Hi there,
It's about time I shared this experience with you all. At the time this happened I was a UK citizen staying in Boston MA with my girlfriend.
In October 2018 I decided after 10 years of an annoying anal fissure that it was time to get it fixed. Pain-wise it hadn't been too bad, but every now and then it would sting like crazy and bleed. I would use diltiazem gel to treat it, this would alleviate the pain and I'd forget about it for a month or two. I researched the common LIS surgery and decided that this was not for me at this stage, the risk of fecal incontinence was something I did not want in my life. So I stumbled across Dr Feingold with his Kenalog protocol. This sounded like it was something new that really could work. So I went to New York and had an appointment with the man. He assured me it was a minor surgery and I could travel back to Boston on the train right after. If the surgery failed then the LIS was still an option after all.
So I went and had the surgery one morning,and got the train back home that evening. Took the vicadin and everything seemed fine. So far so good.
I was warned things were going to be sore for a while, so I took plenty of fibogel (psyllium husk), did daily sitz baths as instructed. There was some bleeding when passing stool and mild swelling in the area. This lasted for about 10 days or so. Apart from not being able to sit on my butt, it wasn't that bad. Then I started to get some increased pain. I contacted Dr Feingold by email several times and it would take him a couple of days to reply, I also sent a nurse there an photo of the area by email they said it looked fine. So I stay at home and wait it out, I checked my temperature regularly, it was normal.One day (maybe day 12) the pain increased even more and I start to get an ache near my balls, I phone Dr.Feingold and he tells me to go to hospital because I have an abscess that needs to be drained. I wait at home for 15 minutes for my girlfriend to come home and help me get to the hospital. At this point I go to take a look at the area in the mirror and realise that my scrotum and penis look light swollen. I calmly say "we need to go to hospital right now'. We get a taxi, I end up at a major hospital in Boston. I get into the ER and they have me under an CT scanner pretty quickly. I had a necrotizing infection. That's right , flesh eating bacteria you sometimes read about or see in documentaries.
I'm completely terrified. They ask me questions like have I stuck anything up there or had gay sex. I tell them no, just the fissure surgery! I go into surgery immediately, they had to remove a small amount of my scrotum on the left and also some fat from my left butt cheek. I had a 21cm incision from my scrotum round to my buttcrack. I was in hospital for a total of 9 days, I had 5 surgeries to remove all traces of necrotic tissue. I was on multiple IV antibiotics and I was on dilaudid or oxycodone most of the time.
I was extremely lucky I did not lose a testicle or my penis or die. It was horrific. The wound in my buttcheek had to have some kind of drainage tube hanging out of it for a couple of weeks after I went home, which they eventually removed and it closed up.
I guess the main thing is I survived, although my balls are slightly wonky now, the scar is a little uncomforable. At least everything else still works. And previously nobody ever said 'hey that's a beautiful scrotum you have there!'. I have to laugh otherwise I would have probably cracked up by now.
I also developed quite severe IBS-D as a result of the antibiotics used to treat the infection, so there was zero chance of the fissure healing because I was constantly sat on the toilet. The IBS is still with me 2 years later. I had relief from the IBS after going on a clinical trial for Blautix (4D pharma), but 6 months after the trial ended the IBS returned, so I'll have to wait for that one. I've had to go on a low FODMAP and sulfur diet to control the symptoms.
Currently I'd say my fissure pain is x2 worse than before the surgery and it bleeds much more often. I also have to take ibuprofen and acetaminophen/paracetamol in the mornings. I have tramadol on standby if it gets really bad. I'm also back to using nitrtogylcerin cream while I wait to see a specialist. I sincerely regret having this procedure done, and its taken me quite some time to be able to relive the experience and write this post. If you have any questions just ask.
I urge anyone thinking of trying the Kenalog protocol to think long and hard about it. The doctors in Boston said they see this type of infection a lot with steroid users as the steroid (kenalog in this case) inhibits the immune system and allows infection to get in. I still have the fissure by the way, the surgery was unsuccessful in repairing it. Doctor Feingold was unphased by my ordeal. He only called me once several weeks after the surgery and didn't really have much to say for himself except 'sorry that happened to you'. There was no interest in the outcome of the initial surgery at all. I've never spoken to him again since.
I cant seem to add jpeg photos of my CT scans here but if you are interested please see my reddit post here:
https://www.reddit.com/r/AnalFissures/comments/i3768w/dr_feingold_kenalog_protocol_absolute_disaster/