Haemorrhoidectomy - sharing the experience

I thought I'd share my experiences of a recent haemorrhoidectomy, in the hope that they may be useful to others. I've certainly appreciated the accounts of others who have kindly shared their thoughts.  

My problems with haemorrhoids date back some 20 years. In the past decade I've had two treatments of injection which have provided only temporary relief. Having concluded I was thoroughly tired of the inconvenience and discomfort of prolapsing haemorrhoids, I got myself booked in for surgery. As you’ll see below, my operation removed three haemorrhoids. 

I am, by the way, male and in my mid-forties and I keep myself in reasonable shape (regular gym goer) and have a good fibre and nutrition rich diet.  I live in the South East of England and had the operation in a private hospital with a surgeon who’d operated on me earlier in the year to repair bilateral inguinal hernias. 

Day Zero (Monday) 

I was out of the ward for approaching two hours. The surgeon had told me the procedure would take between 20 to 45 minutes depending on what he found. Seems like, in my case, it was closer to 20 minutes. I'd been told that they'd want to keep me in for three hours after the op and ensure that I'd managed to eat and drink and go for a pee. Having been nil-by-mouth since 0800, once the usual grogginess of the anaesthetic had cleared, I was guzzling water and it wasn't long before I felt like eating. After having consumed what seemed like endless glasses of water, I finally felt like peeing. Getting out of bed for the first time after an op (I've had a few over the years) is always a little daunting but I felt okay if a little light headed. Standing by the loo and with a little concentration, the pee flowed. Uncontrollably, I also passed some wind which was accompanied by splattered drops of blood. The nurse didn't seem phased by this, saying it was perfectly usual. She said I could expect to pass blood for a few days on bowels movements. Apparently I also had a dressing inserted (cylindrical packing) which would probably pop out the first time I went to the loo. They gave a pile of gauze dressings to put inside my underwear to protect from the blood spotting that I was told to expect.  

So off I went home. I was aware that the local anaesthetic would wear off something after like 12 hours so, although I felt reasonably comfortable at that time, I was rather fearing what was to come. I'd been warned (by the consultant, in particular) to expect a lot of pain. I was given a supply of ibuprofen and cocodamol (paracetamol and codeine combined into a single tablet). Codeine of course can (and likely will) cause constipation, which is really the last thing you need at a time like this. So I resolved to avoid it if at all possible.  

For reasons unknown, I'd been suffering for several days from trapped wind and generally feeling bloated. Not a comfortable condition at the best of times and certainly rather inconvenient post operatively. Passing wind in such circumstances is something that requires care; invariably, some liquid is also passed so conducting the procedure sitting on the loo is essential. To my frustration, I needed to repeat several times. I took ibuprofen and went to bed and eventually dropped off to sleep. I had to get up around four times during the night to pee. I think I was unable to fully empty my bladder perhaps due to the after effects of the anaesthetic and probably because I was feeling sore and being ultra-careful.  

Day 1 (Tuesday) 

I awoke and felt reasonably comfortable and relieved that, so far at least, the anticipated intense pain hadn't materialised. I wasn't looking forward to the first bowel motion, however. By all accounts, that's when the pain really kicks in. I'm usually very regular in the morning but I'm guessing a combination of having been nil-by-mouth and anaesthetic had slowed things down. I sat on the loo and all that happened was mostly wind. I think the dressing popped out. It was either that or a very thin and regularly shaped stool, which I rather doubt. I gingerly wiped up (thank goodness for moist toilet wipes). In a while, I showered (which provided the chance to clear up rather more thoroughly).  

For the rest of the day, I took some pain relief (ibuprofen and paracetamol; no codeine). Much of the discomfort came from the aforementioned trapped wind. Eventually I caved in and took a tablet to treat this, but it didn't have much of an effect. 

The remainder of the day was uneventful. I ate plenty of fruit and a surprisingly hearty dinner (which included lots of veg). There was the occasional wind-breaking operation, after which I needed to clean up using the moist wipes as some blood was passed; I was glad of the underwear protecting gauze. I should also mention I placed old towels everywhere I sat, plus on my bed, just in case of heavy leakage. 

