I had my THD surgery today - hurray for me. I'm going to blog my day by day recovery here - at least I'm planning to as I sit here a few hours post-surgery.
About me: 56 year old male in good physical condition, 5'8" 162 pounds. I have suffered from grade 3 internal hemorrhoids for about 5+ years (as well as grade 1 & 2 hemorrhoids, I assume for much longer, but never really noticed). Image link (*WARNING GRAPHIC CONTENT*)at: http://i43.photobucket.com/albums/e351/TailerDoodle/hemorrhoid.jpg I've been through banding 4 times and it did nothing to help. Surgery or "live with it" were really the only options. I was tired of living with it. While not really painful other than on rare occasion, I had to manually reduce the hemorrhoids (push them back in) after every bowel movement and I would occasionally start bleeding at random times - which really was difficult to deal with, especially the lat 2 times it hit - while on vacation (with limited clothing options) and on the last day of a 210+ mile backpacking trip (thankfully on the last day). I chose THD hoping it would a) be an effective cure for the rest of my life and b) involve less pain than a traditional procedure.
The surgery: We arrived at Robert Wood Johnson (NJ) hospital at 8AM this morning. At about 8:50 I was brought to the prep area to change, be interviewed by the anesthesiologist, and to have an IV started. At 9:28AM I was wheeled into the OR. I was out cold by about 9:30AM. I woke up in the recovery room a bit past 10:30AM so the surgery lasted less than an hour. My surgeon came in and told me everything went well and if I recall correctly (I was still somewhat groggy), she dearterialized the hemorrhoids and raised the 3 biggest hemorrhoidal plexi. My MD or the anesthesiologist gave me a shot of Exparel for longer term (days rather than hours) pain relief and I'm hoping it helps get me past what should be the post painful days post-surgery. Immediately after waking up, I felt a great deal of pressure in my backside, but still, only a 2 on a 1-10 scale. After some snacks and urinating I was on my way home. I have my heavy duty painkillers lined up - Oxycodone - acetaminophen 5-325 (take 1-2 every 4 hours). My doc also prescribed diazepam 2 mg to control muscle spasms. I'm hoping to avoid them if I can, or take them only to sleep at night. The last thing I need is a med that constipates.
It's now 6:30PM. I took 600 mg (3 pills) Advil at 1:30. I'll take more soon and plan on 3 Aleve at bed time to help me sleep. 1 day at a time for pain management and hopefully without need for the oxycodone (but I will take them right away if I need them to stay ahead of the pain). I also took 2 stool softeners and Metamucil - hopefully pooping will be part of my game plan for tomorrow and if I can go, the pain won't be too bad - right now, the thought of anything moving out of my butt is scary, but I know I'll have to do it at some point and if I wait beyond tomorrow, it will only become more painful. Pain level is still about 2-3 which I'd describe as a lot of pressure with discomfort at the threshold of "pain". I can live with this and don't think I'm on the verge of needing the heavy hitter drugs (maybe I'll save those for before or after my first bowel movement). I've been drinking cold drinks all day both to up my liquid totals (80 oz already but I normally drink a lot of water) but also to sooth my sore throat caused by the intubation tube - also at about a 2 in pain, but I know that'll disappear quickly. One side effect I've noticed is that I've had gas a few times today and had no idea it was coming until I heard it. Perhaps a side effect of the Exparel leaving me numb?
That's all for today...I hope to be back on tomorrow with the latest updates and the GO/NO-GO decision on pooping - will he or won't he :)
Day 0 hasn't been so bad so far (still 5 1/2 hours left).
Aug 9 - 24 hours later.
I had my highest level of pain so far during the night. At about 3AM, I took my first oxycodone pill to help me sleep. I also had some urinary retention - No matter how hard I tried, I couldn't pee...Stood there for about 5 minutes and then finally got some out - enough to relieve the pressure. After a morning call to me doc, she suggested I try taking the Valium she had prescribed to stop the muscle spasms I was likely having which might have been causing the urinary retention. It seemed to work as the issue now is still there, but much better.
I had my first bowel movement around lunchtime. It was much better than I could have hoped for. I felt absolutely nothing as it was coming out. I expect this was the result of the Exparel shot I had as my bum is still completely numb. I took a sitz bath as instructed and after, noticed that my pain level had jumped up to a 3-4+. I would have expected much higher for my first bowel movement, so no complaints. I continued to take Valium and Aleve during the day and my pain subsided down to a 1-2 level. Wow, that's exciting for it to be that low. The rest of the day was pretty good. I was up and about and even cooked dinner. Just before bed, I had another bowel movement with no issues. Hopefully when the Exparel wears off, it will continue to be easy.
Aug 10 AM - day 2 - I slept through the night...Well, I got up to pee, but no oxycodone needed so holding at 1 pill since surgery. I had an immediate urge to have a bowel movement in the morning which ended up happening over 3 "events" in an hour...Only slightly more pain afterwards and it subsided pretty quickly. Today will be a relax day - home all alone / no babysitting / watching me needed since I'm not taking any heavy meds (hopefully). I'm looking forward to some binge watching on TV and just overall relaxing without too much pain!