Thanks All, from reading all of your posts I gather the headache is part of the territory and most of you are applying it slightly inside the dark zone.
Yea, I tried the recommendation 1/2" bead twice daily - but it floored me the first time so bad I thought I was dieing !!
I was sure I was going to have a heart attack and be found dead with my pants down on the bathroom floor !
I am continuing to feel relief from using the Nitro three times daily - and only an amount the size of half a pea. ( 2% Nitro )
I still now pull my pants up immediately just in case !!
Dignity is golden ...................

What about trying diltiazem or nefidipine? I was on diltiazem for 4 months and it is what healed me.

im a firm believer in the nitr cream,it took awhile to heal up[like 3 months?] but its been good since,my headaches came and went,some were worse than others and sometimes none at all.i stopped using the cots,i found them to be a pain in the rear[ha ha] i cleaned my hands well before and did this like 4-5 times a day,sometimes more.seems i got used to it,the longer i used it,the less after effect it had..like for example by the end i could have used it as chap stick and would have been fine..not that i did that..thats just an example!!

Lecia , Good Idea - I'm having some blurred vision disturbance with the Nitro but it does definitely work while it lasts.
One definitely becomes tollerant to it though and need to use more for the same affect.
I may try nefidipine next - it's a little expensive because it's difficult to obtain here at Tahoe. I called and got the name of a special pharmacy that mixes the cream up . Ohterwise I guess theres a pill form but the cream is what I want.
Thanks Lecia for the continued suggestions ............

Dano, you're right - I have just began to notice the Nitro doesn't have the punch it did when I started. I'm using it three times per day and that seems almost enough .
The zinc oxide burns a little when I put it on after the nitro but it seems to last and protect pretty well . Just not that crazy about the white skid marks in the undies ---- LOL
Thought I'de share that with you ..........haa

I was using both creams at one point LOL !!!
If your side effect diminish it does not necessarily mean that medication stopped working - it can mean that your body just adjusted to the presence of new chemical in the system. If your spasms return in full force - well, than it means that the cream does not work any more.
JA, don't take oral form since it will have much stronger effect on the whole cardiovascular system and you definitely don't want that unless you have high blood pressure !
All the best !

0.2 % Niphedepe did not work for me. My dr gave me 2% nitro. I appied much less than what the doctor told. I got a pounding headache and nausea. I decided not to apply it again. I am going for LIS now.

That may be the best decision you ever made, Ravi. Butt pain gets old. I got my life back and you will, too...