how do I get it up there? It just comes in a tube, put it on my finger and....

hi 3 years now...i am in the same situation as you, its been over 3 years now and i am going to go get the nitro tomorrow...and i was wondering how in the world am i going to apply it inside...theres just no way...is it just me, unless i have to go to the bathroom thats the only way i can put vaseline in there otherwise no matter what i do i cant apply anything inside not even something small as a needle. any tips advice would be greately appreciated. Also how much does the nitro cost?dont have insurance:(

I've been applying nifedipine internally for 9 weeks now. I never thought I'd be able to apply it. But I was in so much pain from the fissure I knew I had to try.
First I take a warm bath for 20 minutes to help loosen up the sphincter a little bit. I use my pinky finger. I lubricate the finger up to the second knuckle with a little bit of medication. (You may not want to use the medication to lubricate since nitro has more side effects than nifedipine.) Then I put a dime-sized glob of medication on the tip of my finger. I lay down on my left side, pull my knees up, and insert the finger. I use a mirror so that I can aim more accurately. Aiming is a little tricky for me since I have a couple of skin tags in that area. I usually have to prod the area gently to get the right spot. I insert my finger a little past the first knuckle. On a good day, I try to rub the tip of my finger against the inside to spread the medication a little bit.
Some people here use a q-tip and some use an applicator that comes with the ointment. I felt both of those would have been too pokey for me. Some people use a finger cot, which is little a glove for the finger. I tried that and it was very, very painful for me so I stopped doing that. Everyone has a variation of the technique, so you can see what works best for you.
The first week of applying the medication was difficult. It caused me some pain. I felt like I couldn't do it anymore. But after 10 days the medication started working. And then the application of the medication got easier. My sphincter is still tight but not as much as before. It doesn't hurt to apply the medication anymore.
I know it seems challenging but you can do it! I hope that nitro works for you!

Darkeyes has some good tips. I use a gloved finger because it's way more comfortable for me. At first it will feel like there is no way you can do it. But if you breathe very deeply into your lower abdomen, filling your belly like a balloon and just be very gentle and patient you will eventually feel the muscle give way enough, and actually, practicing this helps dilate and relax the muscle. The warm bath before trying is a great idea. Don't be discouraged if the first few times you can only manage to get most of it on the outside or even just a tiny bit on the inside. Just keep with it, keep trying, and above all, don't stress about it. Also, as you gently try to insert a finger you can aim the angle and pressure of your finger away from the side of your anus that has the fissure. Try different positions as well to find one that works best for you. I agree with Darkeyes that q-tips or applicators are too pokey for me too, and actually, a q-tip could possibly leave fibers behind that could cause more irritation.
Good luck!

3 years now, you don't have to put the nitro into the anus or where the fissure is to work, because the job of the nitro is to relax the muscle, the fissure will benefit from that.
When I first started to use the nitro I was in horrible pain so I ask the CRS how I was suppose to put the cream in, he told me that all I needed was a dab on the anus and that was enough.
Now went the nitro touches the fissure you will know because it will burn for a bit.
I hope my post help ease your concerns.

Actually, while you can gain some benefit by outsde application, your best chances for healing success come when you can apply it internally because you are targeting the internal anal sphincter.
Here is a study that demonstrated better outcomes with endoanal application (inside the anus) than with perianal application (on the outside of the anus). Though the study was specifically designed to study headaches as a side effect of nitro. the researchers found higher healing rates in endoanal application.
http://www.ncbi.nlm.nih.gov/pubmed/22810476

i found that when u apply some inside you get a head rush or spacey feeling....so maybe that means its working...who knows

I applied it on the outside as well. Just a dab and boy ! it gave such a headache ! Is it a side effect or a normal thing? I don't know... I changed my CRS and the new guy prescribed Diltizem. How can one feel relaxed with that pounding headache?

the side effect is headache and light headedness. Nitro lowers blood pressure, causing those "minor" side effects. I was told it gets better as your body adjust to it.
I am on day 2 with the nitro, using my finger to get some up there. This is fun isn't it??
splinterboy to answer your question on cost: I live in Canada, the nitro has to be made by a compounding pharmacy - it cost me $33 canadian dollars for a tube of it. I can expense it back through my employer.

I use these little "finger covering things" that were in the bandaid isle at the rite-aid. They are like finger condoms, they work really well, you should get some so the nitro doesnt absorb thru your finger where u dont need the medication.