Surgery is NOT the answer! | The treatment for Anal Spasm!
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- เผยแพร่เมื่อ 26 ก.ย. 2024
- Videos to help you about anal spasm:
-How to know if you have spasm: • 10 signs and symptoms ...
-Why do I have the spasm?: • Info your doctor will ...
-Pranicura 30 Day Challenge!: • Use Pranicura in these...
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Moist wipes:
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Hemorrhoid care:
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DISCLAIMER: This video is purely educational and does not constitute medical advice. The content of this video is my personal opinion and not that of my employer(s). Use of this information is at your own risk. Albert Chung, M.D. will not assume any liability for any direct or indirect losses or damages that may result from the use of the information contained in this video including but not limited to economic loss, injury, illness, or death.
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I got my pranicura thanks a lot dr …hello from India.
I got the pranicura right now doctor 👋 on my 2nd week , lets Go !!
Serious question. I asked in another video but it's old and not sure you'd see it.
I have no pain or itching luckily, but I have had for years, swollen, thrombosed hemorrhoids all around my anus (dark purple lumps) and internal hemorrhoids.
Does pranicura make these go away and, have you ever heard of a product called "healing bottoms"?
I've been contemplating purchasing pranicura, and or healing bottoms kit #2 in hopes one will make these go away
Could you do a video on your thoughts of this healing bottoms product?
I've had anal itch for nearly 20 years and Pranicura is the only product that provides 100% relief. Thanks so much for letting me know about this amazing product doc! Worth every penny.
Please doctor I have spasm in anus and Rectum ; and burning and itching in anus and same time fecal incontinence when it’s soft !! I did pelvic therapy, it didn’t help… the doctor told me it’s muscle problem and she told me may be meditation will help but it didn’t help!! And I’m not able to sit comfortably…. Will pranicura help me to sit comfortably with normal muscles anus ?? Thank you 😢🙏🏻
I really appreciate you Doc! I got injured on my horse 14 years ago (63 now) and, after severe edemas and infections, have had 4 fistulas and severe spasms since then. On the first surgery, the doc did an unsolicited sphincterotomy, left some bad scar tissue, and trauma from his fat fingers, etc. Numerous docs over the years, including 2 at Mayo Clinic, did me NO good at all. YOU are the first I’ve heard putting out SOLID info. Thanks…from the very bottom of me! 😊 Your happy demeanor is also relaxing and reassuring!
I never tought I would subscribe to a proctologist channel but since I have issues, you are the very best at making problems somewhat fun and giving (what seems to be) very good knowledge in the best way possible! Thank you from Québec bro!
You are saving me right now. I’ve had these pains since I was 16, so for 19 years now. Almost 11. And I didn’t realize what was going on for a long time. Shame has kept me from seeing a doctor about it, but I’m sick of having my sleep cycle thrown off, and with that, everything else. I’m going to implement everything in the video along with getting past the shame and making those DR appointments 💛💛
Honestly, no one has ever talked about when the pain is unbearable. I’ve passed out multiple times from how intense it is!
I had this happen and passed out. I had no idea what was going on. I thought I was dying of butt pain
Thank you Dr. Chung for this info. I’m 69 and started getting this about 35 years ago. At that time there was barely any info out there and you are right, the GP wasn't alot of help other than to say many people got it. As I look back it definitely was extremely painful at the highest stress times of my life and if I pushed too hard either walking or a workout. Now retired and they had calmed down and got them maybe once a month and more mild than in the past. They have just started much more over the last few weeks though. And I’ve had skinny stools too, although have no problem going every day. Only different thing for me now is I am walking much more and faster and pushing hard to walk longer more than normal right now, The spasm will wake me from a deep sleep. But I wanted to share with you something that helped me a great deal. All the things you talked about worked well for me. However, if I can catch it right at that point when I get that feeling of the spasm just starting, I take a few puffs of a ventolin puffer, get off my feet and try to put my feet up, or better is laying down on my back knees up and deep breath while mentally focusing on pelvic relaxation. I read this tip probably 20 years ago on a site I believe from Europe. It definitely helps . Also extreme foul gas comes out too. The good thing about this spasm is once it’s done it goes away fast, which is definitely great! Thank you again!
