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I had to camera's inserted wednesday which wasn't to bad had banding done january which didn't work now been told I got to have them surgically removed I am so scared of the after pains as when I had the banding done the bands fell off within 22 hours but I was in severe pain for 9 days don't think I can cope again with pain like that someone please advise me

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pain, however bad, is only temporary. if you don't take care of roids, they're there for life.

no way around the pain, but keep up a fiber-rich diet (no meats) and metamucil powder drinks daily before surgery, then stick to it after surgery to help minimize pain during BMs
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Thanks they offered me the opp next week but I refused it told them september time to book me in I needf time I'm so scared my blood levels driopped and needed blood transfusion a year ago needed 4 pints bleeding not bad anymore but been told the full surgery is my only option now
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maria,

it's understandable to feel scared about this procedure, but i think it's a mistake to reschedule it for september unless that's the only time you can take time off work (or school if you're a student).

i don't have many regrets in life, but putting off hemorrhoid surgery is tops on my list.

i'm no expert in this field, but i just had my second hemorrhoidectomy in 10 years, and a friend of mine is a gastroenterologist, so maybe i can give advice that you may find useful.

the most important thing is to find a good colo-rectal surgeon to do this. DO NOT allow this to be done by a general surgeon, which many people on this board seemed to have done. According to my GI friend, you're guaranteeing yourself longer and more painful recovery from general surgeon in addition to higher likelihood of anal stenosis because general surgeons don't know the optimal length of pathalogical hemorrhoids to cut. everyone has 3 internal hemorrhoids. they're necessary for proper contraction of the anus. if they become pathological (piles), PARTS of them need to be removed, but removing an entire hemorrhoid guarantees anal stenosis. even removing too much of each hemorrhoid can cause anal stenosis. this is the number one reason why some people still have a really hard time with BMs many weeks after surgery. on the other hand not removing enough of the piles can cause them to come back. so you need to see a specialist who's been doing this all his/her professional life. stenosis has NO relation to the stool size you pass post-op. this is a myth. 

if your roids are not that advanced yet, you may qualify for staples, which is far less painful. another procedure to consider is THD, which is also less painful, and even works for some grade 4 roids. but THD is not pain-free, and has about a 12% chance of relapse compared to 1% for closed hemorrhoidectomies done by colorectal surgeons in the US.

if you do get a hemorrhoidectomy, you need a closed (with stitches) hemorrhoidectomy, not the opened (milligan-morgan without stitches) technique. closed is the norm in US, but general surgeons still sometimes use opened technique. the open version is the norm in the UK. studies have shown a much faster recovery time for closed vs. opened surgeries along with less post-op pain and less incidence of stenosis. make sure your surgeon does the closed version!!!

It sounds to me like you did not have a very competent surgeon for your ligation procedure. it should NOT have caused you much pain at all, let alone 9 days. get somebody else for your next procedure!!!

2nd most important thing is diet. get your body used to everything you're going to put in it post-op by feeding yourself the exact same things pre-op for a week. you'll need metamucil 1 teaspoon 1-2 times per day. also 1 cup of fiber one cereal. if you're not used to this amount of fiber, you'll get really gassy until your body adjusts to it. it's NOT good to be gassy and bloated while you're still swollen from hemorrhoidectomy. you should go into day of surgery having no more than 2 really soft BMs per day. If that fiber is causing diarrhea then cut back a little. if it's not enough, then increase dosage. find your sweet spot before surgery. don't wait until you're in pain to experiment with your bowels! i've seen too many cases where people are constipated for the first few days, then take too much laxatives and fiber only to get diarrhea for the next few days, then get constipated again. don't let that happen to you!

being in control of your BMs and fiber gives you the higher likelihood of being able to use opiate agonists to control pain (codeine, vicodin, percocet, etc.) which would otherwise cause constipation. don't be afraid to take these wonderful pain meds (percocet is the strongest). you can combat the constipation as long as you're well prepared. 

of course post op diet is very important too. just like pre-op, stay away from heavy foods. no meets or cheeses. no liquid diets either. you need protein to heel. 

