So, I go to the guy, he say's the State requires a call to my general practitioner (or a note) to make sure I am in "good health" (another words, "my poop is Grade A").   My doc says,  WTF, no way am giving approval for this.    I tell him I'm gonna do not want the pierce through the sphincter muscle itself rather only the skin that covers & protect it- in the butt-nub area.  
He says:
 "what are you PICK3 or something"
Bwahaahahahahahahahahahahha!