As bed time approached, the wind episodes increased in frequency. Each a minor procedure in itself, as previously described. After going to bed, it became particularly frustrating. It seemed that as soon as I lay down, my bowel dispensed a pocket of air downwards. I'm not sure about you, but wind pressing up against the anal sphincter is never comfortable (maybe haemorrhoids had been making that worse? I guess I'll find out) and especially so after surgery to the anal canal. So I'd pop off to the loo for the usual wind passing rigmarole. Back into bed. Within seconds, the same intolerable feeling. Cutting a long story short, this went on for an hour. I must have run-around that loop at least 10 times. I was starting to get a little desperate. How much air can one (slim) abdomen hold? A surprisingly large amount, it turns out. I'd love to know how much air I passed. It must have been a good litre or two. It was, by the way, the foulest smelling flatulence I can recall experiencing. Maybe that's what happens when you have decomposing blood added to the usual contents of a bowel.  

After what seemed like an age, all wind was passed and I dropped into a good sleep.  

Day 2 (Wednesday) 

I woke feeling comfortable. The wind issue was no more, I was relieved to discover. I did, however, feel like my bowel regularity was likely to reassert itself. I took ibuprofen and paracetamol, even though I had little or no pain. I was anticipating the widely reported agony of a bowel movement and I was anxious to soften the blow as much as possible. 

The time came and I kept in mind two things I'd picked up from the posts of others: 

Remember to breathe. 

A bowel movement should be involuntary. With regard to risk factors for suffering the onset of piles, I'd always considered myself to be in good shape. I have a good diet and, I thought at least, I didn't strain when going to the loo. I now realise that over the years I'd fallen into the habit of adding a conscious push. Allowing it to just happen is a really important tip; for everyone and in particular, for those who have just had a haemorrhoidectomy.  

So I sat and waited for nature to take its course and braced myself for pain. Things started to move and a few stools of reasonable size dropped out. So far so good and while not particularly comfortable, it wasn't as painful as feared and no blood in the pan. It felt like there was more coming so I sat and waited. This is where in the past I'd have been tempted to have pushed. I think it's my busy lifestyle: I'm always in a hurry and I've probably habitually tried to speed up everything in life. Turns out that then it comes to going to the loo, patience is a virtue. Some things just can't be rushed. Another involuntary motion came. It was uncomfortable but not particularly painful although my bottom was starting to smart. It was similar to the feeling one gets after a particularly unpleasant bout of diarrhoea; a distinctly sore feeling. I remembered to be patient and once I was sure that that was it, I cleaned up (those moist toilet wipes where once again a godsend). Others have said they've sat in a shallow bath (perhaps containing salt) but I didn't much fancy that. Instead, after a while, I had a cleansing shower.  

The remainder of the day was uneventful and reasonably comfortable. The advice is to keep the area clean so I took another shower before bed. I slept well although I awoke during the night to pee and was a disappointed to discover my bottom was still weeping a slightly bloody liquid. Clearly gauze underwear protection was still necessary. I also became aware of some external swelling. I started wondering if the surgeon had left a pile in place and that I was inevitably destined for further surgery. After a while, I put it down to a case of pre-dawn anxiety and resolved to wait and see.  

Day 3 (Thursday) 

Not long after I awoke I felt the need for the toilet. With the golden rules in mind of remembering to breathe and not adding conscious muscular effort, I headed for the bathroom, mentioning to my wife that I may be some time. This time, progress was slow and frankly, quite painful. Not excruciating but not at all pleasant. Each involuntary push was accompanied by a stinging sensation and punctuated by a few minutes of inactivity. Before now, my impatience would have kicked in and encouraged me to push in an attempt to speed things up. This time, however, I was aware of the need to let nature take its course in its own time. So I sat it out, although I found that standing (carefully!) seemed to encourage the next round of contractions (although perhaps that was just my imagination) each accompanied by a steadily increasing stinging. After about 45 minutes, the task was complete and I had that sense that there was no more to come. I wiped carefully (the ring was really quite sore and swollen) and got straight in the shower, to complete the clean up. Taking a shower is generally a pleasure and this occasion was certainly no exception.  

I felt quite drained and a little faint. Figuring I needed to up my blood sugar, I had porridge and a vitamin and glucose solution. The morning was spend dozing until eventually at around midday I felt normality returning to my energy level. Throughout the day, I experienced occasional spasms. It felt like my anus was drawing in on itself, not unlike the feeling of a prolapsed haemorrhoid being drawn back in. 

