Have dreaded this for 20 yrs. Going into surgery soon. Pls. respond

[nh_user_1395603]

Hi fellow sufferers,

As per my title, I have suffered off/on with hemmies for over 20 years. At first it wasn’t that bad and could be managed, but I just pushed myself too hard with young children/life/work/being a perfectionist and I am now in a place where surgery is the only option. I now cannot participate in any type of activity without extreme pain ( ie - bending down to floor level to pick up trash ) and will have to resign from my highly skilled job unless this is resolved. I do think I have an extreme case. I am unable to perform daily tasks of living without these protruding and most likely thrombosis. I want nothing more than to be free from the on-going pain of hemorrhoids.

Reading these forums has me terrified of the procedure. My doctor uses LigaSure procedures/equipment and a long acting (exparil) analgesic. He is very confident that the recuperation will not be the nightmare I am anticipating, but reading these forums, most doctors say the same thing. Please let me know if you had a good or bad experience with a very confident doctor. Mine says that I can expect pain at a 6 ( at worst ) on a scale of 1 - 10.

Also, I drink alot of alcohol, every day. I will start a different thread on that, but am wondering about that on recovery.

I am in the United states and it seems most everyone one here is over the pond. I haven’t been able to find a USA forum comparable.

Thank for reading, if you got this far.

Terrified in Virginia

[nh_user_1394981]

Hey there. I would gladly give you my recovery experience but it was the conventional method, not LigaSure. So I’m afraid it’s likely not comparable and I wouldn’t want to mislead you. Did you go through with the sugery? I hope you are doing okay!

[nh_user_1395603]

Wolfer, thank you SO much for your reply! LigaSure is the equipment used and it is still considered ( at least by my surgeon) a traditional closed hemorriodectomy.He said he will use ligaSure on the very large hem on the left. The difference, if I understand correctly is that LigaSure uses a laser type heat to seal the wound verses stitches. The one on the right, he said he thinks he will suture. Overall, he does not know how he will proceed until he gets in there, during surgery.

I would Very much like to know about what you have been through and how your recovery is going/has gone. I am beyond terrified but also in a substantial amount of pain atm due to the hemmies. I am off work, as of today and my surgery is not scheduled until 09/23. I teach disabled 2-5 year old children. My admin wants me to take off ( and use my sick leave) now , as we were able to procure a long-term sub, which is hard to get in my line of work.

I just see no way out. I don’t think i will live through the horrendous recovery but I cannot work, as I am.

I’m not in the best of health, underweight ( 94 lbs) and will basically need to recover on my own.

I’m just so scared! Also, my bowels have been a mess for a long time - prolly due to the hemmis. I poop small amounts about 10 or more times a day, with lots of bile/blood. Cannot see that leading to a “good” recovery.

Any help or encouragement from anyone would be greatly appreciated!

[nh_user_1397238]

Hi Jbutt,

I’m Ben and I have been recovering for the past 10 days from a HALO surgery to remove 2 internal hemmys (not actually sure the size). Now I’m not trying to scare you or talk you out of the surgery but i’m also not going to sugar-coat anything as down the line if you think I’ve lied about anything you might come to hate me so here it is.

The recovery sucks, absolutely sucks. I’m unable to go to the toilet without being in a large amount of pain. The ‘pressure’ the doctor might mention sticks with you for alot longer than they say. I’m still unable to sit down 10 days in and have no idea when its going to change.

Thing is, unless a doctor actually has this surgery, they dont know what the $"%! theyre talking about in terms of recovery. Now, what I would say, even after all that, is you need the surgery.

I made the mistake of having the surgery even though I only had the haemorrhoids for less than 1 year, they weren’t painful at all and only bled a little but everything else was fine. But for you, someone who has been in pain for some time and cannot continue, what’s another month or two?

Yes, you’re going to get incredibly depressed and in pain just like I have and you’ll want to world to swallow you whole but just think. In a few months you’ll be back to your self, being able to do any of the activities you want. Thats whats keeping me going. 1 day at a time, 1 hour at a time. I’m a 25 y/o male who has never cried in my whole adulthood until a week ago. Now i’m crying to my GF and family every night BUT I just keep thinking time. Every day I’m 2% better so eventually, after all the rough. I will be back to perfect condition.

I have read most of the threads on this forum and people in your condition say its 100% worth it in the end. SO good luck! and remember, it will all be worth it.

Make sure before you go to surgery to get essential items, soup, porridge, stuff like that. Also use wet wipes rather than toilet paper TRUST ME. You want to use wet wipes.

Happy to discuss anything else.

[nh_user_1397208]

hi there!

I am from the US and 4 week post op from hemmie surgery. I had external and internal piles removed during my surgery.

First and foremost, I feel on line the description of this surgery is completely inaccurate. When i googled information, I felt they down played the pain and RECOVERY terribly! After four weeks, i am still in discomfort! I tried to return to work yesterday (at a desk job) and only lasted a couple hours. The balancing of keeping your bowels loose enough to withstand a bowel movement without causing diarrhea is so difficult. On top of that, the pain medicine that makes your pain a smidge better-constipates you?!?! I went 8 days without a bowel movement, so my first BM was the most painful experience for me to date. Keep in mind, i have had two children, kidney stones and gastric by pass surgery. So, I thought i had a high tolerence for pain prior to this surgery. None compares to the pain that i felt during my first BM . i literally was laying on my bathroom floor crying out in pain and swore inwould pass out if i continued to try and have a BM. Everyday is different, and you certainly have good and bad days! i had way more bad than good! It is completely normal to feel like you cant empty your bladder or you still have a large BM inside. I could not tolerate the pain to poop without my sitz bath. So, make sure you have a sitz bath always ready! I could literally only go while sitting in them. Sounds gross, but I would turn around and pour it into the toilet. Having the water as hot as I could stand definitely helps.

