External Thrombosed Hemorrhoids (Piles) - Pain & Bleeding

To give some context: 

I’m a 20 year old American male, I am very active and athletic, I’m in college right now as a nursing student, I’m a full-time firefighter/paramedic, and I’m assigned to the busiest fire station in the city. This plays a role later on. 

Here’s the entire story, little lengthy but I think it gives light to where I am now. 

Roughly 4 days ago I developed an external hemorrhoid. I’ve had internal and external before, but with relatively no pain and little-to-no blood. That morning, I went to the gym and did some power lifting, which I think may have been the instigator. Later that afternoon, I discovered it after a bowel movement, but there wasn’t any blood or pain associated with it, just a small (about peanut sized) lump. Didn’t think much of it, figured it would go away like the others have in the past. 

Fast forward a few hours after I discovered it, (late in the evening around 10pm), I began to feel some pain, but it was more annoying and uncomfortable that an actual ‘hurting pain’. 

The next day, I woke up in a world of hurt. I examined the area, where I discovered that the previously peanut-sized external hemorrhoid had doubled in size and had a small dark blue/purple mark on it. I still didn’t have any bleeding, just excruciating pain. That is when I realized it had become a Thrombosed External Hemorrhoid. 

I soaked in a warm bath for 10 minutes, cleaned the best I could with some wet tissues, applied a generous amount of the prep H cream, took ibuprofen and an ambien and passed out for the next 6 hours (I obviously wasn’t going to class). When I woke up, the pain had decreased, but still hurt a good bit. I soaked in the tub, and repeated the process from earlier, minus the ambien. The next day I had to go to work at the fire department (24 hour shifts, 7am to 7am, every third day, so I have 48 hours off before I go back on shift), so I repeated the process later that night and went to bed feeling a little better. When I woke up I felt some pain but nothing compared to the day before. Went to work, ran a decent amount of emergency calls throughout the day, nothing too strenuous, but the pain had begun to get worse as I was constantly moving. After we got back to the station from a call late in the evening, I went to the dormitory and laid down and tried my best to relieve the pain. It hurt to move any direction, and shortly thereafter we got a house fire call. Long story short, I thought I was going to die, it felt like my anus was a propane tank on fire and was going to explode. By the time we got back to the station I was in unbearable pain. I took a shower and that’s when I noticed a some blood on my boxers. Fast forward to the next morning, I didn’t sleep at all that night, and the pain had gotten unimaginably worse. As soon as I got home I took off my clothes and that’s when I saw that I had bled through my uniform.

I soaked in the bath, cleaned with wet tissues, applied prep-H, iced for 20 minutes, took ibuprofen, then placed some gauze in the region and got in bed.

Woke up a few hours later to find that the bleeding had slowed a lot, and my pain had decreased significantly.

I did the whole regimen once again, and honestly felt pretty good. It didn’t hurt at all moving around, just a slight annoying feeling. 

Then, I had a bowel movement. I thought I was going to have to summon a priest, some of the worst pain I have had since this ordeal started. My stool was relatively normal, not hard or loose, and I had a fat bright red blood clot sitting on top. I sneezed in the middle of it and was almost certain I shot my lower intestines out of my body. I couldn’t wipe, so I resorted to the shower and those wet tissues to clean, and did the same regimen as before, and it seemed like in 30-45 minutes my pain was almost gone. 

Since I have final exams next week, I have to//NEED to study. So I have to sit at my desk for long periods of time. I had no pain sitting for the first few hours, and the bleeding was there but almost nonexistent. Fast forward 6-7 hours later (I got up a few times and walked around) I felt that annoying pain again and discovered I had bled through my clothes once again. 

Now, it has been 12 hours since then, pain is the same, and I’m still bleeding. I’m a paramedic, and a nursing student, I’m well aware of what can happen if bleeding persists. But it’s not a lot, just enough to be slightly concerning when combined with the fact it hasn’t stopped in about 18 hours despite my efforts. 

I looked online and there’s next to nothing about thrombosed external hemorrhoids bleeding, aside from a few mentions about if they aren’t treated by a doctor with a small incision to remove the clot, they will resolve themselves by popping. 

Has anyone had an experience like this? If you’ve had a thrombosed external hemorrhoid, how did you treat it? How long did the bleeding last? How long did it take the pain to go away completely? How much bleeding is too much? Those who had to sit for long periods of time and/or be active, what did you do to manage this? 

I’m past the window my doctor could do anything so I haven’t bothered with him, plus with final exams and work, I don’t  have time to be out for Even just one day now. I have work tomorrow, and I need this to be resolved. Specifically the pain and bleeding, moreso the bleeding. 

Any advice or personal insight/opinion is 100% welcome and a big thanks to those in advance that will reply. 

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