Hemorrhoidectomy in 12 hours....
Posted , 9 users are following.
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....)
2 likes, 91 replies
jake31434 pita123
Posted
pita123
Posted
Day 4 update:
Well I was sure right about the BM prediction in my last post... I was able to pass a smaller stool earlier in the morning and then had something a little bit bigger later.
It went real sideways for me though at about 9 pm last night. I think I way overdid it on laxatives because the flood gates really opened up.... I had probably about 10-15 BM's from 9p - 5a. They where all relatively solid too, just very soft after the stool softeners except for the last round, which was more liquid diarrhea. Believe it or not, pain during the actual movements was not too bad, it just hurt badly afterwards. I've been using the sitz bath toilet attachment, which has been a lifesaver. I fill that with hot water and a bit of Epsom salt, do my thing and then head into the tub to clean off. I've got a real "hair trigger" down there though now it seems as I have about 1-2 seconds it seems to get into a tub/ toilet. Thank god for adult diapers (gone through 2 packs already) or I'd be buying a new bed... Towards the end of that incident I just gave up and kept going in the tub. So gross, but I was able to rinse off after and get clean with my detachable shower head and some delicate soap.
Things seem to have calmed down today. No BM, which is not surprising as I seemed to pass about 10x as much as I ate in the last few days last night (the overall volume of them was truly staggering, even compared to what I do normally in an entire day). That incident sort of seemed to reset the clock so to speak on pain to about where I was at day 1-2. Still just laying in bed, taking lots of hot baths with epsom salt and taking my max doses of pain meds. Taking a bit of time off the laxitives for sure today though. I had been on Miralax and sene. I'm switching to just Collace for a couple days unless I start to feel things getting backed up.
Everybody's body is different, so don't take that to mean you should never take laxatives in the post op for this (99.99% of people should). My body just seems extremely sensitive to them.
Still seeping a bit of blood regularly, but not as bad as I imagined with all the trauma to the area last night.
Peeing is actually a bit tough for me, as it seems my body needs to sort of clench my butthole a bit to get it going. Something so subtle that while you're well you'd never notice but post op makes it a bit painful. Once I get going though, I have no problems clearing out my bladder it seems.
Still keeping it very simple on diet. I'm drinking only water with a gatorade or two throughout the day and eating 2 turkey sandwiches (no cheese) on high fiber wheat bread a few yogurts a day and a few servings of fruit (cantaloupe, watermelon, banana, pear).
Having read these forums for so long I think has helped me be realistic about the recovery. I know there will be lots of encouraging progress followed by some major setbacks/ pain re-lapses in these first few weeks, so while it sucks, I at least feel like I sort of know what to expect. I feel like overall, I'm making good progress.
jane16431 pita123
Posted
Also agree on the pain AFTER a BM which for me could last hours and be worse than the BM itself.
Super hot baths were my savior!
Hang in there!!!!!
pita123 jane16431
Posted
sus62307 pita123
Posted
That's very encouraging, good news. Your attitude is so positive and realistic. I hope your recover continues to progress nicely, and that you feel much better day by day.
pita123
Posted
Frustrating update... The pain meds I was given are Oxycodone and I was told to take 2 every 4-6 hours for pain. However, they (kaiser permanente) keep only giving me 30 pills at a time. I got 30 on monday the day of the surgery and then a refill of 30 more on Thursday, but after doing the math I realized I'd be completely out by Sunday. The doctor I chatted with on the after hours line suggested I just stop taking them entirely and switch to IB proffin only and that "it can't be that bad". All this literally 4 days after the OP and mere hours after my first BM post op. I still can't believe this happened, but she actually said, "I've told you everything I can" refused to re-fill the prescription and then actually hung up on me!!
I know some of you on here have muscled through this without the opioids but there just no way that'll work for me and frankly those that did, I think you're either nuts or a masochist. This aint the 1800's, so if there is something out there that will ease this pain (even just a little) you bet your ass (lol) I'm using it.
My surgeon seems to be tough to get ahold of even during the week and is proving completely impossible on the weekend, so I am very scared I'm going to be going at this with no pain meds as of Sunday. I'm going to spend every waking hour of my time tomorrow on the phone trying to get more meds though, so here's hoping I can get through to my surgeon or her nurses tomorrow!