I have so much more I could go into, but I will let you ask me the questions. My surgeon was fabulous and answered all my questions promptly. i just wished i had someone that had been through this to help me. I am more than happy to be that for you! Thats why i joined this forum!

[nh_user_1395603]

Thank you so much Ben and Angie for your replies. It means so much to me, as I feel completely alone in this. My ( adult) children and friends just do not understand the unique pain of rectal health problems and my work is putting immense pressure on me to just get the surgery.

My surgeon did say that, in his opinion, a traditional excisional hemmoriodectomy, using LigaSure ( partially, maybe - he said he won’t know what he is doing until he gets in there) is the only procedure that will permanently take care of my issues. So, no HALO, THD, PPH ( stapling) etc. options for me. At first, I felt confident in him, as a surgeon. And when speaking to him, I still kind of do, but there are some red flags. I got the standard " you will be back to work in 2 weeks", “there is discomfort during recovery”, but what really got my attention was when I discovered that there are 2 colo-rectal surgeons in this practice and one strictly does the Ferguson hemorrhoidectomy ( him)and one strictly does the PPH ( stapling) and once a patient sees one doctor for initial consult, THEY WILL NOT LET YOU SWITCH TO THE OTHER. Wouldn’t you think the prescribed surgical procedure would be tailored to the patient’s presentation/needs?

But anyways, Ben, I am so sorry you are having to go through this at such a young age. Your youth/less symptomatic hemmis is on your side for a successful HALO procedure/recovery. I have read that recovery from HALO can be extremely painful, regardless of the marketing. You are now (hopefully) past the worse and have a chance at a hemorrhoid free long future. I so wish I could go back in time and done something to rid myself of these horrible demons almost 3 decades ago, when I was much more physically healthy and saved myself decades of grief. It’s hard now, but you are saving yourself so many years of suffering and lost experiences.

Angie, I do not know how to go back and re-read your response, but it means so much to me. YES, I want a mentor through this! I’m still not 100% sure I will follow thru with the surgery, but cannot see how I can keep my job without. How is your recovery going now? If I remember correctly, you are 4 weeks post op? That is a long time, but typical for what I am seeing on forums and actually, most people post that if they are 75% by 4 weeks, that is a “good” recovery. I don’t know what to believe. Surgeon tells me not to read forum posts/google and says I will experience pain at the max at a 6 ( 1-10 scale), but 98% of the forum posts I have read contradict this. I don’t think hundreds of people are going to take the time to basically post the same horrendous recovery story if this isn’t the norm. I really just want to connect with others that have actually gone through this.

I have had episodes of strangulated, thrombosed hemorrhoids ( golf ball size) and that was the worse pain I have ever been in. It is fear of this happening again that brought me to the surgeon. I have had broken fingers, jaw, ribs, foot surgery ( no fun ), bad car accident that left me wheelchair bound for a year with a drainage tube in one knee and had to have surgery on both knees, plus about 8 inches of skin/flesh abraded from my foot ( you could see the bone - that was REALLY painful), 2 c-sections, one that eviscerated, maybe we forget the pain, but I really think when these roids are flaring, it’s more pain than anything I have gone through. So, so scared to get the operation.

[nh_user_1375752]

Well if it makes you feel any better, I’m having two surgeries at Mayo Clinic in Rochester, Minnesota this Thursday, 9/23. I’m having an open hemorrhoidectomy along with a Delorme procedure to fix a rectal prolapse. I’m terrified, and even more so, after coming to this forum. I’ve picked up the phone every single day for the last two weeks dialing the number to “back out”, but I know I must have this surgery. My surgeon at Mayo is obviously a very highly skilled surgeon. You’re not employed at Mayo unless you’re tops in your class / field of expertise. I’ve conveyed to him how anxious and stressed out I am over the “post-op pain”. He told me:

"I’m not going to sugarcoat it. It is painful for most people. With that said, people tend to post their experiences when they’re bad, not so much when they’re good. So take that into account when you’re reading online. I’ve had plenty of patient’s who are back to work in 3 to 5 days so it all depends on the individual. Those are the stories you won’t read about. I’ll be sending you home with a healthy dose of local anestitic that should keep that area numb for the first 2 or 3 days. You’ll also go home with a myriad of drugs to help you deal with your pain. "

So I’m probably going to stay the course. You mentioned “alcohol”. Well I’m “opioid tolerant” having been on Subutex and Suboxone for over 20 years straight. This creates a myriad of problems with “pain relief” and I’ve told my doctor’s about this. They are taking me off the Suboxone on Monday and replacing it with a full agonist opioid, like oxycontin or morphine tabs, for the 72 hrs prior to surgery. Afterwards, I’ll require steady opioids, not simply for pain, but to keep from going into severe withdrawals. They do not want me aggressively vomiting and having severe dihrrea in the immediate days after surgery. But I’m still so very worried. Being on opioids for 25+ years straight (fentanyl originally than Buprenorphine / Subutex / Suboxone), I find I’m almost “hyper pain sensitive”. In other words, normal minor pain, say subbing your toe for example, hurts significantly more than it should. That means major pain will be excruciating and will require significant doses of strong opioids. I’m not sure my surgeon is going to provide me with those types of pain meds. But “5 MG percocets” or “10 MG hydrocodone” I wouldn’t even feel. I’d feel more from an 81 MG baby aspirin. So like you with alcohol, I have plenty to fear myself. I wish you nothing but the best. Maybe we can draw some support from each other as we go thru this surgery this week.

