Swelling and Pain After Hemorrhoidectomy Surgery

I think I may have had incorrect notions regarding hemorrhoids (as seen per my previous posts).  I am currently trying to wrap my brain around these new ways of viewing things (wife is helping, as she is a nurse).  I may have been incorrect/misinformed on what I had thought, said, and understood. Please stand by the next few days for an internal re~work of how I am going to view this recovery, what is happening, and what I should be doing.  I am actually very nervous now.

Also have been wrong about pain killers:

Hi mudkow. I hope you find the answers you need and some peace of mind. It sounds like it would be helpful having a wife who is a nurse! 

I was on Percocet and then Lortab. Percocet made me feel very hyper with no real pain relief. Lortab just made me sick, so after a week I was only on Tylenol and Advil. I continue to take both of these regularly. Narcotics can really constipate you as well.

I hope you continue to do well with minimal pain. This is a long journey for most and it can help just to know there are others out there who know what it's like. Hang in there!

Oh Aussie I'm sorry to hear you had a set back. I can imagine how you're feeling with that many bms in a day and all the pain and discomfort it involves for hours to come. Wow you sure did have several surgeries in that region! You are so brave and I can't believe you've endured as much as you have. That's a bummer though that this time it feels worse than the other times. I know what you mean...I was always wondering to myself why it was taking so long to recover!? Like you, I will never go through this procedure ever again unless my life depended on it and even so I'd really have to think about that. Haha jk! Seriously though, I just can't imagine ever doing this again. I've had a few other surgeries in the past 15 years and this by far has been the worst of them all. I will do the other surgeries again if I had to, no problem. But this... no way. But Aussie, you're almost to that point though where you'll start to see significant improvement in your recovery process. I'm keeping my fingers crossed for you that your bms are less frequent. I have 1 bm a day most days and some days I'll have 2. Some days I don't have the urge to go at all so I won't push it, but the next day I'll get a major urgency (not emergency though which is good) and I'll have a bm and that one will always hurt way more I'm guessing because it's 2 days worth of eating and not going. I've been off the laxatives and stool softeners for a little while now. I take a Metamucil drink mix packet every morning with water and I do eat lots of fruit for the fiber. I haven't been able to keep up on the fiber chewable tablets and Fiber One cereal as my braces absolutely won't allow them. They hurt so bad! :( I was on prune juice for a while but I started to feel it didn't work so well so I looked up info on fiber content in fruits and juices and it turns out prune juice is not a great source of fiber contrary to what everyone thinks. You're putting more sugar in your body than anything else and that's what I was doing so I stopped. Forget about the prunes..as soft as they are I can't even chew on them because of how much pain it would cause my teeth. Plus they don't provide as much fiber as say an orange or apple would. I'd throw fruits with a lot of fiber (oranges, apples, raspberries, blackberries, pears) into my VitaMix along with ice and a little bit of cranberry juice and I have a juice/smoothie drink. That's how I have to do it for now at least. I miss eating anything I want lol.

Breezie, I hope your days are better than they were. I understand the feeling you're going through about feeling bad that you're not able to help out too much around the house..but please don't beat yourself up over it. Your family is happily there for you as you'd be if it were one of them going through recovery after major surgery. But I know the feeling because I'm the same way. I get really stressed out in situations like that where I feel I have no control and then I start to feel guilty, anxious...all of that, you name it! But just remember this is only temporary. It seems like it's taking forever to heal up but if you think about it you're only a month out. What ever you read about ppl being back on their feet after a week or two that's just so bogus and I can't even begin to believe those ppl. I mean, I guess that CAN be possible?? Because anything's possible..? But I just can't imagine that and I'm sure most doctors would say the same. We had major surgery and we knew going into it that it would be a pretty long recovery process so we just need to remind ourselves that all of this pain and suffering will end, that all this is just temporary. At the end of all this we will be so much happier and so glad that we did it inspite of all the torture we endured. You're almost there breezie. You can do it!! :)

mudkow, welcome to the forum. I'm glad you found this place to share what you are going through. It is always nice to hear about how others handle their recovery because we can all learn from each other. Sorry to hear it has been less than pleasant for you.. I hope that you find days of less pain and discomfort soon. That's great your wife is a nurse. I'd say you're in good hands. Keep us posted on how things go for you.