On the one hand, I think it's great they are finally tightening up prescriptions with the opioid epidemic killing millions of people but on the other hand, if there ever was a real medical application for this (or any opioid drugs for that matter) this has got to be it!! Doing this surgery on someone and then cutting them off on pain meds 4 days later has got to fall under cruel and unusual punishment!
I'm going to go out of my way to complain formally about the doctor who hung up on me first thing Monday. She should get out of medicine and start working for Comcast customer support or something, lol
Day 5 update coming tomorrow. Thanks for the support so far guys/ gals! Staying strong, staying positive but most importantly... Staying in the bathtub!!
jake31434 pita123
Posted
In the event that you may run out quicker than you hoped could you maybe try having a bigger gap between taking your next 2 pills? Maybe try to make the prescription last longer than Sunday. I agree with you making a complaint about that person on the phone-no customer should be hung up on and if she couldn’t help you she should have used her resources to find someone that could!
Here’s to hoping your day 5 update is on the brighter side! Hang in there!
jane16431 pita123
Posted
Instead the continual cycle of Tylenol and Ibuprofen worked. I learned that from some readings on this. You may wish to give that a try.
pita123
Posted
Arghh.... I typed out an extremely long day 5 update but I guess I wasn't logged in and lost all of it when I hit post. Bummer.
Here's the abridged version of day 5 update:
Took miralax in the AM since I didn't have a BM the day before (didn't take it yesterday after my little "blow out"
. I think I've narrowed it down to being sensitive to Miralax, because I had a similar experience of 4-5 rapid fire, fully formed but soft BMs that afternoon. Not painful really going out, just burns like hell afterwards.
I was able to finally get more pain meds after spending hours on hold with Kaiser. I finally got to a surgeon who wrote me a script in about 5 minutes for more after all that.
Here's where things get interesting... At about 9 pm, I began to sweat profusely and became extremely hot/ flushed. I completely soaked my bed and sweated through my pillow which caused me to dig out my thermometer and I recorded a 100.8 fever. Very alarming for me as I almost never get fevers and it's my body's "RED ALERT" signal something is not right generally. I also turned extremely pale during all of this.
I was advised by an on call nurse to go an urgent care, so my girlfriend rushed me over there. They took a ton of blood for testing, urine sample and a CT scan with contrast. All came back normal, which was great. The Doc also took a peek at my wound but thankfully didn't do a full rectal exam, which I can't even imagine the pain of.
The only thing they can speculate as to what caused the fever is a small local infection at the wound site (a little puss was observed around it, which I've been told to expect) or that I just got unlucky and caught something unrelated at the clinic when I got the procedure done in the first place (flu is going around here right now), or it's prortititus related. I've had a history of prostate infections (I suspect from the hemorrhoids) over the years and I actually was having a bit of urination pain (my primary symptom with it) a few days prior to the surgery, so I think those are fairly good guesses.
The prognosis was to just keep doing what I'm doing and follow up with the surgeon on Monday. They didn't want to start throwing antibiotics at me, which I think was smart, given the potential side effects and messing up my gut flora (that's how I got IBS in the first place). We'll see what my surgeon wants to do.
They gave me a liter of saline at the ER (that helped cool me down a lot), an oxy for the ride home and sent me on my merry way with what I'm sure will be an absolutely staggering bill (american healthcare is the absolute worst). Better to be safe than sorry though, I was really worried I was having a reaction to the pain meds or something, so it's good to know I don't need to worry about that or a severe infection/ complication with the surgical site.
I took a shower when I got back, ate a sandwich and a yogurt, wrote this and I'm off to bed now. So far I'm feeling better and my temp is holding right around 99.5.
The bumpy car ride to and from the ER didn't do my any favors with blood loss down there. It's looking a bit more like day 1-2 down there right now as far as what I'm leaking out after that.
I'm going to cool down the temperature of my epsom salt baths (and the length) and also lay off the heat pad, to be sure I'm not screwing with my core temp. I'll also keep drinking lots of water and trying to make sure I move around as much as I can so I'm not overheating from lying in bed too long.
Here's hoping for a better day tomorrow... It's going to take a hell of a lot more than a few hemorrhoids to take me from this mortal coil!