[nh_user_1375752]

My internal hemorrhoids were a perfect case for “stapled hemorrhoidectomy”, but I’ve done A LOT of research and have spoke with several doctors across the world. They all told me: DO NOT GET A STAPLED HEMORRHOIDECTOMY !!! This procedure can cause significant problems if it’s not done perfectly. Anal stricture, bleeding, and long-term pain are all common. Every doctor I spoke with, and it’s upwards of over a dozen, said “go Milligan Morgan (closed) or Ferguson (open) hemorrhoidectomy”. HAL-RAR or THD is a good option too, but still doesn’t have the low rate long-term recurrence that the gold standard closed or open hemorrhoidectomy provides. I seriously wanted HAL-RAR / THD but because of my rectal prolapse my surgeon didn’t recommend going in that direction.
We’re both having surgery this Thursday, 9/23, assuming neither of us back out or test positive for COVID. It’s terrible. I’ve actually had thoughts of hoping I test positive on Wednesday and they say “sorry. Can’t go through with it”.
Please stay in touch. It actually gives me some comfort thinking I might have some one I can talk to and maybe help each other out with tips that we find work well.
Best wishes irregardless. I’ll be thinking of you Thursday.

[nh_user_1395603]

Drug350,

Thank you for responding to me. I am trying to figure out how to P.M. you. I am new to this site and not computer savvy.

In my extensive research, I would never have the PPH. It is advertised to be less painful/shorter recovery time, but from what I have seen this is very much often not the case. The complications from PPH are quite severe and the recurrence rate is quite high after 10 years. It appears that people that undergo PPH or traditional surgery are in extreme pain for the same amount of time.

I eagerly pursued THD/Halo after my initial consult with first surgeon ( geeze, I would pursue anything to get these taken care of as painfree as possible). It was very hard to find a surgeon who performs this procedure close to me and they never called me back. My original surgeon also stated that he did not think i was a candidate for THD due to the size of one hem on the left and I also have rectal prolapse! He said in his opinion, it would not work, it would put me through a painful recovery for nothing and may make it more difficult to recover from the needed full hemorriodectomy I would finally have to have. This gave me some confidence in him.

One thing that made me pause. We only have about 5 colo-rectal surgeons in my very large city. Through research and repeated office visits, I discovered that each surgeon does one procedure and whichever surgeon you see, you will get the procedure that one does! My doctor’s office has 2 colo-rectal specialist. I originally was scheduled to see Dr. Rameriz. My appointment was cancelled. I got a call later that week due to a cancellation and was scheduled to come in. I saw Dr. Buckberg. I had NO IDEA what I was facing. Long story short - Dr. Buckberg does excisional hemmoriodectomy. Dr. Ramariz does PPH. and regardless of what is best for the patient, THEY WILL NOT LET YOU SWITCH DOCTORS!

I have read so much and even though I am terrified, I think I would rather go with the full surgery ( one and done) than continue to try other options. Those options can hurt alot too!

Now, onto the drug dependency issue. I am so worried for you and me that we have a tolerance that the general public does not have. Added, I’m afraid to tell my doctor that I drink a bottle of wine every day, cause I’m scared he will not prescribe pain meds. Due to taking in these substances, we build a tolerance and the pain meds will not work as well. Very scary cause we do not know what we are going into.

My surgery was scheduled for 23rd, but they called and rescheduled for 28th. I was originally supposed to have it on the 17th and the repeated delays have not been good for my moral.

I will SO much be thinking about you on the 23rd. It is so scary, but once behind you,life will be better. If the pain meds do not work, do not be shy about asking for more!

much love and good vibes!

[nh_user_1375752]

