Discussions that mention vicodin

Bowel Disorders board


Here is what I came up with for things to do when I was researching surgery. I also tried to organize things into a reasonable timeline of when things should be occurring. Hopefully this will be of use to someone else also. If anything is a bad idea, don't blame me - I borrowed it from other posts.

Things to Have Before Surgery

Fleet enemas
Panty liners; 4x4 gauze
Flushable aloe vera baby wipes; ie "Kandoo"
Squeeze ketchup bottle for makeshift bidet
Ointments - cocoa butter, diaper rash lotion, aloe plant, lidocaine, Desitin, A&D ointment, hydrocortizone, Prep H, Benedryl cream
Stool softener: milk of magnesia, metamucil, citricel, Sennakot, delcolax, collace, mineral oil, fish oil
Multivitamin, Magnesium pills
Pain pills: Tylenol, Advil, Motrin
Epsom salt
Fruits (prunes also), vegetables, greens, bran, juice (prune juice), canned fruit, Soups, jello, puddings, fig newtons, wheat bread, yogurt
Bucket to carry around for nausea
Book or mp3 player to pass time in tub. Nothing corded to an outlet.

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PREPARATION FOR THE VISIT

Take a stool softener such as Metamucil or Citrucel for a few days prior and after the procedure. Don't overdo it - use just need enough to keep the stool soft. Remember to drink plenty of water - this should make the first BM less painful.
It's a good idea to be eating a high fiber (low meat) diet a few days prior to surgery - plenty of vegetables and fruit and high fiber cereals and breads.

Prior to coming in, take one to two enemas an hour or two before the planned surgery - as directed by your doctor. Hold the enema for 5 to 10 minutes and then expel it. Fleets enemas or tap water enemas are fine.


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Day of Surgery

Surgery

Local anesthetic should last 6 to 12 hours after surgery. You will leave only after the anesthesia wears off and you have urinated.

Care Directly After Surgery

Take pain meds as prescribed and on time. Do not combine Percocet and Vicodin - you'll get ill. Percocet claimed to work best...start with it and switch off every 4 to 6 hrs. Use an alarm to keep on schedule through the night - Pain meds will take approximately 30 minutes to kick in - staying on schedule is important.
Some doctors may recommend that you take an antibiotic (such as metronidazole) to prevent infection and reduce pain.
Ice packs applied to the anal area may reduce swelling and pain.
Frequent soaks in warm or hot water (sitz baths) help relieve pain and muscle spasms. Recommended to add epsom salts to bath - roughly 1/3-1/2 cup of epsom salts either every or every other time. This may speed recovery.
Try to walk some - at least 3 trips to the end of the house. You won't feel like it, but it will make you feel better in the long run. Carry a small bucket in case of nausea.

First Bowel Movement

Recommended that you take stool softeners that contain fiber to help bm.
Have a tub of hot water ready before you have your BM.
Do not strain - you will be risking getting fissures or another hernia.
You may apply numbing medicines before and after bm to relieve pain.
Do not, no matter how much you want to - hold it in. This will just hurt you worse. Breathe through the bm - do not hold your breath - try the Lamaze technique of breathing.
If it is too painful, you can climb into the tub of hot water to relieve yourself & clean up afterward.
Otherwise, finish BM and optionally clean with aloe wipes and get into hot bath for relief.

In addition to stool softeners and citrucel, One doctor recommended to take Sennakot - or any vegetable based laxative - if there is no BM after 2 days.

Food

It is very important to have a high fiber diet so that your stool remains soft. Your diet should be high in fruits, vegetables, greens, bran, juice, etc. Canned fruit is handy for convenience. Soups, jello, oatmeal, and puddings are also recommended. Eat nothing fried, spicey, acetic (take heed with citric and tomato products) for many weeks. Be sure to chew well. Note that some complain that bran and cereals can cause pain due to being rough when expelling later - also some Dr's recommend holding off on the high fiber because of the bulk it adds but other want the bulk to prevent narrowing of the anus. They recommend so to stick with soft foods with softeners. One recommendation is 30 g fiber per day - fig newtons, wheat bread, bean soups (be aware that gas will cause pain) are ways to increase fiber. If you eat only liquids it will constipate you and might cause your rectum to narrow from not stretching from the bowel movements during your healing.
Recognize that fiber absorbs quite a bit of water. You need to increase your water intake - aim for at least 8 glasses of liquids per day.
Pain meds will cause constipation, so additional stool softener is important. Collace, citrucel (mixing with apple or grape juice helps it go down), delcolax, milk of magnesia, etc. with a couple of meals per day reported to help. Prune juice or organic dried prunes are good alternatives that are highly recommended. An additional 2 tsp of mineral oil or fish oil can help as well. Your goal is for soft stools not diahrrea - so don't take everything listed. Everyone's body is different so adjust as needed.
Again, in addition to stool softeners and citrucel, One doctor recommended to take Sennakot - or any vegetable based laxative - if there is no BM after 2 days.
A good multivitamin should be taken to help promote healing. Magnesium pills were recommended to help soften stools and for general healing.
Eating will result in a BM, so it's a good idea to take a pain killer while eating so that it kicks in at the same time as your BM.

