Hey all- this is a naturopathic doctor I saw up in Portland Oregon at the beginning of the year and he was tremendously helpful.
http://hemorrhoidhelp.com/index.htm
They work in conjunction with a local hotel for out-of-towners- I flew up from California & stayed there about a week, having different procedures every day. They took care of 3 hemorrhoids and a few swollen papillas as well as did a "fissure repair" procedure where they removed the existing scar tissue then shaped the fissure so it could close & heal naturally. I was feeling fine within 3 days of being back home. I've since reactivated mine but it's nowhere near as bad as it was. I really can't advocate their work strongly enough and the cost of airfare, hotel and procedures was still less than the cost of my single disasterous Botox injection. I'm actually looking forward to my next visit to Portland and I'll stop in for a 'check up' whether I'm feeling completely healed or not. I hope posting this doesn't break any rules of the forum- he was just extremely helpful in my case. Thank you!