Hi Guys,

Thanks for your compassion PITA - it really does help when it comes from someone like you, or Breezie who understands. Today has been much better for me. I have only had one tiny BM today (this is a first, as I worked out that since my surgery 42 days ago, I have been on average at least 4 x a day which = 168 BMs, so no bloody wonder I've been so sore!! LOL!!). Anyway, as a result, today there is no pain, YAY! But like you say, tomorrow it will be double trouble, I'm sure (no pain, no gain) and to top it off, I had spicy tuna in my salad sandwich for lunch, so I will probably feel the burn!! I also have Metamucil every morning, and through the day I make sure I have some salad for lunch, wholemeal bread, fresh fruit and lots of water to drink. I have been having meat since early after the op, with no ill effects either, although I don't overdo it. Occasionally I have a couple of prunes and/or dried apricots, but they seem to cause more frequent BMs, so I haven't had these for a while.

Even though with all my rectal surgery over the years, I must sound old and decrepid, I am actually an otherwise very healthy and fit 53 year old, with no other health problems. My butt is my weakest link! The only other problem I have is hot flushes recently, related to menopause.

Poor PITA, what, with the braces and butt problems, how on earth do you enjoy life any more? All the thought that must go into what you can eat... I feel for you. I had no idea that braces are so painful. I hope it gets better for you really soon. You will look great when they come off, but unfortunately the other surgery results are not on display for all to admire, ha ha. Is there also a forum on this site for people with braces and have you joined yet?

Breezie, PITA is right. You would be there for any of your family members, and I'm sure they understand that you need them at the moment. You will get back to full capacity, but it is only 4 weeks, and you are not there yet. You have probably looked after all of them tirelessly for years, so now it is your turn to be spoiled by them during a very difficult time. It sounds like your husband is a great help. I have even used him as an example to my husband, of how helpful he is! My hubby thinks it is very funny that I am chatting with strangers on the other side of the world about our sore butts and BMs. And he is half right - it is quite strange, isn't it? Yet somehow, we have an affinity, due to the horrific operations we have all had, and its very helpful to share with others who understand.

Mudkow, welcome to this forum. I hope your recovery is quick, because your operation was very recent. Looking back now, my first 3 weeks post-op were a blur due to the pain I had. I found that no painkillers gave me any relief and the only relief came from heat of any kind, either a sitz bath, hot shower on the area or sitting on a hot water bottle, or a heat-pad, as you have found. As Breezie has already said, beware of taking narcotics. Avoid at all costs, as they will constipate you and this is the last thing you need at the moment.

PITA you are so right about the people who are back to normal after a week or two. I think their surgery must have been quite minor in comparison - perhaps fewer haems, or maybe just internal ones. One of my previous ops was for internal haems, and the doctor stapled them, and there was practically no pain post-op. Apparently the higher up they are, there are not the nerve endings present that are down lower, so there is less pain. I think the people with quick recoveries must have had internal haems. The external ones are the killer haemorrhoids! Take care and speak again soon :)

Hi everyone.

PITA and Aussie, it is always so good to hear from you. I've read both your posts several times last night and this morning just for encouragement. How are you both doing today? Aussie, I hope you have had a truly better day. PITA, how is your mouth feeling with the braces? I am thinking of both of you. Mudkow, I'm also thinking of you and hoping you are doing okay and that you are figuring out what you can/want to eat and getting the BM's going as you need them to.

I am hanging in there. Trying to just keep reminding myself that I will get there. Wednesday will be 5 weeks (counting by Wed - Wed).  Today is Day 33. So, really just a month still. I had a rough morning this morning, but most of my mornings are rough. I think if/when I can get to the point where mornings are not so bad, I can go back to work. My diet has not changed at all, but my BMs are getting firmer and feel harder coming out. They are still not hard really, they just feel hard coming out. I much prefer the softer BM's but I'm not having as many BM's with these firmer ones, so I guess it's a trade off.

