Hello,
I went to CRS today these are questions I asked. I wanted to share my experience.
1) Should I change my diet? Soy Milk no dairy?
--I can drink milk if I want.
2) Treatment options: Diltiazem, Nefedipine, botox, Nitro-Cream?
--He prescribed Nepedipine. he also gave me samples of Calmoseptine.
to buyover the counter.
3) How long can I use a stool softener? What is the best to use?
--Only use a stool softner if I am constipated.
4) What about natural products fish oil or flax seed capsule?
--These are not FDA approved so we don't know whats in them
but I can use them if I want.
5) Can I take calcium? carbonate or citrate? with Magnesium?
-- Yes I can take my Calcium supplement.
6) How much water should I drink?
-- 6/8 glasses of water a day. i need to drink plenty of fluids thru the day.
7) Should I use baby wipes? Any type of powder?
-- Yes I can use my wipes and powder. if I want to.
8. Does the fissure appear to be chronic?
-- Yes it appears to be chronic.
9) Can I take Advil or Aleve for pain?
-- Only when I am having extreme pain or discomfort.
10) Warm bathes, heating pads to ease pain?
-- Continue with the baths an sitz baths.
11) Will I need LIS surgery?
-- Not yet until we try the creams first.
Well thats what I experienced. I go back July 16th for a follow-up, hopefully it will be better. I am little worried about taking this Metamucil to bulk up my stool but he said it would be good for the muscle, my stool does not have to be the size of a pencil because actually it is working against the healing process, the muscle needs to be used. I have to wait until tomoorow to get the Nefedipine because no pharmacy around here have this. I have to drive 16 miles to another town to get it.
I just wanted to share with you my experience. Please give me any feed back. Thanks.
BBG Patty

I used the nefedipine and I was lucky, my own pharmacist could compound it.
It will take from 1 to 2 1/2 weeks for the nefedipine to really start to relive the symptoms, but you should notice a change in your rear fairly soon.
Now remember, the nefedipine is not something you put on the fissure to heal it... it is something you put a bit further up your anal canal to lower the pressure, all that tightness that is really a large part of the problem (if not the entire problem) that is preventing your fissure from healing.
I found that you need to put about a toothbrushed sized gob as far up as you can get it, about 1 1/12 inches or further. You are trying to relax the sphincter. Over time, you will, and this will set up an better environment for healing. But it also reduces the pain a lot, too.
I was not healed by it. Still, if I had a fissure again, I would go back on it because it does help you manage it much better.

Hey Patty,
So they are going to start you on the cream. That seemed to help me heal so it does hold promise! I would use the cream and keep up with the baths. They both seemed to work in conjuction.
I have a few things I might add to the answers just based on my experience.
1) Should I change my diet? Soy Milk no dairy?
--I can drink milk if I want.
Milk is very difficult for most people to digest. It can form hard stools so even though it is generally recognized as acceptable to drink, my honest opinion is to switch to soy milk. I used to drink cow's milk and noticed a huge improvement once I went off of it. I am not saying you have to do what I did/do-but just giving you my experience!
2) Treatment options: Diltiazem, Nefedipine, botox, Nitro-Cream?
--He prescribed Nepedipine. he also gave me samples of Calmoseptine.
to buyover the counter. Calmoseptine is a protective cream that can be used for irritation and itching. I tried it and the menthol which is cooling to some made my bottom hurt. But for most people, it is fine. My husband uses this and even my 9 year old when she gets itchy bottom syndrome!!!
3) How long can I use a stool softener? What is the best to use?
--Only use a stool softner if I am constipated.
I used colace and miralax on and off for years. My good friend here who is a doctor had her 9 year old on it for several years and she does not seem to feel these types are contraindicated for long term use but I can see it could be hazardous if you use too much of it in any given day. But you also don't want stools that are runny either.
4) What about natural products fish oil or flax seed capsule?
--These are not FDA approved so we don't know whats in them
but I can use them if I want.
Supplements are regulated by the FDA but for me they help!
5) Can I take calcium? carbonate or citrate? with Magnesium?
-- Yes I can take my Calcium supplement.
I would say only take the minimum recommended dose as calcium can be constipating.
6) How much water should I drink?
-- 6/8 glasses of water a day. i need to drink plenty of fluids thru the day.
I would go for at least 8!
7) Should I use baby wipes? Any type of powder?
-- Yes I can use my wipes and powder. if I want to.
8. Does the fissure appear to be chronic?
-- Yes it appears to be chronic. That's too bad!
9) Can I take Advil or Aleve for pain?
-- Only when I am having extreme pain or discomfort.
10) Warm bathes, heating pads to ease pain?
-- Continue with the baths an sitz baths.
11) Will I need LIS surgery?
-- Not yet until we try the creams first.
Well, I am glad you got the appointment out of the way and you survived the drive into Rochester. Keep us updated on how the cream is working.
Take care,
Lecia

lecia and Kim,
Thanks for the quick response. Overall he spent sometime with me. I was pleased. He said these are very common and this is what he sees most of the day. I will switch to soymilk I only want it for my cereal anyways. For the calcium I am going switch to the citrate I read that the carbonate can be more constipating. I am a liitle leary about the metamucil and everything I eat during the day that has fiber in it. This scares me about making a bulky stool. What are your thought on this? Thank again for your help.
BBG
Patty
P.S. Kim it is no fun putting your finger up there. I will try my best its not easy.

1) Should I change my diet? Soy Milk no dairy?
--I can drink milk if I want.
Milk is very difficult for most people to digest. It can form hard stools so even though it is generally recognized as acceptable to drink, my honest opinion is to switch to soy milk. I used to drink cow's milk and noticed a huge improvement once I went off of it. I am not saying you have to do what I did/do-but just giving you my experience!
[/b]seconded!!! :!:

Thanks buttgirl!!
I think I will switch.. lol you are right.
BBG
Patty

P.S. Kim it is no fun putting your finger up there. I will try my best its not easy. I know, it is an agonizing and stinky/nasty place to have to deal with...
Here's how I managed. My arse was so tight, there was no way I could get my finger up there. Just too much torture. But I did have this syringe thingy that was designed to go up your butt and deliver a dose of proctofoam, which my GP initially prescribed for "hemorrhoids." It is shaped such that you can gently get it a goodly little ways up your tailpipe...once I started using it like that I got a lot more relief! But it takes discipline...

Ok I will see what I can do. I usually can't get it past the first part of my finger, where the first crease is past my nail. Isn't that enough or should it be as far as your knucke?? ooo I hope not.
Patty

I'm replying about the fiber. You want some bulk in your stool so that your involuntary muscles push it out mostly for you. It actually takes less straining if you have some bulk because the stool moves more on its own without you having to push as much. I don't think a dose of metamucil will be hard to tolerate at all!

sounds like the same speech i got,i was told not to take softeners UNLESS i was constipated also...i am using a 2% nitro compound,which is definately more powerful than before.i get a slight headache everytime i use it,i dont last long though..im on it for 3 months and then another exam..booo...also..the metamucil caps have been a very positive thing for me,i take like 5-6 caps every morning..plus they have ones with a crapload of calcium in too,he told me to def use the ones with calcium if i feel i dont get enough calcium.but they make the "stool" very comfortable and have relieved 90% of my gas!! best thing ever!! i was like a gas factory,now i hardly have it at all! i use my pinky to apply the cream,i know your "not supposed" to use your fingers unless you have gloves??? i cake it on my pinky then weasel it in there..it burns sometimes though,but relieves any discomfort within minutes...