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    Old 11-26-2003, 03:31 AM   #1
    vdang2003
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    Smile Hope for Hemorrhoidectomy/Sphincterotomy

    Hi everyone - my first post and hopefully it will give other's hope. I had my hemorrhoidectomy with internal lateral sphinctertomy on Monday, November 24 and am doing surprisingly well. I'm 34, have dealt with hemorrhoids for 13 years, since the birth of my first son. I had a thrombosed hemorrhoid while pregnant with my second son that I had to have opened and taken out. I was 8.5 months pregnant, and had no pain meds whatsoever....I thought I was going to DIE I was in so much pain after that and swore I would NEVER have anything done for them again. A few months ago I developed a fissure along with the hemorrhoids that wouldn't clear up, so I opted for the sugery....grudgingly. I was scared to death!!! I wanted to let those of you who are contemplating this surgery know that, so far, for me, at least, it hasn't been THAT bad. Monday, after the local wore off, I was in a lot of pain, but it wasn't as bad as what I expected. I kind of felt beat up and sore mostly. There was stinging and burning, kind of like the fissure had felt anyway a little stronger maybe, but I used the percocet the doc gave me and slept most of the day away. By Tuesday, the pain was tolerable and I only took two ibuprofen all day. I was dreading the first BM, though. The worst pain I had had so far was the stinging and burning of the stitches but, like I said, the ibuprofen helped soothe that. This morning, at 5:30 am I had my first BM. It was bad, but not awful. Part of this was due to me making sure I took my Metamucil and drank LOTS of fluids. I ate a lot of veggies (carrots are good for me as far as stool so I ate a lot of those yesterday). The key is to know your body and what it needs PRIOR to the surgery. If you know ahead of time what it takes for a soft, firm, automatic BM, then you know what to do post-op to get that. Well, the BM was a little sticky (probably not enough water yesterday, which I will remedy today!), and the STARTING was the hard part. I felt the pressure building and was scared to death but when you gotta go, you gotta go. Once it started, it was kind of automatic and went rather quickly and I was just thanking God that it was over. I am not even a full 48 hours post-op, so I don't know what lies ahead, but I wanted to give some of you hope that this CAN be a liveable recovery. Good luck to you all and I will come back and post as to my progress over time.

    Last edited by vdang2003; 11-26-2003 at 03:32 AM.

     
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    Old 11-26-2003, 01:56 PM   #2
    lbp35
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    Re: Hope for Hemorrhoidectomy/Sphincterotomy

    vdang2003, Your post was very helpful to me! I am 35 and I just had hem . surgery in August of this year. It was the most horrific thing I have ever experienced. I had so much pain after that I ended up in the er getting morphine. The recovery period was long and now I have a fissure. I don't have alot of pain with it but it seems to be chronic. How long did you have your fissure before you decided on surgery? Do you have any incontinence at all? This is my fear!!! I am on a high fiber diet now and am using diltiazem from the doctor. Please keep me posted on your recovery! I'm glad things are going good for you! Thanks for the info! (How bad was your pain with bms prior to surgery?)thanx

     
    Old 11-28-2003, 04:08 AM   #3
    vdang2003
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    Re: Hope for Hemorrhoidectomy/Sphincterotomy

    I had the fissure since the end of June, had surgery November 24th. I didn't have chronic pain with the fissure, but when there WAS pain, it was bad enough and it seemed to make the hemorrhoids worse, for some reason. I guess I had the fissure 4 months then. It would seem to lessen, and then get worse again. I couldn't be on my feet for longer than a few minutes at a time without having stinging, burning, blood, etc and then hem's would flare up and get worse. I didn't want to have the surgery. Scheduled it once in September and cancelled it (I got married October 11th and was deathly afraid I wouldn't heal in time for the wedding so post-poned until afterwards.) I didn't have incontinence, but I did have bleeding and mucosal excretions from the fissure. My surgeon was fantastic, though. He didn't see the fissure during his exam, but told me it had to be there due to the symptoms I was having. (Imagine that! A physician who admits he might not be able to see something that is there!!! I was impressed with him then.) He gave me several options other than the surgery, which I tried and the fissure did get better, but not completely healed. Also, after 13 years with the hemorrhoids and 4 months with the fissure my husband pointed out to me that it was time for me to do something about this so I could have my life back. I couldn't go shopping, walking, riding bikes or anything physical that we enjoy doing due to the fissure and hems. The burning was the worst of it. I had pain during BM's from the fissure, stinging and burning, but I could probably have lived with it for a while longer. I have a pretty high pain tolerance and was dead set against the surgery, but my husband convinced me it was for the best that I get this taken care of now. I'm really glad he did. I am in pain, the burning and stinging are worse now during BMs than they were with the fissure, but I know that won't last forever and once I heal, I'll have my life back. I am not currently having any incontinence. However, I've been having hard stools (which hurt worse) and if I can get them softer(working DILIGENTLY on this haha!) , I may have some incontinence. It hurts too much to try and stop any gas that comes through so I'm sure I could have some incontinence with softer stools, but I'm not concerned with it right now as I know if it happens, it will most likely pass with the healing process. Like you, I didn't have constant pain, but chronic, with the fissure and it was a personal decision for me that I felt like I had to take care of this now before it got any worse or affected my life more drastically. Sounds like you are where I was at and I would suggest you talk more with your doctor about it and see if there are other options you can try.

