Tuesday 12 May 2015

Haemorrhoidectomy

I've learned a lot in two weeks - but nothing was more vividly presented to me than the limits of my pain threshold.

A number of forums give snippets of the post operation recovery/torment that patients go through but nothing was particularly in depth, so here it is -- a bare all documentation of my experience with the surgery that has me walking the cowboy (very, very slowly)

I first considered the surgery after having been putting up with Haemorrhoids for a number of years. For as long as I can remember I was having trouble with constipation and what my mum called "A lazy bowel". Having ignored it for years and put up with horrible swelling each time I tried to live my life the way I wanted (Taekwondo, Kickboxing, Running, etc) it finally got too much.

I've lost count of the tubes of cream I've gone through. I even have a favourite. Germaloids ointment -- it soothes and cools more than the others, but will only dissolve in soap however so may not be suitable if you can't soap up comfortably. That said, it became a part of the ritual that the dark gods I sat on demanded of me at least once a day.

I'd seen the GP before and they told me on two separate occasions that Haemorrhoids were totally normal and that I shouldn't worry. They even didn't seem too concerned that one was swollen to be an inch long and half an inch wide. I was sitting on "Roidzilla" and the GP's told me to go about my business.

Each time I went to the toilet I was passing blood more often than not and my exercise routine had reached the point of desperation. No exercise for weeks, squeezing in small sessions of shadow boxing to stop me becoming unfit, but without the need to strain with weights or the friction of running.

With the blood loss now affecting my health, enough was enough. So after a particularly bad month of bleeding it was time to see the Dr to consider surgery.

I convinced the GP to refer me to a surgeon only to spend the next 6 months. Yes the Dr and admin staff of the Woodlands Clinic in Kettering really are that good I actually had to go to another surgery altogether due to their incompetence/negligence.

Turn the hands of time forward after another referral from my GP surprised to see me back again with my "everyday problem" who referred me to a second Dr.

This time at the BMI Clinic in Northampton via my workplace private healthcare I saw a Surgeon who found a fissure. This is the first I'd heard of this - the GP's didn't even mention the possibility of a fissure. A couple of Botox injections and a haematoma removal later and I was set on way.

Around 7 weeks later the problem returned. Changing Dr again after reading about a recent fatality he'd been involved in I was booked in for the BMI Saxon Clinic in Milton Keynes. I ordered a pre-emptive round of Amazon purchases (Sitz Bath, Halo Cushion and D-roll back rest for my chair -- we later needed sick bowls and gloves so also buy these in advance!)

Here is where the Haemorrhoidectomy story begins.

Wednesday April 22nd - Admitted to surgery - no idea what to expect. Optimistic and Hopeful that this could be the start of the rest of my life able to live without Haemorrhoids looking over my shoulder (Or should that be cheek)

The rest of the week flew by in a blur of Tramadol - I honestly can barely remember anything apart from having a head that weighed of lead and being bed ridden for much of the time. Most of what came out of me was liquid and a mix of dark blood and stool. I passed a lot of gas and day by day became bloated and uncomfortable. I could barely stand upright and what little came out of me was obviously just laxatives and no substance.

Saturday April 25th - Concerned that I had not opened my bowels and with my slow recovery I went to the BMI Saxon Clinic to seek advice. The Dr not in that day I spoke to one of the nurses who dealt with me who advised that I start taking another Laxative - Natural Senna - two tablets at night.

Monday April 27th - I was bigger than most Pregnant women I've seen and this is coming from a guy who has been either underweight or with a six pack for his entire life so you can imagine the bloating that had occurred. None of my clothes fit, even the large size underwear that I bought for when my Haemorrhoids were bad. I had been to the toilet several times as the cramps were constant and with little to no success. Just blood and pain. Night time came and I was stuck on the toilet writhing in pain. I can remember my missus coming in and being close to tears, asking me, "Should I call an ambulance." My reply was a little less than graceful but hopefully clear enough, "Rarrrrgghhghbllllbmrrraahhhhhh"

I was taken to A&E via ambulance and given morphine to calm me down/shut me up. It settled in nicely and I was even able to joke with the Paramedic who looked strangely like Liam Moone from Moone Boy. I don't advise laughing too hard after a Haemorrhoidectomy however or your anus will punish you with another helping of pain. Nothing like sneezing however - AVOID AT ALL COSTS

I reached A&E and felt myself slipping further and further into dehydration. 3 different types of Laxative, 3 times a day and so bloated I could only sip water left me gasping. I vomited bile 3 times before I was seen too, by this point I couldn't even speak. An IV drip and anti sickness medicine later and I was feeling better. I was taken for an Xray which uncovered I had fecal impaction which is in other words some seriously backed up waste.