Thanks for getting back to me. I can’t believe that “the doctor you have your appointment will do the surgery that he specializes in, irregardless if it’s actually to your benefit”. OMG !!! I’d be running if they told me “you’re with Dr. Ramirez and he does PPH so that’s what you’re getting”. I believe PPH “can be” a good option for some, but the surgeon must be really good, have plenty of experience doing PPH, and it’s got to be a good fit for the patient. From everything I’ve read, and talking to quite a few doctors, they say “if it’s not done perfectly, you’ll have a lot of problems”. Everyone of them advised me to stay away from PPH, and go standard “open” or “closed” hemorrhoidectomy. My surgeon is doing a partially closed hemorrhoidectomy. There’s benefits and drawbacks to each. “Open” has less post-op pain, but it’s extended because the healing takes significantly longer to fully heal those open wounds. There’s also less chance of infection with open, which surprised me. “Closed” has more post-op pain, but it’s duration is shorter as the wounds heal in approximately 17 days. So it’s a trade off I suppose. In Europe they do mostly “open”, here in the US, it’s mainly “closed”. I guess my doctor is doing a hybrid, or “partially closed”.
I really hate the way I’m treated whenever I have to bring up “being on Subutex/Suboxone”. I feel I’m immediately placed under suspicion and looked at as “just another scumbag”. I never had a problem with opiates. I’ve never touched a street drug. I was in a motorcycle accident years ago in the mid 90’s. I was in ICU a month and laid up for over a year with a myriad of broken bones, including a broken neck. I was placed on Duragesic Fentanyl patch, eventually taking 300 mcg’s. I never “came up short on my meds” or was any kind of problem to my doctors. But when I thru with my final surgery, some 3 years later, I no longer needed pain meds. My doctor weaned me down quickly to 50 mcg’s of Duragesic, which at the time, was the lowest dose. 50 mcg’s of Fentanyl is still alot. Today they make 12.5 and 25 mcg patches just as an example. When I got down to the 50 mcg, my doctor said “OK. You’re at the bottom. You’ll have to rough it out a little. It shouldn’t be too bad.” OMG!!! I got so violently sick, I ended up in the ER for dehydration overnight and they put me on Buprenorphine or Subutex and released me the following day and had me see an addiction doctor. This doctor kept me on Subutex, and every time I tried to stop, it was absolutely miserable. I stayed with this doctor for well over 15 years. I was her easiest patient. Never tested positive. Never ran out of med’s. I just could not get thru the withdrawals. I kept thinking “one day they’ll come out with a cure”, and so I take my Subutex / Suboxone every day, just like a vitamin. I’m on a super low dose, only 4 mgs daily. But I just can’t take the withdrawals. My current doctor of the past year, (I moved out of state and with COVID my long-term doctor was unable to see me) says “you don’t have an addiction problem. It’s all in your head. You just need to stop”. He’s right about the addiction problem, but he’s never gone thru WD’s and thinks being at such a low dose, I can stop and not suffer much WD’s. He’s out of his freaking mind!!!
Sorry to be writing this “novel”, but I am a very unique case. I’m not the typical “Suboxone patient”. I wasn’t using heroine, losing jobs, marriage, house, constantly relapsing. I’ve been married over 20 years. Two beautiful teenage daughters. Same great job the entire time, and I’m subject to Federal Random Drug Testing and have never failed one, because I don’t use drugs. But because of this Suboxone, I’m always treated differently. I can’t even get life insurance. I get turned down as soon as the insurance company does a check on my prescription fills. It sucks!!!
I’ve told my surgeon that my doctor is switching me over to oxycontin tomorrow, so I will require constant opioid medications, not just for the pain, but to keep me from going into violent withdrawals. He assured me “they deal with opioid tolerant patients everyday and that you’ll be sent home with everything you need”. I’m going to confirm again on Thursday, prior to the surgery that we’re on the same page because I will have to cancel if he plans on sending me home with “800 MG Ibuprofen”. I’m more fearful of withdrawals than I am of the surgery, and that’s saying a lot because this surgery has me scared to death.
I don’t know if I’d tell your doctor about your alcohol use. You may be right. They may not want to prescribe you pain medication if they’re worried about you drinking. I’d probably keep that to myself. I tried not disclosing my Suboxone prescription, but they pulled up the state controlled substance website and said “are you still taking Suboxone”, so I had to come clean. But with surgery, I’d have to make them aware or they would not prescribe the proper pain meds not knowing I’m opioid tolerant.
How are you dealing with them postponing your surgery date like that??? I’m soooooo stressed out and anxious about it I’d probably lose it if it got changed, especially multiple times.
What are they going to do for your prolapse ??? Is it a “full” or “partial” prolapse (mucosal prolapse) ??? Or is it just the internal hemorrhoids that are prolapsed ???

[nh_user_1395603]

Hi drug350,

It is alarming to me that my colo-rectal surgeon performs one procedure, his partner performs the other ( PPH) and I was told they will not switch patients. I have read a couple of posts where others came across this same dilemma. Fortunately, from my research, I think the closed hemorroidectomy is most likely the one best suited to my needs. My surgeon ( Dr. Buckberg) strongly advised against PPH - and that’s what his partner does! I have not gotten very much information regarding what will be done to me when/if I have this procedure. He has only done a visual external exam. For the hemmies, he said he thinks he will be excising one or two on the left and suturing one on the right. For the rectal prolapse, I think he said they lift it and suture the mucasa/tissue ( ?) onto the back wall ( by the spine). He did state that he really cannot be sure what he will do until he gets in there and sees what is going on. My surgeon also told me that he did not think anyone performed the open ( Milligan/Morgan) procedure in the US.

So, it sounds to me like you are very lucky to have a surgeon that is tailoring your surgery to your specific needs. I wish I had the option of going to a well respected hospital with top notch surgeons. I do think mine is “good” at what he does, but more info would be nice.

Only pre-op instructions I was given was: no food after midnight, enema morning of and report to ----location at 10:00 am. At first, I was told I could return to work in 2 weeks, but after I explained my job, he said 4 weeks. He also said I should eat a normal diet post-op and when pressed, told me i should expect pain to be no more than 6/10.

He is using LigaSure equipment. I think this decreases post-op pain a bit. I wonder if your surgeon is going to use this too. And a long acting (exparil) sp(?) pain blocker, so should have no pain for 1-3 days after.

I am so sorry you are facing discrimination due to your Subutex/Suboxone maintenance. I do understand that the opioid epidemic caused changes in the way medical professionals view these types of medications ( and new restrictions!), but geeze! I mentioned that I am so anxious that I would like some anti-anxiety meds for the day of surgery and was treated like I was a skid row, drug seeking addict.

I have first hand experience with the affects of withdrawal. My very close girlfriend tried so hard and so many times to get off of methodone for a decade years ago. It was awful to witness.

I am glad and relieved that you (had to) disclose this with your surgeon. They are aware of your condition, so hopefully will be able to take the needed steps to aid your recovery. I can’t imagine that you would not be given adequate medication to stave off withdrawal while recovering. I just hope they give you enough to manage pain during recovery. Do you think your normal maintenance regime will be sufficient after taking all the painkillers post-op?

Don’t let yourself feel shamed/belittled due to needing Subutex/Suboxone. From what you wrote, you are successful in all areas of life and your meds just make it so you can continue to be.