    I have a question for you, lbp. How long did it take in your recovery before you started feeling anything near normal? I am supposed to go back to work on Monday (1 week post-op) and I'm not sure I can at this point. I am not in constant pain but the thought of having to deal with sitting in a chair at a desk all day is not comforting to me. Also, there is no WAY I can go back in until I know my BM's are normalized. Right now, I'm all screwed up. I had a BM at 3am this morning and will probably have another today sometime, no idea when the urge will strike and I can't handle dealing with that at work right now. (No nice tub to soak in afterwards and I can't imagine making the noises I make right now in a toilet at work either - haha!) Good luck with your fissure and your decision on what to do.

    Last edited by vdang2003; 11-28-2003 at 04:12 AM.

     
    Old 11-28-2003, 08:20 AM   #4
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    Talking Re: Hope for Hemorrhoidectomy/Sphincterotomy

    vdang, Congratulaions first of all on your marriage! I am glad you made the decision to wait with surgery until after! My healing process was long but my situation was also different from yours. I first went to a surgeon to have a hem. removed ( he said he could cut it off in his office). He cut it off sent me home with no pain meds or instructions about stool softeners. I bled for 2 days and then my first bowel movement was very, very painful. I obviously ripped and developed 2 more hemorrhoids and ended up in the er. The doctor there under anest. removed the hems, and repaired the tear with stitches. I went home but was back at the er that night for morphine because of the pain. The first week was horrible, I had to have bms standing up. I could'nt take percocet because it made me sick. Anyway I guess to answer your question, the first week was the worst. Starting the second week, I felt beat up and sore but no where near the pain the first week. I had the burning during bms for a few weeks after and would do a sitz bath right after which seemed to help. Anyway, I think I developed this fissure somewhere in this time period that's why I am not sure about my healing time from the first surgery. I had such a bad experience and I am so afraid to have surgery for the fissure. I have heard it's not as bad as hem surgery but i am afraid. I don't know how you did it all at once. I do understand how you would get sick of putting your life on hold. I am there now. W hat other treatments did your doctor try first? Mine said about botox injections, did you try this? Also did your doctor say the gas incontinence would go away when you are healed? Thanx for all the info, I hope you continue to heal!!

     
    Old 11-28-2003, 01:02 PM   #5
    vdang2003
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    Re: Hope for Hemorrhoidectomy/Sphincterotomy

    Hi LBP, thanks for answering so quickly. I think sometimes all we need is some reassurance and I appreciate you sharing your healing experience with me.

    After reading on this site in several places, I would agree with you that you probably developed the fissure during your healing process. My doctor suggested the sphincterotomy at the time of the hemorrhoidectomy and I am very thankful for that because even though I seem to be doing really well with recovery so far, I would NOT want to contemplate having to go in for a second surgery. Some of the posts I've found in here and research online suggest that the sphincterotomy not only helps heal the fissure, but helps with the healing process itself for SOME people.
    I too am doing the double thing for the BMs at this point, standing for part of it and sitting for part, but it sounds like your pain was off the charts post-op and I can understand why that would make you not want a second surgery.