How
😊iseventy years gut bowel nerve anxiety pain but waking at night or early morning with burning pressured bowel pain improves on bm or getting up ok when I go to bed but lying down brings on the pain
Helloo.. just wanted to ask did u face any problem with anal stenosis i.e. anal width getting smaller?? Kindly reply
Great info, thank you. All the things you talked about worked for me, especially the mental health relaxation aspect. Helpful knowledge helps me to relax, which in turn helps my spasms diminish. Whenever I do get a spasm now, which is infrequent compared to 6 months ago, I stop what I’m doing and evaluate my mood, what’s going on, etc. it really helps me gain some control over it all. 😊
You are so wonderful and i fewl like cryinf bc i finally feel like someone understands. Ive been in bed all week. I feel like ive lost my life. Thank you for your knowledge and compassion. Blessings to you.
i’m very sorry to hear. How r u doing now?
I don’t have most of these problems…just some constipation…like since birth…I am fixing that thanks to you. Sure wish you were my doctor…you have a great way of explaining it all to us lay people. You are awesome…thanks so much.
I’ve suffered from issues for years due to being on pain medication due to a tumor in my spine. So I’ve had a constant struggle with slower digestion, then I started have hardening of 💩 which led to me getting strong anal spasms, the hemorrhoids, then fissures. As a gay man this was extremely difficult for me personally and in relationship. This year I have been using the slow dilation technique by use of slowly increasing size width! It’s helped tremendously along with your kegel exercises
I am going on 2 years of chronic tip end hemorrhoids & fissure. I can eat healthy, avoid having a flare up then eat a little too much bread one day and it just rips open my injury and im back to square one 😞 I feel hopeless sometimes, but watching this video gives me mental strength to not give up 🥺❤️
Do u have pain and bleeding both or just one of them?
Im going through else different
Thank you. Had my first old man visit to a doctor and he said in our conversation, how’s my stress going. That’s when I knew I needed to make a change in perspective, stress has to much control. I never expected a stress conversation to begin at a proctologist office Thank you for your videos.
Thank you for all the information. I have had 3 surgeries in the past 25 years, the last one just last year. It was extremely painful for 2 weeks post op, but I am doing better. However, I still have not so good days. I take colace and increased my fiber with fiber cereal, but have to be careful not to take too much, otherwise, I need to stay home until I feel I can safely be away from the bathroom. I sincerely appreciate your information on this subject, it's not usually one I can share with many people. Thank you again.
Thanks for sharing your story. I wish you the best.
Three surgeries? Are they all same type? Hope you are getting better each and every day.
The most useful video of all time
fair
People tend to be looking for an "instant fix" when they have an issue, and surgery can sound like the answer. But if you have a procedure, you will still have to go through recovery and physiotherapy, which can take a long time. It doesn't make sense to me why people wouldn't try physio first and avoid the expensive, painful and inconvenient surgery. You're going to get to the physio either way! Just knowing that there are pelvic floor specialists really helps. It might not occur to people to look for this specialty. The other problem might be convincing your insurance to cover it.
agreed!
Great video! The best thing is to have a soft poop, and when contracting the muscle, to do it very slowly. 400mg ibuprofen works as you said can confirm. Tylenol doesn't. Cream works too but need to reach the right spot. The main issue I have is sitting on a chair. Would be great if you can make a video on which seat cushions and sitting postures are best for hemmoroids, fissure, etc.
I second this about sitting! It’s really difficult
I second this 👋😭
Called to be a Doctor! Very refreshing!
What about walking does it help your floor muscles ?
Exercise with bands not straining?
As I mentioned on another post, I can be at work and suddenly with no warning here comes the deep, extreme pain. without prescription pain medication, I could not make it home. People do not understand the pain 9/10.
A glass container with a little DMSO; add aloe gel if you like; add comfrey oil as main ingredient so it’s about 3x amount of what you used for DMSO & aloe gel.
Dab it with a cotton ball & apply to your source of pain.
You should feel a relaxation response.
Look more into DMSO & comfrey.
Can’t be near plastic or chemicals as it drives anything it touches into the bloodstream. But it’s an old anti inflammatory & relaxant.
Comfrey heals tissues & fractured bones.
