I saw many posts on this site and got very concerned. I was scared to death and almost want to cancel the surgery. I want to give you an idea of my history, preparation, and progress to let you know if it is as bad as everything I read. The first post might be a bit long so I apologize, but I believe more detail is better.
-I have family history of hemmorrhoids. My dad had the surgery at 43, also. All I remember is him lying in bed moaning post op. He is one of the toughest human beings I know and as a reference point I was in the Army and played college sports. This concerned me even more.
-I am a 43 year old male that has had been straining when I BM for as long as I can remember and first seeing blood on my stool as a young teenager. I would have minor bleeding on my stool until about 10 years ago when blood started pooling in the toilet.
-I had my first banding procedure by a gastroenterologist during a colonoscopy about 10 years ago. It worked fairly well, but I didn't change my diet enough. The bleeding stopped for about 6 months to a year.
-I continued living with the bleeding, but got a cold dose of reality when I went in to have a microdiscectomy on my back. The pre-op work came back and said I was severely anemic. I was almost given a transfusion, but was on the border and needed the surgery more. I know understood why for years I would fall asleep while I was out or had incredibly low energy during the day. My primary care doc immediately put me on iron pills three times a day and I consulted a colo-rectal surgeon.
-I went to a doc who was in my system to discuss surgery, but he wanted to try other things before resorting to surgery. Unless your case is emergent this is the attitude you want the doc to have.
-I went through three banding procedures and it really only worked effectively once. I tried to change my diet more aggressively and I would go a month without any blood, but then have one BM where I strained and would be bleed for a month. I knew surgery was the next step. The surgeon told me I had three internal hemmorrhoids with one that was prolapsed, which need pushing back in after every BM. He told me at the last banding he could even get a rubber band all the way around it to treat it effectively.
-The farther down the hemmorrhoids and if they external will make the procedure more painful due the amount of sensitive tissue and nerve ending in that region.
-I checked on the surgeon who was doing the surgery to ensure this was a common procedure for him. My primary care doc confirmed his expertise and his staff was well aware of the post op issues.
-I asked the surgeon the following questions:
1. How many hemmorrhoidectomies do you perform a month? 2. How many hemmorrhoidectomies do you correct from other surgeons? 3. How long have you done the procedure?
-I suggest a colo-rectal surgeon or a general surgeon who focuses on the colon. The just understand the disease and anatomy better, I think. A surgeon may say it is a simple procedure, but no surgery is routine for the patient. Surgeon choice is paramount. He staff should know and understand all the issues for recovery. The doc and the staff should be open about the potential pain of recovery.
-I read all the blogs and got nervous. You cannot help yourself. This is what I suggest you to do prepare: 1. Begin to change your diet a 3-5 days out. High fiber, lean meat/fish, lots of water, and limit the sweets, white flour, pasta, alcohol, or anything binding. Add Dextrin Fiber to your diet (this is generic Benefiber) 2. Get the following supplies: Adult male diapers, medicated wipes, mineral oil, maxi pads or the like, glycercine suppositories, pads for the bed, Anti-itch cream, Neosporin, gauze pads, sitz bath, ibuprofen, Mirolax, stool softeners, cotton balls, flushable no-dye/non-scented baby wipes, and more Dextrin Fiber. Have this all ready the day before, so you don't have to worry about it following the surgery. You should save your receipts, because you may not need everything and return it later.
3. I made a soup in the crockpot full of veggies to eat the next day. It had a little spinach, mushrooms, green beans, can of diced tomatoes, a little corn, onions, carrots, celery, leeks and vegetable stock. These are high water and high fiber veggies. You should have something ready.
4. You should ask your doc for Percoset and a muscle relaxer. They won't give you the highest dose Percoset because it will make you too constipated. The muscle relaxer will help with sleep and reducing the spasms post op.
5. I gave myself an enema the day of the surgery to avoid going for a day or so.
6. Be nice to everyone at the hospital, because it will only help.
7. Write a list of questions you have for your surgeon and bring it with you. You will forget if you don't.
8. Get plenty of movies, reading materials, Netflix, and anything else to keep you entertained.
Day 1 Recovery/Immediate Post-OP:
1. You will get a local to numb the pain, which lasts for about 6 hours.
2. You will not want to eat due to nausea and you will be very thirsty.
3. Start drinking water with some dextrin fiber and don't stop. If your mouth is dry then you are dehydrated and need water. Dehydration causes constipation, so you want to avoid it. It will also help you urinate. This was one of my fears. Don't try to push the urine out. It will come but you are numb done there and it will challenge. Plan on drinking and going frequently.
4. Gas is hard to pass. You are swollen and want to push it out, but it will hurt. I tried to avoid any pushing, but the gas came out during the night. It woke me up, briefly.
5. I am having some discomfort, but not that terrible. I am taking my percoset every four hours. I set an alarm to make sure I didn't skip one. This includes during the night. In between the percosets take Ibupropren. I am 6'1" and 200lbs, so I take 3 200mg pills.
6. I had 100% whole wheat toast with a little butter when I got home from the hospital, a pear and 6 Townhouse crackers about 4 hours later, then a bowl of my soup about 5 hours after that. I drank a small glass of OJ with two tablespoons of mineral oil in it before bed.
7. I did a sitz bath in the evening. I used the one that goes over the toilet. I couldn't wrap my mind round the idea of getting in and out of a bathtub. It was fairly easy to use. I patted down with a towel and wiped with flushable baby wipes. Place a cotton ball between your cheeks on top of the wound site. It will keep it dry and clean promoting healing.
It hasn't been that bad yet. I also have not had my first BM. I will keep you posted on that front, but I can honestly say I am scared for that moment. I didn't have much pain, just general discomfort. This surprised me a bit. I think the first BM brings on pain, but I am hopeful. I am spending most of the day laying in bed on my side or stomach watching movies. There is discharge, so where the pads/diapers/cotton balls. You will be glad you did.
I hope this is helpful and I will try to keep updating everyday for awhile.
Everything you read about the first BM is totally true. It was a nightmare. There is a great deal of blood, which is to be expected. However, if you are concerned call your surgeon. My movement came on post op day 2. I had the surgery on Thursday and my first BM on Saturday. It is completely exhausting.
I am waiting for the second one and a bit nervous. I am also going to discontinue the Percoset and move to Tylenol. The Percoset is making me too constipated.
The pain during and just after the BM is horrible. The pain in between isn't so bad. I have worked really hard to stay on top of it, so it doesn't become an issue.n Gas and bloating is an issue. Use the sitz bath to let it go, because it will get uncomfortable.
Please see this post for some great advice: