My Hemorrhoidectomy Experience

I was inspired by this guy to create this blog.  Joe's story helped me get over my fear about having a hemorrhoidectomy.  I'm sure I went through all the same forums you have gone through and read all the horror stories.  When my doctor first made his recommendation, I immediately went home and researched everything I could about the procedure and read all the stories from people who had the procedure.  After doing that, I had decided I was not going to do it.  But then I found Joe's blog and talking it over with my SO I started to realize that there was probably a lot of negative bias in the stories you hear since my guess is that people only sound off when they have a really negative experience.

I wanted to add my positive experience to Joe's story as well.  His blog helped me, and I'm hoping I can pay it forward by sharing my story with others and hopefully it can help you as well.

I do want to mention up front though that every person is different, and that I am not suggesting that my experience will be your experience.  What I am hoping to accomplish is to show that there can be positive experiences with this surgery as well as negative.

Some Quick Facts about Myself

I am 38, in reasonable shape, and I had both internal and external stage 3 hemorrhoids for about 10 years.  Toward the end of that time, my hemorrhoids had started bleeding quite regularly, and quite a lot.  I believe this led me to becoming iron deficiency anemic (I won't know for sure until my next lab work though, but so far I feel fantastic compared to the fatigue I had before).  My surgeon was a well respected colorectal surgeon in the area.  I addition to the hemorrhoidectomy, I also had a colonoscopy on the same day to rule out colon cancer--thankfully it turned out I have a perfectly healthy colon.  

Day Before Surgery

Clear liquid diet 24 hours before the surgery day.  Not difficult, was able to have chicken broth, popsicles, clear liquids.  This wasn’t as bad as I thought it was.  Used Suprep bowel prep which I had been worried about due to the amount of horror stories on the internet over using this stuff.  Turns out it wasn’t that bad.  Tastes like grape cough syrup.  But I also like jagermeister so maybe I’m just weird.  

The Suprep works really well, so had to stay close to the bathroom for about 2 hours after.  Evening prep wasn’t really a problem, but getting up at 2:30am then going to the bathroom every 30 mins or so to launch the super soaker my ass had become was kind of annoying, when all I wanted to do was sleep.  Finally everything out, and I could go back to sleep only get get up very early the next morning to get to the surgery center.

Preface:  I don’t always list it on every day, but every day I’m drinking about 64oz of water.  This will help keep your stool soft and manageable, not to mention it’s good to stay hydrated in general.

SURGERY DAY - Oct 16, 2013

I was a little nervous on surgery day.  I was also so tired though that I think that helped me get through it.  Things went pretty fast.  Even though I arrived an hour early I didn’t really have to wait very long.  The staff was very nice.  My surgeon was ahead of schedule which contributed to me not having to wait very long.  So I’ve never had general anesthesia before and my next fear was the IV insertion.  This was something my girlfriend always hated during her surgeries so I was worried about it as well.  It didn’t bother me at all.  Minor pinch and a slight burn of the lidocain but nothing more than that.  So far everything was easy.

I had been talking to my GF about general anesthesia and I was worried that what if I tried to fight it on a subconscious level.  That turned out to be a ridiculous notion because as soon as they said “okay you should start feeling that in a couple minutes” I think my last words were “there it is, oh that’s really nice!” … next thing I know I’m waking up in recovery feeling like I just had the best nap ever.  I even had a really good dream.

After waking up I was able to get dressed and go home pretty quick.  I didn’t have any pain, or nausea.  The only thing I had was just some kind of bloated feeling that the docs said was from the air that they put in your colon.  They tried to get most of the air out when they finished but there would still be some left over.  Pain level here was maybe 0-1.

That night drugs were still working, and I had a prescription for hydrocodone (lortabs) and valium.  The hydrocodone was for pain to take every 4 hours, the valium was to help prevent muscle spasms.  Went the rest of the night with no pain, had chicken noodle soup for dinner (my girlfriend’s homemade chicken noodle soup, which is AWESOME), watched 3 movies, then went to bed.

DAY 1

Day 1 so far was the hardest, but not for the reasons I thought it would be.  Pain from the surgery still was minimal, but I had so much bloating and cramping from gas that It was hard for me to move.  And I couldn’t pass it because I still had packing in my anal canal.  I had gotten up early in the morning and removed the exterior packing but could not get the internal packing.  This is supposed to soften and come out on it’s own with the first bowel movement.  So I would say my pain level on this day was 3-4 just due to the gas.  Moving around helped a  little with this but laying down was difficult.  I would feel like I had to have a BM but as soon as I sat down the feeling would go away.  I soaked in the tub a bit, hoping that would help soften the internal packing.  Eventually about about 3am I was able to pass some gas which helped a LOT and I was finally able to get some sleep.  Pain now back to about 1-2.  

