So I went to see my GP today because of my concerns regarding healing. He said that I should be prepared for the possibility that my AF is chronic and may flare up from time to time, even for the rest of my life. Yeesh, I did not need to hear that! He did give me a referral to a CRS so I could have my situation more thoroughly assessed. He seems to think that this is something I should prepare to just live with, but I really, really want to get rid of this for good, and I hope I can do so without surgery!
I have a question regarding keeping the AF dry. How is this even possible what with all the ointments--diltiazem and Vitamin E--constantly being applied? Can it still heal with all the ointments???
Arg! It's so hard to find the right balance of care for this thing. I think I'm having another bad moment!

Well I don't agree that you will have to live with a fissure for the rest of your life. It is true that a fissure can become chronic and persist without medical intervention though such as using the diltiazem. How long have you been using the cream?
I think it is good to see a CRS. They are going to much more experienced with fissures and treatment options. There are quite a few here who ended up needing surgery and are very happy with the results. I did not have the surgery and got better but I am not a good candidate for surgery due to a childbirth pelvic nerve injury so I persisted with the cream and baths for 4 months.
That is a good question about using the ointments vs. the advice to keep the area dry. I did air dry after baths and I often skip underwear which helps to keep things breathing down there. Loose clothing is a good idea. I have my "mom" uniform of loose fitting yoga pants that I wear. My daughter has threatened to turn me into "What not to Wear."
The creams need to be applied and act as protectorants. Moisture from sweat or water can make the area more vulnerable but these creams will help cover and heal.
We all have our bad moments and there isn't a true algorithm that will work for everyone the same way in terms of healing. That uncertainty was hard for me to live with since I always like to have a "plan!"
Hang in there,
Lecia

one of the tricks in applying these creams/vitamin e/palmers cocoa butter, is to use a very thin application. don't swab on dabs or fingertip gobs on!
just a light thin application.
perfect right after you blow dry your butt!