Discussions that mention vicodin

Bowel Disorders board

I had my hemorrhoidectomy surgery on the 6th of June, which included the removal of three internal and three external hemorrhoids. In the weeks that preceeded the operation I found this site and got completely freaked out by some of the excerpts in the "Hemorrhoidectomy Blues" thread. I promised myself that if I survived and had a positive outcome I would post a thread.
It will have been three weeks tomorrow since my surgery and I will say it has been a very rough road, but overall I feel that for me it has been worth it. I still read excerpts from the "Hemorrhoidectomy Blues" thread, which has some great tips and really feel for those that have truly suffered for very long periods of time. Before the operation I thought that some of the people may be blowing things out of proportion, however, I don't think that so much now! A normal recovery course is quite difficult and painful, I think that even the smallest complication could be very debilitating.
That's why the first and VERY MOST important thing is to find a good surgeon. If you have any misgivings or "just don't feel right about it" formulate your emotions into clear questions (e.g. how many times have you performed the procedure, what are the typical complications experienced by your patients, what is your success rate) and speak to your surgeon!!! I have a Ph.D. in behavioral sciences and work with medical doctors and I have found that the best doctors/surgeons usually are willing to take time the answer all questions and answer them honestly. I had a great surgeon, with an exceptional track record, and great bedside manner. He took time to answer all my questions (which I had written down on a 3X5 card before our first meeting). He was honest with me and told me the surgery would be really painful, more painful than childbirth based on his previous patients experiences, and left the decision up to me. I found him by basically asking my PCP for "the best." I had to wait a while, but it was worth it!! Even though it is a pretty "normative" procedure, recovery without complications is painful enough.
The thing I really wanted to know before the surgery was "How bad is it--really?" I think I handle pain about average, although my surgeon says that I tolerate pain pretty well. One thing I got really freaked out about was taking the opiod pain medication (e.g. Vicodin) due to the constipation (which I had experienced with another minor procedure). So I went off the Vicodin within the first 48 hours (1 every four hours). I now have some second thoughts about that...I wonder that if I had taken 2-4 Colace a day for the first week if that would have kept my BMs soft enough to keep taking the Vicodin, which would have decreased alot of my discomfort. Also, I wonder if it would have helped to take a Colace the night before my procedure to soften my first BM (which happened the day after my surgery). That first BM really is pretty horrid, but what made it partly so bad is that it was hard, probably from that pain meds, and the Colace hadn't kicked in yet. Something to ask your sugeon about?
Also, while in the bathroom, it is helpful to have a bidet and something to hold onto. During my first 5 post-surgical trips to the bathroom I would get chills, and would have to keep moving my legs to keep my circulation going and keep from fainting...a foot stool (no pun intended) would have helped as well, so that there would be less pressure on my legs from the floor. For the first week to ten days I took enough Colace to basically keep things pretty loose, which helped. My doctor said that when going to the bathroom the first few times "it either feels like you are passing a house (without laxatives) or passing acid (with laxatives). So I went with the latter and I definately think it was the best choice in terms of preventing complications.
In terms of pain here is my daily breakdown:
Day 1: serious, intense pain, with occasional more painful spasms--definately take the pain meds. Tylenol PM helped me sleep through the night for the first 10 days.
Days 2-6: still very painful, difficulty walking, you dread going to the bathroom, and look forward to sitz baths and sleep. On day six (Sunday) following one horrible trip to the bathroom I noticed some red/orange "stuff" coming out of me and my pain level increased significantly. I ended up calling my surgeon's "on call" physician who was very short on the phone with me and told me not to worry. However, when the pain and the "stuff" increased throughout the day and into the evening I ended up calling the "on call" physician again and met him that night at Emergency. I will add that I immediately didn't like his attitude...he didn't listen to me. He took a look and told me that the red/orange stuff was mucus and that he was going to remove it and that it wouldn't hurt. LIAR!!! The mucus was attached to my stitches and my stitches were of course are attached to me. It certainly hurt. He also told me that I also had another external thrombosed hemorroid, which I was afraid that he was going to tell me. He told me he was going to cut it open and remove the blood clot. I immediately told him not to do it and that I would wait to have my surgeon take a look at things. I didn't like that the "on call" physician didn't listen to me or address my level of pain, which also didn't engender my confidence in him. Taking out the clot wasn't going to decrease the pain, which was my immediate problem. And the mucus was not a sign of infection or complications. He did not like my response and told me that he had been doing these procedures for 30 years, but I held my ground. He was not happy. However, as it turned out, my surgeon took a look, on day 8 and told me the I had made the right decision to come in (to rule out infection/complications) and also made the right decision not to have the thrombosed hemorrhoid removed, bc he said I did NOT have a new thrombosed hemorroid, but that it was swelling and that the "on call" physician had misdiagnosed it. I had suspected that since my major concern in coming to emergency was not knowing what the mucus was and the increased pain level--which basically resulted in me going back on the Vicodin for a day. I had noticed the "swelling" and hoped that it wasn't a thrombosed hemorrhoid, it had been going down slowly, so I wasn't so concerned about, which is why I wanted my surgeon (who I liked an truste) to take a look before anyone cut into me again.
Day 7: Start to feel better, (mainly bc back on Vicodin) more mobile. Just VERY excited to have made it through the week, but after my emergency visit decided to go on a "liquid diet" (with my surgeon's permission) which included Slimfast Shakes and soup.
Days 8-16: The physical pain decreases but begins to take a psychological toll, which makes the pain less tolerable. I didn't make as many gains in terms of the pain decreasing as I had the first week. I began to feel really discouraged bc I didn't know how long I was going to have to live in pain. My surgeon told me that some people go back to work after two to three weeks. I think he was being a bit optimistic. I won't be going back for at least six weeks, mainly bc my job is very fast-paced and demanding. Luckily my boss (whose brother had gone through this) told me to take as long as I needed and not to come back until I was 100 percent. So I am really blessed this way.
Days 17-18: Feeling pretty good, good mobility, drove for the first time to the store. Took a short walk. Unfortunately on Day 18 I had a setback.
WORD OF WARNING: On Day 18 I was feeling really good (e.g. had gone off the Colace, but still on the Metamucil twice a day, trips to the bathroom weren't very painful) so I decided to have three bites of my husband's cheeseburger and some tortilla chips. BAD CHOICE!! The next morning my BM was so hard (and very painful) that I ended up tearing part of the area around one of my stitches, which set me back in terms of pain about a week. So I am back on an all fiber diet and my new mantra is "no meat or wheat" at least for a while.

