How to survive a hemorrhoidectomy: Hemorrhoid surgery can be hard to heal. This is my advice to patients for before and after surgery. for more information, go to www.drtoker.com
I have internal and external hemorrhoids. Currently doing my research so i can have a successful recovery. Thank you for all the informative information.
25:07 very informative I’m 2weeks after surgery, and was not told any of this!!! I now feel satisfied with knowing this pain, swelling is normal… thank you x
Goldmine. I find it such a funny thought that im getting an awesome informative consultation from a texan, while sitting here in copenhagen with a broken butt. I love your style, and your video has really put me quite a bit more at ease with this whole thing. Gonna take your advice to heart. Thank you for this.
Good luck! European surgeons sometimes leave all suture lines open, dont panic if that seems different than anything I describe. Outcomes are the same. I hope they can do something minimally invasive! Is Copenhagen known for its bicycles? It may be a while before you can do that after a traditional hemorrhoidectomy
@@drannatoker before i got outsourced to a private hospital (free of charge, god bless my country) my surgeon did say that they leave the wounds open afterwards. Maybe the surgeon im being transferred to, will shift the plan, ill see. Yeah, we love our bikes, but luckily we are spoiled with a fantastic metro system in the innermost city where i live. Gets you everywhere. Perfect for a sore hiney.
Brilliant and adorably comical in a tough situation. I've heard that the mosquitoes in Texas are the size of helicopters, but right now I wish I lived in Texas so that you could be my doctor! Thanks so much for this very valuable information!
This is probably the best soothing video following my surgery, 2 days ago. Have had the piles since 89 after eating too many military ration packs. I was at level 4 in them bastards. Can't believe I waited that long. So far, the pain is the same I had before the surgery so I'm waiting for the other show to fall!!!! lol
Love this video! I know I have a stage 4 external hemorrhoid, got spoked, and canceled a surgery a few years ago. Going in for a new consult after talking with my primary doctor about colonoscopy life now that I'm in my mid-40's. I've never had a second consult so it'll be interesting if this surgeon says anything different. Dreading the idea of this surgery butt.... here we are. :-)
Hi, I loved your video! Quick question. I was avoiding using ice because I read it delays healing. Is that true? And in thst case, is it worth the trade-off?
I’m over 3 months post op now and have delayed healing. Still need gauze pads for drainage. According to my surgeon muscle spasms are what’s delaying things. I wish I saw this video before my surgery. Might have sped things up a bit. But even though pain is still disruptive after bowel movements, things are certainly more tolerable than they used to be as recently as a month ago. Currently applying Diltiazem topically 3x daily to relax things a bit, and going for another post op visit next week. I’m glad I didn’t wait to do the surgery for too long after hearing the horror stories out there, but boy I would be happy to finally get my life back soon.
@@sawmyaj things gradually improved until the wound finally healed at the 6 month mark. But muscle spasms have persisted ever since. I started seeing a pelvic floor physical therapist and while the internal muscle function has improved slightly, things are still out of whack. Fortunately, even though I’m still not fully back to normal, this is something I can live with for a while. I’ve been told it’s okay that things are taking this long. If physical therapy doesn’t get me where I need to be by this summer, I may consider Botox injections.
Thank you very much. If I go to surgery, I would want a doc like you. I've been avoiding surgery for past 5 years - 4th stage haemorrhoids both external and internal. What opened my eyes is that 2 years back when I had both fissure and thrombosed roids togeather, I didn't go to the loo for a week. Didn't have food. Basically it was hell. I appreciate your advise that regularity is important even then. But the thought of it scared the hell out of me. Some time back i became anaemic due to the blood loss. Seeing this video has again opened my eyes to go under the knife. Shortly, this is how I managed my roids - Senna, docustate sodium, Psyllium husk, NAC, Turmeric, Daflon some times, rutin, vitamin c, vitamin b6, b-complex, moringa, keto diet and intermittent fasting. I'm no longer anaemic. And I'm regular. Reducing the inflammation has solved 50% of the problem. But no matter what I do, the pile mass is not going away. I'm trying an ayurvedic herb for reduction of the pile mass. Do you think I'm on the right track (I'm from Asia)?