So far I’ve taken fewer pain meds than prescribed. The routine has settled into ibuprofen, 400mg three times a day and 1000mg paracetamol just once in the morning, in anticipation of a bowel movement.  

Advice is to keep the area clean so I took a shower before bed. I was still using gauze as an underwear protector and certainly needed to, with my bottom continuing to ooze. I changed the gauze after the morning and evening showers. 

Day 4 (Friday) 

Awaking from a restful sleep, I took doses of ibuprofen and paracetamol in preparation for today’s bowel movement. I'd not long been out of bed before the urge took hold. In a post I read someplace, the writer urged caution with laxatives warning that their use could be counterproductive if you're usually regular and reasonably loose. I am, but I can tell you don't bank on this post operatively. I'd been being conservative with the Lactulose, thinking the same. Today, the motions were pretty firm and really rather painful. The whole process took an hour of perhaps 10 cycles of motion and pause. At first, a stool was in mid passing when the contractions paused which added to the discomfort. I took to standing and eventually pacing around in an attempt to encourage the next bout of motion to kick in. I must confess it was somewhat of an ordeal and it left me drained and sore. I cleaned up a bit with moist wipes, finishing the task in the shower. No blood had been evident in the bowl but there was some on the wipes. 

I took a glucose supplement, took a full dose of Lactulose, had some light breakfast and crashed out. My wife said I looked pale and exhausted. Three hours of dozing later, I felt rather more like myself once more. I experienced the occasional spasm while dozing, which was occasionally quite uncomfortable. Oozing continued at a similar rate to previously. As before, the ooze was bloody and smelt particularly foul. I wondered if this was normal for this stage. 

Day 5 (Saturday) 

Another day closer to recovery. I started the day with the usual dosing of paracetamol and ibuprofen, in readiness for today’s bowel motion. This came within 15 minutes of getting up and, thank goodness, was easier than yesterday. It was all over in 20 minutes and four stages. While rather uncomfortable and painful at times it was nowhere near yesterday’s excruciating experience. I felt fine afterwards, particularly after a cleansing shower and was ready to get on with the day.  

Pads were still necessary as my anus was still oozing a watery, bloody liquid. I noticed that it was smelling less foul now as was flatulence. I was wondering when the oozing would cease or at least slow. 

By this time, could imagine going back to work. I work in London but live an hour or so away. This week I’d been off sick and I’d planned to take next Monday off as holiday. Now, I could imagine getting back into the usual routine by working from home on Tuesday and perhaps going back into the office the following week. 

Day 6 (Sunday) 

It was starting to feel a little Groundhog Day-esque. Today’s bowel motion was much like yesterday’s: painful and uncomfortable and took around 30 minutes but at least wasn’t as bad as Friday’s. Although it did come at the rather inconvenient time of 0530. The formula for pain relief remained the same: ibuprofen and paracetamol to start the day, one or two re-doses of ibuprofen throughout the day (especially before bed).  

Oozing continues at a similar rate. It increased in the evening with more blood content. Passing wind is still rather inconvenient as it’s still accompanied by bloody liquid. I wondered whether this was normal, six days post-op; glad that I have a follow-up appointment with the surgeon on Tuesday. 

Day 7 (Monday) 

Monday was a pretty awful day, not necessarily because of ongoing recovery but because I spent around four hours in tremendous pain resulting from abdominal cramping. It eased in the afternoon but by that time I had an appointment booked with my GP so I went along anyhow in case the problem returned. He had a feel of my belly and decided it was probably due to bowel spasms, prescribing Buscopan (hyoscine butylbromide). I took two straightaway and decided to only take more if I felt a hint of cramping (I didn’t). 

Day 8 (Tuesday) 

I saw the surgeon for the first post-op follow-up; he was pleased with progress. He told me he’d removed three piles, each with an incision of around 2cm. He said I could expect oozing to continue for four to six weeks post-op. He thought that my recovery was being aided by showering after a motion and again before bed i.e. making every effort to keep the area as clean as possible.  

Bowel motions are getting easier but are still decidedly uncomfortable. I had three today, the last of which was quite loose (I’ll cut down on the Lactulose). 

I did some very light work today (I'm office based and can work from home). I guess it totalled 30 minutes or so, but felt like a good start. 

Day 9 (Wednesday) 

Started to feel more like my old self today. The morning’s bowel motion was easier; still mildly painful over in a 10 minutes or so. It was preceded by a fair about of wind, which when passed was accompanied by the now usual moistness. I do look forward to once again being able to fart with impunity!  

