Recovering from a haemorrhoidectomy - Part 2

[AniseedBall]

https://www.mumsnet.com/Talk/general_health/2232089-Recovering-from-a-haemorrhoidectomy-warning-TMI-alert

New thread for those recovering from this (awful) operation. Link above to the old thread.

Hi @Dogwalker1 @Aussiemumofboys I hope you see this! The other thread was full so I couldn't post....

@Dogwalker1 I'm glad you feel you've made some progress this week. Hope you'll be feeling back to normal by Christmas!

I'd been doing ok, I reduced the Movicol down and have managed to get BMs down to 2 the last couple of days which is positive. I've still had soreness where the swelling and wound are but more a sharp pain when I sit wrong rather than the pain that lingers. However this morning there was bright red blood again when I wiped so I'm off to the GP again. I just can't seem to get past a certain point 😬 I'm not sure I want the suppositories again though so not sure what else she can do! I used one on Monday after my 4 BMs because I was feeling very swollen and then, maybe coincidentally, had a few spots of blood the next morning 🙁

@Aussiemumofboys thank you for sharing your experience. I'm glad you are having pain free BMs at 12 weeks. It gives me hope!! I'm 11 weeks now and can't seem to get past a certain point of healing and am still getting blood every few days. Do you feel completely healed now apart from the spasms? They sound awful! Thankfully that's one symptom I haven't had since the very early days. Is there anything you've used to help healing that you'd recommend? I need to try something new!

Hi @AniseedBall,
I had read somewhere (maybe on this thread) about taking Vitamin C as it promotes healing so I was taking that daily as well. That's probably the only different thing I can add if you're not already doing so. I spoke to a dietitian as well to ensure I was eating correctly (Fibre) as I have intolerances and follow a Low FODMAP diet so many foods high in fibre are bad for my tummy. I was also taking a Low FODMAP fibre supplement. I'm sorry to read that you are still bleeding at times. I no longer bled after about a week. But then got the spasms! @Dogwalker1 My physio has me doing "Kneeling hip flaxor streches" "Hip adductor stretch" and "glute stretch - supine" google those, it should come up with images and instructions. In the next couple weeks I will hopefully begin Pelvic Floor strengthen exercises and possibly Pilates. When I had my checkup 2 weeks after my surgery I told my surgeon he could look but not touch! :-) He said it looked as it was supposed to and that I should be back to "normal" in 3 months. I'll be 3 months in 2 days. While the area is "normalish" the spasms are hanging around. It affects your mental health too. I had such anxiety in the first month of leaving the house and would only do so for short trips after a BM. Because when I had to go I HAD to go to the loo! Plus the spasms were giving me anxiety. Am still regretful I ever had this done.

Hi @AniseedBall goodness this thread is on part 2 now 😬
Thanks @Aussiemumofboys for the vitamin C recommendation and the physio stretches.

I hadn’t posted for a few days as I had a setback after doing a little better and just couldn’t bring myself to post. You are right @Aussiemumofboys it does affect you mentally too.

Last week I had a bit of of cold and, after a few nights of not much sleep, ending up napping for the entire afternoon one day. I’d been out all morning so ended up not drinking enough. The following morning I went to the loo as usual, so not exactly constipated, but it was hard, and it bled, and it hurt ☹️. And I’ve not bled since week two. Strangely the pain was a bit higher up but as my notes at the hospital don’t match up to what I was told I was having done I’ve no idea if this is an old haemorrhoid or where I had one removed. So I’ve gone back on the Movicol just to protect me from the after effects of accidentally not drinking enough and now I’m feeling a little spiky down there.

And feeling a bit fed up with the whole thing ☹️

I hope you guys have had a better few days.

Hi @Dogwalker1 sorry to read your update. The healing with this operation when it does actually happen seems so fragile that something minor can take it right back. I hope the spiky feeling doesn't last long.

