My THD Surgery -- December 2013
This message board was very helpful for me in learning about THD surgery and determining to go through with it, so I though I would share my experience having just had the surgery three days ago.
I have sufferered with hemorrhoids since high school. However, they got worse as I entered my 30s. In 2005, I started noticing that my underwear would be soiled at the end of the day with foul-smelling discharge. Often the hems would bleed profusely after a bowel movement, and I would press with tissue paper until the bleeding stopped before pulling up my pants. Sometimes the blood would squirt out of my veins into the bowel like a fountain. In 2008, I experienced my first "social" moment when after a bowel movement, the bleeding continued and stained my pants while I was at a wedding. I started walking around with tissue paper stuffed in the crack of my bottom after bowel movements. My hems would proplapse after a bowel movement.
By 2012, the hems were interfering with my life. Every day had to be planned around my daily bowel movement and the 2-hour recovery time for bleeding and discharge to stop. There were days when the bleeding would start again hours later. I talked to a GI and he recommended banding. I researched it and the painful stories made me not follow up. Then I found out about THD.
So I found a local surgeon who does the procedure here in the mid-Hudson Valley. He examined me, and ordered a rectal MRI to determine whether I had true rectal prolapse in addition to the hems. It turned out I had minor rectal prolapse but not enough that justified surgery for that. But he recommended THD for the hems. I scheduled the surgery for the morning after getting back from a trip to Disney. For a month before the surgery, I took daily Metemucil and MiraLax. The night before and morning of the surgery, I did a Fleet enema to clean out the bowels.
DAY 1 -- TUESDAY
The surgery was uneventful. I woke up from the anesthesia and was immediately discharged with a presrciption for Percocet and a direction to take Colace and drink plenty of fluids.
I dozed most of that day. Not a huge amount of pain, but a real feeling of pressure in the bowels. Almost as if there was something huge stuffed up there. I imagine this was the swelling from the surgery.
I did not eat anything at all on Day 1. Frankly, I feared the pain of the first bowel movement post-op. I often had a feeling of having to pee, but not being able to. But I did end up peeing a lot. Before going to bed, I drank a glass of Metamucil and took a Colace with another glass of water. Then I took a Percocet.
At about 1 a.m. I awoke with the feeling I needed to pass stool. I sat on the bowel, and a bunch of gas came out, followed by a stool (must have been dinner from the night before -- an enchilada). Surprisingly, no pain at all in passing the stool. there was blood but not dripping blood like with the hems. I cleaned up and used one of my wife's sanitary pads to line my underwear, as the nurse had said there would be discharge.
Then at about 2, I woke up nauseous, and threw up all the metamucil and other liquid in my stomach. I am not sure whether it was an after-affect of the anesthesia or the painkiller. In any event, I did not sleep well the rest of the night. My bottom was sore, and I still had the horrible bloating/pressure in my gut.
DAY 2 -- WEDNESDAY
I awoke the next day. Still not any significant pain. A dull ache, like a bruise, in my rectal area. I passed some loose stool and liquid--not more than an eigth of a cup. Some blood. I continuned to drink water.
I drank a ginger ale in the early afternoon and took another Colace. Still did not eat anything, as I did not want to push it. Dozed throughout the day, answered some work emails and took some calls. Passed more liquid and a couple of pebbles of bloody stool. Took a shower.
I still had the pressure feeling in my bowels from the swelling, but not as much as the day before. But the soreness was more pronounced. Still no significant pain.
For dinner, I had a small bowel of chicken broth with some rice and pastina. That was the first thing I had eaten since dinner at 6:00 on Monday.
I helped a little with cleaning up the dinner dishes, and then slept for 2 hours. I woke up, took a Percocet, and watched some tv, and then went to bed around 11:30. Before going to bed, I took Metamucil. Slept very well, no issues at all.
DAY 3 - THURSDAY
Woke up and the feeling of pressure was pretty much gone. My rectum is sill sore, however. I had some toast and took a Colace. Drinking plenty of water since my pee looked yellow this morning. I think it is because the Metamucial and Colace soak up a lot of liquid in the bowels.
I will continue to update this topic as my recovery progresses. I pray that my hems are gone and I can return to a normal, active life. I appreciate everyone posting in this board.
DAY 3 UPDATE
Counting my chickens before they are hatched. I ate an apple and yougurt for lunch. Drank a ginger ale. Then I felt like I had to go to the bathroom.
Passed a small stool with difficulty. Really unpleasant. Not horrible pain, but it hurt. Afterwards, my anus felt like it used to feel when I had external hemorrhoids after I went to the bathroom -- angry and inflamed.
For dinner, a small bowl of rice and some garbanzo beans and took another Colace. This made me go to the bathroom again and it was worse than before. The pain of going is not as bad as the pain afterwards. I took a Percocet.
The plan for tonight is more water, Metamucil and maybe some MiraLax.
Did not sleep well between Day 3 and Day 4 due to pain in bowels following a second poop late in Day 3. Day 4 I woke up and took 2 percocet, which made me fell better the rest of the day. Ate some Frosted Flakes for breakfast, took a Colace. No lunch. Some rice and black beans for dinner. Two more Colace, and a glass of Metamucil. No poop today. Took another 2 percocet around 8 p.m. due to soreness in rectum. Slept well that night.
Woke up and took a Colace. Late morning I ate some Bob's Red Mill oatmeal for breakfast. Took another Colace and a glass of Metamucil. Passed a medium amount of hardish stools. Tried the squatting technique with my feet on a footstool in front of the john. Not sure if it helped. Thought I felt a small protrusion when I wiped. Blood with all stools, but not a tremendous amount -- not like with the hems which would bleed uncontrollably.