I did roughly a half day’s work and felt reasonably productive. 

Day 10 (Thursday) 

Another good day. Did what amounted to a full day’s work and was productive. Still taking ibuprofen and paracetamol, of course. 

Day 11 (Friday) 

Challenging day today. My bowel decided to move at 3am, so I went through the usual rigmarole. The stools were pretty firm resulting in a more painful experience than of late. I’d just finished up the whole process and got back in bed and lo and behold, the urge to move came within a minute of laying down. So back to the bathroom to repeat, including showering. All told I lost 90 minutes of sleep and when I finally got back into bed I was rather sore and had occasional spasms, which resulted in poor quality sleep. I was up again at 0700 with another similarly uncomfortable motion. At 0930, motion number four came along. Bowel motions at this time certain rule one’s life: I had to postpone a conference call at late notice due to the last one. 

So, in short, a disrupted night and a tough day of feeling tired. I still managed to get a good day’s work in, however, and I think I was reasonably productive. 

I was really starting to look forward to being fully healed and yet, that felt like it was still some way off. Hoping tomorrow is better. 

Day 12 (Saturday) 

A good day today. The morning’s bowel movement had a hint of normality about it. If previously, they’ve peaked on the pain scale at around eight and settled on average to around four, today’s was at perhaps two on the scale. I felt quite energetic, easily managing a 5km walk in the afternoon. I wore my fitness band for the first time since the op and clocked up 13,000 steps during the day 

Day 13 (Sunday) 

This morning’s bowel movement was a little more challenging than yesterday’s but still not too bad. A little firmer and I’d say it was around three on the pain scale. Needless to say the discharge continues but overall the indications are encouraging. I still require more sleep than usual; I’m not feeling the need to nap but nine hours during the night seems to be what I need right now. 

Day 14 (Monday) 

More progress today in that I dipped my toe into a return to commuting to work. I went into London for a meeting, albeit making life easier for myself by having my wife drop me off and pick me up from the local railway station and by getting taxis to/from the venue in London. I felt fine throughout and didn’t suffer any ill effects. Although it was touch and go as to whether I’d make it; it was all down to whether the morning’s bowel movement would be over in time. It was, just (and not too uncomfortable at perhaps “two” on the pain scale). This came after a false start having been awoken at 4am by threatened movement, but which it turns out came to nothing.  

Anyhow, once the meeting was over I returned home and worked from home productively for the remainder of the day. 

Day 15 (Tuesday) 

After yesterday’s exertion I got an early night and had something like nine hours sleep. Today’s bowel movement was the closest to normality that I’ve experienced so far. At this time I’ve stopped taking Lactulose but I am, of course, still taking care to eat plenty of fibre and drinking many glasses of water per day. 

At this stage, the things I was looking forward to were: 

Being able to stop planning ahead for pain relief meds in advance of a bowel movement. I think I might be almost there. 

Ceasing of the weeping and no longer needing to use gauze to protect underwear. I’m guessing there are a few more weeks of this to come. 

Being about to pass wind without the need to mop up passed moisture. Again, this is probably a few weeks away. 

Day 16 (Wednesday) 

Boy, what a day. Turns out stopping taking Lactulose was somewhat premature. I suffered from constipation today. I must have gone to the loo nearly 20 times all told. Each time, I’d feel like my bowel was moving and a large stool was being passed but little or nothing would emerge. It was really uncomfortable: I felt like I was sitting on a hard stool, trapped in my anal canal (I’m guessing that this was indeed the case). Eventually in the mid-afternoon, I finally managed to empty my bowel and gosh what a relief it was. The good news was that little or no blood was evident throughout and the act of finally passing the stools wasn’t too painful so I think that bodes well for my general state of healing. For the remainder of the day (and indeed, night) I suffered from copious wind, which was occasionally uncomfortable but nothing in comparison to constipation. 

I need to get back on the Lactulose for a while, it seems, at least until my daily physical activity approaches normality. 

Regardless, I managed to be reasonably productive at work. I had intended to commute but changed my plan to work from home instead. In the afternoon I even managed to pull off a three hour conference call, one hour of which I took from the bathroom; I’m hoping the 15 or so other participants were none the wiser of my suffering! 

