First of all, thank you everyone for your posts on these patient forums. I found it very useful, and reassuring, to hear about other experiences and it was good to not feel alone. I've decided to submit my own account of recovering from the surgery as I found it so helpful reading others.
I'm a 56 yr old woman and have struggled to manage constipation for many years. I've periodically had complications resulting from constipation – including an anal fissure (which required surgery), thrombosed hemorrhoids, hemorrhoids that I've had injected, banded, and now (finally!) removed. I've never had children.
It's Saturday today and I'm on day 4 after my surgery which I had on Tuesday 28th November. So far, I would say I've been very fortunate in that I don't seem to be having such a bad experience as some others I read about. Don't get me wrong, the pain during and following a BM is horrible, there's no getting away from it. And when the pain lingers it's debilitating. But I'm also having plenty of pain free time, and I'm sleeping amazingly well. I expect some of that will have been down to the General Anaesthetic and pain killers, but as someone who seldom gets enough sleep, I'm really appreciating the extra hours! I'm signed off work for 2 weeks and expect I will take the full 2 weeks. I don't feel very mobile yet and once the pain kicks in you don't want to be anywhere other than home and near your bathroom.
So I'll say a bit about Tuesday. My admission was at 11am so I went without breakfast and made sure I drank a lot of water before the 9am cut off – I drank about 2L. Once at the hospital, there was a lot of waiting around – the operation wasn't until about 2pm, and we didn't leave until around 6:30pm. Preparation for the op was as described by others on this forum and ultimately included an enema, which I'd never had before. I was a bit ignorant about the enema, I expected it to be more like the preparation I had for a full colonoscopy last year, but the clear out from an enema is much more localised to the rectum, in preparation for surgery. I was a bit disappointed by that as I was hoping to not need a BM for a couple of days after surgery (in the end my BMs started the next day)! The consultant did quite a nice job of describing the operation and explained that they start by stretching the rectum open so they can take a good look before deciding what to remove. Lol it's all so undignified isn't it but what can you do?!! The full procedure normally takes about 50 minutes. In the end I was away from my room for almost 2 hours though – apparently they had a job getting me to wake up again! That aside, the consultant felt the op had gone well and that he'd removed 2 particularly large hems and it had been very worthwhile. When I came round, I was already aware of a throbbing pain and also felt ready to spend a penny … the latter being a good sign as they won't let you home until you've done that. Once back in my room, a nurse came to discuss pain management and once I'd had something to eat, I was given a pain killer.
Back in 2001, I had lateral internal sphincterotomy for a fissure that wouldn't heal. The pain killer I was prescribed then was Diclofenac. I didn't respond well to Diclofenac and had a very painful stomach to add to my woes during recovery. This time, they suggested I had a different type of pain killer that was less likely to upset my stomach – so I've been taking Tramadol, along with Paracetemol, and laxatives (mostly Senna) to deal with the constipation brought on by pain killers. I find the Tramadol great even though it makes me quite drowsy – but it definitely helps with the pain. Senna is best taken at night time so that it works while you're asleep, ready for the next day. As I have problems with constipation, I've decided to supplement the Senna with another laxative in the morning but I think I overdid it today and 3 BM in one morning wasn't a lot of fun! I don't know how long I'll take the Tramadol for, I'm tempted to move onto Ibuprofen instead in a couple of days as Tramadol is pretty strong from what I understand.
I had read that days 4 and 5 can be the most painful and I would agree that today has been my most painful so far. The BM itself is obviously painful but I find it leaves my whole abdominal area in pain and spasm for quite some time afterwards. Almost like a very heavy period pain combined with a raw pain from the wound itself. The pain killers usually help but I can only take them every 6 hours. Things settled down after a few hours today, and I feel comfortable again now.
Anyway I just thought I'd share a few other thoughts and suggestions that have helped me:
Make sure you have everything you need at home before going for your surgery. My list included:
- Comfie tracksuit bottoms – you won't want to wear anything less comfortable for a couple of weeks at least.
- Sanitary Towels – you'll be a bit leaky after surgery – I don't know how long this stage lasts for.
- Baby wet wipes.
- Peppermint tea – this can help reduce wind, and trumping hurts after surgery!
- Paracetemol
- Very mild soap
- Prunes
I'm drinking lots of water and I find that drinking warm water is better for me than cold. My partner and colleagues are a bit sniffy about me drinking warm water, they think it sounds disgusting, but I actually like it and if I don't think about it too much I can even imagine it's like a (weak) cup of tea! I think it helps with the constipation – maybe because I find I can drink more of it when it's warm. It's something I've discovered in the last couple of years.
I generally maintain a high fibre diet and have focussed on the same this week – and yes I probably over did it today! - but the idea of having to strain for a BM … well it just wouldn't be possible! I think providing you drink lots of water, then high fibre eating is essential after surgery.
I read about the Squatty Potty and decided to order one. It only just arrived today so I can't tell you what I think of it yet.
The other thing I did was to have a toilet bidet shower installed. I can't recommend it highly enough. I first came across one on holiday in Turkey several years ago and loved it. My brother has one in his house and I recently stayed with friends who'd attached one to both the loos in their house. Generally though, I think bidets (and bidet attachments) are sniggered about and I'm not sure why – they make so much sense really. Anyway, I finally had one installed a few months ago and it's brilliant. I'm finding it particularly useful now, given that I can't use paper. Mine is only cold water … and given the cold weather it's VERY cold water, but that's OK as far as I'm concerned and still soothing. I believe you can get ones that run hot and cold as well.
I'm also very carefully using baby wipes and YES the lovely warm baths – I'm having at least one of those plus a shower each day. For some reason they are a great form of pain relief as well as helping you feel clean.
I don't have anything else to report today but will send another update in a day or so.