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
pita123
Posted
Day 14/15 update:
Day 14 was my no oxy, no miralax trial and it went fantastic up until about 9pm, when I had probably one of the most violent bouts of diarrhea I've ever had. I have IBS-D, which manifests itself in what I call "blow outs" where I have a 2-4 hr fit of diarrehea, followed by intense cramping and just generally feeling horrible/ unwell. Imagine the worst you've ever had to use the bathroom, except you're on the toilet and nothing is coming out. Getting one of those attacks post op has been my biggest fear and rightfully so it turned out. It was so painful it's hard to describe really. Like every sort of pain I've felt so far, all at once. I also started bleeding more than I had at any point after day 3-4. Not to the point of being dangerous, but still alarming. I finally tapped out at about 1:30am and took 1 oxy in the tub. That slowed down my gut and I was able to finally sleep for about 5 hours before waking up this morning for one more quick blast of diarrhea and then nothing for the rest of the day so far. Hoping it stays that way as I write this at 10pm... I'm still using sitz bath attachment to poop into, so diarrhea into that is just... unbelievably gross. Same with the tub the couple times I just didn't have time/ energy to get out...
I did go see my surgeon for a follow up this afternoon. I really do love my surgeon. She has a fantastic bedside manor and really cares about me, which is very refreshing in the endless shuffle of doctors, surgeons and nurses I've seen over the last month. The first thing she did when I saw her was offer a hug and say sorry for all the hassle with getting meds refilled, not being able to get ahold of her, etc. She did an external examination of the wound (thank god she didn't go in there) and she decided to put me on antibiotics since she considered the discharge I had as an abnormal amount. I'm on amoxacylin for a week, which should hopefully knock out anything else I might have going on like a UTI as well. We didn't bother to test for that, as I'm on the antibiotics anyway. In the past being on antibiotics also generally kept me IBS symptom free, so I'm hoping that trend continues and gives me some time to heal up. She also gave me more pain meds without me even asking. Hopefully I don't have to use them but its very reassuring to know I've got them if I need them finally. I still haven't taken anything today except for IB proffin and tylenol and I'm actually doing fantastic on pain right now. If I'm not moving or sitting down (aka lying down in bed) I'm at a literal 0 on pain as I type this but if I'm moving around, more like a 1-2. I'm finally getting to that pain point after about 4-6 hours post BM after a couple sitz baths and it generally stays that way unless I have to poop. Days like today with BM's all at one point in the day are fantastic, as I'm mostly human again for the rest of the day.
Moving around / sitting I think are my big next steps. Getting myself into and out of the car today for the appointment and 1.5 hr round trip drive and then walking around the clinic, having to sit in chairs in waiting rooms both really pointed out that I've still got pretty bad pain down there and a ways to go on healing if I'm trying to move around still. I'm taking inspiration from Jane in this thread though, who got up and started running long before I have and then hopped on an international flight 8 days post op, so each day I continue to try to push myself with walking around more and also sitting. I'm hoping the more I do it, the less it hurts. No pain, no gain or whatever. I'm also going to be taking Benifiber as soon as I can as well. My plan is that as soon as I can poop without the sitz attachment (aka pain) to start working my way up to a full dose of that. I'm really hoping that also sets me right on IBS. Also going to continue to try to eat better (veggies, fruits, whole wheat bread, etc) because I certainly don't want to find myself back here again.
Drug wise I'm down to only 2 collace a day, max dose IB proffin, max dose Tylenol. If things get really bad I'll also do 1 oxy (mine are 5mg) but that's really pulling the emergency chute at this point.
Here's to a better day 15 and pain free pooping! (hopefully soon)
jake31434 pita123
Posted
pita123 jake31434
Posted
Hey Jake. Yeah, so far I feel like it's worked. She definitely removed the three internal monsters I had before. Pre-op, on every BM they would prolapse, almost entirely blocking my rectum and making it very hard to pass stool even when it was pretty soft. I used to have to apply hemorrhoid ointment to the prolapse and then sit down on the toilet seat until they slipped back in every time. That part is definitely gone now, which is fantastic even though it still hurts like hell to poop.