While of course everyone's experience is different, here are some things that I found helpful to do and keep in mind:
1. Before my surgery, I prepared a basket of things that I would need post-surgery (e.g. Colace, Metamucil, Milk of Magnesia, Anusol/Tucks, Extra Strength Tylenol and Tylenol PM, gause, scissors, wipes, thin maxipads, extra cotton underwear--you don't want to have to do laundry for at least the first week, also keep lots of water on hand. I bought Smartwater from Trader Joe's which has electrolytes in the water, bc laxatives can cause dehydration.
2. In terms of food I am still basically eating just fiber or soup. Going to the bathroom was so painful the first/second weeks that I basically (with my doctors permission) existed off of Slimfast Strawberry Shakes (bc I hate Ensure) and small bowls of vegetable or split pea soup. I am now able to eat a small spinach salad and some fruit.
3. I also did some "nice" things for myself before the surgery to make my recovery more comfortable. The first thing was I bought a bidet attachment (you can get one for about 100 dollars on line) and believe me when I say that, next to marrying my husband, it was the best choice I have ever made. I love that thing!! I also bought a tub pillow for my back, a body pillow for my bed (another key buy), a few ice packs, bought a single CD player so that I wouldn't have to get out of bed to listen to soothing music, purchased a good candle to light while soaking in the tub, and got a pedicure and bikini wax. I found these "comforts" to be key to my recovery. For me, heightening my comfort through my other senses (e.g. soothing lighting, comfortable temperature--ice packs, airconditioning, calming sounds, CD's, comforting things to touch--favorite blanket, pillow, neck support) really helped in negotiating my way through the pain.