I'm on day 3 of hemorrhoidectomy for 3 internal roids, and i'm able to take 8 percocets (oxycodone) per day and still have one super soft BM each day. i delayed my percocet too long on my first day because like many other people, I was afraid of its constipation effects. this caused a lot of unnecessary pain, and i finally gave in, trusting that my pre-op dietary plan would save me. the first BM was soft and painless, although it did sting like nobody's business for an hour afterward, but other than that, my recovery has been pretty pain-free thanks to regular percocet dosing. i never came close to being constipated.

DO NOT strain to poo. no need to expand on this subject.

stay on top of your medication. take it every 4 hours on the hour. it's a lot easier to prevent severe pain than to catch up and stop it after it starts. 

a warm bath is essential. forget the sitz bath. submerge your body and live in the tub. don't use hot water as that will increase the swelling. use water that feels neither hot nor cool to the touch. if you have a thermometer, try to get water at 93-95 degrees. hot water for hemorrhoid pain is fine, but for post-op, take it down a few degrees.

valium can help you relax and sometimes prevent spasms in your anus/rectum, but use with caution when taking opiate drugs as they have synergistic effects. 

lidocaine cream can be very effective for temporary relief right after BM, however, if you have internal roids issues, this may not be a good idea. if your body absorbs too much lidocaine through skin, it can cause heart problems, even fatalities. the membranes in rectum are very efficient at absorbing things, so ask your doctor first. this goes for any topical analgesic like gelclair or orajel (benzocaine)

one other thing to note: fruits and veggies have a lot of fiber, but not necessarily the right type of fiber for soft stools. they have mostly soluble fiber, which is good for reducing cholesterol, but it's the insoluble fiber that you need for your BMs. these come mainly from grains and legumes. as mentioned before, fiber one cereal and metamucil are great sources of insoluble fiber. i'm not saying avoid fruits and veggies. they're good foods to eat, and they won't constipate you, but don't rely on them for your dietary fiber because they have very little of that.

yes, this procedure will cause pain, but you can take control of it and avoid becoming another one of the horror stories you read on these forums.
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sorry, i need to correct something.

fruits have no insoluble fiber, but some vegetables do. veggies like celery and broccoli contain cellulose, which can be classified as an insoluble fiber, but cellulose can undergo another level of digestion within the colon and cause excessive gas if too much is present (similar to galactose in legumes like beans). It also doesn't draw in fluids as much as fiber from bran and psyllium, so they don't soften the stools. 

Again, no need to avoid veggies--they're good for you, but just don't count on them for your dietary fiber source on the road to hemorrhoidectomy recovery.

Ocean
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If you are anemic due to your internals bleeding I would not delay at all if you can avoid to. I was severly anemic due to my internals for over 6 years. I had a 4 pint transfusion 6 years ago and was still afraid to get the surgery. I finally went in a few months ago after continual bleeding over the years (not spotting but streaming blood, prob a 1/2 a cup or so each time, sometimes more, before I could get it to stop, from the internals after patting / wiping with flushable wipes). Went in and got my blood levels checked (Hemoglobin / Hematecrit) in Feb and the h/h levels were around 55% of what they should have been. I have been fatigued and my chest has hurt most of the last 6 years. When I recently read that almost half the heart attack sufferer's are anemic and that anemia increases your risk by almost 50% I finall got scared enough to find a Colo / Rectal surgeon. Thankfully my referred doc's staff got all the insurance approvals done in a matter of days and got the surgury sheduled within a few weeks of the first exam he did. He also did an edoscopy and colonoscopy an hour befor the surgery, he wasnt entirely convinced all of my blood loss was due to my internals and said only like 3% of people with internals bleed severe enough to be chonic anemics. Both scopes came produced no signs of any other issues (thank goodness) and so I guess I was part of the unlucky 3%.

Had my surgery on March 9th 2012, He removed 3 internals and one external (cut and stiched as Ocean mentioned above). 1st week was hell, I wont lie, it was horrible the first 4 or 5 days. Second was better.. 1st bowel movement was pretty bad and mine was loose.

I 100% agree with Ocean above.. fiber, fiber and more fiber. I took Colace stool softener twice a day the first week and dialed back to once a day the second week.

