Hi all,
Have had a few other posts in the past. Years of AF that would come and go, until finally it just came and never went. I had regimens as many of you do with all sorts of different diets and things to rub on said area. It became so bad that I decided I needed to bite the bullet and have surgery.

Looked into Botox -- got 3 different opinions on it and from what I read in the literature, didn't seem like a long term option. I almost did it regardless because it's obviously not permanent, but given the wide variety of different doses etc I decided against. Some get 25 U, others 100 U. They say that the worst case scenario is temporary incontinence with a whopping dose, but 3 months of incontinence would really suck!

I was literally googling my CRS's phone number late one night to call the next day to schedule LIS when I stumbled across the Feingold/Kenalog discussion on this forum. Living in NY, I decided I should look into it. I've been waiting to post till I had more to say, but thinking how desperate I was, I thought it only right to do so now since I don't think there have been many first-person posts on it. Basically, he scrapes out the AF under anesthesia, cauterizes it, and injects kenalog (a steroid). No sphincter division.

Here are my thoughts:
1. Feingold - a great doctor. Great bedside manner. Gentle exam. Parking at NYPH is a b!tch (an expensive one). He spent all the time I needed to ask him questions and get booked for surgery. He accepted my medical insurance no problem.

2. Immediate Postop: I woke up in recovery and Man Alive was I loose! I was flatulating left and right in the recovery (NO PAIN) area in front of the nurses. I was a little embarassed but not really. It felt so good and natural to have gas come out so easily. For the past few years, passing gas felt like blowing up one of those old, hard balloons that doesn't stretch.

I was completely numb in my whole butt which was actually quite unnerving because even touching the area with toilet paper just to 'check it out' I couldn't be sure if I was scraping/damaging the area. It was pretty much numb the whole first day. Before bed I had some sensation but still numb centrally close to the site of action.

I took some asSelfies and noted quite a bit of bruising and swelling but most of this remarkably went down in the first few days.

3. First BM - I think regardless of what you have done you live in fear of this first BM. It wasn't painful, though wasn't bad. I wish I had documented my actual impressions, because I've forgotten them mostly. I do remember being afraid and that it was a little sore and felt like I had to squeeze a bit. After the first one was done, the rest became easier though it probably took a month or so to get to where I wasn't very nervous. (Though I still am now, over three months out)

4. Blood - Blood was the hallmark of my AF and I was doing it regularly beforehand. After surgery, I definitely oozed a bit for the first couple of weeks. I kept a balled up toilet paper in my underwear to catch it all. After two weeks, it was very sporadic postop oozing, and no more AF bleeding (knock on wood).

5. Tightness - I was also very tight with my AF and had to squeeze my BMs out. For the first few weeks after surgery, I continued to feel very loose and it was wonderful. I had some of the biggest BMs I've ever remembered having. Right now, I'm definitely not tight like I was before, though I'm definitely not as loose as those first few weeks after surgery. All in all, I think I'm at a happy medium considering the next point:

6. Continence - Never truly was incontinent, though for the first week, I had to be very careful before I let out any gas because often times I would drop a little poo. I'm not talking having a whole marching band sneak out, but certainly I would have small small bits come out with gas sometimes. In the weeks after I would sometimes have some minor leakage around the area if I wiped (though who knows if I had had this before; I never tested!) to check randomly through the day, but it was never enough to smell or hit the underwear. This may have been related to flatulence, too. Beyond one month this has pretty much stopped, which is probably a good thing because I'd say my sphincter tone is at a good level. I am not at all fearful of losing control of my bowels and have perfectly strong ability to hold it in if I need to. (Though I try like the dickens not to!)

7. Time off Work/Postop Pain - He recommends about a week. I took 5 days off. Really had very little pain postop. I could have gone back to work but definitely enjoyed the time off staying home and catching up on Walking Dead. It was mostly just sore a little for the first week, as it would be if I had a bad AF day. (I was fortunate to never have disabling pain after a bad AF tear. Rather, I had a lot of pain when moving bowels, but afterwards I was able to function during the day.). I didn't use any Vicodin postop; only advil. Spasms -- didn't have many of these every (fortunately). I had a few in the weeks after surgery, though were mild. Nothing terribly, but I'd suddenly feel it squeeze a bit, and then release a few seconds later. Nothing really painful.

8. Where am I now - over 3 months out and ecstatic with my choice to get this done instead of LIS. Of course time will only tell what happens in the future. I'm not fully healed, I would guess, and don't think I'll ever be able to truly let my guard down, but I'm getting my life back. No longer living in absolute fear of the daily BM. I still do approach it cautiously because I know that one errant hard push could throw me back to the ground. But I generally don't have any pain any more. Sometimes I'll have a hard BM and this stretches things a bit and is a little irritating and uncomfortable, but definitely manageable, and no blood (knock knock). My remaining regimen includes a token small dose of metamucil (I resumed too much after surgery and caused really big stools), colace, and lots of water. I also do sitz baths once or twice daily. I pretty much eat whatever I want, which is generally healthy, though I do again indulged in a bit of candy and ice cream. I drink alcohol without as much concern (though I haven't pushed it; alcohol usually causes big problems when I do too much). I'm not rubbing all sorts of concoctions of herbs/oils/lotions on my butt.