I’m not doing well at all with the postponements! My second consult was postponed. When I finally got to see the doctor, I was ready to schedule, however; the person who schedules was on vacation, so had to wait 10 days to schedule ( no, they had no-one else that could schedule!). Was given a Sept.17 surgery date, but that was moved to the 23rd. Now told the 28th and all this time, all I’m doing is freaking out and googling! While my principal is putting intense pressure on me. I was in a much better mental state weeks ago.

I know you are scared. Your surgery is soon. It seems like you have taken all steps to prepare. It seems like your surgeon is highly qualified. You have a family to help you through this. Like I tell myself, it will be painful, but the pain will end. Your quality of life will improve SO much and most likely, you will never have to experience the pain of hemmies ever again. I’m wishing you so much luck.

and you think you wrote a novel

[nh_user_1375752]

Thanks for all the kind words !!! I am very fortunate to happen to live in Minnesota and have The Mayo at my disposal. The entire city of Rochester is built around this institution. It really blew my mind the first time I went there. They do things a lot different. They don’t waste your time. They realize people travel from around the world to come to Mayo so they run a tight ship. For any of your health issues, they’ll do all your testing, blood work, MRI’s, and get you thru all the different doctors you need to see, all on the same day. When you check in, you won’t wait but 1 or 2 minutes and they’ll be calling you. Get in the exam room and there’s no waiting “20 minutes for the doctor to show up”. Nope. He’s there waiting to see you. Really fortunate to live close to this health care establishment.
I saw my GP doctor today as she is also a Suboxone qualified doctor. She was soooooooo nice and empathetic. She gave me so much of her time and wrote out a long letter for me to bring to Mayo, or read it in my medical records, on how to deal with my Suboxone. She explained that “this patient will require stronger and higher doses of anesthesia and pain medication, both in the hospital and when he goes home”. She told me “Drew, I’ll be working here on Thursday and Friday. If you need anything, if they won’t prescribe enough of the proper pain medication, please call me. I have no issues prescribing you additional medications if they do not”.
OMG!!! I just about hugged her. This is why I ALWAYS ask for female doctors. I grew up with 3 sister’s, no brothers. I have a wife and 2 daughter’s, no sons. I find it much easier to talk with Females than men, especially when it comes to my medical issues. I find female doctors listen more, are more sympathetic, and give you more time.
I’m glad to hear you’re having “closed” surgery. Here in the US, that’s seems to be the norm, whereas in Europe, it’s mainly “open”. I’m going to ask my surgeon about this “partially closed” that he plans on doing. I’m sure he has his reasons. It’s funny, my original surgeon from a different health care facility, and this surgeon at Mayo said the exact same thing as your doctor: “I have to get you under anesthesia and once I get you open, I’ll determine what I’m going to do.” I was a little bit confused about it, as I don’t like “surprises” and this made me more stressed out and I told my surgeon this. He said “well if you want, we could get you under anesthesia and I’ll open you up and see what needs to be done. Than we can discuss what I find and plan surgery at a later time if that makes you feel better”. I thought about it, but I already have 5 weeks off from work starting tomorrow and honestly, I know what will end up happening if I go that route. He’ll do the exam, tell me what needs to be done, and I’m going to say “OK. You’re the expert. Let’s do it”. So I’m just leaving it all in his hands and going to go through with it in three days .
As for the prolapse, it sounds similar to mine. It’s not a “full prolapse” whereby the entire rectum sticks out several inches, but a partial whereby just the mucosal tissue is sticking out under an inch. If it was a full prolapse they would most likely do laparoscopic surgery through the abdomen and use sutures and mesh to reattach the rectum to the sacrum, or tailbone. This has a significantly lower recurrence rate vs repairing it from down below via Delorme or Thirisch procedures, but has a much longer recovery time and has risks for men, including causing impotence because of nerve damage. So if your surgeon is repairing yours from down below, it’ll be like a Delorme procedure, but just resecting the mucosal tissue and not the muscle of the rectum. Sorry if this is too much information or grosses you out. I’ve spent a lot of time researching all of this and you can watch videos of these procedures on YouTube.
As for ligasure, that is supposed to help with less bleeding, less pain, and quicker recovery. Here’s a link of that procedure being done on a female with several grade 3 hemorrhoids being removed with ligasure if you want to actually see it being done.

I’m not sure if my doctor is using Expirel or another kind of local anestitic, but I’ve heard that Experil is fantastic and truly helps a lot with the pain for the first 48 - 72 hours post-op.
I’ve bought a donut pillow, sitz bath, and a few other things in preparation. I’ll tell you another great product that I plan on using (unless my doctor gives me something similar), especially prior to BM, is this stuff off Amazon called “Revivol-XR Rectal Care Cream”. This stuff is amazing. It’s got 5% lidocaine, which is the strongest you’ll find anywhere, and it numbs you up down there instantly. I’ve been using it all year for pain when necessary. Read the 668 reviews and you’ll know it’s a great product. I highly recommend it. Here’s the link.

ReVIVOL-XR Hemorrhoid Cream, Max Strength 5% Lidocaine + Powerful Antioxidants for Rapid Relief from Pain, Itch, & Burn. Made in USA. 28g Tube. Amazon.com

I tell you, I really feel for you. Sounds like you have a lot on your plate right now. Having the surgery postponed or date moved back now 3 times would stress me out. Maybe with me going first now, I can offer you some “positive feedback”. I found a guy on YouTube who answered a few of my questions regarding this surgery. We exchanged email addresses as this guy went through it on a Thursday and was back to work on Monday. Don’t ask me how the hell he did it, but he gave me “good feedback” and said it won’t be as bad as you read online. He did say he was sore for a few weeks, and that it took a full 6 months to heal completely, but he’d do it again tomorrow if he had too. He said he was 80% healed within 8 weeks, but that last 20% took the longest. So I’ve been trying to use his experience as a positive and hoping I, or we, can be similar.
I do feel a million times calmer now that I saw my GP doctor this morning and knowing if I’m in really bad pain, she can help me if my surgeon does not.
I’ll keep you posted over the next few days. Hopefully I can post Thursday night after it’s done.

