I am about 5 1/2 weeks into this AF and 19 days of using the Ditilizem cream. I noticed a significant improvement about 12 days after using the rx cream. No pain, no pressure like feeling while standing or sitting, no spasms, no stinging or burning, no feeling like I am pooing cut glass !
Thanks to reading everything on this board, I started taking Miralax (god-send), the rx cream, hot baths 2-3x a day, the change in diet, the increase of water, increased the fiber etc...so my question is How do I know when I am healed ?
Do I go back to the CRS for a confirmation of my AF being healed ? or do I keep on doing what I am doing and just go on with life ?
Also, once you have one AF is there a greater chance I may developed another one ?
SweetPea  

Hi Sweepea
My first fissure healed after about six weeks of Diltiazem and I was untroubled for seven years. I remember I finished the tube of Diltiazem I had left and then forgot about it. I kept up some of the good habits like upping fruit,fibre and fluids to keep regular and just got on with life. So for me the answer to the first part of your question is that you know when you are healed when you forget you ever had a fissure.
But I fear you will remain vulnerable though not necessarily more vulnerable than you ever were. My recurrence was caused by bad constipation as a result of a change in prescribed medication.
Recovery has been complicated by unrelated stomach surgery necessitating changed diet, barium meals, painkillers and other very unhelpful things! However I am well on the road now and will post success story when I am more confident about it.
I hope this helps.

My advice is...don't turn your back on your fissure, it can recur!!!  I actually didn't know I had an AF the first round (I thought it was a thrombosed hemmie, based on GP opinion...though I couldn't tolerate her exam--with no pain ointment!!).  So I seemd to heal after five weeks, the pain just went away and stayed away for a month.  I thought...that clot must have passed and I started feeling as though I could back off the ointment, sitz bath and diet.  BIG MISTAKE.  When I retore, it was really bad, and I'm still not back to baseline or normal five months into it!!! Maybe six.  Much worse than the first time around!!!  Much, much, much worse.  So be careful....very careful....and keep up your water and diet changes.  And keep using the ointments to prevent spasms and tightness and I hope you avoid the 'personal hell'  I've been going through after not knowing and not being careful enough!!!  Good luck!!!

U  ? n'd

Do I go back to the CRS for a confirmation of my AF being healed ? or do I keep on doing what I am doing and just go on with life ?

Yeah, getting that healed confirmation from your CRS  is terrific news, but the challenge for you is finding ways to deal with keeping stools soft after weaning yourself off of Miralax.
Really, it takes several several months for the anus to get back to full strength and perhaps the real test will be what happens when you have the occasional hard bm. If you can survive a hard bm ( though granted we will try everything to avoid these) than you dont need a CRS to tell you the obvious.
Month after month of no blood no glass shards poops much less spasm and minimal if any irratation most of the day are pretty good indicators that your right there.
Try your darnedest though, yes for the rest of your life, never to strain or to be constipated again. If that means you have to keep a box of miralax or vaseline on stanby, so be it. But try to find natural ways to find those perfect bristols 4-6. I believe I have empirical evidence that there a some foods that at least for me, tended to weaken the walls of my anus (without straining or being constipated ). Perhaps that happens to more cases here than we would think.
HTH GL

  Thank you all for you comments ! I truly appreciate it more than you will ever know. I have learned so MUCH from everyone else's experiences....the good & the bad.
I will continue on with my diet, water intake, using unscented wipies, vaseline and A&D cream as well as my rx . Plus I have added in Magnesium and I am off the Miralax (but it is still in the AF arsenal if I need it). The hot baths with lavender infused epsom salts have become my nightly routine which I look forward to. I also added in Probiotics too !
The last 6 weeks my life have been a complete & utter upheavel and I now know it was huge wake-up call for me ! Maybe God was telling me something about my lifestyle and I have finally listened.
SweetPea

Sweetpea,
I am SO pleased to read that the Diltiazem has helped you so much and at 5.5 weeks, you have every chance that this has helped heal the fissure before it has a chance to become chronic (and then more troublesome to deal with)....Seeking final confirmation from a CRS is always a great way to relieve your stress and reassure you that you are back on track, but chances are if you feel better with reduced pain, then you are well on your way (if not) there....I think you will only know 100% once you stop using the cream and then give yourself a week or two to assess the situation....If the pain has reduced immensely, BMs are pretty comfortable, then these are great signs.
As everyone says, you have to be really careful for a long time having suffered once because that area is very fragile and the scar tissue that heals over the tear area has less elasticity than normal skin, meaning it is more vulnerable to future trauma. I find I no longer need all the Sitz baths anymore but I continue to religiously use Vaseline before BMs, always strive for soft stools, never let myself get dehydrated and I supplement with Magnesium as a stool softener. These are small things that go a long way and having suffered once, these will be lifelong practices now as I do not want a repeat of this experience !!
Keep up with all the good stuff you are now doing and you will know by what you feel and sense, whether you have completely healed or you are on the way to healing. If you have any further questions, just ask away! :) 

Thank you each of you for taking the time to respond. I am feeling so much better each & every day.
I do have a sentinel pile that I notices causes me some grief as of lately. I did a hour long walk & the little bugger seemed to be a little agitated, kinda like a pulling sensation.I took a hot bath, applied my rx cream and A&D ointment and the sensation seemed to have disappeared by the next morning.
SweetPea

SweetPea, you sure are in your way to recovery and healing and doing great, just keep your routine and eventually all the discomfort will get better.
Remember that the sentinel pile can get irritated once in while and it can be mistaken for the fissure flare up, mine still troubles me but my fissure is healed.
I am so happy for you.

Well, it has been a few weeks since I posted last regarding my healing question.
Everything has been healing up nicely, no pain, no itching, no spasms etc...I have been taking my fiber supplements, drinking lots of water, my diet has been completely over-hauled, taking Magnesium. My BM's have been good, 1-2 x a day. I did slack off on the hot baths though & I haven't been using my rx cream (ditiliazem) as often, just A&D ointment and vaseline plus still using wipies for my BM's.
Then yesterday out of the blue, I started having that "pulling feeling" around the sentinel pile. Oh no...here we go again. Then this morning my BM was a little on the iffy side...meaning a very slight sting & a small amount of blood in the stool. I am totally scared that it might re-tear !!
So, I have already prepared myself for the worse and I am hoping for the best. Back in the tub with some epsom salts tonight. Maybe the sentinel pile is a little angry , we did go on 2 road trips out of town & sitting in the car for 4-5 hours at a time could of aggravated the little bugger.
SweetPea

Your struggles sound familiar!  I find that walking and sitting still aggravate my chronic fissure and it is an on-going balancing act.  I have had a number of scarey times, including right now, that I have a small amount of bleeding with BM's.  I try to remember that with on-going care these have not returned to the horrid pain of ealier weeks.  So, good for you to 'catch it' and be extra nice to your hiney.  I still use the ointment regularly.  I think I stopped too soon after my first experience with this (not knowing it was an AF, thinking hemmies).  So, I'm going to err on the side of using it for a long-time, this time! They are supposed to help relax the muscle and increase blood flow, I believe, both good for healing!
Buttastic (if you're still following this), I was curious what foods you found tended to make things worse for your AF?
Hang in there sweet pea!  I also like to remind myself there are other treatment options in the event this healing without surgery path doesn't work!