Hello all,
I've been lurking about this forum for the past month or so. I've been planning to let out a good old fashioned super-rant about the experience I've had for the past year and a half with my fissure. I might still do that (with all the glorious details and profanity that comes with such a thing), but for right now, I've got a judgement call to make.
For almost a year now, I've been on diltiazem cream, which has done... pretty much nothing, as far as I can tell, other than possibly taking a bit of the edge off bathroom discomfort. According to my latest CRS (this was number three, and possibly the least confidence-inspiring one, and most definitely the most painful one), he couldn't even FIND a fissure... which seemed strange because I can find the pile (skin tag) with a small mirror and this guy had an analscope... a really PAINFUL analscope. But, I suppose that could also speak to some unseen effectiveness of the diltiazem.
That doctor suggested a ridiculous idea, which was to put me under general anesthetic so he could get a better look and possibly do the botox thing. I agreed at first... and then realized that that would cost me more than I make in three months (yay America). So, between that, his unprofessionalism, his lack of knowledge, and the wonderful "audience" he invited to my anal examination without my consent (three people in total), I was filled with a refreshed determination to take care of this on my own, by any means necessary, since the doctors clearly aren't on my side.
I've been looking into a few medical journals, postings on this forum, and any other place I can get information and I quickly came across glyceryl trinitrate, or nitroglycerin, as one of the main treatments for this condition, MUCH more common than diltiazem. So why didn't my doctors even mention it as a pre-surgery option? Chalk that up to another reason I no longer trust them. Fortunately, I have a GP who's basically a walking prescription pad, and he's willing to write me up a prescription.
Now, as for my question, from the looks of it, both of these ointments are vasodilators, meaning they both work on the same theory that muscle relaxation can promote healing. Has anyone had any experience with both of these medications and how they compare to each other beyond that? Am I right in thinking nitro is a bit more "heavy duty"? I'm planning to try it, but as many people have noted on this forum, the only brand name nitro ointment in the US is Rectiv, which costs slightly less than a month of rent (i.e. not cheap). There's the whole "$40 for the first try" deal (you might remember this tactic from other medical professionals, such as cocaine dealers!) for a 30g tube. How long does 30g last? Would it be enough to at least see if it works? Also, can anyone speak on the comparison between Rective (0.4% nitro) and pharmacy compound ointment (0.2% nitro)? I haven't found the exact cost of the compound, but my doctor seems to think it'd be a lot more affordable, which is great, but... why fight something with a slingshot when you could have a nuclear bomb?
Any feedback would be appreciated. Like I said, I've had it with the medical world, so I need all the help I can get from the only people trustworthy in a situation like this: the people who know how I feel.
Edit: Found some more Diltiazem/nitro posts, so sorry for the repeat posting. Nevertheless, would still love some input, and it was nice to talk it out a little too!

i'm on the Diltiazem cream and it's seems to be doing NOTHING for me either. I thought maybe it was one of those "it has to build up in your system" creams but after researching it further and dealing with day - long spasms which are agonizing, I'm ready (after only a short 5 days of this stuff) to throw in the $50 jar of vaseline and go for some thing more powerful.
Let me know how it works out for you!

Sorry it took so long to get back to this thread! I actually posted that and then just ran right out and found a way to get my hands on some nitro.
Long story short, yes, it worked, within three weeks, and given that no doctor recommended it to me earlier, well... You remember that scene with the Joker and the hospital in The Dark Knight? It all makes sense now...
I'm considering writing up my full story here, but that will be one super-long post. Also, and this is going to sound like I'm kidding, but I'm serious... What's the rule on profanity on this forum?
But, about the nitro specifically, I'm willing to say that FOR ME (big disclaimer) if Diltiazem is a bicycle, Rectiv nitro ointment is a tank. I could actually feel a palpable difference when using it, which wasn't always the most pleasant feeling in the world. And then, of course, there's NG head... Nitro makes for some ridiculous head aches. But, given that Diltiazem seemed like a jar of low-quality hand cream, in an odd way having those headaches felt like I was actually DOING something. So, yes, I came to the conclusion that Rectiv is more "serious" than Diltiazem.
It should also be noted (and will be, heavily, if I write out my story) that nitro was just part of my attack plan. I was going by a medical study I read which combined nitro with thermal dilation. I've been doing both every twelve hours without fail since the beginning of the year. As of two days ago with my last examination, I still have an inflamed sentinel pile which we're watching (and hopefully removing if we get the timing right - it was actually too small to attack two days ago), but my nurse practioner is 99% confident that any fissure I had is now gone, which certainly wasn't the case at the end of 2012. So it's hard to say what was the magic bullet, the nitro, the dilation, or both together.
I wouldn't give up on Diltiazem after five days, but after using it for a year, myself... yeah, I hate the stuff. Placebo at best.

Do you mind me asking... What is thermal dilation??

Hi.
Thermal Dilation is exactly what it sounds like, expansion aided by heat. Like a hot poker heated in the fireplace, then inserted. Works well. Not for the squeamish though.

Butt seriously,
I too just received the Rectiv. This forum is one of my first stops while doing research prior to the first application.
Unlike the 10's of thousands of dead posts started by enthusiastic people wanting answers... who then lacked that same enthusiasm after they found relief, I will most certainly return to this same thread after a few weeks to write about its effectiveness.
And by the way, why on earth do people do that???? It is beyond ridiculous and lazy. There is no shortage of posts which ask very serious questions which anyone using any search engine will come across many years later. Seems like, in some cases, they found their answer, but the 1 or 2 minutes it takes to return and tell all future viewers of their success (or failure?) is far too great a task? That just chaffs my bum.
And speaking of chaffed bums, stay tuned for my results.
I must add, my AF/roids/colitis is most probably slightly less severe then the majority of the horror stories I've read here, and I've only been reading a few minutes. Who knows what other nastiness remains to be read. I feel for all of you.
Anyway, mine is bad, yes. Horrid and foul, yes. But definitely a bit more tolerable then some.
Regardless, my doctor, after a colonoscopy, saw the three conditions mentioned above, and recommended Rectiv. After many days of battling between the pharmacy (Chemist, for you Brits), my doctor, the people at Rectiv, and my insurance, they finally honored the "Pay no more then $40" discount coupon that my doctor gave me. I just picked it up less then an hour ago.
So, due to my worries about the rather intense-sounding side effects mentioned by both the doctor and the pharmacist, I thought I would educate myself before putting this relatively new medication into my dark star (aka: rusty sheriffs badge, spider, bulls-eye). Just to name a few lovely terms.
So rest assured, I shall return.

Well, just over a couple of weeks in, and so far very little to report.
My condition down there is better, but it was already a bit better before I got the Rectiv, due to something which I avoided for many painful months, a good ol inflatable rubber donut. Sure, I know it's always the obvious first step. But it's hard not to feel like someone's grandfather buying/using it. Plus, I never assumed this condition of mine would last. I knew nothing of AF/Roids before. Didn't that only happen to Albanians?
I digress.
So in short, the tried and true donut helped a substantial amount. Didn't cure anything, of course. But seems to have promoted healing. I guess. I saw a huge difference in just a couple of days. But around a week later, is when I got the Rectiv. And there hasn't been what I would call measurable improvement since then.
Is Rectiv working? Dunno.
Stay tuned for more in a few weeks.

Any updates jewpony?

typical guy, first he goes on and on and rants about how people dont come back to report progress and then the same himself. loser.