Just had hemorrhoidectomy - seeking advice - Bowel Disorders Message Board

GuyIncognito · 08-19-2007, 12:28 AM

First, let me say I'm new here, and I'm so glad to have found this board. I have read many of the other posts already, and I do plan on calling my doctor tomorrow. I guess I'm more interested in finding out what specific things I'm currently doing that I should not do.

I've had problems with hemorrhoids for about 13 years or so. I know I didn't drink enough water or eat enough fiber - my stools were only occasionally hard, but I rarely had more than 2-3 bowel movements per week. I had rubber band ligation about 8 years ago, but they came back. Like an idiot, I kept putting off doing something about it - I figured, they weren't causing me much discomfort, I can push them back in after a BM and get on with my day, no big deal. The plan was to take care of them next year. Unfortunately, they had other plans.

BMs became painful and occasionally bloody about 2 months ago (possible anal fissure?); actually I should say more frequently bloody than before. I would still have a bit of burning pain after pushing the hemorrhoids back in. The pain rarely went away by the time I had another BM. Then, a few weeks ago, I had enough pain after a BM that I couldn't sleep, and called in sick to work the next day, although the pain had decreased a fair bit by then.

I went to see the guy who did my RBL last time, and he recommended surgery, which he doesn't do. Unfortunately, he wanted the hemorrhoids out in order to make a diagnosis, so he gave me an enema. After I got home, I pushed them in again. This time, it was much more difficult than usual. Even worse, the pain was excruciating afterward. I was literally rolling around on my bed screaming for the next 5 hours, until I had another BM. I decided not to push them in again. They also continued to bleed for many days.

I went to see a surgeon a few days later, recommended to me by a nurse friend who said he was really good. He said my situation was really bad, too severe for RBL, with some tissue already going necrotic. He prescribed some Anusol suppositories and bed rest for the next two weeks, and scheduled me for surgery.

Surgery (last Tuesday) went well (the doctor said he removed five with a harmonic scalpel but there were "a few" left he wanted to wait at least three months to treat, possibly by RBL), but the anesthesia made me nauseated, so it took a few hours and some anti-nausea medication for me to get out of recovery. I became nauseated again by the time I got home, and the pain medication he prescribed me (Darvocet, since I mentioned Vicodin makes me nauseated) seemed to be making me nauseated for at least part of every day. So I went off the meds. Since I got home, my parents have been taking care of me. I've been drinking prune juice, two glasses per day, as well as water, and eating mostly stuff like oatmeal and vegetable soup, also some rice, bread, and (what I now learned from here was a mistake) fruit - mostly apples and peaches, like 2 per day. I've also been spending a lot of time in the bathtub. I've avoided sitting (other than on the toilet) since this whole thing started. I thought, if not for the nausea, recovery would be easy. But that's only because I hadn't had a BM yet.

About two days after getting home, I had my first BM. Man it was rough. Despite drinking prune juice, and this tea my mom gave me that has laxative properties, the first few pieces of stool were pretty dry and very difficult to pass. After I passed them, everything else came out easily - first, soft, bulky stool, then very watery stool. I felt really sore afterwards, and I'm afraid the dry stool caused at least one of the remaining hemorrhoids to flare up. Also, since then urinating has become a bit more difficult. I can get it out, but it takes longer as the stream is weak and keeps stopping before I'm done.

The soreness and pain has gradually lessened, but I can't seem to avoid the feeling that I'm not passing everything. Stool is either watery or soft but narrow, and usually requires a bit of straining to get out (which is scaring me). BMs are small, and I have about four per day, with lots of "false alarms" (not really, just it won't come out). Today has been the worst in that regard; I've had three or four BMs today, each time passing a little less (all soft and narrow), and now I haven't been able to pass anything for hours even though it feels like there's something there. I'm trying not to strain too much, but I've strained enough that things are getting irritated down there. I'm paranoid that it might be impacted, although I've had that "incomplete BM" feeling pretty much since the first BM two days ago. There's also pain from gas build-up, which is somewhat difficult and sometimes painful to pass.

