I am sorry to hear you are approaching the two year mark with fissure, I can totally understand where you are coming from as I have been suffering this long too

I am glad this fissure nuisance hasn’t brought your down,….. I like your attitude Sunshine !
I used diltiazem for a very long time, it gave me a horrid itch too, i just couldnt use it anymore

Maybe botox could be an option for you before you go on your vacation , falling that I feel surgery is most probley our only option , alternative treatments in my opinion do not come close when dealing with a chronic fissure !
I take miralax everyday maybe that would help for just now and using the cream atleast 3 times a day !
I hope things get better for you soon

Goodluck with you appointment today !