I explained everything to him - my symptoms, etc. - and he examined me. Then my husband came in, and we had a lengthy discussion with the crs about all of this.
I was extremely nervous during my appointment, so I'm sure I'm forgetting parts of my conversation with Dr. C. - but here's the most of it - and to try to condense everything, I'll just type it like headline news:
- Dr. C says I do have a fairly tight sphincter, and says I have a couple of extremely small fissures, but they're not more than 1 mm in size. He thinks my "posterior" fissure (which he saw in Nov.) is better.
- When I explained I had been using the nitro/lido ointment that another crs (Dr. L) prescribed, Dr. C seemed very surprised by that and said he didn't even know there was a pharmacy in town that would prescribe it. He said that nitro, by itself, is probably harmless enough, but it's not made for the anus - BUT the lido will cause a person's anal area to burn after awhile, if used long enough. -- Dr. C knew exactly which crs (Dr. L) had prescribed the nitro/lido - and just by Dr. C's reaction, he seemed incredulous and annoyed that the nitro/lido would be prescribed by any doctor, for use on the anal area.
- Dr. C said that people put all kinds of things on their anuses - most of which aren't made for the anus and can irritate the skin and provoke burning. His recommendation was to keep the area absolutely dry, with nothing on it - except for a type of anal/vaginal lotion (can be used by both men and women), called "Balneol." A 3-oz. bottle cost me $18. He said to use an extremely small amount and just barely rub it on the external anal area, like putting on a bit of lotion there.
- I asked about nifepidine - and I was so flustered and anxious during the appointment, that I can't remember if he said that it's available in the U.S., but I think he said it wasn't. (I'll have to ask my hubs about that, just for clarification.) Dr. C did say that people in other countries have different health-care systems, so their studies on various medications vary from ours, due to the fact that their options/treatments are different from ours.
- We discussed the LIS, but because my AFs are so very small, Dr. C said that the best long-term fix (for me) is to have enough fiber in the diet - and that these things just don't clear up over night. I did ask about LIS - how many he's done, incontinence, etc. He said he's done alot, with no incontinence problems - but he didn't seem to think that the LIS was the necessary measure for me at this point.
- We discussed S.A.D., and he said that no one here does that. He said if that procedure is not carefully controlled, it can permanently damage the anal area. --- So, if I were to ever want that procedure, I obviously can't get it done locally (I'm assuming). --- And I won't even bother going back to Dr. L (the [foreign born] crs who prescribed the nitro/lido, which Dr. C said should not be used on the anal area), even if he does perform S.A.D.'s.
- I asked about my diet. Dr. C said to get enough fiber and that one dose of Konsyl, per day, was enough for someone my age - but that if I were older, 2x per day would be okay. FTR, I'm still going to take it twice per day, because I know it can't hurt.
- I asked about the Miralax. Dr. C didn't have too much to say about that - whether to continue or stop. But, I'm going to continue it for a little while, just to make sure I give myself a little more time to feel better, if possible.
There it is, folks. I'm going to put nothing on the anal area, except for the Balneol (very lightly, at that) - I'm to keep the area dry - I'm to get enough fiber - and I go back in two months. Dr. C did say that baths could help with spasms and discomfort.
So, now . . . I just hope I heal.
