Hi All,

I gained significantly from reading the posts here so I thought I would share my experience in the hopes that it could potentially help someone else.

Over the course of many years, I had internal hemorrhoids that would sometimes bleed for a few minutes but presented no major inconvenience.  The frequency of these events was every 3-4 months.  However, in October of this year I started getting swelling of the anal area every time I went #2 which increased over a month or so to the point where I started getting protruded hems.  I met with the doctor on this, who prescribed hydrocortisone suppositories, which unfortunately my insurance wouldn't cover (cost was $112 every 6 days, taking two per day).  In addiiton, I was using Prep H externally.  I bit the bullet on the cost, fearing surgery more than bancruptcy and stayed this course for almost 4 months, occasionally trying to ween off.  The problem was, every time I tried to ween off, the external hems would come back and continued to get worse each time.  So, I was facing either sure bancruptcy for a lifetime of $112 charges every 6 days OR I had to seriously consider surgery.  My external hems were stage 3 by the time I seriously met with the doc about surgery.   I went to see a surgeon recommended by my family doctor...

Based on my condition (my hems were not getting any better and were causing a serious disruption to my life and mental well being by now) the doctor recommended THD.  Actually, he informed me that, in his opinion, it is the ONLY good option for Stage 3 and 4 hems.  I researched the procedure on my own (including reading this blog) and decided t proceed.

I had my procedure 23 days ago.  I will try to be brief while presenting all valid points that I can think of:

Week 1:   Get ready for the worst week of your life.  The pain was excruciating, beginning from the time I woke up in recovery.  They actually gave me three more "shots" into my IV of the pain meds while I was recovering (I dont remember what it was but it was fast acting but wore off after about 30 mins).  The ride home in the car was horrible.  The only way I can describe the pain is (sorry for the description) if you have every been constipated and then finally go to the bathroom and its a very large t**d that you can barely pass.  That feeling when it is coming out - thats what you will feel like constantly 24 hours a day for the first 3-4 days.  I was prescribed Norco which I took alternatively with 800 mg Ibuprofin.  The Ibuprofin actually seemed to work a little better but their is little comfort even on such strong medicine.

I did not go #2 for the first 4 days (even though I was taking the prescribed stool softeners twice a day).  This adds to the discomfort as you get really bloated.  When I finally did - it was almost pass out like pain.  VERY painful and difficult (like being constipated x10) and the first time I only managed a small pinky size amount.  But it was progress.  The next 2 days went like this until finally some normal amounts were coming out.  Day 6 and 7 the pain started easing up some and I was able to cut back a little on the meds (down to 600 MG ibuprofin per dose).  My diet was very restricted this first week due to 1)fear of having to go to the bathroom and 2) general discomfort from the bloating.  When I did eat it was all high fiber foods (oatmeal, salads, ezekial toast).  Instead of sitx baths, I took full baths 2X per day -  I just did not like the sitx bath and felt some mental improvement from a hot bath as well so thats what I did and it does offer alot of relief.  Plan on this...

About the one week recovery claims from the THD website:  well, no.  Technically, I was up and walking and my pain was manageable to a point where I COULD HAVE gone to work...but I didn't.

Week 2: Very tiny incremental improvements in pain, ability to go to the bathroom, mental health.  The mental health part stems from fear that the operation failed, that something was going to go wrong, that I would feel material coming out again, that I would make a wrong move and jar something loose, etc...

I stopped taking the Norco this week, because I believe the codeine was adding to the constipation I was having.  Seemed to make a difference once I  switched to pure acetaminophen in the same doses as the Norco (Norco is just acetaminophen and codeine together).

I went to work on Day 10, still taking 600 mg Ibuprofin every 4 hours.  Lots of discomfort when sitting for very long.  I have the ability to work from home some days so I would lay down and work on my laptop which really helped.  Sitting is definitely aggravating at this time in the recovery.

Week 3: Incremental improvements (with an occasional lapse) still happening.  For the most part, down to 400 mg Ibuprofin about 3 times per day.  Going to the bathroom regularly although it does still hurt.  Still on Colace stool softener twice per day.  Only major complaint/fear is the feeling of what I would call "ghost hemmy's or ghost tissue - it feels like there is something there but when I feel there isn't.  Doc explained this is part of the healing process and will go away.  Still doing 1 bath per day and slowly migrating to showers.

Week 4: Today I am party through week 4 (23rd day).  Probably the reason I am writing this is it is the first day I feel almost normal!!  No meds (except the stool softener) and pain almost completely gone.  My plan is to continue the stool softeners 2x /day for another few days before weaning down to 1 per day and then none.  Everything is "tight" down there and no more symptoms of internal hemmys.  I would consider myself about 90-95% back to normal.  Not 100% because of the stool softener, slight pain, and still a little feeling of the ghost material.  Dont get me wrong, the "feel" of the area has changed.  I am still learning the new signals for when I have to go to the bathroom and developing new habits not to "push" when going to the bathroom.  The amazing thing is - I never bled a single drop of blood through the whole thing.

I would consider the operation a success and would recommend it.  Not sure what happened on some of the horror stories you read about online but I cannot relate to most of it based on my experience.  I would highly recommend 

1) research and get the best surgeon available 2) set your expectations correct:  LOTS of pain, at least 3-4 weeks recovery (my doc said up to 6 weeks) 3) take baths 4) use the meds as directed, including stool softener and pain meds 5) stay off your butt as much as possible during recover 6)drink lots of water and eat high fiber foods and 6)  try NOT to freak yourself out.  It is an effective surgery...