new here, now on Diltiazem for five weeks

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new here, now on Diltiazem for five weeks

Postby canto273 » 23 Mar 2012, 16:37

I am a 35 year old male. I am glad to find this support forum. I got AF in mid November. First few days were painful but pain subsided a bit after a week. When it didn’t heal after two weeks I went to my family doctor who suggested soaking my bottom in salt water and increasing fiber in my food. This did not help so in second week of January the family doctor referred me to a specialist whose appointment came five weeks later (welcome to free health care in Canada). The specialist prescribed Diltiazem and after two weeks I was pain free. But at the end of third week fissure flared up again. This time the pain was different. It has been more than two weeks now since the second flare and the pain hasn’t gone away. Although I think it is healing or may be I am just convincing myself that it is healing.
I am getting my fiber through vegetables, fruits and high fiber cereal. Because of high fiber intact I go to washroom about 3 to 4 times a day. I am applying diltiazem after every BM and first thing in the morning after I wake up.
I do not get pain during my BM but I feel it when I am cleaning after BM. Before I started applying Diltiazem, it would hurt to sneeze or cough. It doesn’t hurt so much but it is almost five months and I am quite frustrated. I am afraid to do surgery as I do not want go through side effects.
My next step would be to try anal dilation. However, I am not too sure what it involves. Also, I am not sure how long I should keep applying Diltiazem.
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Re: new here, now on Diltiazem for five weeks

Postby workingonit » 23 Mar 2012, 19:32

Hi Canto,
Your doctor suggested anal dilation?
If you go to the 'portal' section, up at the top of the page next to 'home'. Then look down at the lower left side of that page, there is a search engine that is more effective than the one at the top of this page.
Still if you just search for anal dilation you find quite a few topics on it.
The old fashioned way, doctors used their fingers. The patient is anesthetized. There are new methods that use instruments to get a more uniform stretch. The idea is to give the sphincter muscle a good stretch that actually makes tiny tears to it so it stays stretched. Kinda of like rolfing is for massage.
Most doctors don't perform anal dilation anymore. It's kinda controversial. If I could find someone to do it, though, I would go for it.
I know about frustrating!!! And just getting down about it. It seems like you do all the right things and it is a mystery why the darn thing won't heal!!
Image
This is pretty common theme here on the forum, but you will notice when you read old posts, that everyone heals and moves on eventually.
Let us know if you do the anal dilation and who your doctor is please. i am in Canada too. Also, I found that most doctors will keep a cancellation list. You can ask to be put on the list and thereby shorten your wait time!
Welcome to the forum!
-Tanya
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Re: new here, now on Diltiazem for five weeks

Postby canto273 » 25 Mar 2012, 13:35

Thanks for the search tip Tanya.
I am in Toronto. My doctor recommends surgery if Diltiazem doesn't work. I am thinking of self dilation. I am making appointment with the specialist to get more info and see what other options I have.
I wonder if increasing Diltiazem dose from 2% to 2.5% or 3% help?
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Re: new here, now on Diltiazem for five weeks

Postby workingonit » 25 Mar 2012, 13:56

Canto,
I've not tried them, but I have an appointment with the NATCM clinic here in Vancouver. Their main clinic is in Markham. I will post after my consultation with them in early April. You have to pay for them, and they aren't cheap.
It's another alternative anyways.
I don't know the dosages of diltiazem, but I was on 0.9% nifedipine, which is pretty hight. I could definitely feel the difference!
-Tanya
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Re: new here, now on Diltiazem for five weeks

Postby thisfissurecankissmybutt » 25 Mar 2012, 14:22

The general rule of thumb for Diltiazem (as well as Nifedipine, Nitro, etc.), according to my CRS, is that if it is going to work, you should see considerable results in about two weeks. If it is working, you then keep on taking it for the full 6 weeks to make sure the fissure is completely healed. My CRS told me that if the fissure symptoms (in my case, burning and spasms after a BM that can last several hours) weren't gone in three weeks, to make an appointment to come back and see him. I have an appointment to see him this week (sigh!).
I also asked him about a higher concentration and he said the 2% concentration has been shown to work the best.
Unfortunately, if the Diltiazem doesn't work, the options become very limited (i.e., LIS, anal dilation, living with it and hoping it goes away, etc.).
For what it is worth, my CRS said to stay away from anal dilation. He said the risks far outweigh the potential benefits (and this is coming from a CRS that has been completely willing to try several different non-surgery approaches).
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Re: new here, now on Diltiazem for five weeks

Postby canto273 » 17 Apr 2012, 19:33

I have been feeling skin tag for last few days. I went to see a specialist and has been declared fissure free. So, it took about 8 weeks for Diltiazem to work. I had fissure since November 2011 and started applying Diltiazem in the middle of February. continuing with my high fiber diet.
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