I cant speak to the differnt type of fiber but can tell you that I ate Fiber-One cereal in the morning, two fiber choice chewable w/ probiotics in the afternoon / early evening and a bowl of the High fiber oatmeal (Maple and Brown suger), I ate a normal lunch and dinner around all that with no special diet beyond the increased fiber that i mentioned. I tried metemucel but didnt care for it and didnt seem to need it. I was taking vicodin 5/500's every 4 hours and 800 mg Motrin every 8 hours. Like clockwork for about a week and a half. I started dailing them back as soon as I felt comfortable enough.

Now 5 weeks later I am pissed at myself for not getting this done years ago. The BM process is so much faster and easier now, no more bleeding, no more lumps hanging out after. Almost smooth as a babies bottom again. It still itches around the area for now (still healing), but worth all the recovery pain I think. First few BM's suck pretty bad for sure. BM cycle went like this.. BM, wet wipes to pat the area only (no wiping), straight to hot shower to soap and rinse area, then stright to tub soak for at least 20 min or more. after the first two weeks you can probably get away with just the wet wipes only. You will have to play it by ear. You will notice the area to be swelling and painful to touch (patting after BM), kind of wierd like you almost have new small hemorrhoids you didnt have before, this should be normal post op and will start to reduce and mostly go away after a week or two (maybe 3?).

I was actually glad I had it done at my 2 week follow up which kind of surprised the Doc. Hope this info will help you decide one way or the other. Dont let the pain scare you from doing it, yes it will be very painful especially the first week, but it is worth going through.

My biggest advice is to find a good Colon and Rectal specialist / surgeon that has several years experience. Reseach what you can about them for complaints, you may not find much if anything but its worth looking for.

 

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Yes I no its not the same surgeon who done the banding its a new surgeon he seems to think all the other methods will no longer work for me like the injections and banding his not tried these procedures but read my notes he is a specialist and I'm always seen in cdu which in uk is all to do with that area
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have you asked about the THD (Transanal Hemorrhoidal Dearterialization) procedure? if you're not too deep into grade 4, you may qualify. it's a lot less painful with much shorter recovery time. i'd be shocked if you don't qualify. the fact that they even tried the banding procedure means you had no worse than a grade 2 only three months ago (if they tried to band grade 4 roids you need to sue them for malpractice. maybe that's why it hurt so bad???). there's no way your roids would have advanced from grade 1 or 2 to deep into grade 4 beyond THD repair in just 3 months!!!

if for some reason you are stuck with hemorrhoidectomy, demand them use the closed procedure (with stitches) instead of the open procedure with harmony scalpel as UK is notorious for using harmony scalpel for this procedure. but i don't think you need to worry about that because you should be a prime candidate for THD.
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By what I've read on internet where they pop out when trying to go toilet but they push straight back up I think I have grade 3 hemorroids
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spurs--

yes, you most likely have grade 3. definitely not 4 yet. so if you're in the debating stage of whether to operate or not, i suggest getting them looked at ASAP! don't wait for them to be thrombosed grade 4 where your only option is to have a hemorrhoidectomy. you'll save yourself a lot of pain by getting it done early. you should qualify for staples or THD. there's really no way around it because at this point they're too advanced to fix themselves using a healthy diet. they'll just get worse over time. 

i procrastinated, and now i'm on day 4 of my 2nd hemorrhoidectomy in 10 years! this time it's 3 internals. last time it was 1 external. biggest regret of my life.
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Thanks will contact my surgeon but when I was there last week he did say its gonna be the full surgery but I will mention about wanting to no about other options or should I just have the hemorroidectomy and get it over and done with
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THD is a relatively new procedure, so a lot of CR surgeons don't have the experience to do it. You'll need to consult with a THD specialist. 

THD has a higher rate of recurrence than hemorrhoidectomy, although not as high as stapling. 

Even if you have great pain management skills and follow all advice on hemorroidectomy diet and preparation, I'd personally recommend THD first. I'm on my fifth day of dectomy recovery... yeah it's painful, but I can deal with it. The big problem is the amount of time I (and everyone else) would have to plan to take off work. Your life is really put on hold for 2-4 weeks. This inconvenience sets me back a lot more than the pain (in the long run). If that's not a factor for you, then sure go ahead with the dectomy and be confident that it will take care of your problem forever. Otherwise go see a THD specialist to discuss your options.
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