Swelling and Pain After Hemorrhoidectomy Surgery

I went through my surgery 6 weeks ago. And the pain has been excruciating! But the way I took care of the urinating problem was to press down on my bladder and it empties, you'll still feel full, but it helps also I would have squat and stand at times, I don't have that problem any longer but I went through a lot of pain, and now I'm still in pain, but am healing.

Hi Breezie,

Well you can only be guided by what your doctor advises. At least you have your appointment on July 10, and if you are no better then, perhaps he will reassess what is going on. My surgeon was adamant that we should be healed by 6 weeks and there is something wrong if I was still experiencing pain at this point. He ruled out an infection, which I did not suspect anyway, and seemed to think anal fissure or muscle spasm were the diffential diagnoses.

I'm sorry you are so sore today. It makes it very hard to be "patient" when you can't see any progress and you are in pain. I have used my new ointment twice now (I did get a headache from it) but today I don't have any pain after 2 BMs. Perhaps it is working already to relieve the spasm?

I can understand how difficult it must be staying off work for so long, especially with court appearances and lawyers to deal with in your absence. But with the kind of pain you have, it just sounds like an impossibility at the moment. Being there would give you purpose and a diversion from illness, but as your friend said, before long you would be wondering why you wanted to go back and put yourself under such pressure! My job is a bit less pressured at the moment, which is why I could return. I work in an outpatient clinic 4 days a week, and see patients in a clinical role, but I am also involved in some education and research projects, which is why it is difficult to stay away for extended periods. Some of my time is taken up with doing admin duties related to these projects, so if I need to rush to the bathroom, its not really a problem, unlike your role. On the 5th day of the week, I work in a general practice as a Nurse Practitioner, and it is fairly quiet at times, so I am managing to get through each day. I have ruled out taking more time off to go to the beach, like I thought yesterday, based on my workplace being so short-staffed at the moment, and school holidays here in 2 weeks, when even more of the nurses have already scheduled leave.

Re is there anything you can do to heal faster..I think you are doing it all already. Keep up the warm baths as they help healing of the wound, any fissure that may have developed, and help soothe if you have a muscle spasm. You already have a healthy diet, and you are taking time to rest, so I don't think you can do anymore.

It is a small world as you say and I have also found a lot of support on this forum, which has kept me sane during such a rough time. I'm glad it is providing you with the same. Best wishes for a day which improves!

Hi Aussie.

I am really glad to hear that the ointment is working so quickly!!!! YAY!!!!!!!  I feel like celebrating with you!  I think I will look it up and see if it is something they even use here in the US.  Maybe I can suggest it to my surgeon if I am still having pain in another week or so. But so far he is very minimalist. He only wants me soaking in plain water and doesn't even want me using Epsom salt, but I have been using it because it helps. And he reluctantly said I could use a little Vaseline for comfort. I am just thrilled for you that you are already experiencing less pain!!!! 

I think that I would be more at ease missing work if I had enough leave to get paid. In another few weeks, it will really begin to hurt being off for so long without a pay check. I think that worries me the most. Your job sounds really interesting, and I'm glad you enjoy what you do.  I wish you would be able to take some time off. Maybe after the busy time of school leave you can take a little time off to visit the beach and just give yourself a treat. The sun and waves would be wonderful. I love visiting the beach and love being near water when I can (which is the reason for my user name).  It is just so relaxing and peaceful and healing.

I do think that the hard BM's yesterday and the day before did affect the healing. I am having a little more bleeding. It is nothing tremendous, just enough for me to notice, in addition to the increased swelling and pain. I had 3 BM's this morning before 9:30 am and then one after lunch - all back to being more smooth. But nothing tonight. I'm almost glad, but then I know the morning will be a lot of BM's again. I have to admit that hearing the ointment is working for you makes me feel like there may be something I could be using to help feel better. I just don't know if my doctor would prescribe it, or if it is available here. When I saw him at 3 weeks post surgery, he did an internal exam as well (and it was painful), and he did not find a fissure or any sign of infection. Just a lot of swelling and that I was still healing.