He professes having ~100% success rate. We'll see how things go in the next year. I could have been at this same point with Botox I suppose, though Botox's long term success doesn't seem great.

I plan to keep doing what I'm doing. I'll probably stay on colace for a while. I never tried it before, but I do like it and think it's probably helping keep things calm. Will do my best to periodically update. Good luck to all of you out there, and I'm happy to answer questions. If it wasn't for you all, I would have gone ahead and had an LIS! (Which, for those having done /contemplating it, doesn't sound like a terrible option and I was actually ready to do it. The literature on it is actually quite good.) Though I had this other option available and I took it instead.

Nobody replied ? Are you guys kidding me? This is the best solution before lis.

Hi Idontknow, I'm so glad you posted about your experience. It sounds great, and Dr Feingold sounds like a wonderful doctor.
I would definitely consider this if I still needed treatment.
It will be interesting to hear about your progress as time goes on - it sounds very promising so far. Please keep us posted.
I wonder if you would have got more response if you posted in the Success Stories forum. But maybe you feel it's still early days.
Anyway, thanks for posting.

I think nobody is reading, it's not my experience. I am also another patient who wants to get rid of this fucking illness. I don't know, old people must have some cure for this. They solved everything by nature but we still don't know anything. Please, if anyone has a secret remedy/solution, please send me a direct message!

I'm sorry to say its not 100% effective. One of our board members asdf had it done by dr feingold, and unfortunatly it didn't work for him.
I would be very interested for your outcome though ...... Please update!!

I wish you all the luck with your healing!! Fingers crossed.

OMB

How's the saying go? Nothing in life is guaranteed except...
Yes 100% success for anything is not realistic. From what I've read asdf didn't succeed with kenalog but also wasn't a straight-forward AF (due to a botched hemorrhoid surgery, per old post). So I'll revise my original statement (because I did ask him about this) and say it's close to 100% with primary (ie: not due to another surgery and never been operated before on) AF. Even with this modification I'm sure it's still not really 100% but if he can get anywhere close to that, it's quite wonderful considering it's not a destructive surgery. (No muscle cutting)

We've all done/tried things that seemed to work but ultimately failed. I sincerely hope this isn't one of those, but only time will tell. This hasn't been a fast process and I'm not trying to present it as one (though perhaps the Magic title was a bit misleading). I have high hopes though so I wanted to share. I'll post in future with updates.

Not all live in ny.

Phtgrphr: All so well said!! I only have a minute right now to post here, but I very recently had Feingold's treatment and am very happy with how my recovery is going. I will share a more thorough post tomorrow! So exhilarated to be finally close to getting my life back! So far I highly recommend this procedure!!! :). Wanted to thank you for your great post about it!!

LorraineJ, I'm interested in hearing about your recovery. How are you feeling?

Hello! Well...I've had ok days and bad days where I wa at maybe an 8 on the pain scale. This is bc my stools were very hard and caused a great deal of pain. I believe this was bc of the strong pain reliever (Ketorolac). That's even w taking a stool softener 3 times a day. But that med is only for the first 5 days, then you are to take Ibuprofen. One day I took the Vicodin and not only took it without enough food (along w the Ketorolac which requires food in stomach) and I was so sick and nauseous along w my usual pain...I was miserable! But it was my fault...lesson learned.
I've spoken to the Nurse twice and she assured me both times that all symptoms are normal and I have to be patient with the recovery time. It's only been nine days, so I have to deal. I think since I stopped the prescribed pain meds, my stools are a little easier.
So overall, it's sort of been a roller coaster, but I'm ready for the ride. As I've said to my family and friends, I'm going head to head with this fissure and will NOT let it beat me down like it has for the past year.
I'm trying to remain strong, brave, patient and positive. I had two children without drugs and this fissure has been sooo much worse.

I must also mention that I had a fistula with severe inflammation. Which by the way previous colorectal surgeons did not see or ever mention the possibility of me having. Dr Feingold took care of it when I had the procedure for the fissure. He also removed a skin tag. All in one shot. I do have hemmorhoids as well so that could be part of my current pain as well. He said we can talk about those once I'm fully healed.
I will post updates as I heal.
Wishing everyone courage and support. I now understand pain on a whole new level and want to help others any way I can. Feel free to ask questions.
SORRY FOR THE VERY LONG REPLY...just felt like all those details were important to know.
:)