your situation is not the ' norm' ... You've had lots done in the last couple of years.. You can't really compare yourself to bog standard kenalog for bog standard fissures.

I'm sorry you're not healing as fast as you were hoping too... But you have had a good run of blood free days.... And it seems like your pain level is slowly but surely going down??

At the end of the day... It's your choice... Only you know how much more HBOT you are willing to have. What does the CRS who is going to do the kenalog think?? Does he think you should have it right now or after another set of sessions??

OMB x

Hi asdf,
It's encouraging to know that the bleeding has stopped and the pain is a bit less. I also understand your uncertainty about the HBOT being effective. You've been through so many surgeries, most of them pretty invasive. As you probably know I have been through 2 LIS surgeries and even though it's a fairly non-invasive procedure, I feel that I was more uncomfortable and in pain after the second one. I'm not saying that the surgeon botched up something or my fissure worsened after the second one, but I feel that every time there is poking and prodding down there, it definitely makes the area more sensitive and more difficult to heal. Such is the nature of these frustrating anal problems. Sigh.
So, if I were you (and please take this with a pinch of salt because I can't even imagine all that you've been through), I would keep up with HBOT purely because it's non invasive and may be giving some good results, albeit slowly. From my experience, surgeons are bullshitters when it comes to recovery times, so I wouldn't believe the 10 day estimate he is giving you.
All the best and I hope the decision you make turns out to be the one that finally sets you free from this problem forever.

Thanks everyone,

So there is really no "standard recommended time." They said they usually stop at 40 treatments, but have gone as high as 60, so I'd have to ask if they would go to 60 in my case, and then see if insurance would agree to keep paying...

Kenalog guy said exactly what you said, that I am an odd case, and that if I think HBOT is helping at all, I should see it through...but he also said to come back in when I'm at my "breaking point", which I jokingly replied has long long long since passed. My pain hasn't really diminished, it's day to day. Yesterday it was better, today it's worse again. I'm going in for my pre-op blood test on Thursday, so I'll get to talk to him then and decide whether or not it's best to hold off. By then I'll have done all 40 treatments... I *think* my plan is this: If by Thursday, I still have an open wound confirmed by his visual inspection, I'll go through with the Kenalog procedure the following week...and then resume HBOT immediately to help it along. If the wound is still open, a thorough cleaning/scraping and steroid shot can't be too much of a setback, can it? I understand your points, but after 40 treatments, I'd have expected to have a 100% healed butt long long ago...and be just continuing to 40 out of precaution. This is a tiny tiny wound after all...people go into these chambers with massive leg and foot ulcers, to avoid amputation. My wound is literally like just a paper-cut. Maybe if I do the kenalog thing WITH the HBOT, that will be enough to put me over the edge to finally heal, that seems to me more sensible than doing them consecutively. My anxiety is unbearable from all of this.

Ok then .... Sounds like a plan!!!
At least this time you are covering all possible bases. I truley hope this is it for you, and you finally heal!