I hope you continue to experience improvement every day and the ability to get back to living life to the fullest. I told my husband this evening that maybe I would plan to go back to work by Christmas; that way if I get back any earlier, it will feel like a victory. haha!

I called my doctor's office again today to ask about using an ointment for spasms. They asked him and called me back and said he doesn't want to do that because it could slow the healing. I am so discouraged. Everything I am reading says it could help reduce spasms and increase healing. But he's the doctor.

I have cried more this morning than since this all began. I am just so discouraged. I don't feel like I've made any improvement in the last week. And I'm so tired of the pain. It's 11 am and I've already had 2 BMs. Sorry to dump, I am just feeling really down today.

Typing from my iPad so a bit difficult.....
breezie......I am so sorry to read your post and that you are so down. You know I have been in your shoes so I do understand. Some days I feel much the same way. I really believe now that you need to go back to your doctor in person and speak to him before 10th July. I know you have rung and left messages, but I don't think they convey the amount of suffering you are in. You need to talk to your doctor and have an examination to see if there is a reason for this amount of pain. As I told you, this was very useful for me. The weekend is coming up but maybe you can see him early next week. I wouldn't recommend using the cream if he says not to, but if you choose to anyway, it is available over the counter and does not require a prescription. My doc told me just to use it externally as it is easily absorbed, so don't see how this would slow healing. The name of it is in a previous post. You will get through this although it is really testing you out at the moment. I am thinking of you and sending kind wishes.

Thanks for checking in Aussie. None of the doctors are in today since it's Friday. If I am not better than I am now by Monday, I will call and ask to be seen next week. The week after next is a big holiday time around here, so I know I don't want to wait until then. That is the reason I'm not being seen until July 10  - Technically it was to be during the week of July 4, but I guess they are off.

For some reason my BMs are harder to pass. I continue to only have a high fiber diet, drinking lots of water, no dairy, no meat. I am not changing anything in my diet. Maybe it is related to everything healing up?  I don't know. So yesterday I started adding stool softeners back in and a very small dose of Milk of Magnesia just to try and keep things very soft. I am still having some bleeding after BMs. Yesterday I had bleeding in between BMs for the first time in a week or two. I will monitor that today. I think that I am just not healing very quickly at all. I can't help but wonder if there is something that would help speed the healing process, but my doctor seems to think not.

I checked on the ointment here in the US, and it is not available over the counter. As much as I can tell, any of the creams I've seen mentioned on here for relaxing the muscle (Rectogesic, Nifedipine, Diltiazem) all seem to be prescription only over here. I probably would be hesitant to use anything anyway since the doctor is saying not to. Perhaps there are reasons specific to me that make it contradictory. For instance, I am on high blood pressure medication. I also have a lot of allergies/sensitivities to different things. So before I go putting anything down there, I really would want a doctor to say it was okay.

The past few days have just been really bad.... like going back 2-3 weeks. I think the harder BMs that seemed to come out of nowhere may have reopened the healing area a little. I know the swelling increased as well.

I just feel so exhausted emotionally, mentally, and physically. I have yet to be able to return to anything close to normal living. The longest I have been out of my house to do anything is about 2 or 2 1/2 hours. That is all. And that was the max that I could handle. I know the doctor said to be patient, but I haven't found much about someone having such a long recovery with such little return to normal living at this stage. This past Wed was 5 weeks. I think I would feel a little better if I had some idea of when I could start to feel normal again and get back to living life..... like going to work or just going to run errands. Part of me wonders if I am laying around too much and maybe I should push myself more? But then when I do try to sit or walk around, just around the house, it intensifies, so I don't think I'm just malingering.

Anyway, I will see how I am doing on Monday and if I am still like I am now, I will call the doctor and ask to be seen. If he is opposed to using any ointments, I'm not sure seeing him will do much good, but at least it would put my mind at ease about the healing process.

I know you understand, and yet I'm sorry that you do!!!  Is the ointment continuing to help you? I hope so. I hope you continue to feel better and experience improvement. Thank you so much for continuing to check in. It does help to have at least one other person out there who reminds me that perhaps this is all still in the range of normal and it will get better.