It's a good point that people that are back up and around sooner might have had different procedures done. My younger brother had an outpatient procedure done for an external hem that was thrombosed and they drained it. He kept saying it was a "hemorrhoidectomy." My mother finally corrected him, and he was like "oh, wow, yeah, what I had was not as bad as you." LOL!  So I think some folks think that when they get a hem banded or drained that it's the same thing, and it's not.

I also appreciate your feedback about feeling like I have to do it all and not being able to do more. I know you're right. I am just so tired of being in pain, laying down so much, and not being able to do the things I enjoy. Or work!  LOL  I am very fortunate to have such a supportive husband. He is a one of kind. I just hate seeing him be so worn out because I can't do as much. I know it won't last forever. I think he also thinks I'm crazy for being on this forum and talking about my butt and BM's. LOL  But it really has been a great support and has helped me to get through this.

Thinking of you all and sending positive thoughts!

 

Hi All,

Well I have had to take a day off work today, due a particularly bad night last night..SOO depressing. As I mentioned yesterday, I hadn't had a BM yesterday, and it came last night about 9.30 pm. There was no straining at all, and it was formed but not hard, and a substantial amount, but oh my goodness, the aftermath was terrible. I lay in bed unable to sleep due to pain, and decided at 3am that I was not going to make it to work today. The pain was similar to what I was having 3 weeks ago...I thought I had past this point! I have had another BM this morning, and more bleeding than usual, as well, so obviously my wounds are not healed yet. Maybe it really was due to the spicy chilli tuna I had yesterday? I will avoid that in the future just in case. Otherwise I have no idea why my pain level has suddenly reverted to that point, at 6 weeks post-op. It seems to have settled down at the moment, but now I am scared of it becoming severe again. PITA, did you have anything like this after the 6 week mark?

Anyway, I see my surgeon Weds afternoon - not that I expect he can do much at this point, but an explanation of what is going on might be good.

Breezie, sorry to hear that things are still pretty rough for you as well. I do believe it is not our "constitution" or low pain threshold that is the cause of our suffering, but definitely the nature of the operations we had. This pain is not in my mind, or due to tensing the muscles, or anything like that. It is very real, and all I want is for it to stop.

Mudkow, how are you doing now? You can only get through this thing one day at a time, so hope all is well today.

Well, sorry my story is not better today guys, and hope I'm not dragging you down. I really hope you are all having a good day and continue to improve.

Oh Aussie, I am so very sorry to hear that you had a bad day!!! My heart goes out to you, for the pain and for the emotional/mental anguish that goes with all of this. I think we are both hoping that 6 weeks will be the turning point, so for you to have such a rough day/night around that point must be very discouraging. It really sounds like it must have been terrible, for it to be as bad as it was 3 weeks ago!  I don't know if it had anything to do with the food you ate. It sounds like your system is still not where it needs to be with the BMs. I am having similar issues. I am going from having 4-6 smooth and soft BM's daily to 2-3 that are harder to pass. In fact, the past few days I will pass a little and the rest won't come out so I get up and walk around and wait to be ready to have more to go. It is so scary, and the pain is still bad afterwards. (I'm in the middle of one of these "episodes" right now and it is scary because I just want it to pass smoothly and with no straining.) I wouldn't call it constipation at this point because they look smooth afterwards, and I am going 2-3 times a day, but it is definitely odd and concerning. I am still eating whole grains, fruits, veggies, drinking tons of water,taking fiber.... I don't know why this is happening. I am wondering if you and I are having a side issue of our GI systems being out of whack and not being back to normal yet. I don't know. I hope your surgeon can give you some answers. Sometimes just having an answer can give you some peace of mind. I also hope you have pain relief by the time your read this and that you never again have that experience. I just feel so bad for you!

You are not dragging us down!!! Far from it, we are all in this together and just trying to get through it somehow until the day comes when we are better. It feels like it will never happen sometimes, but it will!!! 

I am sending you prayers, positive thoughts, and much compassion over the miles.

