Hemorrhoidectomy in 12 hours....

Hello all... 

My story will be familiar to many of you. I've spent years reading these forums as I've dealt with extremely bad internal prolapsing hemorrhoids (grade 3) for the better part of a decade. Also like many of you, I tried just about everything possible and always swore that if it came to the surgery, I'd just live with it after reading all the horror stories. 

Well... the time has come... The hemorrhoids are so large they're messing with my prostate and the pain/ blood loss has become unbearable. I'm barely able to leave my house anymore. So it's time to man up and crawl out of the tub and into the operating room... And then back into the tub.... 

About 5 years ago I reached a similar point and saw a colorectal surgeon who first tried banding (good lord was that unbearable) and then the THD (Halo) surgery. None of that worked and after 3 glorious weeks of no prolapsing post op they all just popped right back up. They where a little bit smaller than before surgery which bought me some time, but all present and accounted for... 

Regarding THD: If you're considering it, I would think twice if you have a grade 3 (prolapsing every time you poop and needed to be reinserted manually) because I just don't think that procedure is up to the job. I think for grade 2 and below though, it's could maybe work. However, the "48 hour back at work" line they feed you is complete nonsense as many others have said. I'll obviously be able to make comparisons a bit more directly in about 12 hours, but to me it seemed a lot like the hemorrhoidectomy recovery stories I've read on here. Severe pain/ bleeding for 2 weeks, living in the tub, etc, etc.

I've been just dealing with my situation as best I can since then but over the last 3 years I developed Prostatitis. My GP would treat it with antibiotics for a month, it would go away and then it would come back like clockwork a year later, which is very bizarre for an other wise healthy 29 year old male. My working theory (not a doctor by any means, just a research freak) is that the hemorrhoids are somehow causing this. I wonder if I'm getting infected when the hemorrhoids are tearing and bleeding or if just the enormous size of them is pushing on my prostate. Either way, here's hoping the procedure fixes that problem too. 

I'm also lucky enough to have gotten an IBS diagnosis in the last year, which has obviously aggravated things greatly. Ironically I think it was all the on again, off again antibiotic stints that really kicked it off for me. Generally it presents itself as violent diarrhea fits/ gas attacks. As a result of that, I lost quite a bit of weight, down from 190 lbs (I'm 6ft tall) to now 162 lbs pre-surgery. I had a gazziion tests with a GI specialist (colonoscopy, CT scan with contrast, every blood/urine/poop test imaginable) but all came back negative and I wound up with an IBS diagnosis and a surgery referral. 

So... That all brings me to 11am tomorrow morning when I finally face my biggest fear and get the dreaded surgery. 

Leading up to it, I've opted to purchase just about every single "tip and trick" I've seen on here. I've got a toilet sitz bath, a lifetime supply of stool softener, baby wipes, underwear liners, adult diapers, 8 pounds of epsom salt, a heating pad and a new obnoxiously large TV in my bedroom and another in the bathroom. I haven't had cable in years but if ever there was a time... 

The one thing I'm doing a little differently is that while I've been taking stool softeners for about 3 weeks leading up to this (1 Collace a day then 2 a day starting 3 days before the op), I haven't been taking a fiber supplement like many others have. I'm going to very, very slowly introduce some (benefiber) in if I'm having trouble initially but with my IBS, I'm extremely sensitive to it. I remember after my 1st op passing gas was a nightmare for the first few days and fiber has a good chance for me of triggering a gas attack. I think for most people without this problem, ramping up the fiber for a few weeks before this and also starting stool softeners about a week early (I was on them longer just because of the pain I was already in) is a good plan.  

I have another type of stool softener (I would take it in addition to Collace), miralax, milk of magnesia and gas-x ready to roll should they be needed as well. 

Surgeon is prescribing Oxycotton and Valium for post op pain. I'll also be taking the max dose of IB proffin. I found that was a miracle drug for me last time around. The opioids help "take you out of it" but the IB proffin was the only thing able to directly touch the pain. Valium will help with spasms and will hopefully make me not worry as much about that first poop... I've also made some extremely potent marijuana edibles with a 50/50 ratio of CBD/ THC to use (I live in a legal state) I'll mix in as needed. I'd like to get off the painkillers and switch to those as soon as I can to avoid opioid constipation. 

I ate a small PB&J this morning and have stuck to just water (lots of it) until the surgery about 24 hours later. Dr didn't recommend enema, laxative prep beforehand, so I'm going with her opinion on that one but also trying to make sure I'm going in with a fairly empty tank.  After the procedure I'm planning on sticking with soups, chicken stock, yogurt for as long as I can take it (probably 2 days if I'm a gambling man) and then ramping up to some fruits (watermelon, pear, cantaloupe) and avocado toast/ sandwiches (no cheese). I've got a fantastic girlfriend who took 9 days off work to take care of me during the post op and while I work from home, I booked myself 2 weeks completely off the grid just in case as well. 

I was dead set on getting a colo-rectal specialist, but the insurance I have (Kaiser) will only do the procedure with a General Surgeon. I'm a bit nervous about that part, but I like my Dr. a lot and I do trust her. 

It's still a bit unknown what she'll actually do during the procedure. When I went in for the consult, I was in so much pain she was only able to do a rectal exam for a few seconds before making the recommendation for the OP (mostly based on my extensive history). She thinks the sharp pain I currently have is the result of a fissure but I think it might be a thrombosed hemorrhoid. I've "ok'ed" a botox injection fissure treatment (she doesn't want to do a sphinctorectamy at the same time) but we're sort of playing that one by ear after she gets in there and sees whats going on. 

She's also very worried about stenosis (narrowing of the anal canal) if she does too much cutting at once, so she's mentioned leaving 1 in there (I have 3) and then going back in for a second procedure in a few months. That by far is I think my biggest fear going into this tomorrow, that I wake up and still have a prolapsing hemorrhoid. Prolapsing through the wound seems like the worst pain imaginable and I really hope that's not what happens! I trust her to make the right call for my well being though during this, which is really all I can do at this point. 

I'll be posting updates as I go along here, so feel free to follow along. Without the countless hours I've spent reading on this forum, I don't know if I'd have had the courage to do this, so it's the least I can do to pay it forward. 

If you have any questions or advice on what I'm planning post-op, I'd love to hear them. 

Here's to better days (soon I hope....) 

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