To make life even more fun, my bank called yesterday to notify me of a series of fraudulent charges posted against my account. Thankfully they caught it early, but I still have to fool with getting some of the charges refunded. One was coming in from France. LOL My husband asked me when I was in France recently..... I told him I flew there last weekend and my clone was the one laying here in pain and suffereing.

Well, I went ahead and called my doctor's office. And as I thought, there are no doctors in today. If I continue to get worse over the weekend I am to go to the ER, which is a NIGHTMARE!  I would be seen by whatever doctor was in there. Not my idea of good care, just personally speaking. I asked if I could be seen next week and they told me that the doctor was completely booked, but they would leave him a note for Monday letting him know I was having so much pain and that I wanted to be seen. At this point, I am feeling very frustrating, discouraged, angry, and I feel like they are not taking me seriously. The front office person - and no offense to anyone who does this job, but they are NOT nurses or doctors - said it was probably "just still raw and tender from everything you had done down there." Real helpful. I was in tears by the end of the conversation and telling her I felt worse than I did a week ago. I don't have a fever. I don't think there is an infection. And I highly doubt an ER doc is really going to be a big help. The last thing I need is an ER doc to poke around down there if it is not their speciality. Plus, waiting in the ER over here is just horrific. You sit for hours waiting to be seen. Seeing as how I have increased pain sitting for even a little while, I think I would wind up feeling worse after it was all over with and probably not get any answers.

I did some research and found several medical articles (National Institute of Health website) that botox injections and nitroglycerine ointment can decrease healing times, so why my doctor won't consider prescribing the ointment I have no idea. I am very hopeful he will agree to see me next week so a) I can have some peace of mind about what is going on and b) I can ask him in person about the ointment.

I have called that office Wed, yesterday, and today. I am most frustrated that not anytime I got to talk to a nurse or a doctor and instead the front office staff's response seemed to be very minimizing and not connecting me to an actual medical personnel.

I am not a very assertive person when it comes to myself. I wish I had pushed more the past 2 days when the doctor was actually in the office. I also can't believe that they won't fit me in next week just to be checked. I really hate being treated like I'm just over-reacting.

Well, all I can hope for is that I will feel better over the weekend and that maybe the doctor will actually take me seriously next week.

Maybe they are right and it is just taking a long time. But they should still take me seriously.

That is me replying just above. I don't know why it didn't recognize me.

Well Breezie, I am also distressed to hear how you are doing.

I don't believe this is the normal course of recovery at the 5 week stage. I think your doctor needs to take this seriously and triaging patients over the phone is not the role of non-medical staff. It is so patronising just to tell you it is a delicate area and takes time to heal! The facts are - you are his patient, he has operated on you, 5 weeks post-op you are experiencing increased pain and distress and cannot work or barely leave the house - he must see you! I can understand that he is reluctant to prescribe creams over the phone but that is the very reason why he needs to see you in person asap.

Like you, I would be reluctant to go to the ER and have some junior doctor poke around down there at the moment, so I would only do this as a last resort. I think you have to gather all your assertiveness skills (you are a counsellor, so you know how to draw on your strengths) and phone the doctors office first thing Monday and insist on an appointment asap, even if they have to double-book you. They can always squeeze in emergencies, and this is getting to the point where it could be called that.

I imagine your husband is also distressed. He has been so supportive through all of this and it isprobably frustrating for him that he sees you in so much pain and can't do anything to help it. And to top it off, you sneak off to Paris in the middle of the night and spend up on the credit card!

I am feeling ok these last few days. Still experiencing some pain, but manageable, and still able to go to work. I'm not sure if it is the rectogesic cream having an effect, or just coincidence, but I do feel a bit better. I also take blood pressure medication, but this wasn't a contraindication to using the cream.

I will have to cut this short as have to go to work now, but will check in again tomorrow. I hope the weekend improves for you. Please hang in there, things will get better eventually, and hopefully you can pinpoint the problem next week.

