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[B][U]Hemorrhoidectomy Surgery Account: April 2013[/U][/B]


Hi,
I am a happy and healthy 34 year old mother of two girls of 3 and 6. I have always been fit, thin, and kept a very healthy diet. Since suffering with haemorrhoids (H's) with both children I have just had an Open Hemorrhoidectomy on the NHS! This is an honest and hopefully helpful account of H's and the traumatic surgery needed to eradicate them forever (fingers crossed ). Feel free to ask any questions.

* This is obviously a personal account and I advise anyone to talk to their G.P regarding different pain relief options following the surgery.

[B]
BACKGROUND[/B]
I have suffered with two tiny H's since I was around 16. At this point they were not painful at all. Since having children, those tiny inhabitants became a large prolapsed problem. Following useless advice from my GP and Consultant, they became thrombosed and extremely painful. After several visits to my consultant, he advised Halo banding as a first measure (basically cutting off the blood supply to the H's by tying the arteries off). I had this done in September 2012 and suffered excruciating pain following the Op resulting in another trip to A&E Emergency Medical Admissions Unit. Needles to say the Op was unsuccessful and the problem just became worse.

Eventually the Consultant agreed to perform an Open Hemorrhoidectomy. He was very dubious due to my age and all the complications that can arise after surgery. However, following lots of research and weighing up the pain of my H's against my lifestyle it was a no brainer! The H's were affecting my whole life.... no intimacy with my husband, no exercise (too painful), not able to lift my children, unable to sit at work for long periods, depression, no social life. So I was booked in for the op on the 28th March 2013.

[B]PREPARATION[/B]
Following hours and hours studying this forum I came up with the following:
A Diet plan
A Pain plan
A support network
A list of all the things I needed around me in preparation

Bearing in mind that everything I read suggested that the first two weeks would be hell I warned work that I would be off for 4 weeks in total. I did NOT want to risk having the Op and pushing myself to quickly, hence undoing all the surgery. The following plan is specific to me and it worked. I had one night of severe pain but the strict timings of pain relief minimised the effect and the emergency top up relief was definitely needed. At all costs you need to make sure that you don't end up back in Hospital again where they may examine you internally and cause more problems.

[U][B]Diet Plain[/B][/U]
Diet and pain go hand in hand. The pain relief I used is Codeine based which tends to constipate you. Thus without the right high fibre diet and supplements... you are screwed!!

[I]Pre Op:[/I]
Two days before the Op I stopped eating bread and meat. I started a very high fibre diet without any foods that cause bloating or constipation. I also took 10ml Lactulose twice a day. So lots of bran, soup, vegetables, and fruit. (and the odd tiny bit of chocolate to keep you sane!!)
[I]
Post Op: [/I]

Day 1 - 2: Lots of water throughout the day and very small meals so as not to swell your tummy (it may take up to 7 days to go for a Poo (BM) so you must not fill your tummy too much or it will be painful)

Breakfast:Weetabix/ Allbran in the morning with a mug of Green Tea sweetened by 15ml Lactulose, and a drink of Fresh Orange. An Aloe Vera capsule (to ease the tummy and help healing), Butchers Broom Tablet (to strengthen veins and help recovery).

Lunch: Soup and a piece of fruit

Snacks: Fruit.... agiain try not to overfill

Tea: Omelette with Roasted Veg, fruit salad with cream and a square of 80% Cocoa Chocolate (gotta keep the iron intake high for any blood loss :)) You could also try scrambled eggs with Veg or Jacket Potato. Remember, small servings)

Supper: Fresh Orange with 15ml Lactulose and a cup of Decaffeinated Tea

Day 3-4: Same as above but start introducing 1 Glass of Movicol (This will help you bowel to start working again and encourage a BM) NO MEAT until after the first BM. I also tried Hob Nobs when I was deperate for something sweet (they are a high fibre biscuit!!)

I remianed on this diet until Day 7 when I was regularly having a BM. Then you can up the serving size and broaden the range to include meats.. don't shock your system though take it slowly.

[B][U]Pain Plan[/U][/B]

The pain you can suffer with this operation is very severe due to the fact that this area of your body has the most nerve endings! I can honestly say that when I had my banding done (and I wasn't prepared with pain relief), it was worse than giving birth. The key is being proactive and seeing your G.P BEFORE the surgery. Talk to them about a pain relief plan and get all drugs prescribed and ready for when you come home. Your surgeon will ny want to prescribe paracetemol due to the constipating effects of codeine; with a balanced HIGH fibre diet and supplements this is easily balanced out. The pain I experienced was like someone taking a blow torch to the inside of my bum and then deciding to whack it every minute or so with a baseball bat. Hence, the need to be prepared... So from reading a post by an American Doctor I came up with the following:

Remember the key: In the first few days religiously take your medication before pain sets in. Don't contemplate missing a dose. You will regret it. My mum is a nurse so I stopped with her for the first two weeks and she kept a pain relief diary so that we didn't overdose.