Tuesday April 28th - My Dr who was on call came by to tell me about the impaction and that she wanted to give me more laxatives and see if I could go now that my bladder had been drained by a catheter. It was worth a shot but after a week of laxatives and no success I didn't get my hopes up. I went to the toilet only for more blood to pass and nothing else.

Wednesday April 29th - I gave up and managed to convince my Dr that this mountain wasn't shifting. I was taken in the early evening for an evacuation of faeces by a guy who was the spitting image of John Leguizamo. I remember him asking me about my partner. I said I met her while cleaning her flat, to which he giggled uncontrollably repeating, "Naughty boy". Now in the theatre, once more my delicate opening had been heaved open in a scene I can only imagine would have resembled the red sea after Moses stopped the parting - I can't say I envy the surgeons, that could not have been pretty.

Thursday April 30th - New life in a relatively empty vessel. I sluggishly awoke and overseen by a nurse who reminded me to be careful with my cathata (yes they are immensely painful if you let the cable suddenly drop to the floor giving a sharp tug inside your unmentionables) I sat on the floor of the toilet squatting over the sick bowl. Something amazing happened. After the pain subsided I looked down to see that I had actually managed a bowel movement. A small one but it was progress. Later that day I had my cathata removed and downed a whole cup of water. The nurses told me that if I could fill three piss bottles I was a free man and to buzz me as soon as I had anything to show. I was desperate to go home by that point and was gaining confidence in my recovery so took a slow shuffle round the ward and went into the toilet.

I stood there for 5 minutes and nothing. I tried every trick in the book to get me to go. I started thinking about music, sex, anything to distract myself but to no avail. Woozily I grabbed the support to lean against. For some reason at that moment (I'd been watching Spartacus with my partner a few weeks before) I remembered the scene in Gods of the Arena where Batiatus and Selonius were at the public toilet. Don't ask me how (could have been the tramadol) but I started remembering (borderline hearing) the conversation between the two men as Selonius took a piss. 15ml passed that moment. It was painful as hell but it was a start.

Back in the bed I buzzed the nurse who sighed unimpressed by my offering. I drank two more cups of water and prepared again. This time took longer, around 8 minutes but now I half filled a bottle. I drank a whole jug of water and it wasn't long before I was going again. My partner arrived in time for the good news; I was being discharged. I even left them one more bottle for the road before I departed. For some reason my mentality had almost regressed to an infant, showing that he is capable of going to the toilet with a sense of pride. I left hospital with a green bag the size of a bin liner full of my new meds. Another two weeks of laxatives, the fun never stops.

Friday 1st May - My wonderful partner had agreed to take another week off to care for me and believe me I needed it. By this point I must explain that what little of my shame was long gone. She was happy to sit in the toilet with me and hold my arm (I was suspending myself above the toilet by gripping the seat - not sure why this position helped but stamping/moving your leg like a dog also helps. Lastly if you massage your stomach by pushing it down this helps to shift the mass inside. My mum also added at this point to my partner that she used to tickle my back when I was a baby, that always used to make me go. Thanks mum)

Friday 8th May - Day by day I was getting more confident and the swelling in my stomach was going down. By now I was able to confidently tell my partner to go back to work. I was going to the toilet between 5 and 10 times a day - the early morning and the late night shifts were the worst. Midday you have to try and shift as much as possible as this is when the opening is at it's loosest.

Monday 11th May - Forgot to take my Laxatives. Looked in the mirror to see Robinson Crusoe staring back at me. I really need to shave/get a haircut/put on weight.

Tuesday 12th May - Not sure what's going on today my bowels haven't opened. The pressure seems there but I'm passing a lot of gas and liquid matter and straining horribly each time the pressure sits me down. I went for my most realistic walk today, it was almost convincing. I did three laps of the garden in my apartment block and have now retreated to my cushioned chair for a well deserved rest. Getting either hunger pangs/trapped wind/bowel cramps - and yes I'm aware how much like an old man I sound.

That's where I am so far - will maybe write more if there are any other developments but otherwise please consider the following before getting the operation.

Key points to remember -- Preparing for a Haemorrhoidectomy can make your recovery much more bearable

1.) Buy a cushion. This will ideally either be a Ring cushion or a Polo cushion - Personally I have both as each has it's own advantages and disadvantages.

The Ring cushion is much firmer so gives much more support. I bought mine from the local pharmacy - not sure if Boots stocks them but you can pick one up easily enough on Amazon. The Ring cushion does cut off blood supply in my legs so not sure if it's just because I'm very thin at the moment but you could not use the ring cushion for prolonged periods. Also it is so big it will not allow you to lean back in your chair meaning you have to sit upright, again affecting the comfort. I have also tried to use it in the car before but it's impossible as it raises you too high.