My dad is getting me Metamucil tomorrow. I'll increase my water intake, although I swear every time I'm done I can feel and hear the water sloshing around inside me. What else should I do, and what of the things I mentioned above should I avoid (besides the apples)? Also, is there anything wrong with lying/sleeping on my front, versus on my back or side? Anything wrong with using Preparation-H or hydrocortisone cream? How about an enema or glycerin suppository?

Sorry about the very long post. I didn't want to overlook anything upon which I could/should be advised.

lodgen · 08-19-2007, 08:30 AM

you must get impacted or constipated or you will have a longer recovery time
go get miralax and take it in the morning and night it will let you have complete bm so you can be finished in one shot.do not put anything in your
rectum or use any kind of ointment ,just make sure its dry and clean ,no
straining and get off the toilet as soon as possible.you need to bulk up your
stools to avoid getting anal stenosis .psyllium ,flax meal, benefiber are all good just drink a lot of water.drop the prune juice if you take the miralax.
miralax is not habit forming and will give water to your bowels to produce
a soft stool,its better than colace but you can try it also but miralax works
better to get all the stool out at once plus take the fiber powder also.
apples are binding eat veg soups,mangoes,oatmeal,take fish oil capsules,
vitamins that are iron free ,rutin is good it helps make the veins stronger.
i was lying on my side mostly it help a lot.harmonic scalpel is the best way
to get rid of them its to bad he did not remove them all ,having some hemorrhoids left to deal with is hard to recover from with all you gone threw.
finding the best colorectal surgeon thats board certified is the only way to go
asked you doctor for toradol its a muscle relaxer and pain killer and will not
constipate you as much plus it brings down swelling also.please do not put anything on or in your rectum you will cause more problems,keep it dry and clean.miralax works i used it and recover from my surgeries form it ,i had your
same situation and it gave me complete bms.
good luck and you will heal,this is one of the most painfull surgeries to recover
from and nobody understands what your going threw but people who have.

lodgen · 08-19-2007, 08:39 AM

sorry i accidentally push the enter button to quick,the phrase at the beginning should of read you must not get impacted or constipated.
also it took me three months to finally have pain free bms and take the
miralax ,Metamucil till as long as you fully heal and then stay with the Metamucil.makke sure you drink a lot of water or it will constipate you.

GuyIncognito · 08-19-2007, 12:58 PM

Update: I woke up in the middle of the night and had a big BM, mostly watery. It mostly came out on its own, but it still hurt. While in the tub, I could feel things moving around inside, but I didn't get anything resembling an urge until an hour after I went back to sleep. Unfortunately, that time nothing came out but gas.

Then I had another BM this morning. Stool was not watery, but it was also a little bit narrower than it should be, though better than it's been the last two days. Once again, it felt a little incomplete, but I didn't want to strain. I guess I just have to be patient, and watch what I eat. (Update: just had another watery BM. Now I feel empty. Whew!)

Someone wrote in another thread not to eat fruit unless it's puréed. Does that include apples, or should I avoid them altogether (including apple juice)? I'm curious because my dad keeps forcing apples on me - I guess not wasting the apples he bought is more important to him than my health/comfort. And my mom, she refuses to serve me vegetable soup without cabbage, broccoli, cauliflower, and green beans. I appreciate them taking care of me, but ugh. Also, anything else I should avoid? Eggs, rice (esp. glutinous rice), mushrooms, any meats?

Thanks for all the advice, lodgen! I'll ask my doctor about Toradol and Miralax. I think the reason he didn't want to remove all of them is because I had so many, he would have had to cut practically a full 360˚ around, and he wanted to reduce possible complications and maybe reduce the pain a little (he also didn't close the wounds). The thought of having to go back in a few months is really upsetting, but hopefully it won't be surgical (although I fear rubber band ligation just means they'll come back in a few years).

lodgen · 08-20-2007, 11:27 AM

i ate mangoes in a blender with flax meal one tablespoon,i would blend as
much as possible for the first two weeks,the add solids slowly.stay away from all those vegs which produce too much gas .i ate low sodum chicken
broth put pesa and carrots that are fully cooked plus egg whites every
day. baby food is great and buy organic i would put the chicken and veg
and cook it with the broth till it get hot ,it worked great for the first week.
stay away from fruit all i ate was pear and mangoes.juice is fine also and
veg juice also.your mother means well but all that gas forming veg are not
good untill you heal,your rectum needs rest .