I'm just so exhausted with it all I couldn't bring myself to post the last few days. I had more bleeding last Friday so went to the GP again. She says there is still a 'graze' near my swollen bit that hasn't healed and thinks I might have an internal haematoma which is what keeps bleeding. She could feel a lump pressing externally and that bit hurt when she did. It would explain why I don't have pain when I get bleeding. I do think another part of the wound bleeds a little bit occasionally too.

She suggested I use a bit of Anusil near the 'graze' area and try to get a tiny bit inside but I'm being careful with that after last time!! I asked about the improvement I got with the suppositories that then went backwards and she said that can happen with them, to a certain extent they give a false healing that may go back a bit when you stop them. I think she was going to suggest a few more days but as I'm seeing the Consultant this Friday she didn't want everything to look ok when I saw him only for it to go backwards afterwards hence using the cream until then. She said to ask him what he thinks about using the 6 I have left.

She also told me to stop the Movicol and double the lactulose instead. I can't tolerate that much lactulose so I'm still cutting down the Movicol. It's driving me mad - the same amount just gives extremes, too hard feeling one day (not actually hard but feels it and difficult to pass) or too loose the next which gives me a lingering pain and leakage. I have really run out of ideas, my diet doesn't vary that much but I just can't find a happy medium. What used to work before the op doesn't. I don't know what has happened to my whole digestive system 🙁 I am so worried I'll end up with a new haemorrhoid.

@Aussiemumofboys thanks, I'm taking vitamin c and zinc, hopefully they are doing something to help the healing.

What is the low FODMAP fibre that you take? I'm trying to follow a low FODMAP diet as there are lots high FODMAP foods I can't tolerate but it's difficult when I need to keep BMs soft so I'm eating some things that make me a bit bloated for the fibre and also using Movicol & lactulose.

I'm not at the stage yet where I'm glad I had this done. It must have been such a shock for you as you weren't expecting it / prepared in advance. It's bad enough when you are!!

Hi @AniseedBall I’m sorry you are feeling down about the whole thing too. It’s hard at this stage because and most of us on this thread are feeling that the op wasn’t worth having. I’m sure we will get there in the end 🙏🤞🤞.

Your comment about not getting it right re the Movicol, diet and lactulose is what I’m experiencing. As you said, even a not so hard BM is still difficult to pass and the much softer ones bring different problems but pre op we would have been able to pass varying types of poo without giving it much thought. Now we have unhealed bits we have to be so much more careful and it’s difficult. I’m back on the Movicol so cleaning up afterwards takes longer and if I don’t have a decent longish bath afterwards then I have slight leakage. I’m trying to tell myself that this will get better once I’m off the Movicol but am accepting that I’ve got to take it for a while until I’m completely healed.
It will be interesting to hear your consultant’s view on softeners vs
laxatives.

Good luck on Friday if I don’t post again before then.

Happy to find a live thread about this- although it's about the only thing I'm happy about after this hellish op.

I'm on day 4 post-op after surgery to fix multiple prolapsed thrombosed haemorrhoids and perianal haematoma. Caused by my twin pregnancy and worse yet, I am still pregnant! 35 weeks today and scheduled for a section at 37 weeks.

I had piles from about week 28 - I had them with my first pregnancy too but they went away afterwards so I didn't think much of them. Then they started prolapsing. And then one day I couldn't push them back in One thrombosed and while I was trying (probably in vain) to treat that with creams and suppositories, three more joined it. They were the size of cocktail sausages.

I made an appointment to see a colorectal surgeon - he took one look (touching wasn't really an option anyway) and said I needed surgery right away. He booked me in for the very next day. So I didn't have much chance to research the op or recovery - I was more worried about the babies obviously. They're fine, little trouble makers, but oh my god, my ass is on fire

I had a spinal without sedation and the anaesthetic wore off within 4-5 hours leaving me begging for pain relief. I got paracetamol, then tramadol and finally a shot of morphine at 2am because sleep was impossible. The morphine plus a second dose of paracetamol just about got the pain under control. But ever since I came out of theatre I was asking about stool softener and didn't get it until day after surgery I could feel the need to go but I was unable to.

