Hi everyone - finally got in to see a CRS today. I was half expecting to have to have the LIS on the spot, but when the doctor examined me, said that the fissure was superficial, and should respond well to Diltiazem 2% ointment within 4-6 weeks. He said the success rate of this treatment is about 80%. If the Diltiazem has not caused significant improvement in about 3 weeks, he said to call in for another appointment, and he'll do the surgery. I asked about a local anaesthetic (today was a bad day, and I was in a lot of pain so the thought of pain relief was high on my priority list), and he gave me Xylocaine ointment to apply before a BM to make them less painful.
One other interesting thing - he asked about my fiber intake. I proudly said I ate Bran Buds every morning. But he said that's not good enough - you have to have a LOT of them (like a cup!) PLUS drink a glass of water at the same time as the cereal. Fiber does not work without water, and even if you have lots of water during the day, that's not as good as having it with the meal. In fact, fiber without water can actually be constipating. Maybe the addition of the water will make it easier to get those BMs started.
So I will try the new cream, the anaesthetic, and drinking water with my bran, and see if that combination will make some healing happen. I'll keep you posted!
Robin, with fingers crossed

Hey Robin,
Good to hear an update on your situation! I love your new avatar by the way!
It sounds like we are both on the same treatment regimen. I am using the same cream. I had a check up last week and although the fissure is still there (which I could have told her that!) is is showing signs of healing so I have another 6 weeks of the cream and baths.
How is your pain level? Are you still having to kick back the advil? I am, but not as much. I also take a vicoprofen in the morning after the bathroom trip and sit in the tub. I have the lidocaine cream too-it helped a bit at first and then it seemed like my body just habituated to it. I hope it will help you with the pain. Does your pain last all day or just after going to the bathroom?
That is very interesting info about the fiber and water.
I wonder if using a lot of soy milk would have the same effect? I had one day when I didn't get my usual water but had the same fiber amount and it felt like it was coming out the same consistency it did when coming it. I'll have to remember that-it makes sense!
Did you ask your doctor about botox? I know you were interested in that! It costs a lot to get a vial so maybe the board could buy one and we could pass it around! :lolflag:
Well, keep on hanging on-the cream will help and I don't know if you do baths but that seems to help me with the pain and healing!
Lecia:flower:

Dear Robin,
I have also used Diltiazem nearly twelve weeks and my fissure has healed a lot but not probably. Hopefully you will be luckier. Besides I have also used Xylocain and it gave a big help when I had horrible pain but be aware that you have to use it quite a lot that it helps.
All the best for you!

Glad to hear everything is not as bad as it could have been. May I suggest you get the diltiazem up the anal canal high enough for it to relax the sphincter?
Just a dab on the fissure site may not be nearly enough.
As for water, yes,t hats the primary reason why the anal fissure "diet" includes water. As the body pulls water into the colon, it bulks-up any fiber that is present (think of fiber as a sponge) and at the same time, softens the stool.
On the reverse side of the coin, as one dehydrates, water is pulled from the stool and it hardens -- another reason to keep water intake up when you have a fissure.
Kim

Hi Robin,
I have used Diltiazem and the first time I used it after about 8 weeks it worked for me. Unfortunately I got another fissure a month later, so it wasn't a permanent fix, but I must have fallen in the 20% (I'm now scheduled for surgery in April). Good luck with the treatment and I REALLY hope it works for you! Just a tip, don't stop using it even if you feel better until you see your dr. and can verify that the fissure has healed. The first time I tried it (before my fissure became chronic), ditilazem gave me relief after 2.5 weeks which was wonderful, but the fissure didn't heal until about 8 weeks later so I just kept using it. I ended up applying it digitally, and my doctor recommended that I get it 2cm in, which was a little tricky to measure but I just tried my best. Good luck, it should work great for you and I hope you feel relief soon! :D
Suzy