Curious... Anyone else have any fever experiences (or excessive sweating, overheating, etc) similar to this post op? It's actually one of the few things I don't see often reported in these forums so I must just be reaaaaaaally lucky...
sus62307 pita123
Posted
jane16431 pita123
Posted
i hear you about car rides. For my first week post op I was solo and had to drive myself everywhere, not great. I had to kind of prop myself up while driving.
pita123
Posted
Day 6 update time:
Today has been great!
I woke up at about an 7/10 for pain but that was just because I was so full of gas and had to pee badly. I slept for about 7 hours straight, which is a new post surgery record for me.
Once I hoped in the tub, I passed a bit of gas and popped my pain meds, I felt great. I really want to keep having bowel movements daily (thats my normal routine pre surgery) so even though I'm very Miralax sensitive, I'm not done messing with it yet. I went for a half dose this time (half a capful instead of a full capful), which did produce the "rapid fire" effect but this time it was only 3 fairly substantial movements and some gas and I was all done for the day. Still burns like hell afterwards but the warm bath and pain meds fight that off pretty well after 30 min to an hour. I think that half a cap might be the magic dose for me, so I'm going to stick with a half dose of Miralax and 2-3 Collace daily for the time being I think.
Not really much to report other than that. I've been taking my temp constantly after last night and I'm back to normal it looks like, except for one very weird reading of 95.9 and then 96.1. I was in the tub though and using my old thermometer, so I don't really trust that. I'm generally right around 98 all day, which is great. I did start to feel a bit flushed and sweaty twice today, but it went away just 5-10 min later and I never had a fever while it was happening. Still very odd, but if my doctors aren't worried I'm not. I actually got a follow up call from the urgent care doctor this morning, which was very nice of him. Can't say I've ever had that happen before from an ER visit. I'll definitely be going back to that place if I ever need urgent care again. It was a great experience last night with them.
Only thing a little out of the ordinary is that I just randomly started draining out a bit of brownish looking blood and bit of brighter blood today. I can feel it dripping down my butt crack as I lay here, which always makes it feel like more than it is (brain I think is trained to assume diarrhea) but it's probably about 5x as much blood as I've typically been seeing when I change my adult diapers out (every 4-5 ish hours). My surgeon told me to expect this. She said that the wound will start to scab up and then scabs will break and reform, so it's very common to see an increase in blood right around day 6. She was right on the money I guess because that's exactly what's happening right here on day 6. The blood mix smells super gross, like a rotten poop, but I'd imagine that's also to be expected. With all the tests I had last night, I'm pretty positive I'm infection free.
I'm down to every 6-7 hours for my 2 oxys and still taking the same amount/ times for my IB proffin/ Tylenol I have always been. In the middle of a pain med dose at about 4pm while laying in bed this afternoon, I think I actually got to a 0 pain level for almost an hour, which was amazing!
I won't spike the ball in the endzone yet here, as I know there may still be some more painful days ahead, but this is very encouraging progress. I think if I still feel this good tomorrow, I'm going to start up Stage 2 of my recovery plan, which is basically just trying to move around more and spending less time in bed. I'll probably stick to just moving around the house at first but hopefully by the end of next week I'll be walking my dog and some other things outside.
I've eaten the exact same thing for the last 4-5 days (turkey sandwich with avocado and no cheese, yogurt, small handful of ruffles potato chips 2 times a day) which has been great with keeping me consistent. I'm bored as hell of what I'm eating (probably never have another turkey sandwich / yogurt for another year after all this, lol) but what comes out every day is exactly the same and that right now is a huge plus and well worth it. I've only lost about 3 pounds this week, which is really great considering how lightly I've been eating. If I'm above 155 when I can start eating more normally, I'll be ecstatic. This is the lightest I've ever been and I've probably been about 10-15 lbs overweight for the last 3 years (except for the massive weight drop before surgery) so I'm going to take this opportunity to start getting in shape and maybe lifting some weights. I feel like with minimal work as I'm eating a bit more to get some more weight on, I'll be able to get in fantastic physical shape pretty easily. Hello abs!
Anyway, that's what I got for now but then again I went the ER an hour after this time last night, so who knows lol. Doubt it though.
