My new CRS prescribed Nifedipine for me. He said to apply it to the fissure itself. I've read in some places on this forum that some folks applied it higher up. Just curious where you all apply it?
And how much do you appy? About a pea-sized amount? The pharmacist told me to apply a little more than that.
And when do you apply it? Before BM? After BM? My doctor didn't seem to really care. I asked if I should apply it after, and he said "sure."

when i asked about the nifedipine,the gastro doc told me id be better off with the 2%nitro as long as i didnt have long term headaches,i was willing to try another cream too,wonder why these guys all have a different view on fissures,seems if some people have sucess witha certain cream or any other method other than surgery,theyd all knida catch wind of it and prescribe it.like for example hes dead set against the ditizilem[whatever its called] said in 25 years hes never seen any success with it and the nitro has the best clinical results for curing,but some people around here have had sucess with it..beginning to think this guy is a clown :joker:

My doctor told me the best time to apply was about 30 min. before a BM..and inside. I would just like to know how you are supposed to get in it there. I was told to use my finger. I tried and it hurt like hell and all the gel just ended up on the floor. I gave up!!!! What method are you using?

I use a lubricated finger cot to gently lub the opening and a little bit inside. Then I take a q-tib, cover it in cream, and then slowly and gently start working it in for coating. I will repeat the coating of the q-tib usually 3-4 times for complete coverage. I think this also helps to gently open up your sphincter. I takes some practice to make sure you don't stick yourself with the q-tip and cause more damage, so precede with caution and never force it.

I used a syringe that came with proctofoam to deliver my dose of nefedipine up higher, into the sphincter area, maybe a couple inches at most into your anal area. This is above the fissure site.
It makes no sense to just apply a pea-sized amount to the fissure itself. The cream is not a healing balm, it is to reduce the overall tightness in your rectal area, especially the sphincter.
Ask your doctor or pharmacist about an anal type syringe and with a little lubrication you may be shocked at how painlessly you can get it in. Use the amount of cream that you would use if putting toothpaste on your toothbrush..

Thanks for the advice. And thanks, Kim, for the syringe suggestion.
Both of the CRSs I went to seemed to have different opinions on a lot of things. My new CRS said Nifedipine is better than Nitro, but I've heard the reverse from other sources. Yeah, you would think the'd all be on the same page... they're probably too busy planning their next luxury trip to Bora Bora to care about our anal fissures (I'm having a cynical day).
I've gotten more specific/comprehensive/caring/useful advice off this forum than from either of my CRSs. So thanks again, everyone.
Oh...and for the one day that I've been using Nifedipine, I've been using plastic finger guards (that I bought at a pharmacy) and just sticking it up there...although I don't feel like much of it actually makes it in...so I think I'll try the protofoam applicator.

Be careful about which proctofoam type delivery system you get....the one below was very non-intimidating and worked very well, and very comfortably, while the next syringe that came with my proctofoam had a thin, pointed applicator that looked like it could easily be a dart, rather than a syringe...something that could rip your fissure right back open!!!

Thanks for the picture! I went to a couple of pharmacies and a surgical supplies store, but no luck. I'll try other places tomorrow.
I emailed my first CRS, told him I was taking the Nifedipine, and told him the other CRS told me to apply it to the fissure itself...he (the first CRS) then told me to apply it outside on the circumference of the anus. I'm very confused. Kim, what you suggest seems to make the most logical sense...I just don't understand how these supposedly expert nyc doctors just don't know the basics. How can they prescribe something they don't even know how to administer? Crazy.

I am not a medical professional. I can only state what makes sense to me. The two creams are BP meds, and they work to lower the pressure in the area where they are applied. The goal in healing is to lower the pressure and return the blood supply to the fissure site so it can heal. The lowering of the internal pressure also facilitates easier, less painful BMs. So the actual site of the fissure is not a logical place to apply the cream, and I found other sources that lead me to this conclusion. It's the sphincter (at least for many of us) that is too tight and doing all the spasming...thus that is the area that needs relaxing. Which is what happened when I had the LIS, the sphincter was cut in such a way that it could no longer tense up...

Hey,

I agree with Kim. It should be put up farther. I think the Nefidipine is working for me. As I relax I can get my finger farther up there. I use other creams like A&d ointment and nupercainal on the outside. They seem tp help also. I go back to the CRS July 16 so it will be interesting to see what he says. I am afraid to use Nitro because I think I would have a problem with the headaches.

Steve I feel the same way you do sometimes these doctors act like its no big deal and almost like we should figure out things on our own. I hope it gets better for you. I am still trying too.:)

BBG
Patty

P.S. Nice pic high school or college??