Hi Guys, 

Let me give you a bit of info about myself. I am a 29 year old male living in Bangkok, Thailand. I have had hemorrhoids for about 6-7 years and they were getting quite quite bad recently. By that, I mean they became stage 3/4 where I had to push them in after every BM. They didn't cause me much pain but it was getting to the point where they were interfering with my every day life. My life was planned around my BM's, I would rarely eat out for dinner, my diet consisted of nothing but easy to pass food. Suffice to say, nothing was really helping me. The day after eating a steak, or a burger, or drinking alcohol or coffee would lead to a lot of blood loss during my BM. 

I believe that the reason my hemorrhoids didn't really hurt were by the virtue of living in Thailand. In Thailand we use a water spray to clean up after a BM. This meant that I never really had to use toilet roll or wet wipes to clean up or irritate the area down there. It's actually quite pleasant and makes cleaning very easy. All the blood leakage also get's washed away quite easily. After that it's just pushing the hemorrhoid back in - which is irritating, but not really painful.

I definitely recommend anyone with the resources to get this surgery done in a country where a hemorrhoidectomy is an inpatient procedure. Get some good insurance and do it in a comfortable private hospital. The first few days are bad and it is important to have a lot of support and help around. Your body will be doing things that you are not used to. The morphine shots are also definitely useful. I stayed in the hospital the night before the surgery and also for another three nights afterward. 

Pre Surgery Day: Arrived at 6pm to the hospital. Checked into the ward and ate a really light meal - soup and some avocado. At 10pm I was administered a fleet enema - a really weird experience but quite interesting to feel so empty in there. At 12pm I was given IV, saline solution and a sleeping pill - I was quite restless and anxious.  

Surgery Day 1: The kind nurse woke me up at 530am. I tried to relax and have a nice shower. They wheeled me into the operating room at 6am. I still had the IV drip in. They asked me to remove my shirt in order to administer a spinal block and that is the last thing I remember. I woke up about an hour later in the recovery room. They removed three internal hemorrhoids - 3cm, 2cm, and a small 1cm. I was numb from the waist down at this point and in no pain. I had also been administered Fentanyl. I was wheeled back into the room and the next 8 hours were great. Lots of moral support from my family and friends. At around 5pm I went for a sitz bath and that's when things started going downhill. I managed to pee which was great though- 700cc's. Feeling was returning to my body. The actual surgical spot wasn't in so much pain but my stomach was doing flips. I had terrible gas and it refused to be released. At around 6pm I really needed to pee again. I walked to the toilet and tried to.. Nothing came out.. At this point I actually fainted. It must have been from the sudden drop in blood pressure from trying to pee. The nurses helped me back onto my bed and told me to pee into a disposable urinal next to the bed instead of walking over to the toilet. I didn't follow their orders and later on went into the toilet again... again nothing came out.. and again I passed out.. Instead of panicking over fainting, I was panicking about the lack of urine coming out of me. My bladder was immensely full and the urge to pee was killing me. At 11pm I took a sleeping pill. My pain level was at around 7-8 from the stomach flips and from the feeling of needing to pee. Finally at 1130pm I managed to pee into the disposable urinal. Definitely not a complete release but it was relieving to know that things down there were starting to work again. The cycle of trying to pee, failing and it finally coming continued until about 6am. And that is finally when I managed to finally fall asleep.

Day 2: I woke up at around 8am. My doctor came in to check on me. He said that if I need to pass wind to just do it. Better out than in. The wound looked fine. I was still on the fentanyl shots. Breakfast was papaya and high fiber cereal with coconut milk. The day was quite easy. Relatively little pain. 2-3 on the scale. Lunch was mashed avocado - guacamole style, a wholewheat bun and four prunes. Dinner was Indian style porridge. At 630pm my first BM occured. It was no where near as painful as I had read. Pain was at a 6-7. The good thing is that the intense pain doesn't last very long.  Very liquid from the stool softener. At 9pm I had a sleeping a pill and passed out. Pain was minimal.

Day 3: Off the morphine now. I was given the option of staying in the hospital another night and decided to take it. I had a BM at 9am and it was definitely painful - 7-8 on the scale. I assume this is because I was I was no longer taking the fentanyl.  Breakfast was papaya and again coconut milk with high fiber cereal. Lunch was Indian style spinach - saag.  Dinner was lentils and quinoa and some vegetables. I also had a banana, prunes and raisins at some point during the day. I was able to go for a walk around the ward at 4pm. I probably didn't need to stay in the hospital but I am glad I did. The peace of mind is very reassuring.

Day 4: Went home today. Had 3 BM's. All quite painful as I cut back on the stool softener - I was getting diarrhea. Quite an uneventful day. BM pain was at a 7-8, pre and post BM I was at a 2-3. I was only on Tyelonol at this point in terms of pain killers. Sitz baths were honestly not helping me. It put a lot of pressure on my rectum. I got a little bit more daring with my diet and had fish for dinner. 

Day 5: A horrible day. I woke up constipated. Ate some papaya, took my fiber supplement. But no, nothing would come out. I felt like I really needed to use the toilet. My pain levels from the actual surgical sight were very minimal though. At 7am I tried to use the toilet again, but nothing would come out.. There was immense pressure and the feeling was horrible but for whatever reason, my stool would not come out. Felt like a golf ball was stuck in me. Every time I tried to go, I would become extremely flushed and feel incredibly faint. This happened throughout the day. It began to happen even while standing. Apparently it is called a vasovagal syncope. Lying down felt uncomfortable too. I tried to relax and told myself that it will come when it comes. Sat in a bath for an hour drinking lemonade and just trying to relax. Had milk of magnesia that night. Made sure to eat high fiber, easy to digest foods today. 

Day 6: Couldn't really sleep all night. My stomach was doing flips. I was in no pain except for my stomach flips though. My surgical sight was fine. I decided to give the toilet another go at 6am and what ensued was the most painful and pleasurable BM of my life. Suffice to say, I was finally able to sleep in peace afterward. Great day. Walked around. Used the toilet another 3 times through the day. Pain was at a 5 during the BM and 3 after. My wound was starting to burn - probably because of all the BMs. Great day all in all and very manageable pain. Even managed to walk around my neighborhood today. I still have difficulty sitting on my bum though.

That's where we are so far.

Tips:

- The pain can get bad.. Just try to remember that it passes. - It is really important to know what you are in for. This surgery has a tough recovery and it tends to be those who aren't aware of just how tough it is that seem to have the hardest time - Drink lots of water and eat lots of fiber. Lemonade really helps too - A good support system is vital - Stock up on pads. It gets nasty down there. - Do the surgery if it is affecting your daily life. Hopefully I heal to 100% soon and can put all this behind me. Worth it.