Hemorrhoidectomy decision - What tipped the scale to go ahead? Is it worth it long-term?
Posted , 8 users are following.
I wish each and every one of you the best possible outcome you can attain, and peace from hems suffering.
What tipped the scale for you to go forward with hems surgery? Is it worth it, long-term? Can I ever have a normal butt again, instead of bulging squishy lumps that move on their own? Less burning down there, less pain? What are your thoughts about if I should go ahead and bite the bullet to hems surgery? I've chickened out twice, but it's not getting any better...I could have 10+ good years, couldn't I?
Here's my story: almost 70 yo active female, 110 lbs, no complicated chronic medical conditions, no maintenance meds. Have been diagnosed by 3 colo-rectal surgeons and primary care doc with Grade 3, 4 mixed external/internal hems. I thought I took good care of my general health, but not so much. Looking back, I've had pretty chronic constipation from not drinking enough water, eating enough fiber. Probably also irritable bowel. Have changed diet and water drastically since hems began prolapsing more severely.
Looking for comments and recommendations from you very helpful folks. I've already found the post-surgery comments so very helpful. I am a medical librarian who has access to too much of the medical literature, but the personal experiences give me a more realistic picture of what's going on in real people that I can talk to.
Thank you for reading, and I hope to hear from you. Peace to you all.
0 likes, 26 replies
Twopies sus62307
Posted
Since you are a medical librarian, I will share this: I searched “grade 3 home remedies” (or something like that) and found an article in a medical journal that said they studied patients with grade 3 and 4 hems, some scheduled for surgery. By increasing fiber and water, after I think close to a year, over 60% of them were healed. Good stats.
The low fodmap diet is interesting too.
I, probably like you, have read about some people who take fiber everyday along with stool softeners.
Best to you, dm me if you like. I’m sure you are more knowledgeable than me.
sus62307 Twopies
Posted
Thanks for writing, Twopies. Three people whom I know had the surgery said to avoid it, but said they were glad they had it. One surgeon won't do it unless the patient is in a life-threatening situation. The two who have done a lot of them and are well-respected said it's tough, but patients get through. I'm trying so very hard to figure out where I'd wind up, coming up on the other side of the scalpel...kind of looking for a crystal ball, right?
Currently, drink 128 ounces (4, 32-ou bottles) of water daily. Plenty of beans, fiber foods, green leafy vegetables, take 2 magnesium citrates and psyllium husks for fiber, coconut or emu oil on my hems lumps, clean off with hot cloth after BM. It's exhausting maintenance, but I keep trying. Witch hazel, not so helpful...neither are cortisone creams or over the counter creams.
Linked below are 2 freely available articles on PubMed Central. You likely know to copy and paste the link to your browser. I haven't read them entirely yet, but will. Like I said, my pelvic nerve pain confounds the problem. It is real, and it radiates to anal nerves. Going to see my ob-gyn's physician assistant, and thinking of trying some CBD drops to help the nerve pain, but don't like meds too much, or anything that makes me drowsy.
Still, all the lumpy fleshy protruding little balls out of my butt (sorry) get me down.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5730401/
Non-surgical management for hems disease: systematic review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258566/ ;
Hemorrhoidectomy - making sense of the surgical options
Twopies sus62307
Posted
Cleveland clinic suggests Epsom salts and glycerin—just a thought. Helps the pain; unsure whether it will actually shrink hems. I’m too undisciplined to follow through to find out.
I know 2 people who had the surgery; both said never again. I’m taking meds that cause constipation so I’m screwed, I think. Saw 2 docs, neither helpful.
Twopies sus62307
Posted
Zekearoo Twopies
Posted
Hi Twopies,
I've written an extensive reply. I hope it also helps answer any of your questions.
Now I read your friends/family who went through it and said, never again... I don't disagree.... but I also bet they said... it was worth it in the end. If not... I can certainly speak from experience and with confidence, it was definitely worth it.
Z
Zekearoo sus62307
Posted
Hi Sus,
My advice to you is, have the surgery done. However if possible seek a proctologist opposed to your ordinary, everyday surgeon. I say this because proctologists specialize in this area, whereas a surgeon will not look at it the same.