Pain Management

Understand your pain:
The first type of pain is just after the surgery where muscle spasms pull on the surgical site. The percocet may or may not help for this - many claim to take pain pills early in morning before bm to help with this, but a Valium (or other muscle relaxant) and warm or hot baths may be more helpful. Switching out percocet with vicodine every 4 to 6 hrs was recommended; however, stopping the spasm as the source may be more effective than covering the pain with pain killers. Some reported good results with heating pads and a massager in the small of the back. Try ice and heat, one may work sometimes and the other at other times. This may only last about a week or so.
The second is the extreme pain as stomach acids in the BM pass the surgical site. Aloe dampened baby wipes and a squirt bottle bidet make those pass quickly. Witch Hazel on gauze is an alternative. Pain meds seem to hinder the bm so the meds may wear off before you are done. Try to walk until time to really go. Lamaze breathing helps to get you through. A hot bath may help for this as well.
The third is a similar, but less intense, acid irritant ache from seepage from the spincter. Use cocoa butter or diaper rash oinments (see list above) on affected area 2 or 3 times a day to help numb the area and help with rubbing as well. Cuttting off a chunk from an Aloe Vera plant , peeling it (very gooey) and placing between the cheeks (the low down ones) may provide more relief.
A forth type is due to constipation. Polyethyline glycol may be prescribed as a laxative, but more natural alternatives have been listed above.
The last one occurs as the surgical site begins to stretch back to its normal size and shape. Think of it as exercise: no pain, no gain.

First Few Days

Your body needs food to heal. Review the Food section above. Your body needs plenty of rest to heal - sleep as often as the body will allow.
Keep on schedule with meds.
Frequent hot sitz baths (especially salty baths - roughly 1/3-1/2 cup of epsom salts in the bath every time) will help the most for discomfort--just sit in a hot bath for 20-30 minutes 3-4 times per day (or more) and after BM. Some prefer to use a wand showerhead over the bath.
BM will be painful. Do not hold it in, remember not to strain and refer to the Pain Management above. Try to take pain pills when you first wake up and with meals so they'll kick in when you have your BM.
You should have a BM every 2 days. Contact Dr. and increase laxatives if this does not occur. One Dr suggested - If you don't go at all one day, take one Tbs of Metamucil and one Tbs of Milk of Magnesia. If you go 1-2 times, take one Tbs of Metamucil. If you go 3 or more times, don't take anything. For severe constipation, an enema may be needed.
You need to be moving around some. Your body will be very tired after surgery, but you must force yourself to walk. Take a bucket even if you don't feel nausea still. Walking will help regulate BMs. Around day 3, you should be able to take a short walk outside. The sooner people started walking seems to be the sooner they feel better. Don't roam too far from home.
Try not to sit too much right now. Standing and lying are optimal.

First Week

Try to stretch the time between pain pills by using using 600 mg advil. If you are having trouble urinating when taking Loritab, mix with Motrin and it should help. By the end of this week to 10 days, you should be almost off all prescription pain killers except for occasional use. Replace with Motrin or a mix of Motrin and Tylenol. You may go through 100 Motrin for the first 2 weeks. 2 weeks seems to be when most experience a noticeable decrease in pain & it tends to occur overnight. When nothing seems to help, try to remember you just need to make it to 2 weeks.
Continue with high fiber diet and softeners. You risk a setback if you stop softeners right now. If gas becomes an issue, Beeno may help.
Weeping of the wound (blood and mucus) is normal for several weeks. Wear depends, panty liners, gauze between your butt cheeks as needed. Recognize infection of the wound is possible so inform your Dr. of anything unusual.
If you aren't walking yet, you should be.
Try to do things that take your mind off your body. Have a plan to do something while you are in bed - a new book, movies, etc.
Follow-up exams are usually done 1 week and 3 weeks after surgery, but don't feel shy about asking to reschedule if you need to.