I'm drinking plenty of water and taking Colace, so I am not sure why my stools weren't very soft. I'm going to try to stay off the percocet today -- took 2 Advil instead. Maybe that will help.
Friday was definitely the best day so far, probably because I was still taking Percocet and didn't go poop that day. The hardest thing about the last two days has been the pooping. I've tried everything to try to get smooth, soft stools, but they are coming out nuggety and a little difficult to pass. I have been trying not to strain to go. Every time I go poop, I have to lay down for 20 minutes to recover from the pain. Not so much pain while going, but afterwards, a burning and sensitiveness like my external hemorrhoids used to feel.
I have not taken Percocet yesterday or today. I have moved to extra-strength Tylenol. Lunch on Saturday was a small amount of black beans. Dinner was tilapia and sauteed kale. Then an apple for dessert and a couple of oatmeal cookies. Lots of water. Metamucil and colace.
Today I finally broke down and took a Miralax after my oatmeal breakfast. As well as Metamucil. Two more difficult stools today. The last one was the largest since the surgery. Still some blood when I wipe. I suspect i have an external hem. Funny but I did not have it before the surgery. I have been hesitant to look down there. No prolapse anymore, which is great.
I am wondering when this pain from going poop will go away. The surgery seems to have successfully gotten rid of the internal hems. It would be a shame to end up with a new external one after all this effort and pain.
45 Year Old Man here to give the 20 day update. Went back to work on Day 14 -- a two-hour commute, each way. Then sitting in the office chair the entire day. (No wonder I have hems.) No pain. I was taking metamucil and Miralax daily and eating a high-fiber diet. I don't know what went wrong, maybe I wasn't getting enough water. But my stools were hard and very difficult to pass. Had to strain a little even though I was trying to avoid it. I finally got the courage to look the other day with a mirror. I have at least one external hem and what looks like a skin tag. Bleeding while pooping is long gone. A little blood on the tissue this morning from the external hem. Cutting back on the insoluble fiber (e.g., raw kale salads and Metamucil) and taking only Miralax. Will try to increase fruit intake. All internal hems seem to be gone. If I can make this external hem go away I will be wholly cured. Still have to see whether I have any mucus seepage from the minor rectum prolapse. Overall my verdict at end of Week 3 is thumbs-up for the THD procedure.
DAY 30+ UPDATE
It has been over a full month since my THD surgery to remove a massive amount of internal hems. I can say that my quality of life has been improved 100x because of the surgery. I no longer spend my day worrying about when I will go to the bathroom and how I will deal with the relentless bleeding that follows. For example, last Wednesday I went skiing. Before I left the house, I had a bowel movement. Then I just pulled up my longjohns and went to the mountain! Sounds ordinary, but for me an extraordinary experience based on what I have been living with the past 10 years.
No more tissue paper stuffed in the crack of my ass for hours after a bowel movement. No more avoiding sex at night with my wife because I am still bleeding from a bowel movement 10 hours earlier. No more looking in the bowel and seeing it filled with blood.
I still have a couple of external hems but I am taking Metamucil and Miralax every day. I am going about 2-3 times a day. No more straining, no more sitting on the bowl reading. I go when I feel like it and then don't try to push it all out. Hopefully the external hems will go away.
The immediate aftermath of the THD procedure was unpleasant, but not torture. I feel for those who have had terrible experiences, but for me so far it was definitely worth it, without reservations.
45 Year Old Man here to give an update. I had the THD surgery over 9 weeks ago and today was my first post-op appointment with the surgeon. (It had originally be scheduled about a month ago but had to be rescheduled.)
The doc took a look down there and what I thought were two external hems are just bumps left over from the surgery. He said the sutures need 4-6 months to totally dissolve. He said it looked great, no hems at all. The little blood occassionally streaked on my stool is still from the sutures.
I am still taking daily fiber supplement and Miralax. He said I should wean off the Miralax and take Colace instead.
So for me the THD surgery was a resounding success.
Hang in there -- it gets better. If your doc did a good job, you will be amazed at how your daily life improves. The mental relief might even be more powerful than the physical relief!
-45 Year Old Man
I had THD surgery for bleeding internal hemorrhoids about 16 weeks ago. To my surprise, the surgeon also removed two external hemorrhoids that really hadn't caused me any problems, but he thought he would be proactive. I can't say how fast I would have recovered from just the THD, but the external surgery kept me at home for seven days or so. I would say that the surgery has been quite successful, but the first two weeks of recovery were fairly difficult, mostly because of the external removal. I had a lot of pain, bleeding and burning. Actually, the first three days were a piece of cake because I was given an injection of a three day pain block (which allowed me to walk out of the hospital as if I never had surgery). Once it wore off, however, I was fairly miserable for a week or so, and couldn't find a comfortable position to sleep. Bowel movements were actually painless and easy for me due to Metamucil and Colace, but right after it began to burn and throb so much that I immediately needed to get in a hot bathtub, which was very effective in curbing the discomfort; the baths themselves made me grumpy because I began to sweat like crazy and just felt grimy for 10 days. My only advice would be to anyone who is prescribed a steroid ointment: taper off as soon as you can because in my case it supressed my immune system which caused a yeast infection (yes, men get them, too, apparently) and I became allergic to the wet wipes I had used for years. Now they cause incredible itching, so I've had to switch to witch hazel wipes. In the end, not bleeding and - sorry to be graphic - not having to push anything back in has made it all worth it, I'd say. Going back to work after four days is highly unlikely unless you can take baths at your office or someone can drive you while you are taking your pain killers, which I absolutely needed for 10 days and kind of wanted for another week.
45 year old man