Day 17 (Thursday) 

Back to a semblance of normality today, thank goodness. Perhaps a little sore following yesterday’s onslaught of bowel motions but today’s movement was straightforward and not painful. Hopefully well on the way to being on the mend. I worked from home (having canned my intention to commute) and had a productive day. 

Day 18 (Friday) 

Usual kind of day today. Worked from home productively. All well on the bowel movement front. 

Day 19 (Saturday) 

Experienced a little more pain during this morning’s bowel movement and soreness following. I guess it’s my body reminding me that there is still a way to go in order to be fully healed. 

I hit my 10k step goal today, helped in part by a walk in the local woods. 

Day 20 (Sunday) 

Awoken early by the need for a bowel movement (I’d been gassy since the night before). The motion was loose (indication I need to reduce Lactulose, I think) and, a little disconcertingly, was accompanied by bleeding; perhaps as much if not more so than at any time previously. It was bright red, which I took as a good sign (i.e. it was fresh rather than having been bleeding for some time and accumulating) and curiously it stopped as quickly as it had started. The bowel motion, as usual, came in several contractions and on the next one there was no blood evident. 

I was rather concerned for a moment when I first saw the blood but when it quickly ceased I figured while less than ideal, that it was just part of the healing process. I decided that if it does continue I’ll call the hospital but otherwise best not worry about it. On Thursday I have a follow-up appointment with the consultant. I read that bleeding can increase around this time due to scabbing falling off; that sounds plausible so I took that as a reasonable explanation. 

My bottom was sorer than it had been of late; not too surprising, I guess. The road to full recovery clearly has a few bumps along the way. 

On reflection, I suspect I had had an abscess which broke when I went to the loo. That would explain soreness building over a day or so and the blood. Another consistent factor is that later in the day I experienced a yellowish discharge; not particularly unusual in that I’ve been seeing such since the operation but now there was rather more and it was of a gloopy consistency. Evidence of a draining abscess, perhaps. 

Day 21/three weeks since surgery (Monday) 

Here we are three weeks in and today’s bowel movement was still quite sore; specifically, I experienced sharp pains for around a minute after each motion. Once again, I was woken early by the need to go to the loo. I did so, showered, and went back to bed for 90 minutes. I had a few spasms (the first for a good few days). No blood today. Soreness continued into the day (I took both ibuprofen and paracetamol in the morning but no more beyond that) but calmed down within a few hours. 

Day 22 (Tuesday) 

Woken before the alarm by the need to visit the loo. Today was the first occasion I’d tackled a bowel motion without pain relief cover (although several times before, I’d taken tablets only five or 10 minutes before, so in such cases I doubt it had yet taken much effect); this was more by chance than design. The motions were sore once again but not too bad. Perhaps “three” on the pain scale. I thought I’d try continuing the day with no pain relief but quickly decided it made more sense to take paracetamol due to soreness. Better to be comfortable than try to be a hero (at least, prematurely!). 

After the now usual loo related shenanigans, I took a few work calls from home and tackled the commute to the office mid-morning. The day went well (no bowel movements, thankfully, given I’m still somewhat dependent upon showering immediately after) and was productive. There was some discomfort but not at all bad. I left the office early at just before 1700 as I felt my energy starting to wane. I felt no need for any further pain relief during the day. So all told, I felt it was a good step towards getting back to normal. 

As an aside, I ordered some more gauzes as my local chemist’s supply seems to have dried up, I buy non-sterile ones as they’re much cheaper and I don’t see sterility as being an issue at this stage. I used sterile pads for a few days immediately after surgery but reverted to non-sterile when the initial supply provided by the hospital ran out. No sign as yet of these no longer being necessary: still getting a watery, yellow discharge. 

Day 23 (Wednesday) 

A good day in which I distinctly felt well on the road to recovery. I commuted into London (a little later than usual, to avoid the morning rush) and felt find all day with good stamina. Today’s bowel movement was easy enough. Still getting the yellowish discharge, of course, so gauze padding is still very much necessary. I’m still taking 10ml daily of Lactulose, as a precautionary measure. 

Day 24 (Thursday) 

No pain relief taken before the bowel movement today (which was a little uncomfortable but not really painful although I had noticeable soreness afterwards). I caught myself pushing a little so definitely need to continue to be mindful as I don’t want to return to old habits: remember to let a bowel movement be a wholly involuntary action. 

