Back from (a much better) CRS

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Back from (a much better) CRS

Postby dan2012 » 12 Jul 2012, 16:12

Alright, I don't have a lot of time so I'll be a bit brief here... I just wanted to provide an update to this fantastic community that is really helping me through the AF ordeal.
I have had an AF fissure for around 6-7 weeks now. In Week 1 I went to an useless GI that wanted to get rid of me. In Week 3 I went to a seemingly competent CRS that also wanted to get rid of me (!) from his office, but was quick to suggest that if I wasn't healed within 3 weeks through the use of a Diltiazem cream, I'd get a LIS+hemorrhoidectomy combo. He was nasty about pretty much every question and I decided to look for the best CRS in town (should have done that earlier, but he "seemed" good).
Well, I found a GREAT CRS and I just came back from her. To be honest, even though I didn't like my first doctor, the diltiazem worked... And I'm feeling much better (more below).
The exam was smooth (instead of the bloody painful hell of Mr. "Be quick or be dead") and she pointed out that my fissure is HEALING - in fact, it's pretty advanced in the healing but there is still a bit of it open in the outside, which is good. She said that this "3 weeks or nothing" is completely bogus and sad that I should take Diltiazem for at least 3 more weeks.
So here is my current status: pain is MUCH lower, to the point where I spend most of my day pain-free. Diltiazem is causing me constipation, to the point that 10 days ago I needed a glycerin suppository to make things move (which, by the way, was one of the best decisions of my life). After the suppository, I decided to move the Diltiazem to the morning so I'd have an entire day of hydrating after taking it, instead of a "dry night". This move was GREAT and my stools are now soft most of the time, and only got a bit hard a couple of times. I'm also taking a bit of Miralax with every meal (1/4 of a teaspoon, not much really, but any more than that causes me diarrhea and constant trips to the bathroom). This combination is working really well.
I don't know what to think of that, but my bleeding continues. It got to the point where I see a little bit once a day (I have 3-4 BMs/day), but it's still there. Last night, oddly, it actually bled quite a bit with no pain whatsoever. This morning, no bleeding, no pain - I also don't know what to think of that, but since my CRS looked at the fissure and said it's healing well, I guess it isn't a huge deal.
Also, the CRS gave me a couple of interesting pieces of information. She said that in the case of fissures, most of the time the pain goes before the bleeding goes. And since my pain is greatly reduced, to the point of maybe 2-3 hours of discomfort after a "bad" BM, this is already a sign of significant healing.
Second, I surprised to hear that the way to apply Diltiazem she suggested was very different from Be Quick or Be Dead MD. The first doctor said to apply it INSIDE, like with my finger (which HURT) or a Q-tip (which sometimes would get "stuck" and cause pain on the way out). She said that this is not the best way to do it. THe best way is to apply it in a circular motion around the anal entrance. There is no need whatsoever to put the medicine straight on the fissure.
So that's it... Any thoughts?
dan2012
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