Hi Aussie. Thanks for the reply, as always. I so appreciate your continued support - more than you know. Just having at least one other person out there who understands helps me hold onto my sanity. I think worse than the pain right now is the fear. I am feeling very afraid because I don't feel I am healing as well as I should be, or making progress like I should be. I think I should be able to get back to work or at least be doing more normal activities by this point. I think Soar said it a while back - fear is the worst thing.

Today I had to drive my son somewhere - I was gone for about 1 hour. That was all I could do. It is so frustrating!

I will keep you updated. Hopefully I will have good news to share soon. I hope you continue to improve and feel better. And I hope you enjoy your weekend!

I am beginning to really think I have a fissure. On Tuesday evening I had a hard BM and felt like something split down there. At the time I just thought I had aggravated the surgery site. But this week was just really bad after that. And then this morning, the pain is more pronounced in the very rear anal area which is not the original surgery site, and my BM this morning was excruciating in a different way than the hem site. There is also swelling in that area. I plan to call the doctor first thing Monday morning and say the magic words - incr eased pain and bleeding and in a different area than the surgery site. And that I need to be seen asap.

Wed will be 6 weeks since surgery and this is just not okay to be hurting like this.

I just wish I would have been more assertive on Wed and Thurs when I called. When will I learn to stick up for myself???? If it were my family or any of my clients, I would be all over it. But when it comes to me, I get all meek and mild until I finally wake up to what I am doing. Now I am suffering (yet again) for it

I am having some constipation which makes no sense. I have added stool softeners the past few days and I took 1/2 dose of Miralax last night and then a 1/2 Tbsp of Milk of Magnesia this morning and it still took a while to go. This is a big change from a week or so ago when I was having all that urgency and going 4-6 times a day!!!!  I am drinking tons of water - on average 120 oz of water a day not counting other drinks like hot tea. I'm getting plenty of fiber.  In fact, I may be getting too much fiber so I am going to start counting grams and try to monitor it more. I am trying to do all I can to keep things smooth, soft, and going and I am feeling so frustrated with this entire process right now.

HI Breezie,

Well there is definitely something wrong down there by the sound of it. We both expected to be better by 6 weeks and it hasn't happened. Perhaps you do have a fissure and I'm glad you are going to insist on being seen by the doctor. I think when you ring, you should insist on being seen on the Monday, and not another day (presuming the doctor is actually in, as I know some days they go to other locations, or may even be operating). In the meantime, take the pain relief you need and keep having hot baths. Did you get to try using a hot water bottle as well?

I don't know why you would be constipated with all that you are doing. Are you taking any narcotic pain relief that could be causing this? Otherwise, are you well enough to try having a short walk, even around the block, or around your house? Perhaps it is lack of exercise, although this hasn't changed since last week, when you were regular. Maybe even anxiety is causing it, as your focus at the moment is on your BMs and the pain involved? But you are right, it makes no sense with such a high fibre diet and all those laxatives.

I think I am slowly improving these last few days. I still have pain after BMs, which I think is the muscle spasm, but it lasts only an hour or two and is not really severe (although I would prefer not to have it at all). I really feel for you, as even mild pain in this region is a reminder of how severe it was, and I'm sorry you are still experiencing this. I really hope you get some relief and some answers this week. Let me know how you go on Monday.

Hi Aussie. It is so good to hear from you.

As today has gone on, I am more convinced that I have a fissure. It is a different kind of pain and in a different location. The actual hem surgery site actually seems to be feeling better, which is like a real slap in the face. It's like "well, that is starting to feel better, so let's just give you some new pain and new concerns."  I am glad it seems to be getting better, but it is just really hard to stay positive. All I do is think about this, all day, every day. I'm sure anxiety plays a role. I will catch the muscles down there being all tight and then relax them. I am still taking hot baths after BMs and a few in between. I have not been able to order the hot water bottle yet. Money has gotten a little tight with me not working, and we are trying to be frugal. But I'm sure it would be worth it to get one.