Still bloated throughout the day, had not passed anymore gas after that first one so pain was creeping back to 3-4 range.  I did eat some stuff, took a laxative, drank my fiber supplement. ate a high fiber english muffin and some fruit, drank some prune juice and started feeling a little better.  Instructions said not to confine myself to the bed so I tried to get a little exercise by walking laps around the house.  Finally about 5pm I had my first BM.

So this is the thing that all the horror stories on the internet are talking bout.  The first BM being the most horrific pain you’ve ever had, worse than child birth, etc etc.   That was not my experience.  My doc has had me on a regimen of high fiber and laxatives to combat the constipating effects of the pain pills, and I think partially the Suprep still has me a little on the watery side, so my first BM I would say about a 0, maybe a 1 on the pain scale.  The rest of that day I had 3 more BMs, and passed gas about two other times.  At this point I’m starting to feel pretty good.

Breakfast:  half of a high fiber muffin, grapes, strawberries for breakfast, cranberry with fiber supplement followed by glass of prune juice.

Lunch:      skipped lunch, slept a good part of the day

Dinner:     cobb salad … YUM!

Also drank about 64oz of water throughout the day.

DAY 2

No more BMs since yesterday, but did pass some more gas this morning so I’m starting to feel normal again.

Breakfast:  whole high fiber muffin, grapes, strawberries, cranberry juice with fiber supplement, 16 oz glass of water

DAY 3

High fiber pb&j muffin with grapes and blackberries.  Fiber supplement plus MOM as well. 

Chicken Caesar salad for lunch 

Broccoli and green beans, a pear and plum, and chocolate pudding for dinner. 

Pain about a 0-2 most of the day.  Took one hydrocodone and one Advil.  No bms but several almost bms that were just gas.  Have slight bloated feeling but nothing major.  Probably just more gas. 

Going to try MOM before bed to see if that helps get things moving.  Tomorrow will double fiber supplement and eat a more substantial diet. 

DAY 4

First what I would call real bm.  Probably more solid than normal though.  Pain was about a 4.  Definitely an effort but totally manageable, nothing surprising.  Pain gradually built and was able to manage with breathing and relaxing.  Relief was excellent and easily counterbalanced the pain.   Bath afterwards felt wonderful.  Had a second one a couple hours later that was way more significant.  Pain still around 4-5 range.  That one felt good but was definitely achey from the pain for most of the day.  I did take a hydrocodone afterwards to try to help with that.

Brunch: high fiber pb&j muffin with fried eggs, grapes, and strawberries, oatmeal raisin cookie.  Took another dose of MOM at breakfast.  Starting to cut back on pain pills.  One dose of fiber supplement in cherry juice.

Dinner: Baked beans and a baked potato, followed by some green beans.  

DAY 5

Took an ibuprofen and valium night before.  Had a decent BM this morning.  Not as big as the second one yesterday but pain was about the same, on the 4-5 scale.  This is without pain meds of any kind though. A little achey, but not as bad as yesterday.

Breakfast:  two slices of pb&j toast and about 7 strawberries, fiber supplement with cherry juice.

Lunch:  Steak and Potato boomerang meat pie

Dinner:  Popcorn, Apples and Cheese

Two more BMs, one in the late afternoon/evening, another around 12:30am.  Sigificantly more painful, on the 6 scale range (though this was without painkillers).  Very achey afterwards, difficult to sit, lay down, sleep, or anything.  Ended up taking another sits, then two hydrocodone and valium and was able to sleep after that.  Took MOM before bed.  Overall I think this was the hardest day of the whole experience, pain wise and I would still consider it totally manageable, not scary.

DAY 6

Woke up feeling very good compared to previous days.  Very little aches, pain on the 0-1 scale.

Breakfast was pb&j english muffin, fried eggs, grapes, and blackberries.  Fiber supplement with cherry juice.  

Shortly after breakfast had monster BM.  Most significant one yet.  I took to ibuprofen in anticipation but I’m not sure if it had time to kick in because I had to go to the bathroom immediately after.  Even though the productivity of this BM was greater than all others previous, the pain was not nearly as bad as yesterday.  This was more on around a 3-4 and once it was over the relief was awesome.  Hopped in the tub after for about 10 minutes for much relaxation.  Got up and laid in bed for a bit.  Still minimal pain.  Either things are getting better or the ibuprofen double dose is working well.  No looniness like with the hydrocodone.  Current pain I would say probably a 1.  According to other peoples stories, about day 6-7 is when things really start to improve so I’m hopeful that this is happening for me as well.