First BM this morning was hard and AGONY. Weeping in the bath and begging my DH to get me the Tramadol. Went to bed for the next 5 hours. It felt like my bottom was spasming although no bleeding beyond usually pinky-brown discharge. Ice pack and lidocaine gel no effect. Thankfully fell asleep from the opioid. Eventually got up at 4pm, managed a bit of sofa time & gave my toddler his dinner then felt the urge to go again. Second BM thankfully soft and not half as sore to pass. I had another bath and spasms set in again so I've had more paracetamol and currently laid on bed with hot water bottle on my bottom trying to relax the muscles.

I guess my main fear now is how much I'm going to be able to recover before my C-section and how I'm going to manage to look after my newborn twins. Any advice gratefully received. I'm taking Movicol 3x day, eating a light diet with lots of fruit and veg, some brown bread and cereal, and lots of water. Only meds are paracetamol 4x daily and Tramadol 2 x daily. I skipped the latter last night from fear of constipation but back on it after the horror of BM1.

Like others, I don't feel the doctor really prepared me for the pain. He thought it wouldn't be worse than the haemorrhoids- I'm not sure about that! But I couldn't walk or sit down with those so I guess something had to be done.

Anyway - I'm glad to have found some other people going through this. I don't think you can adequately explain the pain to someone who hasn't experienced it.

What a lot to be dealing with, @lifesnotaspectatorsport

If you can manage to read through the previous thread and take a few notes, it does have lots of advice. But in case that’s a bit overwhelming, I’ve attached the dietary advice from two posters who saw dieticians for guidance specific to this op.

Other things that were recommended:

When doing a BM focus on your breathing. Exhale through your mouth and let your lips relax and wobble, a bit like a horse (yes, really!). Some find this relaxes the anal area.

Use a squirty bottle to clean, eg www.amazon.co.uk/Hivexagon-Portable-Sprayer-Personal-Handheld/dp/B07D3N9H83?tag=mumsnetforu03-21

Then pat dry and apply aloe vera gel with a damp cotton wool pad.

Put Epsom salts or plain salt, plus a tsp of virgin coconut oil, into your recovery bath.

Air your bottom as much as possible, so no pants, drape a blanket from the back of a sofa to lie under for privacy.

Buy a heating pad to sit or lie onto, more comfortable than a hot water bottle.

Get a balance of stool softeners and laxatives to keep BMs soft but not trigger diarrhoea. Trial and error.

People tried various creams and suppositories, not sure what you have been prescribed?

Try to avoid codeine-based painkillers as can cause constipation. One person was prescribed a stronger ibuprofen-type drug: naproxen, not sure what you’re allowed in pregnancy.

If I can think of anything else I’ll add it.

Tagging active thread members in case they can help: @aniseedball @dogwalker1 @Aussiemumofboys

Screenshots haven’t appeared, so I’ll try again...

@AuntyElle Thanks so much for that summary and screenshots! I had RTFT but it's so long it's hard to take it all in, so just having the essentials is brilliant

It's day 5 now, only 2 BMs compared to 4 yesterday 😮 I'm cutting down the Movicol to 1 packet in the evening to see if I can keep the number of BMs down. None of them as painful as the first one thank god but still stinging and burning. I feel like my bottom has gone into spasm afterwards and it takes ages to relax. One weird side effect is that I struggle to pee, especially on the toilet. I've had to do all of today's pees half-standing and leaning forward in the bath 😣 Has anyone else had this? Wondering if it's pregnancy-related as my bump is huge and putting pressure across my pelvis.

I can't take any ibuprofen or anti-inflammatory drugs alas 😭 I've got a lidocaine gel for use after BMs but it doesn't really help. I'm basically just on paracetamol now with tramadol for overnight. I suspect that's making the pain tougher to cope with but I'm so limited in pregnancy.

