Ligaasure Hemorroidectomy on 30 Sept 2023
Posting because:
1. Hope this helps someone; I’ve gotten help from this forum.
2. For my sanity; trying to be methodical with my recovery.
Disclaimer:
Find a good doctor.
Your doctor is king/queen/sovereign – trumps all advice on the internet.
Not medical advice; just my own experience
In the midst of recovery, might not reply to questions
Profile:
39yo, Asian, Male, 180m, 77kg, Smoker, IBS M (diagnosed at 24); occasional panic attacks from straining;
History with Hems:
Since:
2016: occasional bleeding, some soreness
2019: more frequent, bleed and pain for days but goes away, about 1 attack a month
2022: longer spells of bleeding and pain about 3 days to a week, goes away about 2 attacks a month
Last month: bleeding daily, heavy blood loss, anemia, faint/giddy up to day of surgery
Seen a “specialist” dept at hospital for 2 years. Scheduled me for banding this Dec. Informed I may have 1-2 x Grade 2
Faint spells led me to see a reknowned specialist in my country, told me the banding ship “has sailed” and I need surgery asap.
Removed 3x “severe Grade 3s”
Day -1:
Bowel Prep; ate only watery rice congee; felt faint; went to work and ended 730pm; fasting from 830pm; phospho soda from 11pm (tip: chase with a little sports drink; don’t get bloated, just to kill the taste)
Surgery Day:
8am: briefing
9am: surgery
About 10am: Done; slipping in and out of consciousness
About 12pm: More awake; informed it was difficult to sedate me and they had to use “a lot of sedation”
Went home at about 2pm; in and out of consciousness; only drank water and isotonic drink
Puked at about 7pm; difficulty urinating; slept through the night; to be honest pain from surgical site about a 1 to 2 (ant bites)
Med regimen:
Arcoxia for pain + some med to protect stomach from it
Tramadol for pain
Antibiotics 3x a day
Daflon 1000mg x2 a day for bleeding
Post Day 1:
Still had difficulty urinating; called into the office; went in at 2pm; Doc said pee by 5pm or cathether; vomited 3 times; given jab to stop vomiting (in my exp, after the jab, you still feel like vomiting with all the symptoms but body doesn’t do it); forced myself to urinate no streams just dribbles; hurt the “hose” (right side purple); Doc said likely bloody vessel burst (tip (no pun): do not force the pee, try to relax); Doc suspects tramadol causing bladder problems; stop tram; drank juice and water (still soft diet)
Post Day 2:
Still hard to urinate but better; surgical site pain about 2-3 (ant bites and spasms) bearable without tramadol; went to bathroom about 30 times today (yes counted) at most a short stream; bed rest; only consumed juice and water; rather uneventful aside from peeing a lot (but only a little); started sitz bath – really helped (hot water – most bearable temp with 3 table spoons of salt)
Post Day 3:
Easier to urinate; streams but not “amazing” or usual function; had soup with slices of fish and tofu; Doc said might be a good idea to stay on soft diet; sitz bath 3x a day (3 table spoons of salt for 20min); Doc advice: “Your “bowels” have been reset” you need to recognize the urge to have a BM or just a sensation, if it’s just a sensation do not try to have a BM
Logic:
If need BM + strain + bleed + pain = productive
If don’t need BM + strain + bleed + pain = counterproductive
Be patient. Reminded myself I’m on sick leave, got no where to be, can always wait
Realised:
If Sitz is hot enough, will relax; released gas + pee (I think; can’t be sure but felt relief)
If Sitz not hot enough, does nothing.
So make sure it’s hot but not dangerous
New Sitz Regimen:
20 min broken down into 4 sets of 5 min
Change water and add salt for each new set to keep water hot and to prevent infections (hygiene purposes)
End of with just sitz of hot water 5 min to rinse of salt
Post Day 4
12pm: Dreaded BM coming; fear was intense; had watery stool quantity (not form) about 1 large banana with 20% of it blood; pain 8/10 felt like someone opened slit me with a razor blade; saw bright lights; took 5 min (used a timer) immediately used shower head with hot water for relief; did sitz bath regimen; for about 2 hours ant bites 4-5 pain scale; calmed down after that down to 1-2
Weak from not eating much; Ate first solid meal (home cooked chow mein with a lot of carrots, cabbage, and 2 eggs beaten)
Learnt to gauge the pain from BM less fearful of next one but still dreading it. Still on water and juice (about 2L a day)
Overall: very bearable in terms of surgical site pain except during/after BM, anemia has gotten better not giddy; at times feeling down but reminding myself recovery takes a day at a time