Oh Breezie,

Thank you for your kind words, they help so much. You're right - it is physical and also emotional/mental anguish that happens with each episode of bad pain. Perhaps we are both having another GI issue at the moment? Or perhaps it is just all those nerve endings trying to heal and causing altered sensations in the area? I will definitely ask my doctor tomorrow and will let you know what he says.

I also feel for you with your episodes. You know, it sounds exactly like what happens to me - knowing I need to go again but not wanting to force it, and just walking around and waiting until the urge is strong enough to go without straing. I know you also look forward to the day that you don't need to plan your activities around your BMs.

Yes we will get through this in time, even if it longer than originally anticipated. Its such a help to know that someone understands. My thoughts are also with you over the miles and I pray for your recovery as well.

Hi Aussie. I hope you are having a better day today. I think Australia is about a half day ahead of us, so it may be night there. It's 9:30 am here. I just hope your day went better and you were able to work without pain. I hope your doctor can give you some good news.

I get so excited when I can go out of the house for 2 hours without incident. But that is the most I've been able to manage. There are moments during the day when I wonder if I could be doing more, but then I get real and remind myself that I am definitely doing all I can. What you said in a recent post is so TRUE - this is REAL pain. It is not because we are weaklings or have low pain tolerance. I have been beating myself up and telling myself that, but that is a lie to myself. This is a very sensitive part of our bodies, it is a very painful surgery, and I know for myself I had both internal and external hems removed and there is still a lot of swelling and bleeding after BMs (and sometimes between), so I know I'm still healing. It's just not going as fast as I want.

I think you're right about the nerve endings and muscles in that area playing a role. I really think that has a lot to do with the number/frequency of BM's, sense of urgency, and pain especially after BM's.  It just takes a long time to heal, unfortunately.

I also had an epiphany last night. I was trying to think if I had added something to my diet that was different that may be causing the stopped up BM's. And the only thing I can think of is dairy and chicken. I don't think the chicken is it. But when I looked up more about dairy intolerance, it was revealing. I told my husband, and he looks at me and said, "I've thought you had dairy intolerance for years!"  I asked him why he never said anything, and his reply? "Because you love milk so much!" HAHA!  I don't love it so much that I want to have constipation!!!  I had gone off dairy for a month as part of our vegan transition, but I added milk in starting over the weekend, including some cheese pizza and ice cream on Father's Day, and it all makes sense. So I am going to stop the dairy and see if that helps. I had to take some Miralax last night and this morning the BM was all dark and dense, not the smooth green stuff with my veggie/vegan diet. So we'll see. I would rather have the smooth stuff and go more than this harder stuff. I am really scared of any kind of straining or hard BM because I don't want a hem ever again!!!! It's been nice only going 2-3 times a day, but not with this harder stuff. I just want it to slide on out. LOL 

I am having pain this morning as usual. I wake up every day wondering "will this be the day that I don't have pain?"  And every day, there is pain. I can't say that things are better than they were last week, though. I really can't. It seems to be about the same. I keep waiting to be able to say "I am significantly better." I guess I am better than I was in week 2 or 3. But I'm nowhere near where I thought I would be. It's really frustrating.

I hope you all have a good day full of healing and with as little pain as possible.

 

Hello Breezie,

I have had a better 24 hours thank you and mangaged a good nights sleep last night, and am back at work today. However, your thoughts echo mine exactly, in that I want to be significantly better, with no pain, and that hasn't happened yet. I am in Sydney, which is probably about half a day ahead of you, timewise, so as I write this, you are probably going to bed.

I wish this was the day for you that there is no pain, but that day will happen. It is really disappointing that this week is not significantly better than last week, but you know when I read that, I thought, that is exactly the same for me. I don't know why this is...you would imagine that with every day that passes, the pain and recovery would be incremently better, but that doesn't seem to be the case.

I hope stopping the dairy alleviates your problem of hard BMs. And if its not that, I hope it settles anyway. You're right, it seems to be a bit of a trade-off between frequent soft ones and less frequent, but harder and difficult to pass. I laughed when I read about you wanting them to just slide out - that is so true and what I aim for as well! Straining would risk new haems forming, but also in the short -term I am worried it would re-open the wounds inside (which are not healed yet anyway).