Fed up of this now 😭😭😭

I bet you are!! People have definitely mentioned finding it hard to pee, as the whole area and pelvic floor is affected. temporarily. Peeing (and even pooing) in a warm bath has been mentioned as an option.

Some mentioned pelvic floor exercises and stretching exercises to help a bit with the spasms. Has your midwife advised you at all?

Do you have help from family or paid help for when the twins arrive? 🤞🏽

You sound like a trooper!!

Here are the pelvic floor tension-releasing exercises recommended by disneylover1:

And the screenshots:

Hi @lifesnotaspectatorsport poor you 😰 you have my sympathy. Not only because I can’t imagine having to have this op whilst expecting twins but also because you are at the very worst part post op.

Reading this thread must be a bit off putting but I do want to say that most of us here on this thread, even though we’ve had a lengthy recovery, there was a 90% recovery for most of us around three weeks. My pain after BMs improved quite a bit after two weeks. Where you are at at this time is absolutely awful but hang on in there.

I agree with everything @AuntieElle says above but will add what helped me too.

Ask your gp if you can use a local anesthetic cream. Some people on this thread were prescribed instillagel and I used this plus another I bought online. On a good morning I managed to numb the area before going which did help. I don’t know if you can use this if you are pregnant so please check! I used it both before and after BMs.

Sleeping off the pain whilst drugged up with pain killers helped me but then I’m really sensitive to anything that makes you drowsy. However do try to move around, walking, doing small chores etc. Two reasons - it will help get blood flowing to the area which will aid healing and it will help with regular bowel movements. I also found that if I didn’t do any activity, because I felt sore and sorry for myself, I got quite bad cramping and it felt like I couldn’t straighten up properly.

Aloe Vera gel, if you’re not allergic to it, is great too. It’s supposed to aid healing and it’s so soothing. I used it on the large cotton wool pads for cleaning up after a BM. It’s really slippy so it was the most gentle thing I found for cleaning. I couldn’t continue sitting on the loo after a BM as the pain was too great so couldn’t use the spray squeezy bottle for cleaning until much later in the healing process. I also couldn’t sit on on sitz bath as the position hurt too much too. I found the best way to recover after a BM was to lie on the floor with my bum raised in the air (propped up on a small beanbag) with a hot facecloth between my cheeks. I apologise for mentioning this on this thread too many times but it helped. Have a basin full of hot water with ordinary salt added with another cloth in so you can swop them over as they cool down. Don’t burn yourself! After around fifteen minutes I’d have a bath which was soothing too. My nurse said it’s better to not stay in for more than twenty minutes but I’m afraid I did. She said keeping the area dry for as long as possible was best.

I found the advice of putting cold/ice packs on the area didn’t help at all. I’m not sure it would aid healing too as it would stop the blood flow a little to that area.

I was prescribed by the consultant Diltiazam cream to put on the area. It relaxes the area and prevents spasms and increases blood flow. They advised me to use a finger to get the cream inside but there was absolutely no way I could have done that. Also in the first two weeks this cream hurt like h* when I applied it so I couldn’t use it straight away. I used over the counter haemorrhoid cream instead which I mixed with the local anesthetic cream. It was a few weeks post op that I could bear for the area to be just left clean and dry as advised by the nurse.

You will have some discharge and the pads used for incontinence are softer and longer than sanitary towels or liners. They seem excessive for the amount of discharge but they really do act as a protective barrier between your bum and the outside world.

I found that taking the painkillers was essential and that because of taking the Movicol I didn’t suffer constipation.

The holy grail is just going once a day as any BMs after the first one hurt a lot more. However all of us on this thread struggled with this, especially in the early stages.

Try not to lift anything remotely heavy. It doesn’t help 😬. You are already carrying twins so I might change this advice to don’t lift anything!

