I just thought I would start a new thread for you. That other one was about 4 pages long so I thought we could start afresh here.
Do you have any friends or family in the area that you could borrow a car from or they could drive you if you found someone out of the city a bit? I know it isn't ideal to have to depend on someone for transportation and you have probably thought about this already.
You are right, you would think there would be more options in Chicago. I wonder if you could call your insurance provider and get an idea of how the coverage works if you find someone out of network to see you in case you don't find anyone on the list.

I wanted to mention that Chris007 is from the Chicago area. Maybe he can share any info he has on doctors in your neck of the woods.

Hi Lecia,
I just discovered this post - sorry, I'm not that skilled at negotiating my way around the forum. I realized I probably hijacked someone's original thread, since I don't know much about posting. I've posted a few more times on the original thread the past few days, so some of my replies here may be redundant. I think I'm going to pretty much be limited to Chicago (there is no one who can give transportation during the day), but I've received some names this morning from the American Board of Colon & Rectal Surgeons. They told me that the directory is not comprehensive, as not every CRS chooses to be listed. My father gave me a book of doctors and specialties last night who participate in my PPO, so I need to take a look at that, as well. Also, I could call my primary care physician, and tell him the previous referral didn't work out. So, I think I'm making progress. Thanks for telling me about Chris007. Maybe I can get an idea from him, too. Thanks for all your help, Lecia.
Queenofpain/AgonyAnn

Ann,
I don't know if this is too far out for you, but Dr. Wiesman at Advocate Luthern hospital is great. Let me know if you need the office number. He's alittle sure of himself, if you know what I mean, but he always taken the time to answer all my questions and address my concerns...a combination that I find refreshing.

Hi Chris,
Thanks for the reply. I don't have a computer on the weekends, so I just read the post today. Alright, I will inquire about him. I have his name on my list of area CRSs (not comprehensive), but didn't put a check by it because he is in Park Ridge (not sure how accessible he is with my not having a car - especially for surgery purposes).
This is what I am thinking about now guys:
I contacted a regular MD who emphasizes natural intervention (I received his name from someone at church). No, I haven't flipped - I might be one of the last ones to consider natural means, especially with a painful situation. (But, my CRS was only working with sitz and fiber with me, anyway, before he dropped me.) Okay, I spoke with this MD, and he was real sensitive (like my friend said), and even took my call from his home. He answered all my questions, and didn't rush me at all. He, himself, had a fissure, and is greatly sympathetic about the pain (pinch me, am I dreaming?). He said the natural means (sitz plus fiber) are not enough for pain management. He had been to more than one CRS, and cured himself with nifedipine (I realize the cure rate with the creams is about 50% or so). The irony is the CRS did not even suggest the creams, and here the "naturalist" MD offered the prescription cream off the bat, without my prompting, plus he wants to interest me in probiotics to help keep things soft. So, I'm thinking of possibly working with him, AND a CRS.
Here are my questions:
1) His clinic would probably want to do a rectal to find out where and how deep the fissure is. How painful is this procedure? I told him even the CRS didn't attempt it because of the spasm. He thinks with enough lubrication, they may be able to observe part of it, and it is probably in the 6 o'clock position.
2) Is there any risk of tearing the fissure more during the procedure? I'm trying to complete a class (Nov. 15), and function at work, and don't want a worse degree of pain. He doesn't think I will feel any worse than I do now. He said the exam actually relaxed his sphincter (he had 3 rectals in a few days) temporarily, and that is consistent with what some of you are saying about some of the exams.
2) I have concerns about being able to get nifedipine up far enough. Maybe I can talk to him about diltiazem (from this post I understand some people have been told they can apply it outside). Just how far do I need to get nifedipine inside myself? Is half a finger tip far enough?
Okay, thanks. Tried to keep the email short - sorry! Thanks, Chris, for the reply and the CRS recommendation.
Queenofpain/AgonyAnn
The Lord is gracious, and full of compassion; slow to anger, and of great mercy. Psalm 145:8

Hi there,
I think that is so wonderful you found a doctor who is sympathetic. I am actually all for integrative medicine and use holistic medical treatment myself and have found it to help where Western medicine could not.
Here are my questions:
1) His clinic would probably want to do a rectal to find out where and how deep the fissure is. How painful is this procedure? I told him even the CRS didn't attempt it because of the spasm. He thinks with enough lubrication, they may be able to observe part of it, and it is probably in the 6 o'clock position. Since he is empathetic I don't think it will bother the fissure much. He may not have to go in very far at all. I wonder if giving you something to help you relax before hand would help. I think another boardie took something before the appointment and it helped.
2) Is there any risk of tearing the fissure more during the procedure? I'm trying to complete a class (Nov. 15), and function at work, and don't want a worse degree of pain. He doesn't think I will feel any worse than I do now. He said the exam actually relaxed his sphincter (he had 3 rectals in a few days) temporarily, and that is consistent with what some of you are saying about some of the exams. He sounds pretty trustworthy and would perhaps give you something to help with the pain if in fact it does hurt afterwards. Maybe ask him about a small dose of Ultram.
2) I have concerns about being able to get nifedipine up far enough. Maybe I can talk to him about diltiazem (from this post I understand some people have been told they can apply it outside). Just how far do I need to get nifedipine inside myself? Is half a finger tip far enough? I don't think it is necessary to put it inside.
Okay, thanks. Tried to keep the email short - sorry! Thanks, Chris, for the reply and the CRS recommendation.
Queenofpain/AgonyAnn
The Lord is gracious, and full of compassion; slow to anger, and of great mercy. Psalm 145:8
Good luck with everything. I am so happy that you found someone who will listen. That just makes the whole difference doesn't it?
Keep us informed!

Thanks for the input, Lecia. I sensed you were into natural resources, as well. I'm still researching the CRS bit, and Chris's is part of my insurance plan. (I'm looking into the transportation part.) There is a CRS at a major city hospital who has been designated a top doctor. He also is skilled in sphincter reconstruction, so he sounds like he's good for surgery, if it goes that route. (I figure if he messes me up, he can fix it.) There might be an insurance concern, though. I do hope to work with the "naturalist" MD, too, at least for the dietary part. Plus, he firsthand totally understands the fissure experience. I just want to get through a test I have in my class (most likely next week) without any possible further injury to the area with an exam. It's crazy how we have to plan our lives around pain. Went through about 80 Advil last week, so I am looking forward to the creams.
Queenofpain/AgonyAnn

Well, it sounds like a step in the right direction for sure! I have a CRS appointment this week and am dreading the exam as well. I will ask her about doctors in Chicago while I am there.
Yeah, I know what you mean about going through the Advil. I killed a 200 capsule bottle pretty quickly.

Thanks, Lecia. If you hear of any names in Chicago, let me know. I will pray about your exam. Yeah, it's the dread of the exam that keeps me back a bit. That was the one good thing about my previous CRS. He said I wouldn't be able to tolerate it, and only did an external. It would be nice to know how deep and long this thing is, though. I wish they could just do an MRI or something. Sigh.
Queenofpain/AgonyAnn
He giveth power to the faint; and to them that have no might He increaseth strength. Isaiah 40:29

Ann,
The Nifedipine doesn't need to go all the way up in the anus. You'll find that as you continue to use it, the opening will become more and more accessible.
Good Luck. An even though I like Dr. Wiesman, I would always choose a female doctor over a male doctor. They just seem more empathetic.