First, if you have both internal and external hemorrhoids, you are likely experiencing both moderate to heavy bleeding everyday, which can lead to other health concerns. Anemia is a huge concern, and can be very life altering, from mood swings to simply feeling exhausted unnecessarily. So if your surgeon is saying he/she won't do it unless it is life threatening, well your surgeon isn't fully aware of the ramifications and side effects of what the bleeding may cause.... especially if you've had this condition for over ten years.
The stage you are at is beyond Witch Hazel, Tea Tree Oil, Apple Cider Vinegar sitz baths, additional fiber or water intake, and so on. The above would have sufficed, but never fully corrected had you been a Grade I or a Grade II. You might even have been able to get away with banding ligation, which may have helped, but even banding ligation is no guarantee that the hemorrhoid flare ups won't return.
Since you have access to a medical library, I'm certain you have read all about the condition and have likely tried nearly everything possible at this point. As well, you may also be aware of the causes such as constipation, diarrhea, poor diet, low fiber etc etc, and by the sounds of it you have tried to change your diet, with little success. Of course that is not to say what you are doing is bad, but what you are doing at a Grade III and Grade IV stage will not eliminate them altogether. Which I am sorry to say, because yes the recovery will be very painful, but I will say this, very much worth it. Les Brown (motivational speaker) says, You're already in pain, so why not get a reward for it... well something like that anyway.
So what pushes people over the edge, health, and an improvement of ones health once they've gone through the toughest portion of the recovery period. That's the positive way of looking at it.
Now having said that, the surgery itself, you won't feel a thing, because you'll be out cold. It's the following 5-10 days of a living hell that will make you curse everything and regret everything in the world, until the pain subsides. However, once that pain has subsided and you are no longer needing to sit on a donut or a soft pillow and you can experience a bm from heaven, trust me you will be ecstatic and relieved.
Can the hemorrhoids come back? Yes they can, but that also depends on the individual. However, you are already doing everything right as far as prevention goes, so I'd say in your case, the likelihood of recurring is minimal to null.
Now, for the not so positive part of the experience. Should you go through with the hemorrhoidectomy, you are going to experience pain like nothing ever before. I've even read where some women will say the pain within the first 5 - 10 days are worse than an episiotomy.
You will need pain medication and anti-inflammatory medication, along with stool softeners, not laxatives. You will experience the pain of burning, razor blades and even an ache unlike any other. You will have random rectal spasms... which come out of nowhere and you'll feel like you are being stabbed...and you may not be able to sit upright for over a week without pain even while on the pain medication. Unless of course they prescribe some heavy duty medication, but I don't recommend you being on anything too heavy, a) you'll feel like you can do anything and may not rest, which could cause additional pain, bleeding and potentially rip a stitch and b) the heavier the medication the worse the constipation. Trust me you don't want to do either of the above.
You'll definitely need someone to be there with you for at least a week. They say you'll need someone for 48 hours, which is true, because of the anaesthesia, but I recommend someone to be with you for at least a week... if not two. As you'll want to minimize even just getting up to pee. You'll want someone to be there for you to do the simplest of things, getting drinks, food and cleaning.
Speaking of going to the bathroom, I'm not going to sugar coat it, it will burn and literally feel like you are giving birth to a brick, the first few times... and it will not be pretty either. As you will likely have a lot of packing inside that will come out during your first bm. However with time and over a course of a few days, the pain will subside to a tolerable level of pain. My suggestion would be, try to take a brand new pain medication, before you have a bm.
Other advice, prior to surgery (should you decide to do it), days before surgery, I'd suggest a very light diet, broths, soups, apple sauce, yogurt etc, and lots of water. Avoid anything that takes awhile to process or will be hard and large coming out during a bm. In addition, continue this diet for a week after surgery, trust me your butt will thank you. After you've had a few bm's, then start (slowly) with more solid foods.
As for the days following surgery, within 5 - 10 days the pain will have improved with each passing day. You will experience pains like no other, and as mentioned sitting upright will be a nightmare at first, but it will be doable.
