I use Diltiazem also. The instructions with it (minimal as they were) said to apply .7 to 1 gram per application, 2 times per day. I ended up purchasing some small liquid syringes, fill accordingly, and gently insert the tip just enough to get the cream inside. I use it in the morning after BM, and before going to bed. Some mornings before the BM, I'll apply a pea size amount to my anus, and it seems to help the muscles relax and the BM starts shortly after, and it's less painful.
Valium 2mg - I was given that also. I take that occasionally, but sometimes I've noticed that after taking it, if I haven't taken something beforehand for the pain, the act of my muscles relaxing seem to trigger some pain. Not sure if that is because everything is so tense or what. So now I just make sure that I've taken some Ibuprofen or Tylenol at least a half hour before the Valium.
Good luck with your healing!