I would have a doctor look to make sure the diagnosis is correct. But typically, if you have large hemorrhoids, there will always be tissue there- unlikely to go away with topical treatments. Have a surgeon do the exam - they will give you best options. Good luck
@@Skandiilicious Thank you Doc, appreciate it. I did go to a surgeon in 2019 and after examination, he confirmed "large piles" and recommended surgery. My haemorrhoids started at the age of 17 and I'm 49 now. My mother's side is prone to haemorrhoids. I'm not applying any tropical creams and i don't have pruritus nor pain or bleeding now. But i would like to stop the supplements and lead a normal life. Is there any way to reduce the pile mass without surgery? Thank you.
Excellent video! Thank you so much for the valuable info that we all need to hear, but seems so simplistic to the medical world. Please recommend what Magnesium supplement we should take on a nightly basis for muscle relaxation?
I am a fan of whole food supplements. Standard Process makes a magnesium supplement that I use, but- it probably does not matter on brand. Always clear supplements with your doctor if you have a chronic illness, are pregnant, or are on other meds
Glad I found you. I have the 3 that are a grade 3 and 4. Having hemorrhoid surgery in a few days for them. I am in a ridiculous amount of pain, have been in bed a week, and I don’t want to use narcotics. Thank you. Ps… how long would you keep a nurse off work who works 12+ hour shifts?
@@barrymichaels2663 update it’s been 15 days since surgery and I had my two week check up. He said I will be off work 8 weeks because of my heavy workload. Although surgery is painful the pain before surgery was so much worse. I bought all the products you give your patients and I only took 1 Norco 5/325 on day 4 and 5. Your advise helped me so much. Thank you. The surgery is worth it and doable without Narcotics.
Avoiding constipation is critical after rectal surgery, but you must avoid diarrhea as well! Starting prior to surgery, you should take a fiber supplement (powder mixed in water such as citrucel), a stool softner, and a pro-biotic. You will want to continue these supplements after the surgery as well to improve your healing. You may want to consider several holistic supplements as well- NOW brands has many of these items online... 1) n-Acetylcysteine (NAC) 600 mg daily. This is a good anti-inflammatory. 2) Inulin and Pectin supplements are prebiotic foods that can sup port the probiotic supplements suggested 3) L- Glutamine 500 mg is an amino acid your intestines like and c an promote more normal bowel function 4) Arnica montana, quercetin and zinc all help minimize bruising, take as directed on the bottle- Arnica is typically a topical cream, quercetin and zinc come in tablet form 5) Turmeric- a great anti-inflammatory- you can get at any grocery store, a medical grade version is made by Standard Process. 6) Boswellia can be found at many whole food groceries- Standard process has a medical grade boswellia which is combined with ginger and turmeric and is available online.
I’m 5 days PO with no constipation. BMs are becoming too active in one setting. My stools are borderline too soft. Yesterday I had 4 morning BMs. Today I had 3. I’m also weaning off pain meds and transitioning to natural supplemental anti-inflammatories that you mentioned. Not asking for medical advice here, but if you were me, would you take a bit less magnesium and fiber to balance things out?
Your video is amazing! So reassuring and knowledgeable. What kinds of foods should someone look to eat after a hemorrhoidectomy? And how soon can someone eat after surgery to ensure they have a BM fairly soon and stay regularly after surgery?
@@Skandiilicious ok so don’t wait a day to eat? Like the morning after, so it as soon as you can, for example if it’s done in the morning can you eat in the afternoon or should you give your body some time to heal before a BM? Also are there any foods you suggest? And can you keep taking the supplements right after the surgery too along with the medication prescribed by the doctor? I know you said you do NOT want to take narcotics and get constipated and I think that’s great! Lord knows there’s an epidemic around those types of drugs too
@@KatoMac8888 start eating when you get home as normal as possible. Ok to take supplements. And any high fiber food you can normally tolerate. Fiber supplement you mix in water. As for suggested foods- kiwi fruit is good source of fiber
Thank you so much for the info! I have gone to many docs and haven’t gotten hardly any information like this. How long should one take the supplements after surgery?
@@Skandiilicious Got it! Another question, do you recommend and specific arnica Montana cream, and should it be applied internally like other hemorrhoid creams or just at the opening?