Thank you doc. You explain things so much better than any of my docs. You are a angel. A smart angel
I use warmth and find it helps aLOT ! A wet washcloth warmed up in the microwave goes a very long way to relax the area and relieve the pain. Just have to be careful it's not too hot. I find this makes the pain go away very quickly
What I can’t understand is why it happens when you have been sound asleep for hours and it suddenly wakes you from a sound sleep when everything in your body is at its most relaxed state. Why does that happen in particular?
Just came here to ask this same thing, mine only happen in the middle of the night too. I am stressed out but you would think you’re the most relaxed during sleep.
Thank you Dr. Chung!!! I was diagnosed with Levator Ani Syndrome 6 months ago and I have gotten more information, education, and HOPE from your videos than from my proctologist and physiatrist. I went to my proctologist 6 months ago to schedule surgery for grade 3 hemorrhoids, after the checkup the Dr. told me I had LAS and that he would not do the surgery because “I would be miserable with pain the rest of my life” but he didn’t explained why this would be the case. It would be great if you can do a video expanding on how to deal with these 2 conditions concurrently and if in fact surgery for hemorrhoids is contraindicated for patients dealing with Levator Ani Syndrome (which btw my doctor told me it is an incurable condition). Again thank you so much for these videos!
how r u doing now with LAS? i heard that physiotherapy helps?
I get rectal spasms about once a year. They come on out of the blue. Yes, although it feels good to either sit on a tennis ball, sit on a toilet and push down like you’re having a bowel movement, they both help. But you know what helps me the most? And some people don’t believe this but if you think about it, yes it would work. Well, my mom used to get rectal spasms, and I found out that using an albuterol inhaler actually works! Yes, it works! I take two puffs of it as if I were taking it for asthma And if they don’t clear up in about 15 or 20 minutes, I take two more puffs off of it. Within another 15 minutes, they are gone. And within a year I get spasms again. There is no rhyme or reason as to why I get them but I do….
Dr Chung thank you so much! I have been getting better but have been frustrated about how slow the progress seems. Thank you for the positivity! I know I will be done with this soon!
Are you better now?
Are you ok now???
How r u doing now
thanks so much you are helping me with this .....ive already seen improvement...youre a 100% solid gold fantastic person... all the best from australia
You are an awesome Doctor. I am going through this exact situation currently, and have seen doctor and specialist but no one has explained in way you have. It is a mental game to manage pain and your sympathetic way of explaining helps with that battle.
Thanks for sharing your knowledge again doc. I really appreciate your videos.
Your angel. Your helping me more than my doctor. Northwell health. Long island.
Thank you so much doctor Chung! You are giving hope
Thanks a lot Dr! I must say that watching your video is not easy as it makes us think about why I am stressed, what's going on, the answers can be critical and emotional😔. But this is crucial for healing and so that the bottom part can cooperate a bit more. Also you share a lot a of personal information. We know that you love persimmon and can eat 6 at a time, we know that you didn't need to use the entire tub of cream 🤣. I think your wiping routine was very interesting and was super scary as I am a person with bad OCD and contamination fear. I am so glad that I was being brave and continued watching your videos! Thanks a lot and you are really being helpful to many of us. 😄
I am going to put your recommendations into action Dr. Thank you so much!
For many years I had a diet of just the wrong type of foods, coffee, and soda.
As a result I developed internal hemorrhoids, and thrombosed (dark purple lumps) hemorrhoids around the anus.
Also fatty liver. All caused daily bloating, discomfort, and constipation.
3 years ago I switched to drinking water only, aside from 1 cup of green tea with ginger, or orange pekoe, black pekoe cut tea in the morning.
I also use benefiber/prebiotics, and nature's bounty probiotic each day.
I've lost extra weight, bloating is now gone, and passing waste is much smoother, easier.
But I still have the internal hemorrhoids and thrombosed (dark purple lumps) hemorrhoids around the exterior of the anus, hoping to resolve these sans surgery.
My point here is, your diet is a big factor, especially as you get older.
And exercise your bum, as you get older those muscles break down and they are needed for bowel movement.
Dr. Chung mentioned that the thrombosed ones can be painful but only for 2-3 days. It will feel hard to touch. Do you experience it for longer duration?
