Thanks Lecia!
I have to ask...are you a photographer? Your and Kim's new pictures keep the board fun and fresh.

"I have thought about flying to Connecticut to see my favorite CRS even, but would that be considered stalking?"
Ha, ha. It's funny you say that actually, because just this morning, I was thinking to myself the same thing -- that I would be willing to travel 4 or 5 hours if I knew my CRS was going to be great. Maybe I'll just go to your CRS in Connecticut next time!!!
My new CRS is highly recommended in the books and affiliated with a top-notch hospital...I think the problem is that because he's supposedly really good, it means he's really busy (there were definitely a lot of people in the waiting room). And he's probably more concerned about life-threatening conditions.
I wish I had a CRS who had actually experienced AF himself/herself.

I wish I had a CRS who had actually experienced AF himself/herself. That might definitely help in the empathy department...

I know what you mean about wanting a CRS that has had this before. I mean, really any anal condition would be good so they could at least empathize with the pain of it all.
I have found that just because a doctor is highly recommended on the books doesn't mean they have the best bed-side manner. No offense to the guys but both women CRS docs I have been to have been superb and compassionate and willing to talk to me as long as I needed.
If you could stand the drive, Steve, I would recommend you see Dr. Christine Mirth. Here is a link with some info for her. Don't know how far away this would be for you.
http://www.healthgrades.com/directory_search/physician/profiles/dr-md-reports/Dr-Maria%20Christina-Mirth-MD-44C59CE0.cfm
Chris-no, I am not really a photographer, I'm just playing around. I actually hate getting my picture taken (I know, hard to believe!) Kim just puts his up so because I bug him to since he is the other mod.
Now, I see Dano put his picture up. Who will be the next brave soul?

Hey Steve,

I know sometimes it is hard to find a good doctor. I am lucky my Primary has helped me out in the past. I also work for 2 ENT's and they know alot of doctors. I have been working for doctors for the past 7 years so it has its perks. My best friend is a chiropractor and she has even helped me with this AF. I might even go get an adjustment after my CRS appt in July. She said this would help merelieve some tension.

Now I have been using the Nefedipine since june 19th. I have noticed a difference. I put it up there with my finger only as far as I am comfortable and alittle on the outside on the fissure. I also use A&D ointment. With my diet and water and the cream I have felt pretty good since Monday. (knock on wood) It doesn't mean I won't have a set back. But each time sometihing not right and I have pain I modify my treatment or what I eat. I also take nice long relaxing baths still like Lecia has suggested.

Keep your chin up. I am sure you will find a CRS that can help you. Have you searched the internet? I found mine thru the hospital in Rochester and I told my Primary and he called him right away. Let us know how you make out.

Patty

You can actually apply ANY of the creams (nitro, nifedipine, diltiazem) either at the anal verge or directly inside the anal canal and get similar results. These are directly absorbed through the very thin mucosal skin surfaces and act on the sphincter muscles to increase blood flow which should help the fissure to heal. All of the physicians I have discussed this with claim NO reported absorptive differences when directly applied to the fissure itself; though I have been unable to substantiate this in my review of the medical literature. I actually have found NO articles that compare results based on where the creams are applied. Also, in my opinion, the less you traumatize the fissure the better chance you give it to heal, so applying it at the anal verge makes most sense to me.

Lecia, thanks for the doctor's name!
Lecia/Kim, your pics are hilarious.
Patty, yeah, I found my new CRS online. I have a couple general practioner doctors, so I might call one of them up and ask for another referral...and state more explicitly what I want from a CRS.
Docray, thanks for the info. I agree about the "less you traumatize the fissure." My first CRS told me to use calmol-4 suppositories...I did for a while, but I felt they were hurting more than helping. And my best stretches of healing have been without them. My new CRS told me to use them too...so I started using them again and the last couple of days haven't been great. There could be other factors involved (i.e. something I ate or stress), but I think I'm going to stop using them again.

I've just tried Nifedipine two days in a row internally and have had two ferocious headaches. The one last night lasted 9 hours! I think my veins and arteries in my head may be unusually reactive. I have rosacea and wonder if the two problems are connected in some way.
I don't experience headaches when applying it externally.
Have any of you had headaches with Nifedipine?

I took it for a week or so and I think it was giving me bad headaches too, but it's hard to tell if it's the Nifedipine or the stress.

Sorry to hear you're having headaches. I have not experienced headaches with it. You might want to check with your doctor or pharmacist just to make sure the pharmacy mixed it correctly. My pharmacist said that not many places make the stuff...so maybe they made it too strong? I know that's a potential problem with the Nitro. Just a thought.
It seemed like I was making progress with the Nifedipine for a week or so, but in the past week, my AF has been as bad as ever. So I don't think Nifedipine is helping me at all.