    Are you healed completely from the hem surgery yet and have you been to see a good colorectal surgeon? Mine has a not-so-great bedisde manner, but he has over a 20 year history with the procedure and credentials out the wazoo, which was why I liked him for the surgery. I was actually referrred to my surgeon by my OB/GYN. If you haven't found a good doc yet, that would be my first step. Find someone you trust and feel confident about their abilities. If your doc hasn't got adequate experience with the botox, then I would ask him to refer me to someone who DOES have that experience.

    Now, as to what I tried prior to surgery. My doc basically told me the fissure would most likely not heal on its own as it had become chronic at that point. He said I could try some things for the hems and that MIGHT help the fissure. I did the anusol, proctofoam, diet changes, increasing my intake of certain vitamins/minerals/supplements. This DID help. The fissure did heal somewhat, but like I said before, it didn't heal completely and would get worse with any exercise (even just walking in the grovery store!) on my part. I felt my doc was being up front with me. By the time I went to see him, I had already had the fissure for 2 months and he said it might heal over a long period of time, but that they are notorious for not healing completely on their own.

    From what I understand, there may be gas/bowel incontinenece for a certain period after the surgery....depends on the person. I have read some of the posts in here and done further research online and I have seen it vary from 2 weeks to 6 months. Depends on the person, the procedure, etc. RARELY is the incontinence permanent. I have been contracting the muscle (Kegel exercise) there a TINY bit during the day and involuntarily at night (in my sleep for some reason, because it hurts and wakes me up-haha!), testing to see if I have control over it. I do, but it hurts too much right now to even TRY to stop the gas and it feels SO MUCH better when the gas is gone that I don't care that I can't control it for now.

    Also, I haven't tried the botox injections, the doc didn't recommend them, and I probably wouldn't have opted for them anyway just like I didn't opt for the "banding" for the internal hemorrhoids either. Again, my case was a little different than yours. I knew I would continue to have the hemorrhoids without the surgery. I'd been dealing with them for 13 years both internal AND external. The only way to get rid of them AND the fissure and be as close to positive that I wouldn't get them again, was to do the surgery. All the other things seemed like quick fixes that were basically going to end up with me needing the surgery within a year anyway, so I opted for the surgery, which was my docs last choice. In YOUR case, however, you have already had the hem surgery, and knowing what I know now, I wouldn't want to have to go through this again, either. If your doc is saying you should try the shots, do some research on them online and in here and see what you find out. First though, decide if you trust this doc and if you don't - find one that you DO trust. I feel for you, knowing what a weight this decision must place on you.

    I did some research on the botox injections and put a few links below for you, but look more for yourself. There is less chance of permanent incontinence with the botox, but still a chance of temporary incontinence, it seems. I wish you luck with your decision. Let me know how things go with you and thanks again for your help to me.
    The first two are good links with other people that have fissures.

    [url]http://www.ambiguous.org/quinn/medical/fissure.html[/url]

    [url]http://www.boardsailor.com/jack/af/[/url]

    [url]http://ibscrohns.about.com/cs/relatedconditions/a/fissurefaq.htm[/url]

    [url]http://www.blackwell-synergy.com/links/doi/10.1046/j.1463-1318.1999.00006.x/abs/[/url]

    [url]http://www.pamf.org/surgery/analfissuebotox.html[/url]

    [url]http://www.ivillagehealth.com/experts/digestive/qas/0,,232657_173868-2,00.html[/url]

     
    Old 11-29-2003, 11:39 AM   #6
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    Smile Re: Hope for Hemorrhoidectomy/Sphincterotomy

    vdang, thanks so much for the info! It was a great help. Please keep me posted on your recovery, I was thinking back to my own surgery and remembering the first week. I think you are doing very well! I went back to work 1 week post-op, had some soreness but motrin seemed to help. I usually only have 1 bm a day (in the morning) so I was able to take a hot bath right after. It seemed like it was hard to get up off of my office chair the first week. The muscles were very sore there and I know exactly what you mean about the involuntary spasms at night! I had that too! It woke me up alot. Anyway if i can be of more help, please let me know. You made me feel alot better about the botox and the incontinence should I have to have surgery. Please let me know how you are doing! Get well wishes to you!

