Can I get a procedure done w MDS and low neutrophils?

Hope someone can help me w this latest problem..

I have mds and low wbc rbc platelets and iron. I had been on oral iron without issue, until i ran out of pills and had like a week gap before getting a new bottle. I just went right back into taking them which was a mistake since I ended up getting an anal fissure from the constipation it caused which has been incredibly painful to say the least. Of course from now on I will only get iv iron.

I have been dealing w this fissure since beginning of June, but had some relief w some special ointment and strangely enough getting a botox injection (yes, right in to the anal muscle ouch). I had partial relief and then it retore and I am terrible again. My colorectal doctor says I need a procedure done at this point becuase the less invasive option didnt work. When I tried to get clearance, my hematologist denied me because my neutophils ANC went too low at 0.7. Also, I lost a ton of weight from this, which is bad beause I was already really thin.

I understand the risk of infection and this scares me too. I have an apt w my hematologist to talk about options/make a plan .. but I just wanted to understand what some options may be for me and if anyone had a personal experience to share. I read about neupogen and how that may temporarily raise neutrophils so that I could get a procedure done. But I am worried because online it said using neupogen is more complicated for someone w mds. And I am worried that the neutrophils may not stay higher long enough to protect me from infection through all the time I will need to heal. Ideally I would want to wait until the neutrophils go up (I am still hopeful) but I am just in a lot of pain and don't know what I should do.

Has anyone with low neutrophils been able to get a surgical procedure done? What extra steps did you need to do? And did everything end up working out?