[nh_user_1395603]

You are VERY fortunate to be able to have access to The Mayo. when my son was 4 years old, he required open heart surgery. To make a long story short, I ended up choosing to take him to Comer’s Children’s institute in Chicago. I live in Virginia. The (very large) hospital complex was much like you describe Mayo. The whole city was built around it. It was the most efficient experience, with cutting edge technology and techniques, the most talented staff and so personal. My son’s short and long term outcome were better than any doctor’s here thought possible and his recovery was miraculous. Again, keep that in mind as you prepare for tomorrow. You are going to one of the best possible facilities AND it’s close to home!

Your GP is an angel! I know this is a huge weight off your mind. if you feel your surgeon does not prescribe enough pain medication, maybe get her to prescribe some back up, just in case? If you get the experil or a pudental block, you may not experience pain until the weekend.

I’m glad you have had the opportunity to speak to someone that has gone through this and not had a very horrible experience. It seems like you are in a good place mentally, although you must be experiencing much anxiety. Please keep the positives in mind tonight and tomorrow. I very much hope to hear you say soon " this was the best decision I ever made!".

I will be thinking of you tomorrow. Do not worry about replying to me until you feel up to it or are just bored/want to “talk” to someone about your butt. everyone in my inner circle is kinda tired of hearing about mine!

Chin up. You are on your way to a much improved life!

Good Luck my friend!

[nh_user_1375752]

Thank you so very much for the kind words. I do hope it all goes well and I can be a positive inspiration for you next week, and be able to honestly say “it wasn’t that bad”. I’ll be 100% honest with you, good, bad, or horrible.
Yes. My GP took a ton of stress off of me knowing I can call her and she will help me out. She has a ton of experience with Subutex / Suboxone patients and she understands that the majority of doctors do not understand buprenorphine (the actual drug name in Subutex / Suboxone) and it’s very unique qualities. It’s not at all like methadone. Methadone is a full agonist opioid, just like morphine, fentanyl, oxy, hydro, etc… Buprenorphine is completely different. It is only a partial agonist opioid, yet has the strongest affinity to opioid receptors. In other words, no other opioid will displace buprenorphine off your opiate receptors and because it’s a partial agonist, it does not offer more pain control (or any if you are currently on it for awhile) the more you take. So it blocks other opioids from being able to attach to your receptors and this they will not offer pain control or any kind of “high”. That’s why it’s such a great maintenance drug. You can’t get high off of it like Methadone, and you can’t overdose on it (unless you’re completely opioid naive and take it). Take more, you get absolutely nothing but a bad headache. So it’s a real problem when it comes to having surgery. Luckily my GP understands this and wrote my surgeon a letter explaining what needs to be done for me. If he doesn’t feel comfortable prescribing stronger meds, like oxycontin, she will. So that’s a huge relief to me.
Sorry for the long explanation.

I’m so happy your son is doing so well. If you have major issues, your choice of hospital can make a huge difference, as it obviously did in your son’s case. That’s wonderful.

My COVID test just came back negative, so I have to call in about 2 hours to find out what time I need to be at Mayo tomorrow morning. Depending upon the time, we’ll either drive down tonight and get a room or drive down in the morning. I’ll post as soon as possible. Thanks again for your support and kind words. I hope we both end up having successful, less painful, surgeries with no complications and a speedy recovery.

[nh_user_1375752]

Welp, I was first up for surgery this morning @0630. I was obviously a nervous wreck but the nurse’s, surgeon, anesthesiologists, and staff were soooooo nice and empathetic. They answered a million questions of mine and made me feel comfortable.
My surgeon explained his “partially closed hemorrhoidectomy” whereby after he removes the hemorrhoids he sutures it closed accept for the very bottom which he leaves open to allow “drainage”. He said if you close it up completely it can fill, swell, and if it gets infected, it’s got nowhere to drain, becomes incredibly painful like a boil, and they have to go back in to open it up.
He did not use ligasure, but uses a scissors type instrument.
I was completely knocked out, “general anesthesia”.
He used two local anestitics, a short acting 6 - 8 hour immediate release and Experil which is a long acting.
He said multiple times after the surgery that he did not expect to see that much mucousal tissue prolapsed as he couldn’t really get a good view during my exam in August, but that when he opened me up, there was A LOT of mucosal tissue that detached and the hemorrhoids were thrombosed. He said "I can see why you were having so much pain and bleeding. These were ALL internal hemorrhoids. I have no external hemorrhoids and he didn’t have to touch much outside, just a little wound from the mucosal tissue that extended out my anus (I know gross. Sorry. Next paragraph explains more on this)
Unfortunately, I was born with a birth defect called “imperforate anus” whereby upon birth I had no “hole/exit” or anus I had to have surgery immediately upon being born to create an opening, and than two more surgeries in the following months along with “dilation” to avoid scar tissue and stenosis. He said this is what’s caused my problems and I will require multiple surgeries in the future because my anatomy (anal canal, rectum, and anus) is not normal. I wasn’t expecting to hear this, but there’s nothing I can do about it. It’s a birth defect.
The surgery took about 1 hour 20 minutes. Upon waking up in my recovery room, I was in a lot of pain. My wife said I was “squiriming” so much she had to leave the room because it made her feel so uncomfortable. They had to give me 3 doses of Fentanyl, 3 doses of Oxycodone, 3 doses of Toradol, and 3 doses of Ketamine over a 90 minute period until I finally stopped being in pain. The ketamine really helped a lot. I felt no relief after each opioid. Absolutely nothing. The outside of my butt felt numb and I had no pain, but inside about 1 inch I felt incredible pressure and pain.
After resting out a couple of hours and getting my “bearings” I got up and walked to the bathroom. I was able to pee without any problems. I was quite surprised. I also felt ZERO pain and COMPLETELY numb. I felt so good, I swear I could’ve gone to work, and it’s not because “I was high”. I really wasn’t at this point. It was the local anestitic that had me feeling absolutely ZERO pain. None. Nada. Nil. If I could be so lucky as to feel like this the next two weeks, I’d be in heaven. I have NO pain. It’s 100% because I’m completely “numb” and I honestly can’t feel ANYTHING down there. I can’t even stop my peeing or squeeze my sphincter muscles shut. It’s completely numb. Not to be gross but I cant even feel my testicles. They’re numb. It’s crazy.
So it’s 4:30 PM now and I’m just as numb as I was this morning. I feel ABSOLUTELY ZERO PAIN WHATSOEVER. I haven’t taken any pain killers whatsoever as I don’t need them. To anyone going through this type of procedure, I would strongly advise you find a surgeon who uses these local anestitics/Experil. I know it’s early, and I’m not too naive to believe “this is going to be pain free”, but I never in a million years anticipated feeling ZERO pain. It’s absolutely AMAZING!!!
Well I’ll update this as the hours and days move along. I’m so hoping this may turn out positive but it’s wayyyyyy too early to draw any conclusions. Stay tuned. Tomorrow could be the complete opposite.
Feel free to ask any questions.

