Yes, it was a GP who prescribed the Proctofoam. It does seem to help though. Today has been a good day with no bleeding and just a twinge of pain. I just don't really know what to do... have surgery or not. The main reason I'm really dreading it is because I was in an accident back in October '08. I'm a cyclist and was riding my road bike and was hit by a car. The guy did stop, I was airlifted to the nearest trauma center with a broken pelvis in three places. I spent time in a rehab center and came home in a wheelchair. It was at that time in February that I got the fissure because I became constipated from being inactive. Well, I went from wheelchair, to walker, to crutches, to a cane and now I'm up and about walking (slowly) with no assistance. I can't believe I survived being hit by a car but I can't conquer this "fissure"! Good grief! My biggest fear is being put to sleep under general anesthesia. I know it would only be for a short time compared to my 9 hour surgery back in October. What to do.... what to do????

That's a very amazing story, Jules. I'm so happy you pulled through that horrible accident! You must have gone through a helluva lot during recovery and rehab.
I was afraid of the GA too, and it's why I nearly chickened out from my LIS. It's a tough call, but it is more like fear of flying, in all likelihood nothing bad is going to happen! Having already undergone GA (like I had) at least you know your body can take it and that should reassure you.
The thing about proctofoam is it is hydrocortisone, and continued use will thin the membranes and that can be completely counter-productive when you're trying to heal a "cut" in such a sensitive area. That's why I guessed correctly it was a GP and not a CRS who prescribed it...I'm not medical expert by any means but you may want to reconsider it or at least get a medical opinion from a CRS about it's use.
Good luck in whatever you decide!

Kim... I've been thinking the same thing about the proctofoam. I may stop using it for a few days and just stick to the nitro and see what happens. Now I only apply the nitro to the outside area... is that correct? My AF is what's considered an internal one. Just right on the edge that projects inward. Oh, and yes, I sit in the tub a few times a day.

Yes Kim... it was a very bad accident and the recovery has been something else. I guess I'm a tough old bird, lol! Thanks for the caring words. God is good

Oh my goodness! You poor thing. I don't even have the words to say how sorry I am for your accident. That sounds terrible. It is so hard to know what to do surgery wise but it sounds like for now you can handle things with the nitro. There is also botox you can consider. I wanted to welcome you to the group and let you know I am thinking about you and hope your fissure stays quiet.
BTW..we are neighbors! (SC)

Jules, think the nitro will move through the tissue from the outside but if you can I see no harm in trying to apply it a bit further up than just the very outside.

I think it is important to get the ointment up 1 cm. Sounds like a horrific experience (your accident). I think GA is pretty safe--I've been put to sleep about 5 or 6 times w no problems!

Welcome Jules !
I was so sorry to read about your road accident and now your fissure
We really do understand the losing our minds part – only to well !
Jules, a wise one here once told me that when I was ready for the surgery I would be eager as to jump on that operating table and she was right ! You will know when you cannot take any more and that cycle of good and bad days just becomes too much …
I have had G/A 5 times now and have no problems, I hope what Kim said about you having G/A before is reassuring, please do not be scared of surgery for many here it was the best decsion they had made..
I agree with Cheryl that it helps to get a little inside, also half an hour before BM you could try applying some cream and even after too :)
I really hope you continue to have more good days Jules

val wrote:....my only regret is not having the surgery sooner as I suffered months of pain needlessly!

I couldn't agree more! Suffered for 1 1/2 year before I had LIS. I regret having 3 painful Botox shots too!
Good luck!

I am so sorry Jules to hear about your plight : ((, first with the accident and than getting a fissure on top of it all - so unfair :( !!! Yes, Fissures are the hardest thing to beat - you are the perfect example how body can heal fast in all other regions but butt !!! I completely can see how one can be afraid of GA - for some people it is easy , for some it can have lasting effects. Did you have any bad experience with your first GA in October ? I just want you to know that I had 2 LIS surgeries so far and both were done with combo of local anesthetics and very heavy sedation (so called "twilight" ), and I was completely out and did not feel a thing or hear anything and both times waked up in recovery room completely relaxed and cozy and could go home immediately with no problems and nicely rested after deep slumber and local was there still working full time : ))) !
I wish you best of luck !!!!