Hey there - my heart truly goes out to you. I have since had a second fissurectomy with botox (two months ago today). After my last post it must sound crazy deciding to do it again but I was advised it was the right way to go. My specialist told me that statistically the second time around the odds are better of the fissurectomy and botox working. I went for a check up a month ago and he said it was healing, but not healed. From going down this road since the birth of my son I am now on antidepressants and seeing a psychologist for cognitive behaviour therapy! Believe me I have done many many things to try and avoid going down the road of antidepressants, various self help techniques etc but I think after a while after a bad birth experience and then a secondary health problem that won't go away it's hard to pull yourself together. I've got about my normal life, being a Mum, returning to work etc but I haven't felt 'right'. At one point I went to a counsellor who said I had post traumatic stress disorder from the birth ordeal. So I think for me, the first fissurectomy was around a time when I was in a bad place mentally and I wonder if that was half of my problem with healing.
I am still having 'discomfort'. I think if I had to be really honest I couldn't call it pain as I can go about any daily activity I need to - it's just 'there'. Some days I have none at all, which makes it harder for the next time when I do!! So I know what you mean about having a couple of good days where you think it is all getting better. Everything I have read about a fissurectomy has told me that out of all the procedures for a fissure, the fissurectomy is the one of the most unpleasant and longest to heal from.
It's hard not to think about it all day every day. The psychologist has told me I must stay away from things like these message boards etc and the worst thing to do is compare yourself to other people's experiences as it can give you un-realistic expectations about your own healing and body. I tend to disagree!! I can see his point but I also think talking to other people about their experience with the same problem can be a huge help - which is why I decided to take a quick look this morning and if I hadn't, I wouldn't have seen your post!
I am finding as well that my monthly cycle has an effect on pain/discomfort down there. When I have my period I have more of a rectal pain, where as when the fissure is bothering its a stinging 'cut' type pain, where I am very aware that I have been cut down there from the fissurectomy. My doctor has suggested the rectal pain could be a touch of endometriosis and advised me to see a gyno, but I am going to wait and see what my next check up regarding the fissure says. The first specialist I saw regarding rectal pain tended to think that the fissure was a red herring as to him it looked nearly completely healed and he couldn't figure out why I was experiencing the type of discomfort I was feeling from a small fissure. So part of my does think that the first fissurectomy may have been un-necessary and has just given me a whole new set of problems. Its so hard not to over think and wonder what you could have done differently. PLus it is awful how the 'gold standard' procedure - LIS - that seems to be the best way to go, is so risky for women like us that it can't even really be an option, yet we know it would probably heal us once and for all.
So I would say give it plenty of time (and I mean plenty) to see if the fissurectomy has been a success. Three weeks out I was still feeling pain from the fissurectomy too. That pain will soon subside. I remember thinking that the pain was almost worst than before the procedure, very swollen and tender feeling. I think healing from a fissure is a very bumpy road, up and down all the time. When I was feeling my worse mentally from this I used to constantly think over and over "I can't be expected to go on living like this" it seemed ridiculous that it can be so hard to heal from what is essentially just a cut. But as small as they are they cause such awful pain at their worse. Although I am still not completely healed I am feeling generally better down there this time around and more optimistic. Plus I am being extra careful with my diet and staying on the lactulose for as long as it takes.
Sorry about the long post but I really want to give you hope. I always look at it that one way or another, things have to heal down there. You are 3 weeks post op and I think it would be more surprising NOT to be feeling pain at 3 weeks out. To have gone through 5 ops already is so brave of you, I shouldn't be complaining at having just 2.
The good thing with a fissurectomy is that, although it leaves this painful wound for us, it has completely freshened that fissure up, taking away the edges, smoothed it back to give it every possible chance of healing, almost like a clean slate to start trying to heal again. Some people after LIS still have trouble healing it as the fissure is so chronic.
Another piece of advice I was given was to let the surgeon/specialist worry about why it isn't healing - its their job and that's what we are paying them to do. Easier said than done, but it is true. It costs so much money, even with health insurance covering some of it.
Do you have to go for a post op check up any time soon??
I know what you are going through and let me know if you want to know anything else