The Polo cushion (I bought from Amazon; Putnam's Standard Sero Pressure Cushion - Polo Cut-out) It was actually the cheaper of the two and is very comfortable. It's soft but the spiky foam gives good support to the legs without cutting off blood supply. Definitely my choice of the two. However it is much thinner and much less dense than the ring so if the chair is hard underneath you may find your bum actually touches the hard chair and provides discomfort. I use it on my office chair at home and  plan to use it in the car.

2.) Alongside these I also use an Original McKenzie Lumbar Roll - D-Shaped (Also bought on Amazon) This has helped when using these big cushions to give me back support and stop me slouching. A good buy in my eyes.

3.) Sanitary Pads. These have been a lifesaver. I've bled everywhere since my operation and then my missus suggested I use her sanitary pads. She had some cheap ones that were no good for her but hey, I'm not fussy. Also you can get very big sanitary pads for the bed - they use them in hospital and really save you from wrecking your nice new cushions. I bought Lille Healthcare Bed and Chair Pads (again from Amazon) These big pads are very useful - have one on your bed, one on your chair, have one on the floor in the bathroom and if you can get a chair in the bathroom in front of the toilet put one on it as well. The one on the floor in your bathroom is for lying down to get rid of gas without making a mess and the chair is there to grip onto when you can't bear to sit on the seat. You can hold it while you squat - over the toilet or over a sick bowl.

4.) Gloves - buy a big box of Vinyl powder free gloves (mine are St John's Ambulance gloves bought from, you guessed it, Amazon.) I recommend these over the latex ones you can get because the last thing you want is for you to discover you have a latex allergy in the most sensitive area of your body. Also the latex ones have powder in and that will dry your hands terribly, especially as you'll be washing them every five minutes.

5.) Sick Bowls - disposable sick bowels double as great emergency toilets.

6.) A Sitz Bath - Invaluable for both Hygiene and to calm your straining muscles. A useful tip is to have it in the shower with you. If you need to go, don't fight the urge or risk constipation or a mess in your shower. Just turn off the water and squat over the sitz bath. Then when you're done get on with your shower.

7.) Bottled water - I've always been a tap water man (Scottish blood, what can I say) but having bottles of water strategically placed around the home can save you an agonising wait for medicine and stop you getting dehydrated when you get stuck on the toilet for a couple of hours. Keep it handy, but keep it clean!

8.) Ghee - Indian cooking ingredient by day - legendary healer by night. Ghee is a form of purified butter which will be your best friend in the kitchen and the toilet in the days to come. In a cup of milk, add one teaspoon of ghee and heat in the microwave. Add a little sugar for taste and down in one. It's a great way to lubricate your bowels without the harsh effects of laxative because you're already having enough of these. Take one cup of this before you go to bed.

Ghee is also great a lubrication in another form. Melt some ghee and carefully (after checking it isn't too hot!! Use caution - do not burn yourself!!) let it run down your crack and over your back passage. It naturally lubricates without the chemical burn that Haemorrhoid creams give when you apply to an open wound.

You can also use it to cook deliciously authentic curries which are also going to help you pass stool

9.) Distraction - I have BBC iplayer radio on my phone and have it on when I go in the bathroom. Anything to distract you from the pain is a great thing. You'll also notice every time you relax you'll get another "movement"

10.) Get a rhythm - listen to your body and make sure that you have bowel movements, empty your bladder and break wind in a good rhythm. Basically if you can't go for a piss your bladder is likely being blocked by something. Try lying on your back in a childbirth position (remember that pad you put on your bathroom floor) this should allow you to pass the gas. Once this is done you will probably need to go straight onto the toilet for a bowel movement and then afterwards for a piss, which may actually free enough space for another bm.

11.) Patience - Everything you do now is going to require a lot of patience. You are basically teaching your body it's basic functions from scratch. Just don't sit on the toilet for too long or you may risk DVT. Best thing to do is squat.

12.) Lastly keep up on hygiene - it may seem a challenge some days but make sure you are showering, getting up and moving around and cleaning yourself thoroughly. Alcohol hand gel in each room should keep things safe.

Well I hope this guide has been useful and will prepare you somewhat for what you're about to go through, or give you some tips to help with what you're suffering with.

It's been a hell of a ride so far, can't wait to be better, but very grateful to be up and about and having fairly decent bowel movements.

Good luck to you - I wish you a speedy recovery

~Fraser