Botox and Kenalog

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Botox and Kenalog

Postby ihatethisclub » 06 Jul 2015, 17:37

After going round and round with home care measures, OTC creams, a lackluster CRS and nitro, I finally got in touch with a CRS who listened and cared. I traveled to Nevada to see him. He read up on the Feingold procedure and agreed that it was a reasonable measure with a good likelihood of succeeding, and we paired it with Botox to keep residual spasms at bay. He didn't anticipate much pain while healing, said it likely wouldn't be worse than what I've been dealing with (again, eliminating spasms is key).

I had general anesthesia. He found and cauterized one fissure and removed a fleshy papilla (sp?) for biopsy. My local anesthesia is is still in effect. I'm not completely numb, but I also don't feel any pain. The nurse had me take a percocet, but all agreed I probably wouldn't need more than Advil or Tylenol hereafter.

The worst part was the IV!

I'll keep everyone posted about my progress. I'm feeling very optimistic. Along the way of this 7 month journey, I discovered that candida/yeast exacerbates/d the problem. Keeping a low sugar, low dairy diet will be key for the foreseeable future. I need to get my gut flora in better shape.
Last edited by ihatethisclub on 07 Jul 2015, 01:06, edited 1 time in total.
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Re: Botox and Kenalog

Postby msimon » 06 Jul 2015, 19:02

Glad to hear you found someone caring to help you. Has your CRS done this procedure before? That's interesting that someone other than Feingold is doing this. Hope all goes well for you. Let us know how you are doing.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Botox and Kenalog

Postby ihatethisclub » 06 Jul 2015, 19:31

As a surgeon, he's used all of these procedures, of course, but not together in this way. He was very intrigued by the cautery/Kenalog combo and felt it made a lot of sense. What I noticed from the Feingold stories of recovery was that they continued to feel a lot of pain and spasming for weeks until healing was complete. We felt that Botox would let us bypass that and give me a greater chance of healing.

ETA: He had not heard of the Feingold procedure before I emailed him about it. I'll be following up with him and if I'm
a success, he'll be able to use it on others.
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Re: Botox and Kenalog

Postby msimon » 06 Jul 2015, 23:26

Wow! Great that you are willing to be a guinea pig and great that you found a CRS that is wiling to try something new. Those can be rare! Hopefully things won't be too bad for you before the botox kicks in. In a couple of weeks you will hopefully be pain free.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Botox and Kenalog

Postby ihatethisclub » 07 Jul 2015, 01:04

Thank you! I'm very hopeful! Before today, I had to sit just so and not move or I would set off a sphincter spasm. I lived in fear. It would wake me up at night and I'd pace the floor for over an hour sometimes until it went away. I was scared to use the restroom away from home because I'd be hit with a spasm--I didn't even have to have a bowel movement for that to happen. Just the act of sitting on the toilet and the area stretching would cause it to occur.

Today, I haven't had a single spasm. I don't know if it's the botox or the fact that the fissure is now closed, but I've had NO spasms. I had a bowel movement tonight, and of course, I was SO scared. As I said, he took off a fleshly bump and put in a couple stitches, so I'm dealing with a bit of blood, too. Anyway, had the bowel movement. Felt some stretching, some stinging and a bit of blood but it's nothing in comparison to the pain I had before. I'm crossing my fingers that it only gets better from here :) Right now I have a bit of stinging, so I'm off to take some Miralax, Magnesium, fiber, and go to bed!
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Re: Botox and Kenalog

Postby ihatethisclub » 08 Jul 2015, 23:13

Just want to update day 3. I am doing really well. The spasms are still completely gone. There is no fissure pain. I have no pain during a bm, but a little achiness after. Nothing like a spasm or shards of glass.

Right now, the stitch from the skin tag removal is driving me insane, but I'm trying to keep things in perspective. I felt so hopeless before and now I'm on my way to healing!

My rear end is a little sore and achy tonight. I think I've felt so good that I've taken on too much too quickly. I did a lot of walking today, errands, getting out with my kids. My bum needs to rest (along with my aching feet).
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Re: Botox and Kenalog

Postby msimon » 09 Jul 2015, 02:49

Yay! This is great news. Keep up the good work on healing! I know what you mean about those stitches! Mine felt like being poked with a needle repeatedly right into my incision site. I was in so much pain I could barely move most of the time (I am super sensitized down there by years of chronic pain). I also think I reacted to the stitch material, like an allergic reaction of sort. I swear I felt the moment they dissolved too, what relief!I think it was around a week to 10 days. Hang in there! Hopefully it will fall out soon.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
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Re: Botox and Kenalog

Postby ihatethisclub » 09 Jul 2015, 20:29

Day 4 update. I felt a bit spasmy after a bm late this morning. It was very annoying, though not debilitating, and it lasted about 30 minutes. I hope this is just a part of healing. I have read all different timelines for botox from hours to days to weeks. I definitely don't have a tight sphincter all day long, which I had before my procedure, so it seems to be working in that respect. The cauterized fissure doesn't give me a single twinge, thankfully. I can't feel it at all.
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Re: Botox and Kenalog

Postby ihatethisclub » 25 Jul 2015, 13:23

I'm 2 weeks and 5 days post op. The fissure hasn't caused me pain since surgery (he cauterized it and injected kenalog, a la Dr. Feingold). As of two days ago, the spasms have calmed radically. I'm not sure if this is because of the Botox (which I thought was to take effect earlier), or if it was because the fissure wasn't causing pain. However, about a week ago, I developed a very painful thrombosed hemorrhoid. It pops out after a bowel movement and gradually recedes. I'm not sure what my next step is. I have an email into my doctor, who is an hour away by plane. I'm just crossing my fingers that this go away as I continue to heal.
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Re: Botox and Kenalog

Postby msimon » 25 Jul 2015, 15:30

Glad to hear the spam pain has improved. This is likely due to both the healing of the fissure as well as the botox kicking in. It usually takes 2 weeks to kick in to a noticeable extent. As for the hemmie, that sucks. Although, it is not uncommon for one to flare up with a hemmie or two following botox. Not sure why but it is a common finding on this forum. Thrombosed hemmies usually resolve themselves within a couple of weeks as the clot dissolves and the body reabsorbs it. Hope you feel better soon.
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain
msimon
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Posts: 1343
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