By mid-morning I was feeling a little uncomfortable, which I was finding distracting and felt it was sapping my energy so I decided today wasn’t destined to be the first entirely pain medication free day. I felt more focused after taking paracetamol. 

The next milestones I look forward to are: 

The remaining soreness to subside and having no need at all for pain relief. 

Being able to comfortably clean up after a bowel movement such that I don’t feel the need to shower, and the confidence that this’ll give. 

Weeping to cease such that I no longer need to use gauzes. 

Beyond that, I still feel the need for an extra hour’s sleep than usual and of course, I look forward to getting fully back to normal and being able to do things such as go to the gym, ride my bike, etc. 

In the afternoon I had a follow up appointment with my surgeon. He said my recovery was going well and that the op site looks good. He reckons I shouldn’t have problems with lingering skin tags as the area “looks flat”. He said the discharge is plasma and not pus and that there’s no sign whatsoever of infection. In earlier stages of regeneration the skin is very thin and fragile and exudes plasma. The yellowish tinge is simply because of the nature of that region of the body. In short, it’s perfectly normal and of no concern. He said he’d like to see me again in five weeks at which time, with luck, he’ll discharge me from follow-up. In the meantime he said I could return to the gym so long as I was sensible and took it easy. Using the swimming pool is also no problem. As an aside, he made an interesting comment: it’s not well understood how and why the body responds so well to rectal surgery rather than developing, as one might expect, a “raging infection” (his words!). He said it’d make a productive research subject. 

Day 25 (Friday) 

Another good day, with a full day at work in the office. I walked to and from the railway station today for the first time, clocking up over 10km according to my Microsoft Band. 

Day 26 (Saturday) 

Even nearly four weeks in, bowel movements are still a little uncomfortable. But that said, today was a milestone in that it was the first that I’ve managed with no pain relief whatsoever. 

Day 27 (Sunday) 

I received a short message from my bottom this morning: “you’re not out of the woods just yet, matey”. I woke early needing the loo which turned out to be surprisingly uncomfortable for this stage of the game. In a short burst, I’d say it was pushing “four” on the pain scale accompanied by mild soreness for a few hours. It definitely felt like a throwback from a few weeks ago. The only factor I could think of was the meal I consumed on Saturday evening; I made a dish which contained a good volume of spelt, quinoa and wild rice. It’s possible this was a bit scratchy on its way out. 

I took two paracetamol to calm things down and got on with the day.  

Week commencing day 28 i.e. four weeks since surgery 

Recovery from Sunday’s set back took a few days in fact soreness continued throughout the week with even the occasional spasm. That said, I managed the week mostly without pain relief taking a few paracetamol or ibuprofen only here and there when I felt the discomfort was distracting. I started the week with a few days of holiday which included a trip to see relatives, a drive of five hours which I managed without a problem. I worked for the remainder of the week, two out of the three days from home. On the day I went into the office I had a dose of the runs, which was pretty inconvenient. It was the first time I’d had a bowel movement without being able to shower immediately after. The weeping continues as much as ever, necessitating continued use of gauzes.  

Overall, I feel like there is still some way to go and I’m not entirely sure I feel any better than I did a week ago. 

Week commencing day 35 i.e. five weeks since surgery 

A week of mixed results. I believe I have possibly developed an anal fissure. I’ve booked an interim appointment with the surgeon so I’ll find out for sure but the combination of discomfort, pain and also appearance makes me reasonably sure that that’s the problem. The pain peaked around Tuesday, with sharp stabbing pain for a few minutes following the morning bowel motion with strong and excruciating albeit brief and infrequent spasms for a further hour. Reading up on the subject, I decided that I’m possibly over-washing or more specifically, worsening the situation by the use of shower gel. Most contain sodium laureth sulphate which is reasonably unpleasant stuff at the best of times; even the so-called “sensitive” products contain it. So, from Friday, I started using just plain water on my bottom. The wand attachment in our bathroom’s shower certainly helps. I’m also taking 400mg of ibuprofen several times a day, for its anti-inflammatory properties. I ended the week feeling considerably more comfortable and, fingers crossed, am on the home run. 