Next few weeks

After 2 weeks, you can expect a noticeable decrease in pain. BM will still be an issue. You will need to plan around them.
10 days to 3 weeks seems to be the earliest for going back to work - don't be surprised if it takes 4 to 6 weeks.
Check with Dr, but with itching try mixing hydrocortisone & prep H with a little lidocaine. It should provide immediate relief to get thru the day.
There will still be weeping and spotting for 4 to 5 weeks (2 months for some). Around 10 to 14 days, some experience an increase in bleeding due to a scab falling off. This is normal.
10 days is too soon to stop laxatives, but everyone is different. The suggestion is to keep Metamucil or similar in the diet for months following the surgery. At 2 weeks (or sooner if you can), you need to be decreasing laxatives if your stool is not firm at all (you still want soft stool though) to help prevent narrowing of anus. In the next few weeks, slowly work toward a more normal BM. DO NOT STRAIN. You are progressing too fast if you are straining at all.
Continue with HOT water baths to promote healing and 2 motrins at bed time to be preventative for pain. Try to take with Tylenol to see if it helps more. At week 3, some are taking 3 to 6 Motrin daily. At 3 weeks, some are no longer doing hot baths, but replacing with a wand showerhead. At 3 weeks, some are adding meat back into diet but do this slowly and on a day when you can spend at home in case it causes discomfort.

6 weeks

Most of swelling should go down and you should have a good idea how you healed up. You will not be completely healed - that takes months, but you should be noticeably better.
You may be still taking stool softeners, but no laxatives. This is the soonest to consider weaning off fiber drink if you choose to do so. Again, do it gradually - every 2 days for a week, then every 3 days
I'm on day 11 today...whew. A long 11 days.

Wow, you gals go all out for the Christmas stuff. I'm single so I put up a tree usually and some lights, but if I miss a year it doesn't really bother me much. I wish I had my Christmas shopping done. I haven't bought 1 gift yet. That sure is getting here quickly, but I don't have my mind around it yet. Just tomorrow at work. Thanks for the good luck...I'll let you know how it goes.

"A hard ridge of tissue"... well that sounds lovely, Ilovefrogs. I wouldn't worry about it too much this early on - I've read that you need to wait until about 6 weeks to evaluate the end results. It sounds like it might just be tissue growing back together to me. Some days my rectum is all swollen and sticking out and other days it goes back in like it should. It may have something to do with whether I take my ibuprofen often enough, but I think it's all part of recovery. Actually my butt is less sore since the stitches aren't there - so I think they were the dissolveable ones and that now they aren't straining against the tissue in there with BMs. I wasn't able to really wipe back there until day 9 and since then it's been getting easier each day. I haven't really felt around back there too much except putting the A&D on it. I did try to use a mirror once, but that was next to impossible and I didn't care enough to try again.

Ilovefrogs, I read somewhere that increased bleeding after 7 to 10 days is pretty normal. I read that your body will try to create a sort of scab over the wounds and in about 7 to 10 days, it will pass with a BM and you'll see an increase in bleeding. It should stop soon after that though. If it continues, I'd call your surgeon's office. I haven't really noticed that I've been passing much mucus, but I keep gauze between my cheeks and there is always some on it. The gauze is a 4x4 inch and I fold it in half. It is never soaked but sometimes a forth of it is. Other times it has very little on it, but there is always a little - and yes it has an unpleasant odor. By now I suspect you know what the normal mucus looks like. If it changes consistency and you start running fever (101+), then you have probably gotten an infection. Otherwise I wouldn't worry.

The first few days I was always in pain so I stayed on my pain pill schedule religiously. After the pain changed to discomfort, I didn't stick on schedule at all, I just wrote down when I took a pill so I'd know I wasn't taking too many or if I was taking them too close together. Because of taking less prescription pills and changing to advil and such, I did feel the uncomfort of swelling more. It was different than the first types of pain of felt so you may be feeling that. I took less narcotics and increased my ibuprofen and tried to take them at least every 8 hrs - not over 800 mg in an 8 hr period.

I haven't been using any ointments on my butt until the last 3 days, and I haven't used any witch hazel. I've read that anything oily will prolong healing so I stayed away from everything until 3 days ago when I tried to see what effect A&D ointment would have on a BM. Even now, I only apply it when I think I'm going to on my feet for a while or if I'm expecting a BM - and only occassionally for that. I read somewhere that some ointments will thin the tissue back there - and I don't know which ones do that so I've been very sparingly with what I put on my tush.

I have been using "Kandoos" baby flushable wipes to clean with, but again that only really been the last 3 or 4 days. I tried a couple of times before then, but I couldn't stand the pain.

Just out of curiosity, did you eat regular corn or popped corn? Popped corn sounds almost suicidal. I have eaten regular corn without issues, but again I chew the hell out of anything I eat. It takes me a long time to eat a meal and my jaws get tired due to all the grinding. Especially any fiber I put on anything...I really chew on that.