I ordered Pranicura right away as soon as I heard you mention it in the first video I’ve found 🙏🏼 So grateful for the info and this great product recommendation. I have a prolapsed grade 3-4 hemorrhoids and I gotta say, DON’T accidentally get a smudge on the inside parts 🤣🤣 Love the menthol once I learned how to properly apply it. Doing the 30 day challenge - applying it after my banding right now 🙌🏼🎉
How you feeling now
Dr. Chung I found myself here because I may have experienced it all down there, but now I know for sure because of my anxiety I have been suffering this. Thank you for your sharing your expertise with comedic efforts and providing simple solutions. I don’t have the pranicura but I made my own remedy using peppermint oil - which I believe is anti spasmadic
Thanks Doc great video
Thank you, great video it’s amazing the things we just don’t know or understand that can help us get better.
Thank you for sharing
As I'm trying to push a good one out. Straining. But what a great feeling when its all done. I do love what he says about pa8n medications. I couldn't get through the day without them because of back pain.
I don’t relate to the symptoms he mentions here, but I like his positiveness, my symptoms are weird. Sometimes I feel that the pain irradiates to the side of my lower abdomen.
This subject is helped by your knowledge mixed with humor. 😅😅😅😅😅😅😂😂
Dr. Chung you gave me hope. I’ve been dealing with post infectious inflammation, a small hemorrhoid, and a small fissure for 6 weeks. I’ve been improving, but the progress seemed so slow that it was affecting me. I have gotten a little better, and like you said, that’s good news. Thank you for changing my outlook today! 🥹
Dr i have a steroid suppository that was prescribed a while back for my hemmheroids..can i use that to help reduce the internal inflammation and for pain? My muscle tightness and spasms were so bad and the pressure from constipation just added to it. Now im sp sore with a constant throbbing pain all day. Do you recommend the steroid suppository or should i just take IB PROPHIN?
Thanks!!!
The problem is a retear is inevitable wen I reduce stool softeners even when I’ve been healed for months. Could at home dilation be answer to this? There is a study ongoing for this at the moment
Have had problems with piles for 30+ years, always just suffering in silence, because of things I was told when speaking out about it. Piles got worse and multiplied, from grade 2 they grew fo 3 and four, but I was holding on. It was when I started getting reoccuring fissures, that the pain and spasms became intolerable. I started seing doctors, one told me he has to do a sphincteractomy, I ran away. Another surgeon looked at me from far, and said I do not have anything, and "it is a women's thing". (Men make over 60% of patients.) Another, private, doctor said my case is too advanced for the procedures he was doing... I have now lost count of how many doctors have had their fingers up my bum 😅 even a simple prescription requires an examination. Going for my second surgery now, first I had HALO, but because of reoccuring haemorrhoids going for a haemorroidectomy. Already suffering from anal spasms, and I am terrified that I will get stenosis 😢...
I only wish the very first doctor had knowledge and empathy of you, Dr Chung!
You are fantastic, thank you. 🙏
Super great videos 💪💪
Bad eating habits I believe caused my anal fissures. Hard stool due to eating red meat. I can’t wait to solved my problem.
Thank you doc ❤
Great info, thank you Thank you THANK YOU!!😊
The cream def does help me a lot so if anyone hasn't tried it its def worth a try to see if it helps you! I get itching on my skin around it though and have to rest using it sometimes which is annoying as its helping so much. Do you think i am allergic to something in it?
Place electric heating pad or warm towel in your lap and the sphincter muscle will relax in no time. This helped me big time and I take it with me wherever I go.
My proctologist gave me an internal pelvic floor massage ( 10 times). First time the muscle was hard as a rock, now soft. I suffer from chronic anal fissures. ( for 3 years, with 1,5 good yers).
I am so thankful for your content!!!
Is your fissure healed ?
Is it like dilatation?
How do they massage it?
How was the massage?: please my muscle. is hard now 😢
@@deepanshu1456 yes!
Hello. I am having a lot of pain from a fissure ( I believe) and am wondering if it is normal to have pain by tail bone as well. I had a fissure 17 years ago that needed surgery and minor ones that have "healed" on their own intermittently ( 1 or 2 time a year) but now I have something that feels like a fissure, inflamed sore anus but also pain in tailbone and occasionally pain that radiates to left leg with the pain. Wondering if this is normal with a fissure.
I am pretty sure I have a fissure right now and YES!!! I have pain in my tailbone and radiating pain from the nerves down my legs and even into my feet. Some times it’s just a sharp stabbing pain and other times it’s full rectal, anal, bone and nerve pain.