Also went for about a 1.5 mile walk today.  Was nice to get out of the house.

Lunch is a chicken caesar salad.

Dinner was minestrone soup.

Day 7

Woke a little achey this morning.  Took a bath and two ibuprofen.  Did the trick, went right back to sleep.  Didn’t take MOM the night before due to doctors instructions.  If having more than 1-2 BMs per day then back off the laxatives.

Breakfast was fiber supplement with cherry juice, pb&j english muffin, grapes, and strawberries.

Had very productive BM shortly after.  Pain on about the 3-4 scale.  Getting a lot better.

Lunch was Greek Turkey sandwich from Planet Sub.  YUM!

Had a pear for a snack.

Dinner was frozen boullibaise soup and a plum.

Normal pain level seems pretty much gone, now I just have an occasional itching.  I’m guessing that’s part of the wound healing process.  Baths help with that.  I’m down to about 2-3 baths per day now (as opposed to 5-6).  

Had popcorn for late night snack.  One more small BM pretty much no pain, then bath, then to bed.  No MOM.

DAY 8

Woke early a little achey, but nothing too bad, maybe a 2.  Urinated which seemed to help.  Went back to bed, no problems sleeping after that.  Woke up a few hours later a little itchy, but no aches.

Had breakfast — pb&j high fiber english muffin with strawberries.  Fiber supplement with prune juice (I ran out of cherry juice).

Had good BM shortly after breakfast.  Minor aches, again 1-2, sitz bath afterwards helped.  No pain killers or ibuprofen needed.  At this point I’m still using baby wipes and have a little blood on the wipes afterward.  Ranges from a 1x2 inch spot to a 0.5x0.5 inch spot depending on my productivity.  Blood gone after about three dabs.

Did some light housework, changed AC filter (which in my AC closet is kind of a big deal since it requires basically dismantling the closet to get to the furnace).  Again, same level of achey afterwards but nothing requiring medication.  Took a shower which helped.  Sitting down to get some work from home time today.

Lunch was sesame chicken and veggies.

At this point I was feeling ready to leave the house.  Since I’m no longer on the heavy painkillers I can now drive, so went to movie with dinner.  Dinner was chicken wings and fried pickles at Alamo Drafthouse.  Their fried pickles are my most favorite thing in the world.  If you haven’t had them, you really need to.

Stayed up late in the evening watching old movies also.  Any pain now is right after a BM.  BMs holding steady at about 2-3, sitz bath after, then after getting out of bath I’m left with a very localized dull ache.  The achey area is definitely dwindling in size.  The ache eventually resolves to a small itch.  

DAY 9

Things are pretty much the same today.  Going to do next update at the two week mark since currently the changes between day is so little it’s hardly worth mentioning.  They key parts to this whole recovery process though I think is the following:

Take the fiber supplement and eat a high fiber diet.  Black beans with a little cheese on them is one of my favorites.

Eat lots of fruits and veggies.

Go easy on the red meats, dairy products, caffeine.

Drink tons of water (I try to maintain at least 64oz per day)

Sitz for immediate relief.  Take pain meds on the schedule the doctor tells you at the beginning and that will easily get you through the hard part.

BTW, through this whole process I’ve lost 10 lbs though a lot of that could be muscle because I haven’t been able to really exercise like I was before, but I had been working extra hard in the gym for about 1.5 months before surgery so I could get myself in the best shape as possible before surgery time.

See you at day 14!

DAY 14

It’s officially 2 weeks since my surgery and I’m starting to really like life.  My pain levels during BM now rarely go above a 1.  I’ve stopped sitzing and I’ve pretty much stopped taking all pain drugs.  The only things I have left to complain about at this point is minor itching (kind of like your most minor hemorrhoid itch) and still bleeding a little bit on the toilet paper.  I think that the itching is just the last of the stitches being absorbed.  They seem to be mostly gone but in a couple spots it seems like there are a couple of stitch ends poking out which I think is what is causing the itching.  The bleeding is just slowly getting less and less and considering I used to literally spray the toilet bowl with blood every time I had a BM I can take a small amount of bleeding for just a few more weeks I think.

The frequent hot baths throughout this ordeal I think have left me with dry skin so I did have problems sleeping last night due to itching from a rash on my sit bone area and thighs.  Rubbing some almond oil into it seems to really help.  I expect the dry skin and rash will go away soon since I’m not spending so much time in the bath tub.