     
    Old 11-30-2003, 03:34 PM   #7
    vdang2003
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    Re: Hope for Hemorrhoidectomy/Sphincterotomy

    Hi LBP,

    Sorry it took me so long to get back. I had a good day yesterday and blew it last night with a hard BM. Been bleeding more today and overdid it with housework on top of that. I wanted to tell you about the coronary/venous "natural cocktail" my Aunt (a nurse) put me on prior to my surgery to help with the healing of the fissure. Please ask your doc before taking these as I don't know what meds you are on and if there would be any side effects, but they all promote venous health and healing and it DID help my fissure prior to the surgery.

    1000 mg. capsule fish oil concentrate with omega-3 fatty acids : 1 pill 3xday with meals (too much of this can make your stool sticky so make sure you take it AFTER the meal and drink 8oz water)

    50 mg capsule grapeseed extract: 1 pill 2x day with meal

    100 mg capsule Co Q-10 : 1 capsule 3x day with meals

    My Aunt put me on this as soon as she found out about the fissure, and like I said in previous posts, it was helping. However, with my internal and external hemorrhoids the darn thing couldn't heal on it's own. But since you have already had the hemorrhoids removed, it might help you more. It takes a little time for you to see the effects (took me about 2 weeks but it was noticable) and you'll have to be careful to make sure the fish oil doesn't interfere with your bowel movements. In my case, the coating helps it come out a little easier.

    Anyway, hubby is home with some movies and I'm going to lay down and relax and try not to worry about what tomorrow's bm will bring (haha!) Have a great night and let me know how you are doing.

    hangin' in at day 6,

    vdang

     
    Old 12-01-2003, 05:07 AM   #8
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    Hi Vdang, Thank you so much for the info on the "natural cocktail". I will try it for sure! You have been so helpful, I appreciate it! I will try anything because as you know surgery is no picnic. Although you seem to be doing well!(doing housework already). I did have some bleeding also from bms from time to time after my surgery too, so i'm sure it's nothing to worry about, just do your best to keep your stools soft.How would you rate your pain level the day after surgery compared to day 6 on a scale of 1-10? Also how bad is the pain with bms? Did your doc use stitches? Sorry for all the questions just trying to prepare myself just in case! Thank you again for the info, I'll be waiting to hear from you!

     
    Old 12-01-2003, 11:01 AM   #9
    vdang2003
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    Re: Hope for Hemorrhoidectomy/Sphincterotomy

    Hi again,

    I hope the meds help you! I'm doing okay. I'm REALLY weak today, but I started my darn period, and it is a WEEK EARLY!!!! I freaked out until I figured out that the blood wasn't from the surgery site. Other than that, I am doing okay today.

    Yes, I have stiches. I have 5 external and I have no idea how many inside. The external stitches feel kind of like my episiotomy (sp?) when I had my kids. I hope to find out more about exactly what the doc did when I go in next Monday for my 2 week checkup and I'll let you know how many internal stitches I had and which ones were for the hems and which for the sphincterotomy...if I can find that out??? We'll see.

    I was doing so well at day 2 post-op. I was sore from the surgery, but not in the same type of pain as I'm in now. I had a really hard stool Saturday night (day 5) and I think I set myself back with that. Overall, I'd probably say I'm at about a 2 or 3 on the pain scale, on average, now and I was probably around the same at day 2 (just from feeling like someone hit me in the arse with a baseball bat). However, I would trade the burning/fullness/stinging I get now for that soreness of day 2. Sometimes it spikes up, but most of the time it is manageable for me. Like I said, if I hadn't had the hard stool Saturday, I'd probably be feeling great by now. Still, 2 or 3 is NOT bad. Plus, with the period starting early, I'm in pain from that, so I'm trying not to include that in the equation (haha!).

    I'm very happy with my progress, even with the mess up Saturday night. I think I'm doing well.

    Let me know how things are going with you! Take care,
    vDang

     
    Old 12-01-2003, 04:22 PM   #10
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    Re: Hope for Hemorrhoidectomy/Sphincterotomy

    vdang, I think a 2 or 3 on the pain scale is great! good for you! I think at day 5 or 6 i was still around a 6 or 7 and very swollen. Do you have any more gas incontinence or is it easier to control now? I have my doctors appointment on thursday so i will let you know how things go. I'm also headed to the store for the things we talked about. Maybe that will help in addition to the medication I am using! Also how long did you have the hemorrhoids from your first pregnancy and did they go away completely and come back with your second? Did you get them during labor? I'm getting married in feb. and would like to have a baby soon after, I'm not getting any younger(loL)... just courious, THANKS AGAIN!

     
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