Hemorrhoidectomy (external/5 weeks post op) Experience/Rant and Questions

After noticing a very small pea sized bump on a Friday evening, which grew to a thumb sized moderately painful lump by Saturday evening, I immediately went to an urgent care that was open on a Sunday morning. The only reason I didn't go saturday was because I had to go to an out of town wedding. After reading a lot on it, I was hopeful that something could be done if caught fast enough. The doctor that day did nothing but send me to a specialist.

An appointment was made for the following week, at which time the doctor examined me and said I was a "tough man," then recommended surgery. (I should have known it was going to be all downhill from there.) I asked the normal questions about healing time (was told a weeked to a week and a half out of work and about a month to be completely normal again), pain levels, chance of it getting better (since it had been regressing slowly), and was told that the surgery gets a bad rep and it's really not that bad. He continued to say if I was dealing with the pain right now that well that the surgery shouldnt be a problem for me. It was also said that I would recieve a packet in the mail for pre-op prep which I never recieved. After calling twice I was told that I needed to take a fleet enima the night before and the morning of the surgery. I was dissapointed about having surgery but felt a little relieved. The surgery was scheduled for two weeks after the doctors appointment which was the 19th of June, 2017.

Surgery was fine, anesthesiologist was excellent. I did not see the doctor after surgery which I thought was strange, and was discharged with prescriptions and directions for care. The first day I was bleeding as much as you would imagine a surgery wound would bleed. I was given Oxycodone/Acetaminophen in a 5/325mg caplet for pain, Ketotolac 10mg as an anti-inflammatory, told to take Citrucel Tablets once a day, and prescribed a cream of Diclofenac 3%/Lidocaine 1.5%/Metronidazole 10%/Nifedipine 0.5%. The  instructions also stated that if I did not have a bowel movement after 4 days to take Milk of Magnesia twice a day until I do.

After 4 pretty easy days I still hadn't had a bowel movement and wasn't taking pain medication because it really wasnt that bad. I'm not really one to complain about pain. So i began taking Mild of Magnesia and on the fifth day I had a bowel movement. It was aweful, about an hour on the toilet, lost a lot of blood (maybe 1/4 pint), and ripped out one stitch. I had surgery on the 19th of June and that day was Friday the 23rd. I had planned to go back to work on the following Monday earlier that week but after that day I called and confirmed I would not be going back to work the next week. I had been taking two sitz baths a day, I took one after and literally just went to bed. I continued to bleed a moderate amount for the next two days. On that Monday I had another bowel movement that was far worse than the first, I had never been so constipated in my entire life, and lost the rest of my stitches. I had been taking pain meds since the 23rd. I started readin up and contacted the doctor. The doctor said that thw medication was correct and that sometimes people loose stitches early but and open wound there wasn't a major worry as long as kept clean. After another very bad bowel movement i started researching laxatives and found out the citrucel was a bulking agent and discontinued taking it. I switched to a stool softener and things got a little better. 

After two weeks the follow up appointment came, in which the doctor who did my surgery had another doctor do the follow up. After examination, he noticed I had lost all of my stitches and ofcourse still wasnt healed. I also asked because It still looked identical to before the surgery except with an incision next to the hemorrhoid. I was told that the lump was just swelling and that over the next week or two it would naturally go down. He also stated that the open wound wasnt a big deal just more aggravating than a real problem. I also told him that I stopped taking the citrucel and started taking a stool softner. 

I'm now just over 5 weeks after surgery with my supposedly final appointment is in about a week. I still bleed everyday and more after every bowel movement (maybe a teaspoon or two at most) and they are still painful but not that bad. My first three were almost unmanageable. It now seems like I have another thrombosed hemorrhoid, which is crazy because I'm having a much easier time now than right after surgery, I'm so sick of this. I'm going to see if I cant make an appointment this week.

Is a stool bulking agent normally prescribed after a hemorrhoidectomy? That just doesn't seem like a great idea, I firmly believe it didn't do me any favors. Should it take 6-8 weeks to heal? Should I seek a second opinion? 

Anyone having this surgery should prepare a week before by changing their diet, I wouldn't recommend taking citrucel, take a stool softner and begin it before your surgery, just take two weeks off if you can. The surgery doesn't have a bad rep. I was really of the opinion that most people just don't deal well with pain and that it wouldn't be that much of a big deal. I was wrong. After ripping out stitches in such a sensitive place I'd give it an 8, painful enough to have trouble thinking about anything else. Breaking my femur and having it straightened to be put in traction was like a 7. It's one of those things where you're tired of constantly being uncomfortable even when you don't hurt.

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