Hello all.
First, sorry about the over abundance of thank yous at the end. I have an iPad and have learner plates! Can't get three off there.
I have an appointment with my GP this afternoon, and hope that he will prescribe the Diltiazem ointment/gel for me. The last doctor that I saw (a general surgeon) gave me what is known as Analpram which did not really relieve anything. And the skin outside my A is fragile in the extreme from repeated ulcers forming and fading (Behcet's Disease joy), and I sense that this skin has small breaks in it, which freak me out no end. Like pin pricks where there is sepage - or maybe this is my incredibly active imagination. Hope so.
I have been using Vaseline on that skin and it actually provides me with a little relief to the outside. I tried inserting some, but that did NOT go well. The thing is with 'not going well' with various ointments that I have tried - and they are quite a few - is my worry that the A was just too fragile on that day, not that the cream/ointment did not work.
So, hoping that the dr will give me the Diltiazem topical cream, I am wondering how to get it inside me with the least pain. My muscle there is very tight, and from so many past hemmy ops, my A is very small and to me does not even sit in the right position! Imperfect I am. When it comes to pain, the only person to examine me, and that was about 3 mths ago, and attempt to insert a finger (at which time I almost fainted/screamed/swore), was a nurse who I see for GYN things. She wanted to send me off to a sphincter sparring surgeon, but I did not want to go that route until I see a GI specialist.
Sorry, I am going on a bit, wandering off the Diltiazem line... So much pain, including not being able to wee properly, and coccyx pain. Actually the coccyx pain has improved, so maybe am doing something properly, or it is just a brief respite.
I am hoping for the Diltiazem, praying both to get it and that it will work. It is always such a rush going to the doctor where I live. I used to live in Denmark, and I miss my doctor in Copenhagen who I knew so well.
Ramble, ramble. The pain is getting to me!! Thanks for reading.

Hey there, I used a baby oral syringe like this:
http://images.google.com/imgres?imgurl=http://ecx.images-amazon.com/images/I/21LUKQAuLzL._SL500_.jpg&imgrefurl=http://tweetfeed.com/gindee/buy-oral-syringe--baby-syringe--elderly-syringe-5ml&usg=__RdoKXZNpxTdMlTz7E0Ebycuzf7k=&h=280&w=280&sz=6&hl=en&start=0&sig2=hVDxCda3UK2Y44qBoJAhCQ&zoom=1&tbnid=GUcGTpBshiYIQM:&tbnh=127&tbnw=107&ei=Dt5STdXbH5P6swOLnNDKBg&prev=/images%3Fq%3Dbaby%2Boral%2Bsyringe%26hl%3Den%26safe%3Doff%26biw%3D1280%26bih%3D843%26gbv%3D2%26tbs%3Disch:1&itbs=1&iact=hc&vpx=462&vpy=59&dur=237&hovh=224&hovw=224&tx=116&ty=118&oei=Dt5STdXbH5P6swOLnNDKBg&esq=1&page=1&ndsp=35&ved=1t:429,r:2,s:0
It allowed me to get the ointment "up there" without forcing things too much. Worked okay even when I had bad spasms. The main drawback is that it's kind of a pain to draw the thick ointment up into the syringe, but you get the hang of it after a couple tries.
BTW what part of South Africa are you from? A good buddy of mine is from Durban, spent his whole life there until after college. He later moved to Norway (where I met him while I was working) and now lives just up the way from me in San Francisco.

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My doctor was very understanding, by the way. Now to wait a couple of days to get it. Thanks for the link to the syringe. I will report my progress. Hope it works for me, but will not expect wonders then will be pleasantly surprised. I am quite amazed that Vaseline has brought me some relief externally while all sorts of fancy stuff with cortisone did nothing. .

I used the "ointment applicator" that came with my anusol tube (for hemroids). It was/is smoothly rounded. The pharmacy gave me an applicator with Diltiazem which had hard edges that my butt did not like! Be sure to get the ointment at least 1 cm upwards, per my Mayo CRS. I think a cotton q-tip might work also. I got the applicator inserted and then squeezed the tube to make the ointment dispense into my rear end!!

I haven't had diltiazem - i had rectogesic - but I used just my finger covered in plastic wrap, and the doctor told me that about 1cm in was good. I might put a little on before the morning bathroom visit and then wait for a few hours after a BM until I had less pain and swelling and then apply the full dose. It seemed like a good strategy for me, since putting any ointment in right afterwards seemed to be more irritating than helpful...

I am hoping against hope that it will not irritate my skin. I will start off slowly, in the evenings. I already take Diltiazem by mouth, and the first lot of those I had a weird reaction to, and they had to change the pills. Very sensitive skin - but maybe everyone who has AFs has sensitive skin? Whenever things are going really south (expecting a lot of pain the next day), my face gets a very sore rash on my right cheek. Could be something to do with Behet's, however...who knows! But, that is my 'early warning system' and not a pleasant one.

I cannot imagine sticking my finger upwards into a sore rear end, but I guess everyone is different. The applicator I use only goes in about an inch and worked extremely well for me. I also guess I was lucky in that I never felt any side effects from Diliatzem, and it was effective for me. We're all different in the ways we react to various meds and ointments. That's for certain!!

Yes, Cherylk, I know that I won't be able to put a finger anywhere inside! So glad that everyone on here understands all the ins and outs of what you have to go through. I have to say that I am also worrying about the examination that might happen on my first visit to the GI specialist. Hopefully the Diltiazem will help to rid me of the pain.
I use Serrapeptase as an anti-inflammatory, but really the one good thing it has done is stop the bleeding I was having. The outside of my A tends to be a bit swollen after a BM, but then calms down.

I thought I would write a little update to my Diltiazem saga, and basically with the fright I had with the terrible pains in the lower left of my belly for 36 hours (the surgeon that I saw a few days ago looked at me with disbelief/surprise when I told him this)' whatever caused them, I have not used the Diltiazem since. I definitely do not react well to Lidocaine, which is I my mixture. Wo, I am just sticking with Vaseline on the outside for now. And that is it.

I have Isosorbide Dinitrate 1% gel, which is different than Diltiazem.
But as of yesterday afternoon, I've used a different manner to apply the ointment.....
A while back I've used the ointment for approx 4 weeks without any result. I mean the muscle relaxed but the pain came back violently after a while.
So now i've gone back to the gel and tried to apply it differently. Instead of spreading it all over the "site/wound" I've only applied it to the outside of the sphincter and a little bit inside, but avoiding the wound.
So far i've been completely, and i mean completely. pain free for 1.5 days.... Even with contracting the muscle, or going to the toilet. And even after not applying the gel every like once in a while.
I will apply the ointment 15 minutes before i go to the toilet, but no pain there either.
Hopefully this will help in curing. Because i believe that if there's no pain than something is going right. If there's pain than it's wrong.