If I think of anything else I’ll post it.

@AuntyElle @Dogwalker1 Thanks so much for the advice and support, it is genuinely helpful to chat with people who've been through it and come out the other side.

I will definitely try the pelvic exercises and the aloe Vera. Also the hot flannels. I struggle with the sitz bath now, just need to clean up ASAP and then focus on trying to relax the muscles that cause the spasm. Hot baths are good too.

I've got just under 2 weeks till my section so just focusing on getting BMs under control and being able to sit on my bottom (!) so I can feed & cuddle the babies. Luckily my DH is off work until the 8th Jan so he's been looking after me and running round after our 2.5yo DS. The timing of the op sucks but the surgeon said I would be in major pain if I'd left the haemorrhoids too, and I didn't think I'd be able to manage the babies. Maybe the pregnancy hormones are helping me get through it! And the section will be a walk in the park after this op!!

This might be a dumb question, but given the circumstances, could you delay your c-section by a week, to give yourself more recovery time?

@AuntyElle One of my twins isn't growing as well as the other, unfortunately. Dopplers, heartbeat etc are all fine but he's measuring small. Hence the docs want to deliver by 37 weeks latest in case of placental insufficiency.

I'm actually feeling almost ok this evening so fingers crossed my body is healing well. And once babies are out, I can take ibuprofen etc.

Hi @Dogwalker1 how are you getting on? I hope things have improved since your bleeding earlier in the week and you have seen some improvement.

The whole fibre / Movicol balancing act is such a nightmare isn't it? I just fluctuate so much regardless I'm not sure I'll ever get a good balance. I did trying asking several times at my appointment yesterday but the Consultant wouldn't offer any advice. All he did say was you don't want anything hard as you risk getting a fissure so even though it feels bad I guess too soft and difficult to pass in a different way is better than that. What a situation to be in!!

My appointment was ok but he confirmed what I thought, there is an area, only 3mm x 1mm that hasn't healed or vela's then re opens. Otherwise he said everything looked good and no sign of any haemorrhoids. He prescribed me rectogesic cream to use 3 times a day for 8 weeks. Thanks to this thread I have read about it previously and the chance it can give headaches so I'm not going to try it until after Christmas and even then I'm not keen. The info leaflet inside said not to use if you get migraines, I mentioned that I get them at my appointment and he didn't say not to use it. Until then I'm using the 5 suppositories I have left and hoping for a Christmas miracle!!
I might get some Epsom salts to use in the bath, I'd stopped with the table salt as I'm getting patches of eczema with all the baths/showers/salt. I can't wait for the day I can have a lovely hot bubble bath!!

Regarding the leakage he said that should improve as things heal apparently and he wouldn't / couldn't say categorically but it seems less likely that the swelling / lump will need any surgery and that it will just become a skin tag.

Overall it was quite a positive appointment so I was feeling better then more trouble with BMs this morning and I'm fed up again 🙁

@lifesnotaspectatorsport you have my sympathy. Coping with the recovery from this operation while pregnant must be something else!! Hopefully you are past the worst days now. I was told the swelling would be worst on days 5-6 are so that's when I would have the most pain. By 2 weeks things were definitely more manageable.

I don't have any tips / advice that @AuntyElle and @Dogwalker1 haven't mentioned apart from taking a vitamin c and zinc supplement. The dietician I spoke to advised this, nothing high dose, just a standard one is enough.

@AuntyElle have you been through this operation? I'm looking for some hope that one day I will be fully recovered!!

Hi @AniseedBall I'm so glad that your appointment was a positive one, I've been watching out for your post to see how it went! Great news about the swelling/lump and you not needing any further surgery. Your consultant sounded quite reassuring and I am so pleased to read what he said about the leakage, I've been feeling increasingly upset and worried about this in the last few days. Starting the Movicol again seems to have made it worse after a BM.