hey robin,
what are you putting in your bran buds? are you using milk or soy milk?
i love eating the bran buds. in one cup, you get 39 g of fiber. i highly suggest to use Eden Blend (a soy/rice/seaweed milk) along with a combination of fresh raspberries, blueberries, blackberries and strawberries in addition to some cut up bananas, raisins, and some wheat bran.
i eat bran buds and i love having the fresh fruit and wheat bran in it.
i have bran buds every other day; the every other morning, i eat miso soup or oatmeal with the same fruits/wheat bran.
i have not resorted to need to drink water with my bran buds. but i do tend to drink about 1L of water thru the day.
perhaps, drinking some green tea along with the cereal would be good.
****
congrats on not needing the surgery.
i wish you lots of success.
don't forget to squat on toilet rather than sit. it has made a huge improvement for me.
still going so well as if i never had a fissure........

WOW, im so glad is offering so much great advice here!! Thanks guys!!! Im not sure i can really add any more?
Im just glad Robin that your CRS gave you a positive report and that your recovery seems not too far off!!
Cheryl

Hi again gang. Well, 5 days of Diltiazem so far and I'm a bit disappointed that I'm not feeling a whole lot better yet. I've had about the same number of hours of spasms, maybe slightly less intense, but still requiring my daily dose of ibuprofen. Damn. Here I was hoping to give my poor liver a rest. Oh well, I'll persevere, and if I'm not feeling a lot improved in 2 more weeks, I'll call the doc up again and see what the next step is. Well, I'm pretty sure I do know what the next step is, but the surgery doesn't frighten me nearly as much as it used to. Besides, when I expressed concern about getting right back to work, the doctor said I'd be fine and the pain from the surgery would probably not be greater than the spasm pain that I've been putting up with for so many months now.
Gareth, I keep on eating those Bran Buds and yes, thanks to your advice I'm now hooked on that EdenBlend milk. I suspect I'm allergic to cow's milk anyway - I always get a sore throat immediately after eating or drinking any - so this EdenBlend is a remarkably non-gross alternative! I've never liked pure soy milk, so the rice in this stuff makes it much more palatable. Only problem is I went back to my grocery store which used to stock it in their natural foods section, and they've stopped carrying it! I asked the clerk what was up, and she said they haven't received any shipments of it recently. Fortunately we have a good health food store in town, so I managed to stock up on 3 cartons there. But I do hope it's not going to be discontinued - it's much too good a product for that to happen.
Suzy, Cinderella and Hugh/Kim. thanks for your encouragement. I'm hanging in, and hope you all have a great weekend,
Robin

Do hang in there Robin! When Diltiazem worked really well for me it took about 2.5 weeks for it to start working. I was applying it 2x per day and was so frustrated after the first week because I still had all the pain. I underdtand what you are feeling!!
Give yourself a good 2 weeks and have faith that it will start feeling better soon!
Suzy

I can understand how you feel too! I have been on the diltiazem for almost 2 months and its really only been in the last few days that I have noticed an improvement. That being said, my experience is complicated by hemorrhoid surgery so I had that wound to heal from and the fissure so I would think you would feel better way sooner than I would.
The other thing that helps with healing are the baths. Even if you could squeeze one in a day and soak your bottom for 20 minutes that would help.
BTW-My pharmacist told me to store the cream in the fridge but sometimes I forget. How do you guys store it?
I am still on ibuprofen but down to 3. I am planning on getting some milk thistle to help with the liver since it is good for detoxification. Alpha lipoic acid is supposed to be good too which I already take for nerve function health.
It can be like watching grass grow at times but not as fun but you will get over this either way. After painful spasms and pain from the fissure I would think surgery couldn't be any worse and then the pain would be from healing but I think it makes since to give this cream a good try though!
Maybe you can sit in the tub and play on a gameboy to help with the distraction (referring to another post I made about video games and pain)!
Hang in their All Bran Boy!
Lecia