@@MeadTheValkyrie is your fissure healed completely? Pain reduced?
how r u now?
I get mine off and on sometimes at night the pain is intense 😢
Hello dr. U r simply amazing. I would like to ask u if u could give us yr opinion about colonoscopies. If they are safe procedures and worth it concerning all the horror stories we hear about them. I am terrified to have one.
Thank you so much
Big Nice Professional Young Man.&.❤❤❤❤❤❤❤.&.Respect Love You Forewer. My dream to be checked from you for my health troubles. Good Health Doct Change b
I use an electric heat pad right now. And it helps so much
I may try that. I go for weeks doing good then I will go back to having problems. I have found some help by taking magnesium glycinate. It helps me to relax..... mind maybe a bit more than butt.... but I will take that as this is just crazy that I can't just take a bowl movement everyday without feeling like I got hit by a truck.
By the way: Dr. Chung I really like your videos, because they are very informative. Could you maybe tell us why is it that some of us are not able to use products with menthol in it beause it causes even more pain, while for other people sooths pain?
Hello doctor can scar tissue be fixed by surgery? I am a post op patient, I had undergone fistula surgery two years back but after that my anus feels like it is swollen. Although very minimal pain but i am not able to completely clear my bowels , probably due to the scar that has formed that was diagnosed in colonoscopy post surgery. So is this cure able with few incisions or cuts or surgery?? Please help sir..
Curious to know if anything came of this. I’ve had 2 hemorrhoid surgeries and I have that constant swollen feeling with tight muscles. Wondering if anything can be done for scar tissue
I am having the same problem, last fistula surgery was done 2years back , now I am having scar tissue.... suffering with it now, hope scar can heal by itself without surgery 😢
Scar tissue does not go away on its own. Hope you find some help.
I have been facing chronic pain in anus area from last week and coughing just increases the pain, plz let me if this would go away by its own or what remedy is required, thanks in advance
Thank You Dr. Chung. Can you do a video on Proctitis?
Hi dr what can he used for lubrication..is vaseline a good option for long term use
I’m not a doctor but since Vaseline is a carcinogen, NO! You can use coconut oil
How r u now ?
This is my life. Colitis and Fibromyalgia. Body feels totally screwed. Tight arse. I hope this helps.
Your fibromyalgia begin from your arse 😂 remember your chronic abdominal pain that's the key
The fibromyalgia coming from the colitis? I have the similar problem just very painfull fissure never healing up
OMG, too funny: So, when you said ‘toy’, I was trying to picture an actual kids toy….a TOY, lol…..that would work! 😂😂😂It took me a minute to realize just what you meant, OMGLMAO!!!
Does having hernia in stomach muscles make the pelvic floor weaker when doing exercises
Awsome video
Yeah pain meds can help. I've never felt addicted and in fact, I hate them the more I've taken them really. They also make me super constipated so I cannot eat and take these. I only drink juice.
Thanks
Can these spazams cause increased visits to the bathroom? I'm going about 20-30 times a day. I feel my sphincter tighten. I try to relax and ultimately go. However, it's been over 2 weeks, and it won't stop. I have lost 10 pounds in 15 days. I feel horrible!
You are so good in explaining I have levator ani spasm since nearly 2 years and the pain is everyday and comes better after 6pm but it's so frustrating and I start feeling depressed I am 65 years old
is your pain mild or moderate and how long it lasts? i’ve got same symptoms recently
I have them as well, no fissures causing the pain, saw a PT and said very tight up there and believes it to be levator syndrome, now what? dealing with mine for about 5 months.
@@davidless57 levator ani is more common in women , sometimes tight there is due to anxiety and stress as well if this cycle is stopped it gets better i’ve read
@@peterobrien2537 my PT also claims it may have been due to the UTI i had which caused trauma in the muscle area. Since I'm an athlete, she also said athlete's are also more prone to get the spasms, go figure
@@davidless57have you found relief? Is it any better?
Get a squat stool . Squatting is better than sitting . The stool lifts your legs to line everything up
Break the cycle with tronolane (pramoxine) it’s an anesthetic like lidocaine which you can use too but it’s milder.
I’ve had these spasms so bad I’ve blacked out and think I had a seizure. I was grunting loudly and rocking back and forth uncontrollably as my vision became tunnel vision and blurry. It was like I had no control over my body.
