You Don't Have to Live with a Pain in the Derrière!
by Lisa B.
(Killeen, TX USA)
I am a 46 yr. old female and tried to manage the protuding internal hemorrhoids with no success and finally opted for their surgical removal. The surgical removal pretty much guarantees they NEVER return. Banding and stapling have high failure rates. I knew it would be a painful recuperation and I made it clear to my doctor that he better make darn sure I had appropriate pain meds and he did. The entire op room time was booked for 1.5 hours as I opted to have a colonoscopy at the same time.
Day One Post Op (Monday): You feel reasonably good because the meds you receive during the surgery don't wear off for about 6 hours. Begin taking your pain meds about 4 hours after the procedure. I took 15 mg. of Narco with a 5mg. Valium kicker. I opted for more pain med because when I was in the recovery room I remember coming to and hearing the nurse tell the doctor that each time I became alert I had complained of pain (I don't remember these statements) and that she had given me (5) bumps of Dilauded. Remembering this conversation made me aware that when these stronger drugs wore off I would obviously be in tremendous pain. Also began taking the Docusate Calcium 240 mg. pill 3x's per day per doctor request. (Pain meds make you constipated)
Day Two Post Op (Tuesday): 10 Mg. Narco every 4 hours. Used 5 mg. Valium beginning in late afternoon and at night. Nights are pretty much sleepless because the pain is constant unless you take 10 mg. Valium to knock yourself out. Still no bowel movement although diet consisted of high fiber items (Oatmeal,Broccoli, Salad w/out dressing, etc). To be honest you really don't feel like eating. I also put a spoonful of Benefiber in everything I drank (8 glasses minimum of water, tea, coffee, etc. Began taking (2) Docusate Calcium tablets (240 mg. each) that night. Felt deep internal muscle pain all around the rectum/vagina area. Observed black bruising around the anal area (thanks to the mirror!)
Day Three Post Op (Wednesday): Came to realize I had external stitches as well as the internal stitches when first bowel movement occurred that evening. Any bowel movement abrading against the area will cause you to almost scream in pain...take the pain meds! I had called my physicians nurse that morning and spoke about bowel movement. They like to see a b.m. by day three expecially if you've been eating. Took 4 tablespoons of Milk of Magnesia mid-afternoon. and ate about 5 dried prunes. Six hours later the b.m. arrived. It was an up and down ordeal, running to the toilet over course of several hours. You do NOT want to strain...let it come when it comes.
The toilet ordeal is painful even with loose stool. Be prepared for pain. Found myself having normal muscle spasms in preparation for bowel movement and paced around alot. Took one extra pain med and Valium in preparation for this first bowel movement. Good thing I did!! The cleansing of the anal area was done by using water/sitz bath from my Spaloo Primus toilet seat bidet. Dr. Pappa had already advise me I would need to do warm sitz bath 10-15 times per day as this promotes blood circulation which promotes healing. Ordered my Spaloo and it came in two days before the surgery. I do not know how I would have survived this recuperation without it. Otherwise, I'd have been messing around with the cheapie sitz bath or in the shower to help relieve pain. The warm water sitz baths provides comfort that pain meds do not.
Dr. Pappa advised no lidocain cremes to the anal area as this area needs to be kept clean and dry for healing. You do not feel like sitting down, trust me on this one. It was day 5 post op before I could sit in a chair at the computer for more than 20 minutes at a time. Each day you do feel better and better provided you follow the HIGH FIBER diet, walk atleast 20 minutes four times a day to aid in not being constipated, take the laxatives and for heavens sake, take the pain meds faithfully!! You want to keep your stools very loose and you want to manage the pain. I did do a "shot" of bourbon 2 evenings in a row after bowel movements due to the pain. I don't recommend drinking while taking the pain meds on a regular basis...I'm just telling you...IT WAS PAINFUL.
Day Eight Post Op (the following Monday): Felt pretty darn good, walked for about one hour continuously. Got tired, bowels were working towards the much desired bowel movement. Still taking the pain meds, but have decreased to 5 Mg. Narco every 4 hours. Have had very little bleeding or mucous discharge which they said to expect. Although the area inside the anal canal was cauterized when the hems were removed, they were also stitched to promote faster healing. Muscle spasms are normal and this is why taking the Valium is important.
Day 11 Post Op (Thanksgiving Day): Actually feel almost normal again. Continuing with high fiber diet, adding Benefiber to just about everything, still taking the Ducosate Calcium at least 4 pills a day and I still take a large "swig" of Milk of Magnesia when I go to bed at night (1:00 am). Morning comes, bowel movement comes, everything is feeling just about normal except more obvious the external stitches/healing is occurring due to very mild itch which I find not to be bothersome compared to the pain which I have lived through. Sitz bath relieves the itching.
If you are in a position to have surgical removal, I would say to do it. I did waiver back and forth as to having this surgery and I can now say, YES, I'm glad I did it. I had watched the surgery on Youtube numerous times, got myself prepared mentally, ordered my Spaloo toilet seat and went for it. I live in Central Texas and had the procedure done at S&W Hospital in Temple. My doctor is Dr. Harry Papaconstantinou (Dr. Papa) and he was right about it all....when you have internal hemorrhoids that protrude outside the anus and bleed, nothing other than surgery will provide permanent relief.
I hope this blog provides helpful insight into what to expect with surgical removal. The upside is the hemorrhoids never return and, you will lose weight after this procedure (I have lost 12 pounds!) One last note, my Dr. and myself had concerns the internal healing process would take longer since I had previous radiation to the general area due to cervical cancer treatments. Right now I would say that was an unnecessary concern, but I still have at least 2 more weeks of healing to go according to Dr. Pappa.
I found these hems had changed my quality of life for the worse and I finally opted for the surgery. I will have my first post op follow up w/ him the first week of December. I'll try to remember to post again at that time.
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