After the 7 - 10 day mark that's when I'd suggest light walking, 5 - 10 minutes a day at first, which you can increase with each passing day. Avoid lifting anything over 5 lbs for the first 5 - 10 days or anything strenuous, as the wound will still be fresh and you want to avoid any unnecessary bleeding and pain.
This type of recovery can last anywhere between 4 - 6 weeks, in some cases less, in some cases longer. However that will depend on how you take care of yourself post surgery.
Sure I've read some people are running, active, back at work or the gym within 2 weeks... but I assure you, those people either only had a couple of small hemorrhoids removed and you can bet those people will be back on the operating table within a year. You really want to take your time during your healing period, as to avoid any chance of reoccurring.
So in conclusion, will recovery be painful, long and boring as sin at times, absolutely yes... but will it be worth it, you can bet the house on it.
I apologize for the lengthy and detailed message, but I've seen some of the messages people post, I've read some of the literature, and none of which prepares anyone for what they may be in for.
I prefer to give the person the truth and let them decide. However, as mentioned, I still say it will be well worth it.
However, also as mentioned, seek a proctologist... see what other types of surgical procedures are availability. Some swear by banding ligation, which again, may help, but with Grade III and IV, they'll either come back or not be very helpful at all. You could ask about stapling, but if you have external hemorrhoids, I'm not sure if that would be helpful. Then there is the full on hemorrhoidectomy, either laser or excision, which is probably the best in your case, and yes the above pain is as mentioned, is real.... but totally worth it.
Hope this answers your questions and you found this to be helpful.
Unfortunately there is no magical wand waving... if there was I definitely would have opted for it 🙂
Good luck with your decision and all the best with your recovery, should you decide to take the plunge.
Z
sus62307 Zekearoo
Posted
Thank you for your kindness to me in replying, and for the details which I want to know. I have a surgeon in mind, who is a colo-rectal surgeon (in the US, they used to be called proctologist, but no longer). He is reputable, experienced, and my pelvic pain physical therapist knows about him. Hearing her say "he is an excellent surgeon, and that's what you want"
, makes me feel relatively secure, as best as I can under these circumstances. He doesn't have the warm-fuzzy bedside manner of another colo-rectal surgeon I saw (have seen 3), but skill trumps personality...I have a boyfriend who delivers warm-fuzzy!! :-) So, there's that.
No bleeding, that's what's so strange. There is already seems to be burning in the canal, and when I squat down to do housework, or anything like that, there's irritating stretching which I guess is pulling of the hems skin. Who knows how these things work, other than they're taking over my life!
I appreciate the Les Brown quote, and yup, that's the truth. I've had 3 episiotomies, but I'm sure that pooping over raw tender skin would be much, much worse. I don't know how I'll do it, but I'm no good to myself this way, is what I figure. If I can only keep my courage up...that's why I need the help and encouragement.
Thank you!
omar92469 sus62307
Posted
1. Most pain imagined for two weeks
2. Discomfort for two more weeks
3. End of week 4 relief starts
4. Week 8 on : happy , pain free , feels good
If you can manage the first two weeks pain wise , then the rest should be a breeze .
I sure hope that I would never experience such pain again in my life !
Best of luck to you !
That was my personal experience !
pita123 sus62307
Posted
sus62307 pita123
Posted
Pita123, one more comment before I leave this alone for a bit and let everything gel. This week, I see ob-gyn's physician assistant whom I trust, and who seems to have excellent knowledge of body systems. I've got bowel stuff going on (IBS diagnosed with a couple of past colonoscopies by GI docs) which feels like I'm always constipated despite drinking ginormous amounts of water and eating right, all the time. I'll gather more information from exam and discussion with the PA. Truth of the matter, surgery seems like the ultimate crap-shoot and I'm not a gambler...doing nothing is the sure thing, but really not, 'cause how much worse could this get as I get older? If I'd done it 2 years ago, it'd be over. Round and round I go, til I'm dizzy...what a predicament! Then too, loved one and I are taking a short road trip, so I'll see how traveling goes this time. A change of scene is much needed.
