Diltiazem: cream or ointment?

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Re: Diltiazem: cream or ointment?

Postby StevePain » 15 Mar 2010, 14:22

LOL, I am really amused that a doctor had to check on google to see if it was really supposed to be 2% Image . NO...Wait.... I'm actually astounded Image !! No wonder we're getting nowhere with our a$$ issues..
All I can say is..... Thank god your actually getting the 2% at last NG Image
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Re: Diltiazem: cream or ointment?

Postby StevePain » 15 Mar 2010, 14:26

Diltiazem Info:
Diltiazem is a non-DHP member of the group of drugs known as benzothiazepines, which are a class of calcium channel blockers, used in the treatment of hypertension, angina pectoris, and some types of arrhythmia. It is also an effective preventive medication for migraine. It is a class 3 anti-anginal drug, and a class IV antiarrhythmic. It incites very minimal reflex sympathetic changes. It is based upon a 1,4-thiazepine ring.
Diltiazem is metabolized by and acts as an inhibitor of the CYP3A4 enzyme.
Diltiazem is also being used in the treatment of anal fissures. It can be taken orally or applied topically with equal effectiveness. When applied topically, it is made into a cream form using either vaseline or Phlogel. Phlogel absorbs the diltiazem into the problem area better than the vaseline base. It has good short term success rates does not address the long term problem of increased basal anal tone and does not decrease the subsequent recurrence rate that can vary between 40 to 60%.
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Re: Diltiazem: cream or ointment?

Postby cherylk » 15 Mar 2010, 14:27

I know the docs can't remember everything. But it is amazing that the doc checked google and admitted to doing so!! Thanks to Steve and Google you are now going to be set, NG!!!! Image
Steve,
You should go to med school if you found that info on Google!!! Image
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Re: Diltiazem: cream or ointment?

Postby StevePain » 15 Mar 2010, 14:40

hehe cheryl..
I think we, as sufferers choose to find out every aspect of our illness and pain and also any possible cure, I never really thought i'd find out so much about how my a$$ works and the things that can go wrong with it, this forum is a godsend, in my opinion, the information/advice available by the users on this forum is better than any doctor could ever give..
Image
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Re: Diltiazem: cream or ointment?

Postby NeuropathicGuy » 15 Mar 2010, 14:50

LOL there was about a 3 minute wait on the phone while the doc checked :) I don't know if he checked on Google or elsewhere but I'm glad he did check. I thought about requesting a refund or credit for the 0.2% stuff from before but decided it wasn't worth it over $50. There's a way the world ought to work, and then there's the way it actually does work in reality, so unless it's a really big deal, I'm happy to let little things slide. Plus I didn't want to pick any bones over $50 with a guy that I may eventually get LIS from :) This minor diltiazem ordeal has shaken my confidence a bit, but I'm conscious of the fact that a small prescription slip-up doesn't necessary mean the doc's not a great surgeon, as I have it on good word that he is.
Anyway I just picked up the 2% stuff -- apparently it's such a common prescription that the pharmacy had a bunch pre-compounded already -- and it's indeed a clear, thick gel, much like the nitro and nifedipine. I explicitly asked the pharmacy if this is the right stuff for rectal use and they said yep. Cost less than the 0.2% stuff too because that one they had to custom compound haha. Some irony in there.
Now I shall give this morning's nitro a few hours to clear out of my system, cross my fingers, and put my faith in diltiazem. I'll admit to still being a tiny bit annoyed but if this stuff helps at all I think I'd have a pretty easy time looking past it :)
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Re: Diltiazem: cream or ointment?

Postby cherylk » 15 Mar 2010, 15:03

I think it helps to VISUALIZE the ointment working and even hold your hand over the area while sitting in the tub. Don't think I'm crazy--that is what one of my handouts stated!! That silly ointment ought to work after all you went through to get it!!!!
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Re: Diltiazem: cream or ointment?

Postby NeuropathicGuy » 15 Mar 2010, 15:11

Cheryl, I don't think anything is crazy anymore :) I've been consciously trying to focus more on my mental well being lately anyway because I don't think my mental state has been too good lately due to various things. I've actually got a bottle of nortriptyline (AKA Pamelor) that I'm supposed to take for neuropathic pain, but it's a tricyclic antidepressant and supposedly good for mood, too, so I may also give that a go and see where it takes me. Been holding off on it but maybe it's time.
But yeah I don't think visualizing things is off the wall at all. I think there are probably lots of mind-body connections that conventional medicine has yet to explore. It definitely can't hurt, that's for sure. Thanks for the tip :)
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Re: Diltiazem: cream or ointment?

Postby StevePain » 15 Mar 2010, 15:35

Long before all this crap started I used to be happy and always the life and soul, but once the fissure kicked in I became withdrawn and my moods got very low, but recently i've had a bit of relief and I feel almost manic when there's no pain (or very little) and it's quite scary, maybe it's because I have been so accustomed to pain on a regular basis that going without doesn't feel right, infact that's it, I don't feel right, it's as though i'm expecting pain and when there's none I feel weird, don't know if any of this makes sense or anyone else has felt the same Image
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Re: Diltiazem: cream or ointment?

Postby NeuropathicGuy » 15 Mar 2010, 15:48

Dude when I have a painfree poop I literally come dancing down the stairs to announce to my wife what a great poop I just had :) I know what you mean, Steve, I used to be rather carefree and always tried to get people to have fun but now I just don't really want to even see anyone anymore. One thing I worry about is that the pain has been there for so long that maybe the body has grown accustomed to it and it'll never go away even after the problem is fixed. Like it's been a part of your life and you can't really imagine what it's like without it. I try to remind myself that I can't really complain too much, though, after all I had a great run of 30+ years before I got a fissure and other health problems, and there are people everywhere living with far worse conditions.
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Re: Diltiazem: cream or ointment?

Postby cherylk » 15 Mar 2010, 18:54

You guys will get butts that have no pain. It's just a matter of time. I think the AF can play havoc with one's mental status, and the docs think we are crazy lunes about that because they most likely have never had their lifestyle altered by butt pain/issues! Image
NG, This diliatzem had better work for you after all the time and effort you, your doc, and Steve have put into getting you the correct Rx!!!! I had a thought--maybe the doc was consulting his PDR or handheld device. My doc used to use his handheld device to check for info. We cannot possible expect them to remember everything. Maybe you should give your doc some slack in that regard! Better yet ask him if he consults Google for advice!! Image
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