Oh and I’ve lost 12 lbs which to me is good news.  I credit my new high fiber, low calorie, nutrient dense, mostly plant based diet for that though I’m sure a lot of it comes form muscle loss through not working out like I used to.  Not going out to eat for lunch every day also has a lot to do with that as well, I’m sure.  I’m planning to start doing moderate exercise for the next few weeks until my followup visit with the doc at 5 weeks where hopefully he will give me the all clear to resume regular exercise and other activities.

I’m CAN use toilet paper now also, though I’m still using the baby wipes until I run out.  I mainly use them because they just feel really good and frankly, after all these years, I think my ass deserves a little extra love.

Posting weekly updates from here on out until I see the doc at 5 weeks, unless anything interesting happens.

DAY 21

Getting better by the day.  Itching is very minor.  I have a little bit of drainage, I think there are still some stitches left but can’t tell for sure.  It could be scar tissue forming.  Patient instructions did say to expect drainage / bleeding for about 4-6 weeks.  To the second point, the bleeding has all but stopped.  BMs are completely painless at this point, but maybe 1 in 3 BMs will result in a small amount of blood, which is usually gone after one dab of toilet paper or baby wipe.  Oh, and I’ve lost 15 lbs by maintaining my recovery diet up to this point (no alcohol, mostly fruits / veggies, high fiber, some lean meats, low calorie meals).  

DAY 28

Progressing nicely.  Itching is gone.  Drainage is minimal, and clear.  Bleeding has stopped completely it seems.  Tissue is softening where it was hard before so I think that was the last bit of stitches disappearing.  I think I have maybe one small bit of stitching left, if it’s not scar or scabbing.  Not much else to say really.  Life is much more awesome now.  I have a follow up in a week that I’m looking forward to so I can thank my doctor, and ask him if I can stop taking iron pills for my anemia since hopefully, I’m no longer anemic.  

WEEK 6 

It’s now been over six weeks since my surgery.  I had my post-surgery follow up a week ago and everything is healing perfectly.  The drainage is definitely slowing, but doc said drainage will probably continue for a few more weeks and recommends staying on fiber supplement for at least a couple months. He did also suggest  just staying on it permanently because it’s very beneficial as a health supplement and there’s no good reason to not take it.  I decided to back the dosage down to 1/2 teaspoon rather than a full teaspoon because I did notice that my stomach would feel overfull to a slightly uncomfortable degree.  1/2 teaspoon seems to be about the perfect balance though.

An update on my overall general health — At my followup I did ask the doc about my anemic state pre-surgery, and how after surgery I’ve felt like I’ve had more energy and wondering if the surgery cured my anemia as I suspect it has.  He said it’s very possible, but to stay in iron supplements and then check labs again a couple months post surgery.  Full recovery from anemia would take about 6 mos, but you start noticing it at around 2 months.  I have a physical with my general practitioner in a little over a month so I will definitely be asking her to check it at that point.  I do want to point out a couple things though.  Since doc gave me the all clear to go back to regular intensive workouts like I was doing before the surgery (spin classes, running, yoga, martial arts) I have done one spin class and have gone for a 4 mile run.  I was expecting to be completely exhausted since it’s been about 6 weeks since I’ve worked out at that level.  I was very surprised to find that I actually performed BETTER than I had pre-surgery, even though pre-surgery I had been following a regular exercise routine.  I did not get winded nearly as easily in both the spin class and the run.  I used to experience major fatigue after running about a quarter mile, and today I ran almost two miles as if it were nothing.  The only reason I stopped to walk is because my ankles were not yet back up to par so I wanted to go easy on them, but I think from a cardio-vascular perspective I could have easily gone the whole 4 miles of my route today.  Since the surgery, I have also lost 20 pounds, and even managed to not gain weight over Thanksgiving.

If you are at all scared about this surgery like I was (I put it off for 10 years) then I hope my story gives you some encouragement.  The benefits WAY outweigh the scariness and the pain in my opinion.  I am by no means saying your experience will be like mine (I have read all the horror stories too) but I wanted to let people know what kinds of experiences are possible.  I have a feeling there are others out there who had similar experiences to mine, but because they aren’t extremely negative you never hear about them.  The people who have the extremely painful experiences seem to be more vocal about it and I believe that contributes to a negative bias.

This will be my final entry unless anything weird happens.  I’m also going to send my doctor a Thank You card.  I know it’s his job, and he gets paid for this, but I am so glad there are people like him who go through the pain and expense of medical school so they can help people like me improve their quality of life tenfold.