Hemorrhoidectomy in 12 hours....

Digestive health
1

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

May all go well, and you feel better soon. I empathize with your decision-making, and trying to prevent surgery. It's very hard living with Stage 4 mixed hems, I know.

3

You have been very thorough and have educated yourself very well leading up to this important decision. I had a general surgeon perform my 2 rectal procedures and it has gone well but requires diligence, rest and patience in your recover stages. As you mentioned they don’t know what they will find until they get  into the plexus of tissue. You seem to be very well prepared for what’s to come. You are very fortunate to have a partner with you to help you through this difficult time. I could not have done it alone without my kind and caring wife. All the best to you, you will get through this adventure and feel much better in time. Patience. 

4

Thanks guys. Here goes nothin! 

5

Ok guys. Back from the procedure so I guess we can call this a day 0 update... 

Surgeon said the procedure went well and she was able to remove all 3 hemorrhoids. Turns out I didn't have a fissure, it was just scar tissue that had developed on a hemorrhoid that had its own little fissure in it. 

The op was fairly quick. I checked in at 11:30 and was wheeled out to my car at 4pm. 

I was giving a medicine that numbs the area for supposedly 72 hours but I have quite a bit of soreness/ pain down there already. I reacted a bit poorly to the anesthetic. The nurses say I "turned green" and I sweat what felt like gallons. I also woke up uncontrollably shivering at first which then turned into feeling incredibly hot and sweating. Thankfully, urinating wasn't a problem. In fact, I think I screwed up by drinking too much water before the procedure. When I woke up I had to pee very badly and wasn't able to at first, but about 10 min later the floodgates opened and I had an extremely long and satisfying pee. Did the same again when I got home and the anesthesia   problems seem to be fading away. 

They gave me a whole ton of pain meds through the IV after I woke up, fentanol and tramadol I think and also had me eat a handful of animal crackers and take an Oxycodone pill. 

Currently high as a kite, laying on a heating pad and watching TV. 

Pain is not bad at all at the moment, but I fear when this local pain numbing medicine wears off. 

6

I’m glad to hear the pain is bearable at this point for you! Hopefully you have no complications and an easy recovery! Keep us posted on your journey I had banding done twice and it has helped but hasn’t 100% done the job, I’ve asked the surgeon about Sclerotherapy and he said it’s something we could look into as I’ve head that has a great success rate but if that fails I dread I might need a formal surgery. Mine aren’t bad they said they’re grade 1 maybe small grade 2 but I’m sick of them being an issue in day to day life! I hope you’re still feeling at ease!

7

Hope your recovery continues to go well. You're following the best directions that I've read about. Following because like many others, I am so mentally exhausted about hems being a daily issue. I chickened out of surgery twice, afraid of urine incontinence post-surgery...glad that didn't happen to you. Of course I've read the scariest complication...permanent bladder damage if cannot pee after surgery.

May all go well with you, and thank you for your postings and the comments.

8

Hi , i would like to share with u about my experience. Im a 21yrs old female. I got hemorrhoid 5yrs ago,at the beginning the hemorrhoid will goes back on its own(grade2) after BM but as time passes, i have to manually push it back after BM(grade3).

So i went to hospital and consult a colorectal surgeon. He got me checked and told me that i have grade 3 haemorrhoids, i got 3 hemorrhoids by the way, but their size was not that big(according to what my doctor said) So he recommended me to go for a surgery called laser hemorrhoidoplasty (LHP) and he told me that this procedure is painless.

I decided to go for it and today is one month plus after my surgery. I would say that the post op pain level is about 3 out of 10 and it lasts for only about 1 weeks.The pain occurs only after BM , but is definitely bearable. The doctor prescribed me only paracetamol for pain killing, but i only took it on the first day after the operation and a stool softener which i took daily for a week.

 returned to my normal daily activity after 1 week post op. It was the best decision i have ever made. 

My doctor told me that this procedure only suitable for grade 1-3 internal hemorrhoid. Chances of successfulness of the surgery depends on your size of hemorrhoid. 

I did this procedure in Malaysia, im not sure whether this procedure is available in your country. U may ask your doctor about LHP

9

Update time: Day 2:

Last night was hell on earth. I'm not sure if its because of the packing still inside me up there, but I had a really tough time passing gas. Finally at 3am in the bath I was able to pass a little gas. In the tub is just about the only place I can pass gas still. 

There is some tissue poking out of my rear (feels exactly like a thrombosed and prolapsed hemorrhoid) which is just agonizing. Pain is right at a 10/10 and the only relief I have right now is passing out after my 2 oxycodone every 5 hours. Even the tub doesn't really help the pain at this point. 

No BM yet and I'm frankly terrified of when that happens with how difficult/ painful just passing gas has been. Been taking my stool softeners and miralax once a day though anyway.... 

One thing I was not expecting is how much blood there has been. I've been wearing an adult diaper and soaked through about 5 of them in the last 24 hours. It seems to be slowing down though thankfully... 

Off to the bath... Hopefully next update is post BM  

10

Day 3:

OWWWWW!! lol. But seriously, this pain is unreal... 

Still no BM yet. My routine at the moment is just switching between laying in the tub and on a hot pad in my bed. I'm taking 2 oxys every 4 hours but they seem to wear off right about 3 hours in, so I'm going to call my dr tomorrow and see if we can tweak the meds. 

I havent been eating very much yet. Just had a yogurt, a few slices of watermelon and a turkey sandwhich with no cheese at lunch time. I added Sene (another kind of stool softener) to my Collace as well as a daily dose of Miralax. 

I can't even imagine how bad it's going to hurt when I do finally go... I suspect tomorrow is the big day... 

Here's hoping I see some improvement soon! Off to the bath....

11

Good luck it will get better.  You did a lot of prep which is fantastic.  Bath bath bath bath!  I was taking 5-8 baths per day the first week post op.  Keep up the stool softeners and laxatives.  I found that cycling Tylenol with Ibuprofen worked well.  Getting through the first week is rough for the vast majority of us, don’t be fooled by the occasional “minimal pain” stories.  I don’t doubt them but they are a rare exception.  A couple of adult beverages per day helped me as well.

Keep posting.  I did exactly what you are doing; posting the experience daily, often while laying in the tub.  There appears to be some therapeutic value.

It will get better!

12

Hi Jane

How did it work out for you? Are you fully recovered?

13

I’m sorry to hear you’re in struggle town! I hope the pain starts to subside soon! Thanks for updating us  

14

Yes, I would say that now (9 weeks later) I am 98% recovered.  I still have a few minor challenges from time to time but nothing more than an mild annoyance requiring the use of a gauze pad.  There is no more pain, discomfort, or restriction.  I am still careful with my diet and I am very OCD with hygiene, although I was before as well.  Like Pita I chronicled my post surgery days in detail under another thread started by Gee. 

That said, I would not recommend this procedure to anyone unless there is no other reasonable alternative.

15

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. 

16

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.

17

I experienced the same peeing thing that you described.  Not really a problem but an off sensation at start.

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!!!!!

18

Thanks guys!! 

19

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!! 

20

That does sound very frustrating!

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!