Hopefully the spasms will stop soon for you. Day 7 was the last spasm I had after a BM and then there was the one at Thanksgiving, but I think it was from too much activity that day. That was also the last day I had burning after a BM, but I've used A&D ointment since then. If you have valium, I'd try that for the spasms...I really couldn't tell if they helped, but they are relaxants and they are supposed to help for them. Also, someone posted a massager in the small of the lower back would stop theirs as well as a heat pad in the lower back. I never tried them, but it's worth a shot if you are suffering still.

I haven't noticed the pain pills I'm taking giving me the dreams you are talking about - I was given valium and vicodine. However sinus meds do that to me all the time so I think you are probably correct it's med related. You just have to figure out which one is causing it. My mind races and I have very vivid (and usually very colorful) dreams on sinus meds.

Michelle, sorry you haven't felt all that great today. I've been sneezing so I'm really concerned I'm catching a cold or something. Since I had the hernia surgery too, the sneezing really smarts a bit - although I can feel it in my ***** too. But my stomach really feels those. I have lost about 5 lbs but that's about it. I think it's because of laying around so much too, plus I've added lots more carbs to my diet than normal. Most things that are high in fiber are high in carbs so I may be getting quite a few calories still. And I'm so concerned with stenosis that I eat several times when I don't feel like it at all. Plus I've read that you need fuel to heal, so although I've changed my diet I haven't really eaten less. I am eating less fat so that's probably where the 5 lbs went.

On another note, I did eat a burger late last night right after a BM. I still haven't had a BM today, so I'll let you know how that ends up. I did take 2 collace with it instead of the usual 1 with meals. Hopefully that was enough. I also was roped into going dancing last night. I drank 2 beers, but I don't feel bad today - yet. I danced quite a bit and nothing unusual with the behind issues so far. I am concerned with the BM.

Ilovefrogs, I wouldn't have considered doing that 2 days ago. It's amazing how quickly things have been turning around recently. I'm just hoping that I don't overdo it and cause a set back - but I'm sure a work day will slow me down quite a bit.

Take care hope you both are feeling better ....
I thought the staple surgery was supposed to be an easier recovery, but I'm having my doubts with your description. Day 8 is really the last painful BM that I have had. That includes spasms, burning, etc. I did have the spasm at the parents but I think it was completely because of me driving and standing way too long. Everything step forward seems to just happen one day, so hopefully you don't have too many more days of anything painful left.

I thought twice about posting that I was looking at my butt in the mirror - but after reading your professional photo session, I don't feel so silly. :) I must admit, I've never tried to see what it looked like back there before the surgery so it has to be curiosity causing us all to stand over mirrors. And that's not a pretty site no matter how you do it. Actually, I never looked til I noticed a stitch was missing. Sometimes you just want to make sure things are holding together, but a camera never crossed my mind.

I had my first real food for thanksgiving - which was day 8 after surgery for me, but I was very choosy what I ate and I had small portions. Saturday, day 10, is when I really ate pretty normal meals and things went well afterward. I must admit that I did increase my collace pills a bit though. I've been having 1 collace with each meal, but I had 2 with the burger. And I'm not sure I mentioned I had pizza today - everything is alright so far. I have 1 collace before starting the meal and have another about half way through.

Women tend to eat differently than guys do, so I can't really offer much advice on that. I do the citrucel in the morning, just to keep things the same at this point. I follow it with oatmeal and hot water to bring on a BM from my dinner the night before. That way I know I have a while that I can do stuff without worrying about one sneaking up on me. Up until about day 7, I was mostly doing soups for meals and sometimes baked fish for dinner for a change. Everything else was fiber rich things like graham crackers, snack bars, bread, raisin bran, fruit, veges, etc. I wouldn't try a steak just yet if I were you. You might try a bite of one and see how you react to it, but steak is hard to chew really finely. I'd start with ground beef first.

I don't think it matters how often you are having BM, I think it matters the consistency of them though. If they are really thin or runny, I think you should change something about your food habits. But if they have some girth to them, I don't think you will have any problem with stenosis.

From what I've read, percocet is more effective for pain than vicodine (and I think vicodine and lortabs are the same). From people that were prescribed both, they said that switching each time they needed a pill seemed to be the most effective way to take them, but not to take them at the same time. I don't konw what Skelaxin is, but I'm glad it's helping. Hopefully in the next couple of days, the spasms will stop like mine have.

I should have not napped today, because getting up in about 3.5 hrs is going to be rough. And yes, I'll be wearing my feminine napkins (I won't tell you how confusing and embarrassing that was to buy - is there really any reason to have 50 types of those?) to work tomorrow and I'll be wearing black slacks - just in case. I have some that are pretty thick that I have been wearing around the house, but I'll be wearing the thinner ones at work. I don't really like the thin ones cause they seem to unstick and bunch up some, but I'm scared someone can see the thicker ones through my slacks.

As always, thanks for all the support.