THD Post-Op

Today is Thursday.  On Tuesday I had surgery to fix my bleeding arse -- I mean, my hemorrhoids.  There are really just too many potential jokes about this sort of surgery, but of course there's a serious side, too. 



My Symptoms


I've had hemorrhoids for years and years, but since the IBS kicked in, they've gotten much worse and become disruptive to everyday life. First off, they were butt-ugly, like a sizable bunch of purple grapes attached to my asshole or some bizarro mushroom.  But I don't have many occasions to show off my anal area, so the cosmetics of it didn't upset me too much. More importantly, I had gotten to the point where I bled not only every time I shat (ooh, I don't think I've ever written that word!) or farted, but also if I wore the wrong underwear (I gave up thongs in my 20's but even a poorly placed seam would cause bleeding), or if I squatted or sat criss-cross applesauce.  Or sometimes I just bled spontaneously for no discernable reason. 


I would spray copious amounts of blood in the toilet bowl and regularly bleed through menstrual pads when I didn't have my period.  I avoided having sex on any day that I had been bleeding because I was afraid I would end up rupturing a hemorrhoid and ruining our bed (not to mention totally killing the mood).  Some days, I wasn't wearing a pad, and I ended up bleeding through my pants when I was at work.  Awkward.


In addition to the inconvenience and embarrassment factors, I was also getting worried about becoming anemic.  So I started taking an iron supplement (carefully selecting one that seemed least likely to have constipation as a side effect) and seeking out foods with high iron content.



Seeing a Doctor


You would perhaps think I would have gone to a doctor about this, but... um... I didn't until very recently.  I just kept thinking I could heal myself if only I could avoid foods that led to diarrhea or constipation (yeah, right), and irritating clothes, and if I used the right creams and took sitz baths.  I knew I needed surgery but just didn't want to face it.


A few weeks ago I finally broke down and went to see a new GI doctor about it.  He quickly informed me that colorectal surgery is outside his purview.  He also looked through my records and couldn't find any evidence of the Celiac bloodwork that was supposedly done last March.  He thinks my general symptoms very much sound like Celiac but at this point I would have to go back to eating gluten for at least 2 weeks before testing, and even then I might get a false negative.  Same problem for blood test or endoscopy. Test results or no test results, I know that gluten is causing me pain and problems so the treatment is they same whether or not I have confirmed Celiac.  I haven't decided whether to take the test or not.


Anyway, the GI doctor referred me to a general surgeon who initially gave me an appointment almost 8 weeks away, and then after I bragged about my impressive bleeding, somehow got me an appointment the next day. Funny how that works.



The Operation


So this general surgeon, Dr. John Choi in Poughkeepsie, does a newish hemorrhoid procedure called THD - Transanal Hemorrhoidal Dearterialization.  For more information see (I have to admit, I was a little put off by the fact that the website has the word America in it... weird branding but I guess it's a proprietary procedure).  There is no cutting of tissue and it's supposed to be far less invasive, with a much faster recovery time, than a traditional hemorrhoidectomy. Plus, there is a lower rate of recurrent hemorrhoids. The procedure basically involves stitching up the major arteries that feed the hemorrhoids, thus cutting off the blood flow, and then suturing along the artery to pull up the excess tissue.  It's relatively new in America and not very many doctors are doing it -- perhaps because colorectal specialists (formerly known as proctologists) tend to be an older bunch and not open to newfangled ideas. 





I was told I'd be back to basically normal after four days, with no heavy lifting for two weeks.  There was a chance I could be back at work after 48 hours.  So I went into the hospital thinking of the surgery as a very minor procedure.  I underestimated.  To be fair, so did my doctor.


I had the operation in the morning, under general anesthesia, and was home by 2:30pm, feeling fine.  Having a history of allergic reactions to medications and knowing I have a high tolerance for pain, I turned down the option to pick up the prescription painkillers.  I didn't realize how effective the local anesthetic was until it wore off around midnight.  I was up all night in agony.


The next morning I sent my husband out for the prescribed Percocet, and that helped a lot.  The level of discomfort and pain I have with the Percocet is about what I had been expecting without any meds.  Two days later, and I'm still in pretty intense pain when the Percocet starts to wear off.  I have a constant feeling of pressure as if I have to have a bowel movement and passing gas is awful.

I called the doctor's office today to find out if this is normal, and the nurse said, yes, totally normal and I'll probably want to stay on the pain medicine for two weeks.  WHAT? I was wondering why there were 50 pills in the bottle! What happened to 48 hours and back to work? What about 4 days and back to normal?  She said, SOME people do have that experience, but that Dr. Choi sutured six major arteries around my anus, and that's a lot of stitches and a lot of healing.  For most people, that means weeks of pain. She also said the doctor tends to minimize the pain to be expected because he's comparing it to traditional hemorrhoid surgery which is so much worse.  Um... he should rethink that and maybe give people a more realistic idea of what to expect.


So, I guess it will be weeks of working around the timing of taking the Percocet so I can still drive the kids to school and myself to work, hope that I can function well enough on the pain meds during the day, wait for them to wear off so I can pick up the kids and drive home.  I gather that farting and shitting will be painful for weeks.

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