[nh_user_1395603]

I am so glad all went well with your surgery and that you are home and pain free! i was thinking of you frequently this morning and praying that you were able to keep your anxiety at bay and for a successful surgery. Good to hear that your medical team was comforting and informative.

Get plenty of rest, please don’t over-do it. I will write again tomorrow, if for nothing else, to give you something to read

Congratulations!

[nh_user_1375752]

Thanks a lot !!! It’s 8 PM and I’m STILL completely numb, feeling absolutely NOTHING. Not to be gross, but I can’t even tell if a pass gas. I feel nothing. I’m SOOOO glad you’re getting that Experil too. As of right now, I’d strongly recommend it. It’s nothing short of amazing.
Now for some not so good news. With the assumption that at some point this weekend, when this Experil wears off, that I will face some severe pain, my surgical team let me down on the pain medication. I made it clear to them “I’m opioid tolerant” and on Suboxone. They sent me home with a total of (8) oxycodone 5 MG’s for pain every 4 hour’s, which will offer me less pain control than an “81 mg baby aspirin”. In fact, I told the wife "don’t even take it out of the bag as I wont be bothering to use it. It’s completely useless to me being on Buprenorphine/Suboxone. So my choice is to deal with withdrawals or suffer in pain and I’ll ALWAYS avoid withdrawal at any price. So pain is going to have to be my only friend, unfortunately.
I wrote my surgeon a very negative message regarding his statement of “taking care of me and sending me home with the proper pain meds”, as promised. I asked him: so, for your opioid tolerant patients, who have not simply mild pain, but moderate to severe pain, you prescribe them 5 MG Roxicodone/Oxycodone ??? My teenage daughter who had her wisdom teeth removed this summer received this exact prescription, 5 mgs oxycodone, and she’s obviously NOT opioid tolerant or on Buprenorphine. Do you honestly believe I will receive ANY pain control from this medication ???
So now I have to reach out to my primary care doctor tomorrow and hope she’s willing to do something for me. Tomorrow is Friday, and I know this Experil will be wearing off by tomorrow night or early Saturday morning, and I will most likely start to feel some pretty decent pain. I’m scared to death now and getting stressed out by the minute because reaching anyone over the weekend will be impossible. My only hope would be my local emergency room, but just as my anesthesiologists and surgeon did, I’m sure I’ll be looked at as: “the scumbag drug addict looking to cop some drugs” so I won’t even lower myself to going there. I really hope the pain isn’t too bad as all I have is Tylenol and alcohol to use.

[nh_user_1395061]

hi jbutt, have u done ur surgery? just did mine today and now recovering at home. I not only remove hems but also a big ball of polyp. apparent my hems are not big but the polyp is the problematic one. thank god, they are removed now.

all went well so far for Day 0 and I even pooped a little in the evening after dinner and NO PAIN during poop. probably because stool is very soft & little and also maybe because I took paceco tablet right before pooping. I also passed alot of wind while pooping. wonder is it because I drank 1 ltr of water during in recovery observation ward that I manage to poop on day 0.

Doc told me she only injected local anesthesia on area of incision. I have internal stitches as well as cauterized wound. After woke up from GA, i felt pain of scale 6-7. but within like 30 minutes, pain scale went down hill like maybe 2-3.

Doc said my local anesthesia will only last around 4hrs. it’s been already 12 hours. and I can say my pain scale is 1 or 0.

Day 0 has been going well for me. I pray that tomorrow will be same or even better.

hope to hear your progress too.

[nh_user_1395603]

It is good to hear that you are completely numb atm, but I believe your concerns are more than valid. My daughter had her wisdom teeth ( impacted, two lower ) and was given 12 oxycodone ( I don’t know strength, but it was the lowest) and a few valium for anxiety.