See ya'll tomorrow for day 7
pita123 jane16431
Posted
Jane: I'm very impressed with your recovery story. No opiates, doing it solo and also driving? That's totally nuts! I think most people getting this done should probably try to plan on having a caretaker, taking meds and not driving anywhere for a few weeks, (so pretty much the opposite of what you did lol) but props to you for being so tough!! Beyond impressed, really.
Sus: Yes and thanks for reading my rantings here. Everyone has a different situation "down there" with the hemorrhoids, so it's tough to recommend something without feeling what you're feeling or seeing it myself, but my advice would be if they are prolapsing (poking out of your butt) and needing to be poked back in, causing significant pain or bleeding a lot, it's probably time to do something about it. Once they get to that point, they won't get better on their own and will inevitably complicate until you're forced into a surgery. Way better to plan this out carefully and do it on your own time in my opinion.
I had plenty of doctors tell me not to get the surgery as well. They where often the ones who didn't do a rectal exam or didn't specialize in issues of the butt though : ) At the end of the day, the best advice you can get on this is from a surgeon. A consultation with one will take less than an hour, probably not cost very much and while it might be a bit uncomfortable for about 5 minutes (brief rectal exam) it's well worth it to have a definitive answer, regardless if you actually go through with the surgery or not. It's funny to see you write "if I survive" because I said the exact same thing verbatim for years before this surgery. The reality though is that while there are risks with any surgery, you are not going to die from this. You may feel like you want to at points during recovery (lol) but this surgery actually wouldn't be a big deal at all if it wasn't in such a sensitive area. Anyway, that's my big pitch for you on why you should at least do a surgical consult and discuss your options. Best of luck and I'm around to help answer any questions if you need.
Thanks for reading and keep your heads up!
sus62307 pita123
Posted
I am sorry for all of your suffering, but your words bring great comfort, and are a treasure/gift to me. I have no bleeding (hence the "no surgery" surgeon said "you can manage these," but yes, prolapse. I am an active senior, approaching my 70th. Chronic knee pain from too much running in the 90's, but I walk A LOT, and work out 3x week with weights at the gym. I feel like the hems prolapsing rub up against each other a lot, causing irritation that aggravates the discomfort. Can't say that for sure, because to the touch they don't hurt...well, maybe a little tender because the hems skin is rather delicate. They are brown, not red, until you pull them apart and the vessel shows a bit more (apologize for the details, everyone).
I have already chickened out and took myself off the schedule of a surgeon I'd trust...twice! It would be awkward to go back, but I could do it. Let me ask this: Surgeon #1, came well recommended and is well-respected at the hospital. He is in late 60s, hospital is small, he said I'd stay overnight to make sure all is well because of my age. Surgeon #2, came well recommended and is held in high regard at the university hospital. Said I would go home on the day of surgery, pending all went well. He deferred post-surgery management to nursing staff. He said, his surgeries go quickly...so anesthesia would be short and surgery would go quickly. Considering these qualities and this story, do you have any thoughts?
Lastly, I am managing current flare-up and associated anal/pelvic discomfort until I see my pelvic pain PT on 9/11. I trust her completely, and she will do muscle, spine and internal pelvicexam to see to what extent the pelvic/anal nerves are aggravating my butt issues. From there, I'm back to making the decision whether to go to surgery.
Wishing this was a dream, and I'll wake up feeling glad it's not real. But, sadly, it is my reality.
Thank you, pita123 for reading, and for all of your patience and endurance of my posts. It is much appreciated, and I wish you all good health. Now, to the gym!
jane16431 sus62307
Posted
However more generally, as I have mentioned before, I would only have surgery if absolutely necessary.
sus62307 jane16431
Posted
Good day...if you have time and want to, it would help if you would tell me what you mean is "absolutely necessary." #3 surgeon said hem-ectomy unimaginable pain and she'd only remove if the bleeding were life-threatening and immensely interfered with quality of life. In my case, she said "I won't do it." Also, OB/GYN nurse practitioner told me "Even mixed internal and Grade IV external hems are mostly managed without surgery." Surgeon #3 and NP thought my pelvic, spine issues were referred nerve pain to hems, and my perceived hems pain is incidental, not the real issue. I am fortunate, my pelvic physical therapist had a cancellation so I see her on 8/30. I'll know more about the state of my pelvic nerves. Meanwhile, I manage...as we all are doing...sigh.