All the best to you, and recovery be yours!
SUS
Zekearoo sus62307
Posted
Hey Sus,
Not sure if you will read this or if you have put the thread to bed yet, but have you tried fasting to help repair your IBS?
If not, give it a try.... water, vitamin and of course softest foods possible once you return to eating again. As well, have you ever gone through a full on test, to see what types of foods you may be allergic to?
Of course I don't know you, or what your eating habits are like, but if you are eating anything with a red sauce, anything that is acidic, drinking carbonated drinks (pop or perrier) or alcohol... those I would stop immediately... along with processed foods as well as wheat and sugar.
Again I don't know you or what you are currently eating.... but the above is just a suggestion.... and the fasting I did.... which helped me.... as I was taking a boatload of acid diffusers (antacids) for years..... but once I did the fasting..... I found it really helped and cured my stomach issues. That along with a 180 regarding my dietary intake.
Worth a shot.... and many doctors won't suggest it etc.... but if it works for some of the oldest cultures in the world.... and a regular guy like me.... it is definitely worth trying.
Even if you only did intermittent fasting.... where you get up.... only have water and vitamins.... for the first 8-14 hours, everyday.... that may work as well....
Essentially what you are doing is giving the body a break and a chance to heal.
Think about it this way.... if you had a deep cut on your arm.... and you scratched at it all day..... how long would it take to heal vs if you left it alone to heal with a bandaid on it?
The same rule applies to our insides.... common sense right? But most think they can't go without food etc... hence the water, supplements or very soft foods.... the less the irritation.... the faster it will heal.
Just a thought....
Z
Zekearoo
Posted
Oh, and one other thing.... regarding the testing for foods you may be allergic to.... I'd suggest a naturopath or dietician.... versus your everyday standard doctor.... yes it may cost more.... but it will be very much worth it.... as the naturopath or dietician will test you for things a regular doctor may leave out....who knows.... you may have an issue with soy or gluten etc.... or something you crave a lot.... and avoiding whatever it may be.... could also be the answer...
Again just a thought and worth a shot
Z
sus62307 Zekearoo
Posted
Hello...I'll keep checking in here for more thoughts and suggestions...so helpful.
About a year ago, I saw one dietician who was going to work through my primary physician to get me tested. She suggested trial of FODMAP diet first, get blood test results, then devise a plan. It was expensive (though I could stretch budget to do it), and so many foods would have to go. My "poor me," "why me" attitude reared its head. I didn't feel like I could work well with this dietician, and she was located a bit too far from my home, so there's that. Okay, I'll ask Physicians Assistant on Wednesday for her dietician recommendation...truly thinking about this and taking it seriously this time. I'm tired of feeling bloated and really don't want to go to the GI doc who will just order more GI tests, scopes, etc. They'll all come back with the same IBS diagnosis, I'm sure, because the symptoms are the same as over the years. Looking back, I took my body for granted...like my car...I just want it to work, effortlessly. Ooo, there's lots of attitude fixing going on in my mind...so unrealistic, so lazy!!
Would life be worth living without coffee, Indian food, chili, bar-b-que? I hope it doesn't come to that.
Thanks so much!
SUS
Zekearoo sus62307
Posted
Unfortunately SillySus, you're gonna have to switch your diet.... especially the spicey stuff.... I will disagree with one point though.... I don't think we take our bodies for granted, do much as we are simply not educated enough about our bodies.
I mean when we buy a car, unless someone says... "Be sure to put diesel fuel in the car"... how are we supposed to know?
Wouldn't it be nice, if at birth, we were told... Ok your blood type is X and you need to avoid these foods and increase your level of those foods... etc?
Unfortunately life doesn't come with a manual and sometimes we have to learn the hard way.... just sometimes it wasn't always so hard.... or in this case.... painfully hard.
Z
sus62307 Zekearoo
Posted
If I can substitute pleasant, interesting, tasty ones for spicy foods, okay. My morning cuppa, and an occasional 8-ounce cup with a friend, probably not happening!