by thisfissurecankissmybutt » 26 Jul 2012, 16:55
Well, I went to three CRS's before I decided on the one I chose for my surgery. It all comes down to who you feel comfortable with and trust. Past performance is very important, which is why I was impressed with Dr. Mangione's reviews - they are very good. He's also been a CRS for a long time, so he probably has lots of experience and a long track record.
Most CRS's will not do surgery right away. They will want you to try conservative measures first (i.e., increase your fiber, drink lots of water, take hot baths, etc.). They will also usually prescribe some medication, such as Diltiazem or Nifedipine, which will help relax the sphincter, hopefully allowing the fissure to heal. According to my CRS, most fissures heal (70% to 80%) without the need for surgery. Your CRS may also prescribe muscle relaxers and Valium. Most CRS's will want you to try conservative measures for 6 weeks before considering surgery.
If it were me, I would call Dr. Mangione's office ASAP and make an initial appointment. He will probably perform a visual inspection to determine if you have a fissure, and if so, how bad it is. He may have to use a scope if the fissure isn't visible.
Be prepared with a list of questions. A good CRS will take the time to address all of your concerns.
Good luck!