I am not taking any narcotics at all. I haven't taken any since week 1 after surgery. I am just taking Tylenol and Advil. I take 2 Tylenol every 6 hours, and I take 2 Advil every 4-6 hours. I will try to walk more around the neighborhood if I can tomorrow. I do walk around the house a good bit because I am bored and I also want to keep moving - and I get pretty sore just laying around.  But it's not the same as exercise. But you're right, lack of movement has not been a change. I don't know what is going on. I am just doing all I can to keep things smooth, and it's not been easy. BMs are excrutiating.... again.... but this is different. The pain is mostly located in the posterior region, and I can feel the pain all the time there, even in between BMs. It is a sharp pain. I could cry. I keep telling myself that I don't know for sure what it is, but my gut intuition is that the hard BMs last Tuesday did it. I vividly remember feeling like something ripped that night, and when I've read up on fissures that is a common experience. I really worry because it can take 4 weeks to heal, and of course, my mind goes to the worst case scenario since I don't seem to do anything on the timeline!  The hardest part in some ways is the feeling of hopelessness, like I will never get better. This is yet another set back. Our family has been through so much the past number of years. After a while, it really starts to get to you.

I do plan to call first thing Monday morning. And if my state of mind stays like it is, I don't think I will have any problems with presenting my case. I will let you know how it goes. I do think he is expected in on Monday since the front office person said she was going to put a note on his desk for Monday. I still plan to call first thing so they know I am still in pain and still need to be seen. If I have to, I will let the tears come. I really don't like to cry in front of people or on the phone, and I try to be positive, but sometimes that doesn't get you very far when you are trying to convey how much pain you are in!!!!!

I am SO GLAD you are having improvement!!!! It is so good to know you are doing better, and I am happy for you. I also wish you weren't having any pain at all, but I'm also hopeful that you are headed in the right direction. Your story gives me hope, as does your caring and compassion.

I deeply appreciate you checking in, especially since I am not a real joyful person right now. I know it may be hard to believe but normally I am bright and cheerful and positive and I go around trying to "mother" everyone else. LOL  I have thought of talking to the doctor (or even my primary doc) about going on an antidepressant. I really don't want to, but if the news with the surgeon isn't too great, I may do this to try and keep my sanity.

I know I need to stay off online websites. Of course, when I am reading up on hemorrhoidectomies and anal fissures, I run across all the horror stories. It doesn't help my mindset, but at the same time, I feel that the more informed I am, the more I can benefit from a visit with my doctor (such as asking about the ointments).

 

Well you might be right about the fissure, as it sounds like such a different pain to what you have had. I know what you mean about catching the muscles down there being all tensed up, and having to consciously relax them, as I do the same thing. Are you able to get massage (either professionally or from your husband) to help you with muscle relaxation? If I knew your address (I know you can't put it on the website as the whole world would know) I would send you a hot water bottle, my treat! (they are cheap and plentiful at the moment as it is Winter here). I find the warmth of it relaxing, and it diverts my brain from only sending signals of pain, as it senses the sensation of warmth instead (I don't know if this makes any sense!).

Anyway, come Monday, you will get this sorted. Get a diagnosis and an action plan for what is going to happen next to get you better. If tears are what is needed to get an appointment, go for it! It is very hard to capture 6 weeks of severe pain in a short conversation, and the tears will probably flow spontaneously. Mine almost did last week when I saw my doctor too.

I have no doubt you are normally a positive and happy person as I sense that in you. I think we sound similiar in many ways. But I also found the last 6 weeks depressing and I lost any joy in my days. I think this would be quite difficult for someone to understand if they had not been through this, but it's true. If antidepressants are what you need to get you through this, you should discuss this with the doctor by all means. Just remember, they also take 4-6 weeks to have an effect, generally.

It is difficult to stay off websites offering information about your symptoms. I have also trawled through them many times. Its true that usually only the most horrific personal stories are posted though, and they may not represent the majority. Look at this forum, and you and me as an example of that!!

OK so only one more day till you can speak to the doctor. Just get through this and things will get better. You have lots of strengths you have used before when your family have had problems, so you need to draw on them again now (I know you know this). And believe that you will get better, because you will.

Hi all I had my op on 26 march .....worst op ever , so much pain for weeks after it ! Would never advise anyone to do this unless life depended on it . Just getting right now , can go to the toilet pain free for the first time since march . On the plus side it does get better ....hang in there x