I'm new to this site and posted a rather long (venting) message yesterday. I just feel like this damn AF won't leave me alone. I'm 4 weeks into using nitro cream having had this AF for 7 weeks now and after I thought the cream was working, this last week has been awful! Is this normal? Does it mean the cream won't work? To top it off, I have been eating all the usual regimen of foods; all bran with 6 prunes and a tablespoon of flaxseed, fruit and the usual stool softeners and I ended up having a bout of diarrhoea this afternoon! Razor blades in the butt! I'm looking for reassurance that the cream may still work following setbacks. Has anyone else had these setbacks then healed via the cream?
JT

JT,
Everyone I know and have read about who has healed with the creams have had setbacks. Npt sure why, some people blame a slight change in their diet, some say it was hormones and some blame the setbacks on stress. Who knows.
So long as each setback is less of a setback than the previous, then healing must be happening. It is true though, that the body gets used to nitro after 6-8 weeks. There are other creams (calcium channel blockers), that are also used for high blood pressure. These work as well as the nitro and don't wear off.
Try not to slack off with your regimen, even when you are feeling better. It will take the skin there a good long while to get strong again, even after it heals.
I would seriously reconsider your training. IMO
Just the thought of sitting on my bicycle makes me cringe. ouch!
I did read of another lady here whose AF would get worse every time she went for a swim. She thought it might be the strong chlorine they use in public pools. I myself have had setbacks after swimming and now avoid public pools like the plague. My CRS says to keep the area as dry as possible. Of course he hasn't been much help to me so I take his advice now with a grain of salt.
I use the rule of thumb when it comes to exercise. If it doesn't make you feel worse, it's OK. I basically just stick to long walks though.
Did your CRS suggest botox at all?
Don't worry about venting here or too much info or any of that. We have heard it all before!
:D
Sure hope you have a better day today!!
-Tanya

Totally hear you! I haven't used Nitro cream, been using diltiazem (my doc assured me diltiazem won't become less effective with prolonged use). But that might be something to consider with nitro-- that it might become less effective?
I've totally been on a rollercoaster--- been doing EVERYTHING right, and I seem to go backwards more often than forwards-- so frustrating! Makes you begin to doubt if people are ever really healed!

Thanks guys; it's good to hear that setbacks are probably par for the course. It just gets so depressing when you have a great week and you think that's it! Then it kicks in again.
Training; yes, I do question whether I should ease off. My CRS did say I should carry on, infact excersise is good. I went into detail about what I do and the only one he said be wary of was the biking. I have backed off the biking somewhat. If you knew me, you would understand why I can't stop training. It would kill me! Sorry that swimming gave you setbacks Tanya, it doesn't seem to do anything to me, but perhaps delayed reaction so could be my wishful thinking!
Just finished a long soak in the bath with Epsom salts; has eased off the "burn". Tomorrow is another day!
Oh, just one thing which may sound a little bizarre as it only sprung to mind after my bath; when applying (inserting) the nitro/cream, what finger? I naturally use the middle finger, but then thought it's the biggest finger! Why not downgrade to the little finger? Has anyone some great techniques for applying the cream, and "how far" do you get that finger? (never thought I'd be writing that on a forum!)
JT

Like I said, I use diltiazem, but I'll share what works for me!
It's used to relax the muscle, so I figure I should try to get it all around the whole muscle so that everything can be relaxed. It hurts when there is an open fissure, so I just put a little on the edge with a q-tip otherwise it burns too much. When the fissure closes, I get in there with my pinky or ring finger-- a small finger, but the one that you are best in control of!
I gently locate where my sphinct is the tightest and put it on all around there, about 1/2" in.
Hope that helps!

Thanks for that; not thought of using a Q-tip (cotton bud to us Brits!). Silly; I hadn't thought to ask the CRS about this! I sometimes think am I getting the cream to the right places but I'm sure it must be; 1/2 inch is about right for me too.
This site is so informative; we should all tell our CRS's to get on this site!
JT

I know! If I had only gone by what my doctor had told me to do I would probably be in a wheel chair by now. All my most useful tips come from this forum!
Some people mention using an oral syringe, or you can also use the anal applicators that come with hemorrhoid ointments. But the q-tip & finger are the easiest for me!

Hey JT,
I'm healing from a small setback I had last friday - my BM's got a little on the hard side (had taken more vicodin that week, but didn't adjust to taking more stool softener to counter it). And then, quickly swung too far in the other direction by overcorrecting with too much stool softener, making the stool super too soft which I think is equally irritating to the healing tissue. I don't see it much in the posts because there is so much emphasis on strategies and efforts on how to get the stool soft, but in my experience stool that is tooo soft also creates problems (at least for me).
Each time i've had a setback (i've had 3 since botox: 1 from too soft, 2 from too hard) they've not been as bad as the one before it, recovery from it has been quicker - and it also has taught me how to "tweek" my efforts of diet,fiber,water,pain med,stool softener so that if one thing changes, I can try to more precisely adjust the rest of it to keep it just right, like goldilocks: not too hard, not too soft.
Also kinda reminds me of stearing a sailing ship: at first it's easy and common to overcorrect when trying to adjust for being a few points off course, but then you just end up swinging all over the compass and zigzagging across the ocean; as you fine tune your adjustments, you can stear more accurately by responding to the changes in the wind and water before it hits the ship so that you are not reacting to the ship changing course. not sure if any of this is making any bit of sense! :)