Sunday, July 1, 2012

TMI Hemmies and Hernies

I had outpatient surgery on Wednesday for hemorrhoids, and I just haven't felt up to writing over the past few days. The recovery's been going well, and I've been taking Vicodin for pain. It tends to make me sleepy and nauseous. Most of the time I can manage my pain with Ibuprofen alone, but last night I had my first bowel movement after surgery. Today I feel like I'm starting all over in the healing process.

"Hemmies" are an embarrassing talking or even writing point. In fact, I can't believe I just wrote about them in this blog! I am hoping that my experience encourages others to get hemmie help sooner rather than later. Hemorrhoids are mentioned in writings across the ages and have afflicted famous and infamous people alike, but that doesn't make it any sunnier when dealing with discomfort where the sun don't shine.

I've been harboring hemorrhoids since my first fullterm pregnancy in 1996. Hemorrhoids are swollen varicose veins in the anal canal. They can occur internally or externally, and increased pressure can cause them to swell. Everyone's got them, but only some suffer. My hemmies tend to flare during my monthly flow, but at the beginning of May they became a major pain in my ass. I had one explosive stool that setoff a blaze. Every time I had a bowel movement it felt like I was passing razor blades. My anus would burn for a couple hours after, and the only thing that gave me any relief was wrapping an ice cube in a paper towel and shoving it between my butt cheeks. I tried nearly every tip I could find on the internet to help alleviate the discomfort - hot sitz baths, witch hazel wipes, Preparation H, various creams and ointments as well as natural home remedies. Nothing seemed to help, and the longer I suffered physically the more I broke down emotionally. Screaming and crying as I voided, curling up in the fetal position on my bed, weeping and sobbing for relief I finally accepted the need to see a doctor.

My hemmies weren't noticeably engorged with blood or thrombosed so my doctors's initial plan to lance them providing instant relief didn't come to fruition. Instead, I was prescribed steroid suppositories to help calm and sooth the swelling and irritation. After two weeks, my condition did not improve.

During my followup, I talked to my doctor about a softball-sized lump in my abdomen. I'd lost weight, and this bulge was more pronounced. I thought maybe it was putting pressure on my pelvic area aggravating my hemorrhoids. The doctor sent me for an abdominal and pelvic ultrasound. Thankfully, she also wrote me a new prescription for an ointment containing 5% Lidocaine to help numb my hemmie pain.

The radiologist reported an umbilical hernia. A hernia is a bulge of small intestine that manages to work its way outside the abdominal muscle wall near the belly button. I underwent a hernia repair in 2006. The surgeon inserted mesh into my abdominal wall for reinforcement, and I assumed it would prevent any future problems. The ultrasound also showed an abnormally thick lining with a small fibroid in my uterus and a 1.5" mass on one of my ovaries, probably a cyst.

My doctor called me immediately and referred me to a general surgeon. This surgeon had already performed two previous abdominal surgeries on me. He removed a fistula from my abdomen in July of 2002 and repaired my first hernia.

Presenting with a high fever and pressure in my abdomen one week post cesarean section in June of 2001, I underwent a medical procedure performed on a CT table to drain an abscess that had formed in my abdomen. After using a local numbing agent, a doctor and CT tech used the imager to help guide a giant needle through my abdomen directly to the abscess and drain it. Miraculously, my body managed to wall off the infection. I watched the medical team fill two 32-ounce Nalgene-like bottles with this vile smelling brown puss during the first procedure. Lab results proved the fluid contained e. coli and other intestinal bacteria. When finished, the doctor sutured a tube and surgical drain into place, and I sported the device for nearly a month. In addition I was treated with heavy duty IV antibiotics followed by antibiotics in pill form when I was sent home from the hospital a week later. After a year the pain and pressure in my abdomen seemed to return. After more tests, imaging and another CT procedure to drain the infection from my abdomen I met with my general surgeon who recommended open cavity surgery to remove a fistula that had formed and repair my small intestines likely at the root of the problem and leaking into my abdominal cavity.

Now it's 2012, and I'm diagnosed with a second hernia, an intrauterine fibroid, a mass on one of my ovaries and a case of horrible hemmies! On Wednesday my surgeon removed 3 external hemorrhoids plus a skin tag. I am nervous about my recovery and getting back on track with my weight loss quest after a doctor mandated 10-day break from biking, running, lifting and working out. I do plan on trying to take a nice walk tonight, though. I'm worried this speed bump is going to slow my progress. I stepped on the scale the day after surgery and gained 6 pounds surprising since I didn't really eat anything. I know it was because of all the fluids they pumped into me for surgery, but it's still disheartening to see a gain.

So far, the pain from the hemmie surgery pales in comparison to my suffering these past couple months. However, last night I thought I was going to pass out having my first bowel movement post surgery. I've been taking Miralax and stool softener since the surgery, and my surgeon warned me that I'd want to load up on the pain meds and Lidocaine before my first BM. I even did some reading online about it, but I must say that I was wholly unprepared for the shear agony of it. Straining and screaming at the top of my lungs, it felt like that I was pushing a pool ball through my b-hole. Even with soft excrement it was excruciating! I've had a couple more BMs today, and thankfully they were a lot easier and definitely not as painful. I'm using witch hazel wipes to clean and continue to reapply the Lidocaine. I've also had couple warm sitz baths. I am crossing my fingers that this surgery ends my hemmie suffering!

I still need to schedule a hernia repair with my surgeon, and I'm having a followup pelvic ultrasound in August to check the fibroid and mass on my ovary for growth. I talked to my primary care physician and surgeon about a possible abdominoplasty/tummy tuck along with my hernia surgery. Neither dissuaded me from looking in to it. My general surgeon works with a plastic surgeon, and I am going to do a consultation. I'm just not sure if my health insurance will cover an abdominoplasty. I doubt I can afford to do it otherwise.

Since I've had several abdominal surgeries my muscle wall is weak. My fat tends to gather around my mid-section resulting in a belly apron. Since, I've lost a lot of weight already my belly sags and pulls. I've been doing crunches and planks trying to increase my muscle tone. I want to shed another 70 pounds before I schedule a hernia repair and an abdominoplasty. It's just something I'm considering. It would definitely help during my workouts not to have all the excess skin hanging around my midsection. I'm not even sure if it's even possible to fix my belly apron with exercise alone after a 140 pound weight loss.

Today, I am just going to concentrate on recovering from this hemorrhoidectomy without gaining weight. That means adjusting my caloric intake to meet a more sedentary lifestyle.

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