A lot of what I think people will feel post op depends on what kind of hemorrhoids they have and where they are located. I had 3 internal and then a skin tag removed and they where all pretty close to the end of my rectum. That meant a lot of swelling post op and the feeling of still having a prolapse that still continues but gets better each day as swelling goes down. That I think is the skin tag that the surgeon removed is really the only thing bothering me at the moment now, as it is a bit swollen up and feels like protruding hemorrhoid. This is a symptom though I've seen widely reported in the post op on this procedure though and most people report the swelling finally going back down after a month or so. I will most likely end up with a little bit of a skin tag when this is all said and done since she had to cut so much out and so close to the end of the rectum but it should be painless after it's all healed up. Much preferable even if I do end up with a tag then where I was at pre-op. I probably would not get it removed (that is an option) if so. It's less painful than the full hemeroidectomy but anytime you start slicing stuff up down there, you're going to have a bad time.
I was saying this as early as day 2-3 when things where really, really bad: If anyone reading this is still debating doing the op, just do it and get it over with. Life is too short to live with hemorrhoids and while the post op really, really sucks, the end result will be very worth it. The full hemroidectomy is really the only guarantee you can get towards getting rid of hems permanently. I'm going to also eat much healthier and take fiber regularly after this to prevent this happening again, although it's pretty unlikely with how much scar tissue I have down there now.
sus62307 pita123
Posted
Love the continuing good news, pita123...I'm very happy for your progress, although the IBS-D is the pits. I've got IBS-C, hence a diet of high-fiber foods, few sugars, easy on the caffeine, lots...lots of water, and occasional Miralax dose if feeling stuffed up. Just thinking out loud here...I watch my office mates on the days that I work...they drink zero water throughout the day and rarely get up to take a bathroom break, or a stretch break. I'll bet they can't talk poop and hemmies as well as my forum-friends....feeling fortunate to have found such an educated, experienced group.
Continuing pain free days to you, pita.
SUS
pita123
Posted
Day 15/16 update:
It's been a weird few days. My stomach is still a little messed up and I've been having diarrhea. Thankfully I haven't had an IBS "blowout" type episodes, it's just like my normal BM's have just been liquid. I'm even able to pass gas normally between them, which is very odd compared to what happens when I normally have it. That was the case all during day 15. I only had 3 movements all day (2AM one PM) but they where all diarrhea. When it's liquid, its much easier pain wise on my stitching that is "up there" but it is really aggravating the wound I have right at the end of my rectum. I suspect that is where the surgeon removed the skin tag. It's opening that up each time I'm going and it's diarrhea, resulting in a bit of blood on wet wipes as I clean up and results in a sharp stinging pain that lasts a few hours until it scabs back up. I'll take it over the deep aching pain of the last 2 weeks, but it's still very annoying. Other than that though, I'm feeling pretty good. I have a decent appetite, I'm just a little afraid to eat very much with the "liquidity" going on down there. I worked a full day (from my bed) on day 15, watched a couple movies and went to bed.
Day 16 (today) was a little better. My stool has gotten a little less liquid. It was just like a big pile of sand for both movements today (1 AM, 1PM) but the effect of opening up that wound at the end still remained. I worked another full day in bed and ate a pretty good amount of food throughout the day. Before I went in for this surgery I had a truck posted for sale and I finally felt well enough to show it to a couple people today. Not much in the way of activity, but a lot more standing/ moving around than I've been doing. That wound at the end of my rectum I think is swelling up a bit. It feels like when you have a prolapsed hemorrhoid sticking out but it feels better with laying down or being in a bath. I think the stuff inside me is healing really well now. The deep aching pain is pretty much gone now and I just have that stinging pain from the "end wound" after BM's or moving around a lot. Sitting is still not great so I'm still working from bed and hanging out in there most of the day.
I think the antibiotics (amoxacylin) might be what is messing with my stomach, although I had that first bout of diarehea a day before I started taking them and this would be the first time I didn't tollerate an antibiotic well. I only have 4 more days worth of them though, so I'm a little hesitant to call the doctor and switch to a different one at this point as I'd have to start over. Hopefully I'll have some more formed stool tomorrow and if not, I'll probably call the doctor for an opinion on what to do. I haven't had a really solid (this is relative, they've been formed but soft before this) one since in the day on Monday before that big IBS blowout. The antibiotics do seem to be helping a bit with the discharge I've had though. I have less of it now and it's much less smelly, which is encouraging. I also haven't had a fever yet, so I'm really starting to think that was due to my body fighting off the infection at the surgical site.
