How often do you use Diltiazem / and how do you do it?

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How often do you use Diltiazem / and how do you do it?

Postby rw76 » 18 Sep 2013, 10:38

I had to beg my first (horrible) CRS for Diltiazem ointment. THe first time I used it I had itching but that since has gone away.

My directions say small amount as often as every 4 hours. Isn't that too much It is 2% ointment.

I started on it yesterday - had pain in the AM after a BM but I felt almost normal in the afternoon.
Of course this morning BM has me in pain although not as badly as last week when it lasted all day and all night.

My second CRS also gave me Valium 2mg and yesterday it seemed to helped. This morning maybe not so much because I am in spasm hell but then again 2mg is mightly small dose I think.
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Re: How often do you use Diltiazem / and how do you do it?

Postby rw76 » 18 Sep 2013, 10:59

ALSO how long does it take to really kick in and tell a difference?
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Re: How often do you use Diltiazem / and how do you do it?

Postby Scientist2516 » 18 Sep 2013, 12:38

I used it 2 times a day, in the morning after a BM and after my shower, and evening before I went to bed.
Mine was 2% also. It seemed to make a difference within a day or two.
I used to try to put it up inside (but never could tell how much was actually getting inside).
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: How often do you use Diltiazem / and how do you do it?

Postby rw76 » 18 Sep 2013, 13:04

Thank you! I think it is making a difference. I am still in pain after BM in the AM which thankfully I seem to now have been able to do 3 days in a row in the early AM. Yesterday I was in pain until about 4pm. Today pain seems minimal at 1:00 and was less than in previous days overall. The new CRS also gave me valium 2mg which is a tiny dose but that might also be helping. Last night I felt totally normal for the first time in this week of hell since I have had the fissure. Thank you thank you for your response you are always so helpful!
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Re: How often do you use Diltiazem / and how do you do it?

Postby Scientist2516 » 18 Sep 2013, 14:03

So glad to help. This forum has made all the difference to me, and it's nice to pass some of that on.
I want to put a smiley here, but don't see any!
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
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Re: How often do you use Diltiazem / and how do you do it?

Postby Ever the Optimist » 18 Sep 2013, 14:36

Hi Scientist,
You have to click on "Full Editor" below to get the smileys! but I can't see any other emoticons at the moment?
RW76,
I used Diltiazem in exactly the same way as Scientist and at the same times of day, although you can apply it after additional BMs too. I applied a toothpaste type streak from the tip of my finger down to the first crease and always tried to apply it as internally as I was able to.
I noticed an immediate effect also in pain relief after only a couple of days and I have to say it was my life saviour!! I got better and better using it through my whole 7 weeks. My fear was stopping it - but I didn't need to worry because the pain didn't come back & although not completely healed still, the fissure had healed enough to allow me to continue the recovery process without any of that initial horror!......I truly hope this works for you too & definitely persist with it if you are beginning to feel better... :)
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: How often do you use Diltiazem / and how do you do it?

Postby rw76 » 18 Sep 2013, 14:51

I was really worried that it didn't seem to help the first time I put it on - I am glad to hear that it is a process over a few days. I am still in pain but less so and I am starting to have times where I feel normal. I am guessing that is progress.

I always have a hard time with gas - and not confusing the pain with the need to go. It is horrible having preassure and needles feeling down there. I did notice though that when I was pain free I def. did not have any feeling like I was needing to go so it must be the spasms.
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Re: How often do you use Diltiazem / and how do you do it?

Postby Ever the Optimist » 18 Sep 2013, 15:14

Hi Rw,
No it takes a few days to really kick in and if you are already feeling less pain, that's a great sign. Honestly, just stick with it & have faith it's working for you......
I also understand where you are coming from with distinguishing between gas and the need to go with a fissure because of the intensity of the spasms and that "pressure feeling" it causes in your bottom! I actually found for a while that I was unable to pass gas properly when that was really intense - I don't know why - perhaps because things were too tight/ tense down there that I couldn't even pass gas properly??.....but this does pass.
To get through this stage, I worked out when I generally had BMs in my day and kind of stuck to those times (the morning was always easy because I've always been as regular as clock-work first thing!) I used to struggle later on in the day....Key for me was being relaxed and trying not to worry & stress about it - I've also learnt now to try not to anticipate BMs because they only come out when they are really ready and you should be able to feel the natural urge when you really need to go. If you've got a good soft stool diet going then it will naturally fall out anyway and you shouldn't need to be excessively straining too.
If I was unsure, I would just go to the toilet anyway, take a few deep breaths and if nothing happened after a few minutes, I knew it wasn't time and I'd end up going a little later.......Being relaxed really does help the process and plotting times when you think you are generally more likely to go in your day...
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: How often do you use Diltiazem / and how do you do it?

Postby Scientist2516 » 18 Sep 2013, 15:56

rw, are you trying heat? I use a hot water bottle - very warm, but not hot. It helps the spasms tremendously. Also, I read a scientific paper that showed that heat reduces the anal resting pressure - which is what diltiazem does too.
Even though I'm not getting spasms any more, I still use the hot water bottle, because I'm certain it aids healing.
Good luck!
Nifedipine/lidocaine, no help
Diltiazem, effective, but caused major rash
Nitroglycerine, effective.
Topical estrogen for final healing.
Gentle heat to bottom - pain relief, muscle relaxant
Kondremul mineral oil
Time - lots of time.
Status - Healed!
User avatar
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Re: How often do you use Diltiazem / and how do you do it?

Postby rw76 » 18 Sep 2013, 17:27

I do have a heating pad that I keep in the area as well as baths. Doesn't seem to totally take it away but it does help some. I think just the fact that my fissure is so new is what is the problem here :( Sometimes being in bed hurts more than being up. What is up with that? This is so crazy. I have to say although I am still not well I feel I am slowly improving. I have to trust that I will get well and go back to feeling normal again. I am so glad I caught it early. I pretty much knew something was really wrong last Wed - and on Thu I saw the first (Horrible CRS that diagnosed me) and then yesterday saw the one I really did like and whom I trust. Surely just knowing what to do will help me heal. I am also loosing a ton of weight. I guess there is something positive for all the pain we endure!
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