I want to see a physio again - but I am scared of them opening my fissure again if they do work there!
Hey Chung ! I just wanna ask you one thing is people got surgery for chronic fissure tag 2x or 3x times .
Is it cause fecal incontinence please reply sir?
I really appreciate your efforts but please tell us for more convenience and support please see some pictures regarding the issues because some common poople like me not know about the situations which you talking about and situation they current facing the mess with each others
I’m in so much pain. 8 hours of spasm now
@Senin Dua I cry
Buy some dilators and water base lube fix my spasms no more pain and helps my muscles relax and allow blood to flow. Started with my finger then move up on dilator size. I’m on second dilator and been feeling back to normal pre fissure
Explain Plz@@Tested128
Is Colace the only OTC stool softener you recommend? I do not use gelatin products and I do not see any Colace that isn't a gel cap. I know they have tablet forms which include laxatives but not just the softener.
Dr Chung can you please do a video on tenesmus.
It is something I have had since I hàd surgery to repair rectal prolapse.
It has changed my life and it is disabeling.
I’ve had it too since having a hemorrhoidectomy.
Awesome information
Thanks for the info I took a long sitz bath to let myself relax I spasmed about twice in the bath then no more. I just laid there for about 2 hours to let the muscles take a long break. I see now it's the muscles over working that creates the spasms gotta let them loosen up.
I've been diagnosed with anal fissure and it's so PAINFUL. I refuse to have surgery and was given nifedipine 3%. Is pranicure similar or better?
All your videos have been very helpful and informative. Thank you
Are you sure it was 3%........ mine is only 2%.
howz ur fissure now mannymack?
Dr. Albert Chung, thank you so much for your videos! I'm now 9 weeks post partum and have been experiencing what I think is an anal fissure. I thought they were only hemorrhoids, but pretty sure it's more than that now! Pain really flared up in the second month PP, but that could have been because I was on more medication in the first month. BM are uncomfortable, but not horrible, however the pain begins to come on within the minutes after the BM, and it can last for hours (2-6). I am solely breastfeeding, and sitting has at times been unbelievably uncomfortable. Even side lying breastfeeding has been difficult - to the point I have to hand off my boy to my partner and go for a sitz bath :( My questions for you are: Does this sound like an anal fissure / spasm to you? And what kind of medication can I take while breastfeeding? I am currently taking two ibuprofen every six hours.
Can you do a video on sphincteroplasty? (specifically recovery time) :)
What do you think of yeallow pitayas as a laxative ?
I haven't done LIS but know atleast 4,5 individuals had undergone same in India
All are doing good plz plz don't give evil reputation to surgery
Kya hua tha bhai aapko kaise ho ab ?
@@deepanshu1456 fissure huwa tha laser surgery karwai ab all normal h
Ayurved m koi relief nhi mila
@@rituraj303 bro surgery baad incontinence thodi na hua ? Kitne time se tha aapko fissure
@@deepanshu1456 surgeon expert tha 0% incontinence
6 months se tha fissure
14 may ko krwaya operation
5 days operation baad incontinence tha fir all ok
Ab agr constipation ho jaye to koi masla ni hota?? Matalb ab ap stool softener use ni krtyy bilkul
Dr. Colace will hurt your intestine in the long side. How long can we used ir with out side effects. I get scare that it will affect my intestines.
My Gyn told me about Calm magnesium research it if you want.
dr i have started eating dry figs in the morning on empty stomach.i have started feeling good throughout the day.but the only problem i am having is that whenever i pass the stool its not hard but very smooth like diarrhea on daily basis.due to which i feel pain near butthole.plz suggest me what to do doctor?
Any idea how cremaffin works...and is it safe sir?
Calmoseptine works too if you can’t afford Pranicura
I have IBS-constipation. Tightness on my upper abdomen below my ribs.
What about wheatgrasssuperbalm cream for fissure please reply it is safe for use
Its not painful when it pulsates
How do i get pranicura in India please
Hypnosis can work too and mental determination
I want to buy pranicura . I have nail forger and two side two small skin tag and too much pain . It will worked please dr reply me .
But opiods pain med can lead to severe constipation ..then what ?
How do I know if i have proctitis from all the trauma from constipation and pelvic floor dysfunction?
Working on all this. My C section changed e everything for the worse. If ordered pranacure.
Most of my pain is felt at night..