Obviously with the diarrhea problems, I've backed off the stool softeners/ miralax routine. I took only 1 coallace on day 15 and didn't take any at all today. I've also been off the Oxy completely since Monday night and I'm able to manage the pain with baths and IB proffin + tylenol as needed. No Miralax since last week. I'm wondering if maybe the stool softener had a cumulative effect or something too which might be causing the diarrhea, who knows. I've been mixing up what I'm eating too and it all seems to have the same result with liquid constancy, which I think points the finger at the antibiotic. The only other thing I'll change for tomorrow is just no wiping at all (I've been very gently using some wet wipes on the outside to clean up a bit before jumping in a bath or shower to clean off). I'm going to just start jumping right into the shower right after and let the water clean it off instead for a few days. I hate the idea of the wound opening/ closing all the time as I think that will just drag out my recovery time even more and possibly leave me with worse scar tissue there.
I'd say overall, I'm at about 80% so far, which is a big improvement in pain over where I was about a week ago. Once this diarrhea finally goes away, I'm thinking I'll be jumping up to 90% pretty soon. I'm also being realistic that it could take the better part of a month for that last swollen wound at the end to finally shrink down a little more and stop opening up all the time based on the other posts I've read. That will also be the key to finally sitting normally again I think too. Most people with this are convinced they have another hemorrhoid but after a month or two the swelling finally goes down it looks like for most people. My surgeon didn't seem to concerned about it when I saw her, so I won't be either. I feel like if it really was another hemorrhoid or something that isn't supposed to be there she would have mentioned it after her exam.
It's really just an endurance race of patience at this point as I very slowly work my way up to that magical 100% back to normal state. Just going to keep up what I'm doing and let my body do it's thing.
jake31434 pita123
Posted
Sorry to rant about my follow up appointment here haha. I just feel like if this doesn’t work then my only option is to wait until they’re bad enough for a full hemorrhoidectomy! What an event to look forward to. Although I have heard that banding sometimes doesn’t work if they’re too small so maybe if they get worse I could try that again. Who knows with these horrid things!
pita123
Posted
Day 17 update:
Solid (but soft) poop again! Hooray! lol. Had two pretty normal BM's this morning, which is great. I'm eating a bit more too, which is also a good thing as I'm down to 152 now (162 pre op). Can't afford to lose much more weight at my height. Pain with the more solid BM's is back to the deep aching for an hour or two afterwards, so it seems like an either-or situation with aching vs sharp stinging depending on if my stool is liquid or solid. Manageable without pain meds though still except IB proffin, which is a good sign.
One thing that is driving me nuts is something that is poking out of my butt. It feels a lot like a small prolapsing hemorrhoid like I had pre-op but that shouldn't really be possible this soon after the op and after she cut them all out theoretically... I hope.... It's the same thing I was mentioning in my post yesterday that was opening up/ stinging after the diarrhea. It's sensitive to the touch and red. It's what is making sitting so uncomfortable too I think. Putting pressure on it hurts. I'm really hoping that this is just remaining post op swelling, possibly from one of the hemorrhoids she cut out near the end of the rectum or the skin tag she removed down there. I see the surgeon again on the 18th (11 days) so I'll ask her about it then if it's not (hopefully) gone already. I really, really, really hope it's not another hemorrhoid.... I've read some stories previously about people getting this surgery and then suddenly developing an external hemorrhoid after getting internals removed when they'd never had one before. I would think though that this soon post op, doing 0 pushing with pooping at all (and into hot water still), considering everything she cut out and how carefully I've been eating that it would be impossible at this point for it to be another hemorrhoid...
Anyone have any similar experiences with the little poking out post OP I'm describing?
pita123
Posted
Week 3 update:
Well... I'm not going to say 3 weeks was THE magic number but it certainly was A magic number in my recovery here pain-wise. The antibiotics seem to be doing their thing. My yellow/brownish discharge is not just a couple drips every 6 hours or so and it doesn't smell anymore at all. Also no more low grade fevers, so all signs point towards the infection being under control. Just took my last dose of antibiotic this morning (1 week course).