My Diltziam ointment is v similar to rectogesic and I'd been wondering whether it was pointless using it so long after the op but, having read your post, I might start using it again as I definitely still have a sore bit. It's also is supposed to cause headaches but it didn't affect me at all and I get migraines too, so hopefully you will be lucky.

What was the trouble with BMs this morning? I feel that I know you well enough now to ask :) I'm sure once you can (eventually!!!) stop taking stuff that makes you go everything will go back to how it was pre op.

Are you still cutting back on the Movicol and trying to swap it with the stool softeners? If it wasn't for the fact that they make me incredibly windy I would have tried them before now as I think Movicol makes things too loose, which isn't helping with the leakage. Perhaps after New Year when I'm not socialising...

@Dogwalker1 I definitely get more leakage when things are too loose or I've been a number of times. I'm hopeful that it will go as last time I used the suppositories it almost went away entirely.

That's reassuring to hear about the cream you have. I'm going to start with a small amount and see how it goes. He said to carry on using it, if it doesn't give me bad headaches, for the whole 8 weeks even if it seems like everything has healed. I'll then have to go back and see him again in another 6-8 weeks.

The problem today was the weird fragmented BMs I keep getting 😭 Even though they are soft they are difficult / painful. It's either that or too hard, no middle ground. I'm now taking less Movicol than I did before the op and I never had this before and it isn't the lactulose as they were like this before I started that. I thought by reducing the Movicol gradually I'd get to a level where things were okish but it just isn't working like that. Previously my diet would vary, I'd take the same amount of Movicol and things would be fairly similar each day now it's just all over the place. The Consultant said the op only really affects digestion / transit time for 2-4 weeks so I can't blame that!! I'm terrified to think what's going to happen with the inevitable diet changes over Christmas 😬

Ugh, having a tough 24 hours today. I go for a BM and pass some, but still feel like there is more. I try to push a little but daren't do too much. Then afterwards I feel like there's still something there plus I get a ball of pain/ spasm in my higher rectum area (feels like). Am hour or so later, go again, press repeat. And I can't pee for ages after each BM. Ended up going 5 times yesterday, had a very comfortable night and morning, then exact same thing at midday today and I've already had BM2. I just don't know if this is normal, part of healing, or if something is wrong. I cut Movicol back to twice a day and only taking paracetamol now. Day 7 and it feels like there's still such a long way to go 😭

Just read about your littlest twin, lifesnotaspectatorsport. Bless him.
I hope it all goes smoothly.
What you’ve described above does sound similar to what others on here have posted early in in recovery. I also noticed that quite a few people saying they felt they turned a corner at 10 days ish 🤞🏽

I haven’t had this op, @AniseedBall... I’m a fraud! I was considering it so read both threads. I am no longer considering it. But thought I could at least summarise what I’d just read for @lifesnotaspectatorsport. I do think that people who are totally better tend to leave the thread as they’ve moved on, so you don’t get enough happy ending stories to reassure.

@lifesnotaspectatorsport sorry you are having a bad time. Everything you describe sounds normal sadly. I had the feeling of incomplete BMs early on and still do occasionally. I think some of it is due to your body tending up either with the pain or anticipating it. It does settle down when the BMs become less excruciating. I also had the issues with peeing, either not been able to pee until I'd had a BM or not being able to go for a while afterwards. This does settle down too although I still get it now sometimes. My Consultant said the whole pelvic floor is affected by the operation unfortunately. As @AuntyElle said 10-14 days is a turning point for a lot of people. I've found the recovery isn't linear but comes in jumps when suddenly some aspect has improved. I hope you have a better day tomorrow.

@AuntyElle I hope the thread didn't put you off the operation, I'm sure in the end people are actually glad they had it done (or that's what I'm telling myself!!). Your summary was really useful, I'm sure it'll help a lot of people and save them reading 1000 posts! I found the dietary advice @disneylover1 posted especially helpful preparing for the operation.