@@lashellora93 the best arnica are the little pearl tabs. The cream can be applied directly if that is what you have. Beware of skin irritation as some creams are water based and the butt likes oil based ointments
I did it 5 days ago still no bm i took to many stool softener still nothing the pain is awful just from passing gas i was about to faint everything was black the first time i went to the bathroom i never thought i would envy ppl for having a normal bowel movement😥
You will want to be seen by a colorectal surgeon. If you are post-op, you may be developing scar tissue that needs to be broken up- your surgeon needs to see this and if that surgeon is a general surgeon go seek a specialist. This video is intended for my personal patients and with that complaint I would have a look to see how to intervene
Am 8 days after surgery, after watching this, i regret going to the general surgeon who didn't even check me and just said surgery..... Now am suffering, i even feel hemorrhoids were better than after surgery..... Am in South Africa and wish had seen this earlier. I even feel most of the things are doing are based on the Internet as doctor didn't tell me anything to take care if this besides drinking water and eating fibre. Sharks!!! I've been opening my legs while resting for a week now, I'll start closing and putting ice to make sure i don't swell. I drink movicol for. Stool softener,, i think it works as i have no diarrhoea. The only thing is its so paonful when i poop that i can end up poop 3-4 times in an hour. But once done, i can only poop next day. But still would take me an hour to get evrything up, like sit 2-3min, standup, then starts again! Thank you once more
I had the milligan an Morgan done 6 days ago, yesterday was my first BM and I have diarrhea for years now, and I can't seem to get rid of it. Sometimes it's better but I can't seem to find the source of the problem. No food allergies, no parasites,... Pain is starting to get better but more annoying and therefore might even say worse because of the duration. .. waking up with pain is heavy for me, might set an alarm just to get my painkiller on time...
For diarrhea- take fibercon tablets (compressed psyllium fiber)and for the surgery- as much hot baths and ice alternating as possible- it helps. Diarrhea and this operation are a bad combo
@@Skandiilicious thanks ! I just bought Kamilosan solution to add to my sitz baths, I heard it helps with the healing. For now I've only been able to rinse well with the shower head bc of the pain when sitting or bending over, then I always feel like a wound opening up again and needs to grow new skin all over again... I'm guessing healing seems to be fine for now, but I have no reference to compare. Just had my second BM, a lot less blood loss compared to two days ago! No fever so far. I'm gonna look into the fibercon tablets! Wondering why none of the doctors I've seen so far recommended me something similar as I've had 2 gastrointestinal exams so far, recently one and one 1,5 year ago... The main reason being diarrhea and second time also for the pain and they couldn't point anything out to be wrong as for the diarrhea, second time I had a polyp and a very inflamed fissure removed !! Blood work also came in pretty normal except for low iron and something else but that was to be expected if one is struggling with diarrhea the GP told me... I am now looking into going to a physio therapeute to check out my pelvic floor if that's not too tight as a friend recommended me to do so. If that doesn't help, maybe a dietitian. I don't eat processed foods, I eat fruit and veggies almost daily, I drink sufficient amounts of water and I have an intensive labor forestry job and am pretty fit. I consider myself above average healthy. I rarely use any kind of medication... only for things like after surgery or something, never for a cold, which I rarely ever had in my life. ...and limit my soda and sugar intake... It's been a struggle but I do have had an aneurysm bursted back in 2019 and after a month and a week in the hospital it just got worse, before it was 50/50 chance of diarrhea now it's 100% of the time I have a BM. I never have to run to the toilet, but I noticed it's always yellowish or oker colored. usually it also floats but not always. anyways, again thank you so much for responding before! 🍀 have a nice day!
@@Skandiilicious thanks for your response. I know its hard because i am not your patient and you have no looked at my condition. But if i had a choice of a doctor who uses the ligasure and a doctor that uses the traditional method, will going with the ligasure greatly reduce the pain and healing time? Or in the end it doesnt matter?
@@Yalbou good question. The pain is actually more related to the part you do in the skin and that part is not done with ligasure. So- your best approach would be to find a board certified colorectal surgeon who is over the age of 40 but younger than 60. That would likely ensure a surgeon who uses latest tech (although not necessarily-ask)
Hello thank you for sharing your knowledge. I am almost 6 days post and this am i did my second bowel movement and i saw a bit a blood. Tonight i have started bleeding first time.. is that normal? Thanks
Thank you for the video!!! Have any of your male patients reported genital pain following a BM post surgery? Every time now I have a BM, I get this horrifying pain on my left testicle and I don’t know what to do
Disclaimer: because I am not able to examine you I can not comment to your situation. As a general statement, Pain after this surgery is driven by muscle spasm which can affect all pelvic structures. You should see your surgeon to make sure there are no other issues before assuming muscle spasm is cause of this issue
Is Mayinglong Musk cream good to heal internal hemorrhoids? My surgeon said that I need to have a hemorrhoidectomy. I’m losing a lot of blood when trying to have a bowel movement. Sometimes I’m not even trying to have one and the blood just flows out. But I honestly don’t want to have the surgery. I’m hoping that the cream will help. What should I do?