Pooping is still not normal but not nearly as painful as it was before. Depending on the size, frequency and consistency, I have varying amounts of mild stinging/ burning after but it's managed pretty well by a 20 min hot bath soak after a BM and then laying down on a pillow afterwards. I'm still not using toilet paper (just jump into the shower to rinse off after) and haven't had any blood at all after switching to that last week.
The biggest thing bugging me right now at week 3 is just the swelling. I have a little red thing about the size of a skittle sticking out of me that feels and looks exactly like a tiny little prolapsed (and thrombosed) hemorrhoid. It's right in the middle of a bunch of stitching that I can feel as well. It makes walking uncomfortable and same with sitting or standing for more than a few minutes still. I got very discouraged when this started (a couple days after the 2 week mark) as I thought I might have developed another hemorrhoid after all this, but after combing the internet, this seems to also be normal.
There is a A LOT less information about what to expect with this week 3 onward on the forums (makes sense, there is much less pain at this point so people are less likely to post about it) but from what I can track down, it seems like people have experienced this swelling for up to 2 months post op and that it should start shrinking gradually soon. People get better and then forget to post follow up's so it makes it pretty hard to track but most people report being mostly back to normal in about 6-7 weeks. I'm stealing this from another member, but I'd coin this as "the swelling stage" of the recovery.
Aside from the annoying swelling though, I am doing pretty well. I'm eating more now and my bowels seem to be at least slightly going back to their normal routine of just a couple morning BM's. I've even gained a pound in the last few days instead of continuing to lose weight, waa hoo. Hopefully I'll be back up close to my pre-op weight (162, 156 now) in a couple weeks at this rate. Still off the opiates (just NSAIDS and tylenol and 1 stool softener a day is doing the trick) and just drinking a ton of water. Coughing was rough stuff for the first couple weeks, so I've finally been able to start smoking weed again, which is great for the pain and keeping me sane during this endless recovery marathon!
If anyone has any stories to share about the post op "swelling stage" I'd love to hear them. There's not nearly as much info out there on how long that can last, so I'm curious to hear people's experiences. As soon as that goes away I think I'll be pretty much 100% back to normal I think. Hopefully I'm one of the 6 week ones, not one of the 2 month ones.... And hopefully I'm not one of the 5% of people who get new hemorrhoids after this procedure... Seems unlikely that it would happen this soon after all the hacking and slashing down there and that I haven't been pushing at all when using the bathroom post op but still always in the back of the mind...
I see my surgeon again in a week, so she'll be able to take a look at this swelling and tell me whats up. I'll report back what she says. It better not be another hemorrhoid!! Lol.
I'll be off the daily updates now and probably closer to weekly unless something dramatically different happens.
jane16431 pita123
Posted
Peter
pita123 jane16431
Posted
Did you have these swelling problems as well? Consensus seems to be that I’ll see a dramatic improvement on that too somewhere around week 5 or 6. That’s the only thing bugging me anymore really. Makes poop come out perfectly vertically thin because it’s squeezing though all the swelling lol. Sucks to sit / stand/ walk because of it still too (feels exactly like a prolapsed hemmerhoid)
jane16431 pita123
Posted
sus62307 jane16431
Posted
Wondering, and I mean this seriously...does "normal" mean a typical/normal bum as in people without hemorrhoids? I so want to get rid of the lumps that require a great deal of cleaning after pooping. The lumps also feel as if there's pinching and rubbing that irritates the skin over the lumps. Did you have that, too, and is the skin typical bum skin? Thank you for reading.
jane16431 sus62307
Posted
sus62307 jane16431
Posted
Ah, I understand. "No lumps or bumps" would be my goal. You raise another question, if and when you have time to reply...what was the big issue with returning to normal BMs?
Thank you.
SUS
jane16431 sus62307
Posted
But for me it was less the pain of actually going but more the subsequent pain which could last hours and almost be worse than the BM itself. That took a good 10 days to become consistently tolerable.
pita123 jane16431
Posted