I was offered the nitro by my first surgeon, but I declined since I already had migraines and more headaches were the last thing I needed on top of the butt pain!
Do you use the nefedipine about an hour before your BM? That should really help loosen things up at bit more. That is a prehistoric High School pic, BTW, Patty!

I've been using it after the BM...because I figured if I used it before then it would all just come off in the BM...I asked my CRS if I should put it on after the BM, and he said yeah...but from the disinterested way he answered, I'm sure he would have said "yeah" had I asked if I should put it on prior to the BM. Maybe I'll try it both ways.

so i guess its good that i can get my pinky in there? sounds like some peoples spasms are pretty intense since a plastic syringe has to be used..see,i dont really know wheter my muscle is really tight or not compared to others that have fissures,i do know that it does hurt sometimes! and a pinky full of 2%nitro cream..is a pinky full of temporary happiness...,hopefull by the end of the year i can overcome this thing...

I posted a link in the references section of this site that has a ton of comparitive studies done all over the world for AFs. A majority of the studies have indicated that Nifedipine was better for healing AF's then the Nitro.
What is A&D ointment and what does it do? Thanks!

My doctor told me to put mine on the fissure too which is what I did and it helped. I asked about putting it in higher and he said that it wasn't necessary.
I don't know what to make of this difference in instructions.
Are the people who are prescribed nefedipine told to put it inside and those who are prescribed diltiazem told to put it on the fissure?
Chris, A&D ointment can be found in the baby care aisle. It is diaper cream but can be used as a skin protectorant. I put some on to protect the fissure site before going to the bathroom.

I called my new CRS and spoke to his assistant. She said put it on the fissure if you can, but if you can't reach that high up without hurting yourself, put it on the outside of the anus and it will be absorbed up...then as time goes on, the area may loosen up and you might be able to reach higher. I might take a look for that rectal applicator thingie some more, or I might just continue with the dubious "pinky method." Who knows.
Lecia, I can't imagine the way to apply it would be different for Diltiazem, since they're supposed to do the same thing.
My new CRS had actually never heard of Diltiazem...which again makes me question his credibility. I just feel like if you're charging $600 for 15 minutes of your time, you better at least be more knowledgable than me.
Brad, I've also read that it takes two weeks or so to work. Hope you feel better.

I just feel like if you're charging $600 for 15 minutes of your time, you better at least be more knowledgable than me.
NO kidding!!!
I was told it would take 14 - 21 days for the nefedipine to work, and it is almost the same thing as the diltiazem...

Steve,
I wish we could find a better doctor for you!
I always seem to run mine off. Every time I find one I like, they move to another state. I have thought about flying to Connecticut to see my favorite CRS even, but would that be considered stalking??

Thanks Lecia,
Sorry to beat the question to death, but A and D ointment is vitiman A and D ointment or is it just a straight up diaper rash cream with zinc oxide.
Thanks!

It is Vitamin A and D ointment. They have a kind that has zinc oxide but the kind I use and was recommended was the straight A&D ointment w/o zinc that looks like petroleum jelly coming out.