I also hope you can get out of the house again soon. Perhaps aim for the afternoon if the mornings are the worst time? It would be good for your mental health to get out for more than 2 hours if you can. And if not, well it will happen eventually.

Well I see my doctor this afternoon, and have written a list of things to discuss with him. I will let you know what he says.

Fingers crossed for you for a significant improvement soon :)

Hi Guys,

I have just returned from seeing my colorectal surgeon and thought I would update you. Officially now, I am NOT a malingerer! I will give you all the detail in the hope that it may be helpful to you Breezie, or anyone else who has persistent pain after this operation.

He was not happy to hear that I still had pain after 6 weeks and said I should be better by now. From a description of my symptoms he thought I had developed a fissure. But when he examined me (youch!) he said I didn’t have a fissure. 2 of the 3 external haemorrhoid sites have healed, but the 3rd one is only healed in one section. There is a section of only about 3 mm which has not healed and is growing granuloma (excess) tissue around it and still bleeding. He said the whole muscle around there is in spasm, and this constricts the blood flow to the area, which stops healing. The solution is to use Rectogesic ointment (glyceryl trinitrate) which relaxes the muscle, but will take about 4 weeks to work! It also drops blood pressure in 70% of people, causing bad headaches (its the same drug that is used under the tongue for angina), so I have to use it, then lie down for 30 minutes afterwards, and the ideal is to do this 2-3 times a day. I will be lucky to manage twice, but it will mean getting up at 5 am to put the cream on then going back to bed for another 30 minutes before I get up again for work(probably with a headache). The other thing I need to do is start having warm baths again to relax the muscle - I had stopped this after the first few weeks.

Breezie, he said the nature of this pain (starts soon after a BM and lasts for hours) is related to muscle spasm - so this could be your problem as well, as your pain is similiar?

Re the change in bowel habits - he said the frequent BMs were probably related to an upper GI issue, and not due to the anal problem. He suggested I stop the Metamucil for now. He said if the pain is bad, to take strong painkillers (Endone) and reintroduce laxatives to counteract their constipating effect. But I wouldn't use these often anyway, as I have to work and drive.

The feeling of urgency to have a BM is fairly common after the operation, more likely if internal haems have been removed but it can also happen after an external haemorrhoidectomy. It will settle in time.


At least he reassured me that it will eventually get better and I won’t have this pain forever, which I was very worried about. I have to go back and see him again in 4 weeks.

The other thing he told me is that my colonoscopy, which I had on the same day, showed a polyp which was precancerous (he removed it) so I need another colonoscopy in 3 years. He reassured me that waiting this length of time was fine. And the colonoscopy also showed diverticular disease (apparently mild and it is asymptomatic).

So what a day! Enough to give me a headache without even using the rectogesic ointment yet! I am thinking of taking a week off work if I can arrange it, to maybe go away somewhere to a beach and relax and try and recuperate. I think my whole body is out of balance at the moment and I need to treat it a bit kinder. I am getting skin problems and hot flushes, you name it! I think my body is trying to tell me that it needs some TLC. As my daughter just told me, take the time, as in 5 years time, you won't remember that you left your workplace short-staffed for 2 weeks, but you will remember if you became seriously ill by not taking the time you need.

And Breezie, I think this also validates your decision to stay home from work for now - you are definitely doing the right thing.

Well hope you are all making good progress and getting through the day without discomfort. Best wishes :)

Hi Aussie.

Thank you for sharing how your doctor's appt went. I wish it were better news - such as "oh you are doing fine" without the need for more medication - but I'm also glad that he was able to give you some answers. The medication sounds like a pain in some ways and will take a while to work, but hopefully it will set you on the right path. I think your idea to take some additional time off and rest sounds like a good idea and may help the healing process. I'm sure being at work and on the go doesn't help, plus with needing to take additional baths and use the medication as directed, you may appreciate just being able to relax. I do think I am doing the best I can and making the right decision to stay off work longer. Honestly, I am not able to go to work which has more to do with it than anything. The pain is such that I just can't do much for long. It is so discouraging.