Week commencing day 42 i.e. six weeks since surgery 

A mostly positive week in which the slow process of recovery continues. Just one minor setback on Wednesday, when I experienced during the morning's bowel motion a little more pain than on recent average and a few drops of blood. I was concerned I was experiencing another setback but the subsequent increase in discomfort lasted only for 24 hours. I had a follow-up appointment on Thursday with the surgeon who took a close look and assured me that the recovery was progressing satisfactorily albeit perhaps more slowly than I'd like. He said there was no evidence of a fissure developing although, yes, part of the wound had opened up (very slightly). His message was that healing will take as long as it'll take and patience is the only option. He suggested applying Vaseline as it provides a protective layer. 

I ended the week with little discomfort and able to operate more or less as normal. I am, however, still experiencing discharge (hence still need to use gauzes as underwear protection) and I've not yet felt sufficiently confident to venture back into the gym. 

From day 49, i.e. seven weeks since surgery, and the following month thereafter. 

The shallow recovery curve has continued with just the occasional wiggle here and there. At 11 weeks since surgery I finally feel mostly back to normal and am able to do everything I could before the operation. I do feel like there's more healing to go as I'm experiencing a few occasional minor twinges. I'm still using two (four-ply) gauzes (I was using four and was having to change them three times a day, whereas now they easily last all day) due to still experiencing just a little seeping now and then. Judging by the rate of progress, I'm expecting to be able to ditch them entirely within a week or two. Right now I continue using them just to provide a little extra confidence, if I am honest. 

So it's taken a while - longer than I'd expected - but I feel I'm finally out of the woods. The results are worthwhile; it wasn't a pleasant experience of course but I'm glad I did it. 

And Finally! 

Last brief update at three months from date for surgery: I finally feel like I’m fully recovered! A little over a week ago I felt sufficiently confident to cease use of underwear protecting gauze. It’s certainly taken a while to get to this point but I’m glad I had the surgery and am satisfied with the result. Being haemorrhoid free has made it all worth it.  

In closing 

In the months prior to surgery I became rather adapt and managing prolapsing haemorrhoids. I discovered two things which helped create prolapse-free days to the extent that I'd suffer a day with a prolapse only roughly once a fortnight.  

First, I made a very conscious effort to slow bowel movements. I guess it's the opposite of straining. And once the main flow had ceased, I resisted the urge to squeeze (which, I now realise, is something I'd got into the habit of doing). If it felt like there was more to come out I'd just wait on the loo for it to happen or clean up and come back later (usually the urge would return within half an hour). 

Second, if a prolapse during a bowel motion couldn't be avoided, I discovered it could often be drawn back in by way of an exercise: stretching out straight (for example, by sitting on a sofa and taking a slouch to an extreme, rather like planking) and clenching one’s buttocks. After a minute or two, if I was lucky, I'd feel a spasm and the sensation of the pile being drawn back up (it feels similar, for a moment, as when passing a stool). It didn't always work but it was quite reliable.  

I wish I'd known these tips years ago. 

Regarding my haemorrhoidectomy surgery, these are my takeaways: 

Don’t get complacent regarding diet and use of stool softeners. If you’re like me, you’ll be reasonably mobile after the operation but it’ll take weeks before you’re as active as before. I suspect this means you’ll be more susceptible to firmer stools so better to err on the side of use of stool softening than not. 

My pain peaked around four days after surgery. Plan ahead with pain relief to help with bowel motions. Hop straight in the shower after a bowel movement. If you have a detachable shower head, running that directly over your bottom provides considerable relief! 

It could take many weeks or even perhaps months before weeping ceases. Don’t worry about it in the early stages. Get yourself a supply of gauzes to put in your underwear. I used ones which were 5cm x 5cm and used five at a time. They were cheap (Less than £2 for a pack of 100). Overall, don’t underestimate how long it’ll take to completely heal. I’d rather hoped it would be over more quickly than it was but in the end, nature will take the time it needs regardless of any impatience. 

In my case I had three haemorrhoids removed. Roughly speaking I imagine you can dial up/down your recovery duration expectation depending on the treatment that you receive. Remember that everyone is different and that your experiences may vary. Don’t worry if you read recovery accounts online and your progress doesn’t seem as rapid as others are reporting. 

You may want to consider your choice of soap. I suspect my copious use of shower gel was detrimental by dying the area and causing soreness. I don’t know this for sure but if I were to go through this process again I’d not take the chance. 

All told, while the surgery is not at all pleasant, you will get through it. To me the results are worthwhile even though it took longer than I’d hoped to get to a full recovery. It’s a relief no longer having to be concerned about the inconvenience of a day spent with prolapsing piles. 

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