What I read on these board both scared and helped me prior to my surgery. I wanted to share my experience to give back.
I am now 10 days post surgery in which I had both internal and external hemorrhoids removed (very large). My first piece of advice is to get the surgery done by a specialist (proctologist/colorectal surgeon) -- not a general surgeon. I had to drive an hour and a half from where I live for appointments and surgery but it is totally worth it (husband drove me home after surgery obviously). I think my recovery has been faster because of it (I would not say I am totally recovered by any means -- I just feel way better than I did those first few days). My next piece of advice has to do with the constipation issue. I am not one who has ever had problems in that area -- I go every morning and some days I will go again in the evening. However, these boards and my doctor put fear in me about getting constipated after this surgery. So, I avoided the prescribed narcotic pain pills for the first three days (they are constipating) and just did over-the-counter ibuprophen alternating with Tylenol every three hours. I drank prune juice. I ate foods high in fiber. I took the maximum dose of Colace (stool softener). I drank plenty of water. The result? Diarrhea episodes 5-6 times a day for the first three days after surgery. I am sure that hard stools are not pleasant after this surgery but diarrhea is not either -- OUCH!!! Went back to my usual normal eating and other habits and only took 2 Colace before bed and am back to my usual bathroom habits, which is much better because you reinjure yourself every time you go. Going merely once or twice a day gives you more time to heal between episodes. Bottom line (ha ha): know yourself when it comes to following the advice for preventing constipation. Like I said, I have only taken a couple of the prescribed narcotic pain pills this entire time. I will say that I had trouble falling asleep the first few nights because of the pain/discomfort. Rather than turn to the prescription pain pills, I took Tylenol PM. You should not mix Tylenol with your prescribed pain pills because that is too much Tylenol. I took Tylenol PM instead of prescribed pain pills. That stuff knocks me out, and I was able to sleep. Better yet, it makes me sleep longer than normal, which I appreciated in those rough few days after surgery. The first few days, icing the area helped me a lot. I used someone's advice from a board about wetting and freezing disposable diapers for 3 month olds to do the icing. This worked well. There is nasty oozing after this surgery, so you can just throw this "ice pack" away after using it. Similarly, when you are not icing, you need to wear a maxipad to catch the oozing. Have a detachable shower head for cleaning yourself after bowel movements is extraordinarily helpful. Install one before your surgery if you don't have one. In the early days, I would follow the shower with a shallow bath in warm water with some Espom salt and baking soda. These helped too. The oozing afterwards can have the effect of essentially giving you something like diaper rash, which also hurts. After bathing/showering, I put on my skin (not the wound, the nearby skin) Bag Balm, which helped with the skin irritation. A spray of Dermaplast on the wound would burn for a minute but them provide relief as well.
I got a squatty potty stool to put my feet on for BMs. It minimizes straining. It was worth it. I am on and off in a minute or so, and the stool helps. I got it on Amazon. The very first day post surgery really was not that bad. There was a lot of swelling, but it was more discomfort than pain because my surgeon injected a lot of numbing medication that lasted 24 hours or maybe even a bit more. It was the next 3 days that were the worst. However, I have been feeling graduate better each day since. BMs still cause a flair of pain, and I still use the shower to get clean. I don't need a sitz bath afterwards any more. I still take over the counter pain meds almost around the clock (ibuprophen then Tylenol three hours later and then ibuprophen three hours later then Tylenol three hours later, repeat). I don't use the Tylenol PM to sleep anymore. I feel like my recover is going pretty well. That said, I can't imagine people who go to work 1 week after their surgery -- at least if they had multiple external and internal hemorrhoids removed like I did. I see two weeks of recovery as the minimum -- and that is for someone like me with a desk job. I think it would be much better to take three weeks off if that is possible. The closest that I can compare the experience to is the aftermath of child birth. However, this is worse because of the BMs. Yes, you are sore and swollen and have vaginal oozing (and, if like me, have stitches) after giving birth, and this is similar (anal oozing instead). However, there is nothing like the retraumatization of the injured area after giving birth like there is with this surgery every time you have a BM. So, I think that this recovery is worse. Not impossible to manage, but worse. Get all of the supplies that I recommend prior to your surgery so that you are prepared. Good luck. If you are in the early days, be encouraged that it does get better by the week to 10 day mark.