As it goes...

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Re: As it goes...

Postby felix » 11 Aug 2015, 04:13

Oh my diltiazem is called anoheal so perhaps if you google it, there will be a list of ingredients?
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Re: As it goes...

Postby hopefull » 11 Aug 2015, 04:15

Thanks Felix, did you use Anoheal or a compounded form of diltiazem?
AF since Jan '15 postpartum
Taking: Lax-sachets, flaxseed oil, Mg
Topical: Diltiazem, Sudocrem
Circulation: Warm wheat bag, relax, short walks
Tried: Rectogesic, slippery elm, Lactulose
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Re: As it goes...

Postby felix » 11 Aug 2015, 05:25

I used anoheal, lovely to have in the fridge!!
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Re: As it goes...

Postby msimon » 11 Aug 2015, 10:31

Hopefull, this is the base used for my compounded ointments, hormone and fissure:

http://www.pccarx.com/pcca-products/pcc ... /versabase

I wonder if it, or something like it is available where you are? It is so non-irritating.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: As it goes...

Postby hopefull » 14 Aug 2015, 03:52

Thanks for that msimon, I've managed to find a doctor to prescribe the diltiazem ointment, yay! I went to a drop in clinic and waited my turn - took ages - then luckily got one of those doctors that will write out a prescription for anything. The first lot I got was gritty so am trying again with a proper compounding pharmacy. My options for bases from the compounding pharmacy are either PLO gel/phlojel or paraffin wax. I've not been able to find out which is better to use from the internet or this forum, might put it out in another post. Diltiazem wikipedia page says the gel is better at getting the diltiazem to the target area and is more effective but I can't find it the published references. I'm tempted to get the gel as I feel like the Rectogesic that is in paraffin wax takes me sitting on a heat pad for it to work or maybe it's not working and the heat is, who knows. But then the paraffin wax is meant to be good for healing and probably protects the fissure a bit if I get it in. On the other hand I could use a syringe to get the gel up like I do with the Lignocain. Hmmmmmmmm... :dunno:
AF since Jan '15 postpartum
Taking: Lax-sachets, flaxseed oil, Mg
Topical: Diltiazem, Sudocrem
Circulation: Warm wheat bag, relax, short walks
Tried: Rectogesic, slippery elm, Lactulose
hopefull
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Re: As it goes...

Postby chachacha » 14 Aug 2015, 08:00

I would suspect that the gel would be more easily absorbed. My diltiazem was compounded in vaseline (I'm in Canada), and my doctor told me not to put it up inside my anal opening, but instead put it around the outside, because it would be absorbed through the skin (even though my fissure was fairly high up and in). It's too bad that your first batch was gritty. Do you know what they mixed it with on that one?
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: As it goes...

Postby hopefull » 14 Aug 2015, 17:22

Thanks Chachacha, congrats btw on becoming a VIP :)
Yeah I think I'll go with the gel, the rectogesic hasn't really worked and I wonder if the wax has something to do with it. The gritty one was done in paraffin wax, I read on this forum that the pharmacy needs to use a ointment mill rather than just a mortar and pestle to get a nice smooth ointment. I applied a bit on the outside anyway and think it helped. To get the gel one it's going to be very expensive, over $100 for two pottles. I take it it only lasts for a month and then expires?
Yesterday I had a blood free day YAY! I've stopped taking the slippery elm and so now just have a BM in the morning and evening instead of 3-4 a day which it became when I started taking lax-sachets/movicol.
AF since Jan '15 postpartum
Taking: Lax-sachets, flaxseed oil, Mg
Topical: Diltiazem, Sudocrem
Circulation: Warm wheat bag, relax, short walks
Tried: Rectogesic, slippery elm, Lactulose
hopefull
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Re: As it goes...

Postby chachacha » 14 Aug 2015, 18:31

Thanks!

That is very expensive indeed. I didn't have an expiry date on mine, and I'm pretty sure that msimon on this board has said that she'd used hers for months on end, so I'm not sure that yours would expire quickly or not. Maybe the vaseline mix makes it last longer, and the gel doesn't though?

Very good news about having a blood-free day and also that you're now down to only 2 BM's a day.

I hope that the gel mix works well for you.

:goodnews:
Fissure since about 2007
Fissure diagnosed in 2011
Diltiazem for two years - didn't work well
LIS January, 2015
Hemorrhoidectomy December, 2017
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Re: As it goes...

Postby hopefull » 31 Aug 2015, 00:40

So its been a while since I last posted. I am now 17 days of no blood, YAY! The double dose of movicol is helping a lot but it does mean that I don't have formed BM's as I'm only eating porridge, smoothies and pureed vege soup.

Today I went to the general surgeon for a check up and it was bloody awful. He saw me for literally 5 min in which time he put his finger in to no conclusion. Not sure what DR's can tell from a fingering. Anyway he just said that not having formed BM's is bad and that I should be bulking with psyllium. When I say that it hurts to bulk and will bleed if I don't keep it loose then he stares at me blankly and says that the bowel likes to be used and is more relaxed the more inflated it is just like a balloon. And I repeat by saying it will bleed every time then. He still looks at me blankly and then on his way out says see you in 6-8 weeks if it hasn't improved and he will do a proper inspection under anesthetic. I'm starting to cry as he is walking out and he and the nurse try to avoid eye contact with me. It was so depressing. I didn't get a chance to ask any questions. I want to see a different surgeon, not sure how I go about organising it, will ask my doctor to refer me to someone else.
I still have pain not bad just annoying. What worries me is that since I am keeping it so loose that the fissure will heal tight and then one day when I get back to the normal sized stool that the fissure will be too weak to handle it and split open again.

I finally managed to get diltiazem, in gel form. Very expensive. It feels good to put up so hopefully it is doing something positive.

Ugh, so confused again. My plan was to double dose the movicol for a few months of serious healing with loose stools and then start to slowly bulk up. Might go over to the success stories page to see if this is how others have done it.
AF since Jan '15 postpartum
Taking: Lax-sachets, flaxseed oil, Mg
Topical: Diltiazem, Sudocrem
Circulation: Warm wheat bag, relax, short walks
Tried: Rectogesic, slippery elm, Lactulose
hopefull
Proctosphincteranalogist
 
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Topics: 7
Joined: 11 May 2015, 17:53
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Re: As it goes...

Postby msimon » 01 Sep 2015, 16:57

Hi Hopefull! Glad to hear about the lack of bleeding but very sorry to hear you found an idiot Doctor. I really wonder about these people sometimes. Yes, a finger is not diagnostic in the least. Maybe if you had a huge gash or something! Good grief! Hopefully you have recovered from that and the diltiazem helps you.

As for the bulk, I can't be of much help as I am stuck at that stage myself. I have to keep things very loose or I get stuck. The other day I had a cork (a solid start stuck behind a tight sphincter) and I haven't had that since right after my last surgery (6 months ago). No blood so I am relieved. I think ultimately I will have to deal with my tight sphincter but for now, I am waiting until that new skin has more integrity before I challenge it too much. I think eventually some controlled gentle stretching is the way to go. So, my opinion would be if you can keep things consistently soft then I would wait a bit before challenging it to stretch too much. My physio has me first gently pulling on the skin around the anus. This is the first step for me.

Hope you continue to do well and can get a referral to a descent CRS.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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