Even if you were not tolerant, that is not enough for 2 days. Given the amount of pain medication it took to achieve some relief when you woke from surgery, I think this is highly inadequate. I’m not sure oxy is the best pain relief for this surgery. My doctor said he would prescribe perocet or percodan. I don’t know if this would be any better. He also said he was prescribing an anti-inflammatory and muscle relaxant. When I asked about how much medication I would have acccess to, because like you, my biggest fear is being in agony with no recourse, he answered “as much as they will allow me.” I believe “they” meant the pharmacy. Although comforting at the time, it really is not a definitive answer.

I am SO glad you have your GP as a secondary option. She is familiar with you personally, so hopefully, she can assist you during the next few weeks. Please share all your concerns with her, first thing in the morning. If i was you, I would not be shy about demanding to speak to her tomorrow and letting her know your situation. What your surgeon gave you is a joke.

Unfortunately, my personal opinion is that the ER would not be much help. This is one of my big concerns, as my GP just retired. My vision of the need for the ER is a nightmare drive, while in extreme pain, followed by many hours in the waiting room. I’m afraid that once finally seen ( our ER has very long wait times), they really won’t do anything for me and send me home.

Would that limited amount of oxycodone be enough to keep you from withdrawals? Will the surgeon at least offer refills?

I don’t want to feed into your panic. Maybe none of these things will happen to you and you will manage okay. I haven’t even had the surgery and these are things that more than concern me about my recovery. As a long time daily drinker, I think I have increased tolerance to anesthesia and pain medication, so even though I am not you, I understand. I also worry about more liver damage with the amount of medication required to recover.

In my profession, it is very true that the squeaky wheel gets the grease. If ever there was a situation where you should be that wheel, I think this is it.

I read on here that gabapentin could add in pain relief. I didn’t really believe it, because I was prescribed this ( and discontinued it) for an unrelated issue. Since I have a bunch in my medicine cabinet, I did ask my surgeon about it. He didn’t discount it. He said that he doesn’t routinely prescribe it, but does in specific cases. Just some info for you. I also asked him why I could not get additional experil shots. He said "That would require me to inject a large needle (s) into the surgery site and you do not want me to do that!). I’m thinking maybe I would!

Sorry for rambling. I know i don’t know you in person, but i am very concerned about you, worried about you and hope for the best outcome for you.

Please put your self-shame aside. By your writing, I can tell you are a very intelligent person. You also come across as honest, caring and real. Regardless of how the medical community reacts, and they react that way to just about anyone asking for any meds on the “no-no” list, you know who you are. In my opinion, your maintenance medication is no different than a diabetic needing insulin or me, needing blood pressure meds. It is a fact of life, due to how our bodies function.
You are better than me. I abstained from any alcohol for three days. But, I have now drank 2 glasses of wine, due to an emotional distressor. I know I will pay for it. Please think long and hard before you drink alcohol during your recovery. You may not be like me, but alcohol exacerbates my hemorrhoids horribly.

BTW, I have experience with imperforated anus. I work with disabled children. As a congenital defect, this was always one of the lowest concerns, just like next to webbed toes! None of the developmental pediatricians were ever concerned about lasting difficulties after early childhood repair. Good to know on a professional basis.

I’m not really religious, but praying for you tomorrow. Maybe take some tylenol and ibuprofen tonight, just in case.

Take care.

[nh_user_1375752]

Thank you SOOOO much for taking your time to post. I really appreciate it !!! Hopefully I can make you feel better about your up procedure. I cannot say enough great things about this Exparil. After getting my pain under control post-op recovery, I have been literally 99% pain free. I am so numb down there I actually worked out (not advised) for 2.5 hours last night lifting weights doing chest and triceps. I had Zero pain. I haven’t touched my small dose of Oxycodone yet. I haven’t needed to. Just taking Advil and Tylenol just in case.
Here it is Friday night, roughly 38 hours post op. I still am numb throughout down there and are pain free. The Exparil is still working great. I’m not as numb as 24 hours ago, but enough to be virtually pain free. I walked 3 miles today and went shopping. I do have bloody drainage and have to keep gauze between my legs and wear these “knit stretch briefs” under my underwear or I’ll easily bleed thru. It is a little bit gross, and maybe I am “over doing it” and making this worse. My wife certainly believes so. I have not had a BM although I’ve been trying. I’ve taken several doses of Dulcolax last night and today along with Colace but I have zero urge to “go”. I want to get this 1st BM over with while this Exparil is keeping me numb. I may need to drink a bottle of Magnesium Citrate soon if things don’t change. I’m eating a regular diet so I should “go”.
My GP got back to me right at 5 o’clock and phoned in a new script for 16 qty 10 mgs Oxycodone so I’m very appreciative of her help. She said “it’s ridiculous that they gave you 5 MG’s Oxy and only 8”. She was soooooo nice to me. I haven’t taken any Oxy and I hope I don’t have to but I have them available just in case which really relieves my anxiety. I also have Gabapentin on hand which, like you said, should help me if needed.
Unfortunately, my surgeon said my birth defect, imperforate anus, and the surgeries required as a baby, is the cause of a lot of my problems. He said my internal sphincter is incredibly high and my anal canal is very short because of the imperforate anus. He said I’ll require multiple surgeries in the future as there’s still more hemorrhoids and tissue that will need to be addressed in the future. He did not want to remove any more tissue as absolutely necessary in this surgery because he said that could cause me other problems, including fecal incontinence. That’s something l 100% want to avoid at all costs. So I’m glad he’s taking the conservative route, even though it means more days like yesterday .
So I’ll post again tomorrow, Saturday, and let you know how I’m doing. If yours goes anything like mine, you should do great. I’m SOOOO glad to hear that your doctor is using Experil as well. Z’s