just to share my experience: I had done rubber band for 3 internals 4 years ago, but it turned out not working. Then I had this internal and external mixed removed 12 days ago. The 1st night was very very difficult, but starting from next night I started sleeping well. BM was not so bad first few days, but the blade feeling started to hit me on 5th day la)sted 3 days, and after that it reduced gradually. Sitz bath is very effective and helpful so prepare before your BM. I also had this swollen bump (like a new external hemo) appear from 4th day, put an ice pack under there is very helpful, the swollen started shrinking , so don't worry too much, it will get back to normal. I didn't take any medication after op, no painkillers, no softener. overall I feel I am on the way to normal. forgot to mention I used a prescription cream for hemorrhoids to treat my swollen bump, and it felt working on me.