After reading your post, I did call my surgeon's office. I talked to the front office person and she is going to leave a message for the doctor. When I saw him 2 weeks ago, he said "maybe another week or two" and I might be able to go back to work. I am nowhere close to that point. So I just wanted to run it by him and see if he had any concerns. The front office person did remind me that this is probably the most painful surgery you can have and that it can take a long time to heal. As long as there is not an increase in pain and bleeding or straining with BMs I am most likely still headed in the right direction. Right now it feels like I am not making any progress. Last night I had another harder BM and I felt like it split me in two. I really don't recall doing any straining, but it was just painful to pass. I had a recurrence of some significant swelling down there in an area that had previously improved. Now it feels like I have regressed. I have not had an increase in bleeding, so I think it is more that the harder BM aggravated the swelling and it is just painful. I don't think I really "split" anything. The significant increase in swelling is in the very rear area of the anal area, if that makes sense, and I think it's very sensitive.  I will keep monitoring it. I don't think it's a new hem, but of course that is my fear. I really don't think I strained or did anything that would have caused a new hem. I will say that the regression of swelling made me realize that I had improved more than I realized... only to now have this return. Today my BMs have been back to smooth and soft (3 so far today) so I think eliminating the dairy is key. I am learning to like Rice Milk. LOL 

All of the information you shared is very helpful. When I went to see my surgeon I took my husband so he could hear what was said. I think my anxiety/fear causes me to forget some of it, so it has been helpful for him to remind me what the doctor said. Reading what your doctor said also is helpful. It is a reminder that we are not malingerers or weak or anything like that. Just human.

About my work.... My immediate supervisor is really easy going. I think if there was a tub at work, she would say "hey just use the tub as you need and lay down when you need." LOL  Not that I would want to do that, but that is how easy she is to work with. But my supervisor above her (I work with them both closely), she is a very nice person, but more anxious and micro-managing. She has been wonderful about me being out. But she is also the kind of person that when you come back, she expects you to be 100%. I know when I go back, she will be on me like a fly on honey with projects and updates and things we need to do. I'm a counselor but I also manage several projects for our agency and coordinate services in the community, etc. So I know when I go back I have to be at my best. Otherwise, she'll tell me to go home. LOL  There is also the reality of having to be present mentally and physically with clients. I can't just run out of the room on someone in the middle of a session....."Oops, I have to run to the bathroom!" LOL I have to laugh just thinking about it. I got 2 subpoenas this week at work and I'm having to contact the court and the lawyers to say I can't be there. I feel bad about it but I can't physically do it. I have to submit a letter and documentation to the court so I don't get in trouble for not being there. Can you tell I miss work? I told one of my coworkers who is also a good friend to record me saying how much I want to be back at work so that in a few months when I'm complaining about being at work, she can remind me!!!  I think I just miss having purpose and something to do with myself.

Your daughter was right in saying that in 5 years you won't remember taking some extra time off, but you will remember if you get very ill or have increased problems. I need to remind myself of that as well!!!

My husband's cousin lives in Sydney, by the way. I only share that to acknowledge that while it seems like we are worlds apart, it is really a small world. I live in Virginia in the US. I'm glad to have found this forum and the support of others. This is indeed a truly horrific surgery, and it has made a tremendous difference to have support and sharing of information.

I think I will read and re-read the post about what your doctor told you several times today and over the next week or so,  just to remind myself that this is all in the realm of "normal."  I asked my husband last night "isn't there anything I can do to heal faster?"  LOL He just shook his head and said "probably not."

My doctor's office called me back this afternoon. They said that unless I had a significant increase in pain, to just keep doing what I'm doing, keep BMs soft, and "be patient."  UGH. I hurt worse today than I have in 2 weeks but I think it is just a temporary setback from the harder poo yesterday and not due to infection or anything.

I go back to see him on July 10. I sure hope I'm better by then and back at work!!!!!!!