A "Good" Hemorrhoidectomy Experience

I decided I needed to write this post to help the next poor guy or gal facing this surgery who stumbles upon all the horror stories out there

TL/DR:  My experience was not nearly as terrible as most of the posts on here make it out to be.

I'm a 41 year old male in good health.  I've had internal hemorrhoids for at least 20 years, but they'd gotten much worse over the past year or so.  It had gotten to the point that they would protrude after most bowel movements and any moderate activity would cause them to swell and be painful.  They had also started to bleed, so off to the doctor I went and she recommended a hemorrhoidectomy.

Starting about two weeks prior to my surgery, I made a conscious effort to increase my fiber intake.  I don't generally suffer from constipation, but this seemed a wise idea anyway.

My surgery went smoothly.  I woke in the recovery room with ZERO pain; in fact, I could barely even tell anything had been done.  Very quickly, the nurse had me up and in the bathroom.  I had heard that urinating after surgery can be difficult due to the swelling in the area, but I had no problems at all and had a normal pee.  I was discharged and on my way home.  I was prescribed hydromorphone (dilaudid), ibuprofen, a stool softener, and a topical gel (metrogel).

When I got home, I had a large glass of apple juice and some crackers.  I was still feeling a bit out of it due to the general anesthesia, so I went to bed.  Even though I wasn't feeling any pain, I took a dilaudid based on the nurse's recommendation.

My surgeon had advised me ahead of time that she uses a very strong local anesthetic that lasts for 2 or 3 days, so the next morning, I still had very little pain, though I was starting to be aware that something had happened down there.  I took off the bandages from the hospital (just loose gauze, really); there was very little blood.  I took a few short soaks in a warm tub throughout the day.  I bandaged myself with a small 2x2 gauze pad (with the metrogel on it) between the cheeks and a larger gauze pad to line my underwear.  These I changed several times a day.  I was able to be up and moving somewhat comfortably. 

The next day was more of the same, though the area was starting to ache more.  I want to stress that it was an aching feeling, not a sharp, acute pain like I'd been expecting.  I took ibuprofen a few times during the day, but tried to stay away from the dilaudid as I wanted to avoid the side effects of constipation if I could.

The third day (not including the day of the surgery) was definitely the worst.  By evening, that powerful local had worn off and there was a definite increase in the pain level.  Also, I had developed a fever and was worried that meant infection.  Ultimately, I took the dilaudid for the pain and more ibuprofen for the fever.  Even on this day, though, I would describe the pain as "significant" but not "agonizing" and it certainly wasn't constant.  Hot baths helped quite a bit.

The next morning was better, but not great, and it was time for the first bowel movement.  I was VERY constipated and it took a HUGE effort to get it out.  Surprisingly, however, it wasn't painful, it was just VERY, VERY difficult.  I didn't even bother trying to wipe; I just got straight into the shower.  I learned my lesson and started taking the stool softeners regularly.  I would have another difficult bowel movement the next morning and an almost normal one the day after that.

Frankly, after that difficult bowel movement, the worst was over.  I stopped the dilaudid, eased back on the ibuprofen, but continued taking the stool softener and applying the metrogel for a few more days.  I was back to work 10 days after surgery.

I'm now 6 weeks post op.  I had a followup at 4 weeks and mentioned that I was having some minor "leakage".  She noticed that some of the stitches had not yet dissolved and said that can sometimes contribute to the leakage.  She removed them in the office and it helped a bit, but I still have the occasional unclean feeling.

Overall, it was a positive experience.  I can now go to the bathroom without worrying about my hemorrhoids protruding and causing pain every time.

So, with all that said, here are my tips for anyone looking at this surgery:

1) Before surgery, increase your fiber intake.  You do not want to be constipated.

2) Have some clear liquids and soft foods available for the first few days.  Apple juice, grape juice, bananas, chicken broth, Ensure drinks, etc.

3) After surgery, skip the opioid painkillers if you can.  The constipation is not worth it.  That said, however, don't let the pain get ahead of you.  If you need them, take them.

4) DO take the ibuprofen if it's prescribed.  I think the anti-inflammatory nature is as helpful as the pain killer.

5) DO take the stool softeners, and start taking them right away.

6) Drink lots of water.

7) Lots of hot baths and showers.

8) Sign up for Netflix and watch a lot of movies while you recover!

-Ed

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