[B][I]Days 2-4:[/I][/B] Up to eight paracetemol a day every 4 hours (set your alarm at night) and Ibuprofen every four hours. 1 Dihydrocodeine every 6 hours. For breakthrough pain I took Oramorph (liquid morphine) at a rate of no more than 10ml an hour.
During the first 24 hours you may not feel much pain due to the Anaesthetic but as soon as you feel the first hint of pain start on your meds. My worst pain was during days 3 & 4 when all the bruising and swelling was coming out.

[B][I]Days 5-10:[/I][/B] Up to eight paracetemol a day every 4 hours and Ibuprofen every four hours. 1 Dihydrocodeine every 6 hours. You may only need some Oramorph when you have been for a BM.

[B][I]Day 10[/I][/B] onwards becomes much easier. I stuck with the Ibuprofen and Paracetemol and only took the Dihydroc when needed. Since day 14 I have only had to take Ibuprofen for the swelling as I am not in much pain at all now.

[B][U]Support Network[/U][/B]

You will need a 'Bum Buddy'. In the first 4 days I could'nt even walk to the toilet by myself. Infact we hired a Kermode which proved invaluable. I had trouble going for a wee due to the pain so I was up and down to the loo a lot. I stopped at my mums and she was fantastic. She helped me to the toilet, ran me baths, prepared my food, made sure the children were dropped off at Nursery and friends (you will need to get help with the kids - peace and quiet for recovery). What ever you do make sure you have planned a support network and help with the house, kids, husband, dog etc etc. Print the plan off for everyone and make sure that they realise that this is going to be like a major operation due to the pain levels and debilitating effect on your bowel function. You will need FULL support for at least two weeks. I am 18 days post Op and still resting!

[B][U]Preparation List[/U][/B]
Foods: All Bran, Weetabix, Fruits, Tinnned fruit (for ease), cream, Green Tea, Decaffeinated Tea/ Coffee, Lots of Soups, Cream & Brown sugar (nice on All bran), vegetables.
Supplements: 2 bottles of Lactulose, High Strength Aloe Vera Capsules, Butchers Broom Tablets (order well in advance), Movicol. These can all be bought on Amazon
Medical Items: Sensitive Baby Wipes (for when you can wipe; you will not want toilet paper!), Preparation H wipes (sterile and soothing to finish off with), Kermode (can hire from Red Cross shops), Padded Raised Toilet seat (Amazon), small stool (helps when on the loo or Kermode, when the legs are raised its easier for a BM), Knickers you can throw away after, Panty Liners (for any mucous / blood in the first week). Sitz Bath (from Amazon), Salt for the bath.
Drugs: Oramorph (I really had to push my G.P for the Oramorph and promised to use it only as a break through pain relief.). Dihydrcodeine. Paracetemol and Ibuprofen (in copious amounts). You need to persuade your GP that you understand the need for a high Fibre intake to offset the effect of constipating Opiates.
Other Items: Laptop: (join Netflix for free and watch TV in bed to pass time) I couldn't even concentrate to read in the first week. Books to read for when you feel up to it. A V pillow for sitting up in bed. An extra pillow for sleeping (put in between legs to relieve pressure on your bottom)
A BUM BUDDY (you will need them 24 hours a day for the first 4-7 days)

[B][U]Recovery[/U][/B]

Be prepared your recovery will be HARD WORK and you will have to build yourself back up again. Everyone is right that you will only feel slightly human after 14 days. In the first few days be prepared that you will revert to being a toddler... you will need help with everything as you will be in pain, spaced out, and unable to go to the toilet. Be prepared to take a bath up to three or four times a day, have your bum looked at by your BUM BUDDY (they need to make sure its not getting infected), have tantrums, and feel massively depressed. This is all very normal but none of explained by the NHS!!!

Bathing: Always keep the area clean and patted dry after a BM.

Going to the toilet: You may spend along time waiting to both wee and poo. Get the comfy padded seat. Prepare for tears and pacing, lots of Sitz baths to relax the muscles (hence letting you push). YOU WILL GET THROUGH IT. Keep up with the meds and they will make it bearable. You will feel alot of pressure down below. (This is another good reason for any children to be taken care of as they don;t want to see mummy go through this).

[B][U]Result[/U][/B]
As I explained I am now 18 days post op and I felt the compulsion to start a new thread online as I hadn't read many threads from the UK with people referring to the Pain Relief available over here. I can now walk around with no problem and go for a BM without pain and without the need of a bath. I am back at home and can do jobs around the house. I still have a sleep every day and let my husband do the bedtime routine with the kids. I fully intend to take the four weeks of work, I don't want to regress and go through this again.

My only worry now is that I am still very swollen. There are not many threads after two weeks and not much talk of how long swelling takes to reduce. I live in hope! My wound is still slightly open and producing sticky pus but I pat this dry and use Prep H wipes after I have been for a BM. I have no pain when going for a BM.

This has been one of the toughest years of my life. I hope it has made me stronger. Yes it was worth it as I have no pain now. I imagine I will have some rather large skin tags as I ended up having three large rascals cut out!!

Good luck to you all and please don't hesiate in asking anything you wish to know pre or post op.

Warmest Regards,
Post op Pam!!





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