@@matthewtokerclassof24dline36 I’ve had multiple colonoscopies. I’ve had hemorrhoids banding at least 7 times. The last time I had a colonoscopy the surgeon banded off 2 hemorrhoids. That’s when I was told to have the hemorrhoidectomy
Another quick question I got to ask I heard from another doctor is X Parell I heard that they can inject you with that before waking up from surgery and it’s supposed to not let you have pain for two days would you recommend that if so I wonder why doctors never tell Us patients that
@@nathanieldeans1226 my pleasure. My generation of surgeons is a dying breed. Before I retire I want to at least educate folks on what the hell is going on. Docs just wont tell you. In their defense- they dont have the time. We are expected to see a triple load of patients so education goes right out the window
This was great advice. I had the surgery but 1 week later I had an external hemorrhoid come out and now I am trying to heal from two incisions and an external hemorrhoid. Is there anything I can do about the external hemorrhoid while I continue to heal? I am on week 4 from the surgery. Thanks.
It is possible this external hemorrhoid is just severe swelling in an incision (most commonly is the case) have surgeon look, but, ice, pressure, ibuprofen and time are the best approach. Consider a clean non inflammatory diet. Go to cleanflex.kyani.com and shop for the nitro nutrition 21 day challenge. This may help calm things down. If that is too complex, get the triangle of health whole food supplements- should improve healing process
The more research I do…I think it might be a skin tag from the surgery. Is there anything I can do for that or just want to heal and see my specialist on August 30 which is another 4 weeks. Let me know. Your help has been greatly appreciated.
@@ellenahodder4148 wait 3 months before making any decision, most of those inflamed tags calm down snd never need removal. Your surgeon will know what to do
Already I enjoyed your video I I have a question and that is I'm having this procedure done in 5 days from today and with that same procedure they're going to do an upper GI and a colonoscopy and then this surgery do you recommend that
The main difficulty with this approach is that bowel preps can cause bowel habit changes for a week or two. Both diarrhea and constipation are bad for the healing process. For this reason, I try not to do surgery the same day as colonoscopy- unless the surgical plan is hemorrhoid banding or HET. An excisional hemorrhoidectomy will struggle to heal if you have diarrhea or constipation. You can try to avoid this issue by maintaining a high fiber diet, probiotic, and stool softener (if needed). Avoid narcotic pain meds. From an insurance standpoint, your colonoscopy will no longer be considered screening if combined with surgery. This will not change the surgeons fees, but the facility fees will increase as a result depending on your location of service. Tempting as it id to make one trip to the OR, the decision can cost several thousand dollars and worse yet, lead to a couple weeks of post-prep diarrhea that may cause anal stenosis, chronic pain, and potentially the need for more surgery.
The main difficulty with this approach is that bowel preps can cause bowel habit changes for a week or two. Both diarrhea and constipation are bad for the healing process. For this reason, I try not to do surgery the same day as colonoscopy- unless the surgical plan is hemorrhoid banding or HET. An excisional hemorrhoidectomy will struggle to heal if you have diarrhea or constipation. You can try to avoid this issue by maintaining a high fiber diet, probiotic, and stool softener (if needed). Avoid narcotic pain meds. From an insurance standpoint, your colonoscopy will no longer be considered screening if combined with surgery. This will not change the surgeons fees, but the facility fees will increase as a result depending on your location of service. Tempting as it id to make one trip to the OR, the decision can cost several thousand dollars and worse yet, lead to a couple weeks of post-prep diarrhea that may cause anal stenosis, chronic pain, and potentially the need for more surgery.
The only laser for anorectal surgery in the US is an adler micromedi ablative laser for fistulas. You can use that laser for pilonidal cysts as well. You can Yag laser condylomas and skin lesions but as of now, there is no FDA approved hemorrhoidal laser that has insurance approval or long term outcomes trials. There is a IR device which does not work. There is a bipolar device I love called an HET. The mainstays of hemorrhoids then are THD, PPH (losing favor) and excisional. Rubber banding like IR is short lasting, limited by anatomy. So which laser do you use in your practice that is covered by insurance and effective?
@@drannatoker Never said I was a doctor. Just asking why lasers are used in hemorrhoid surgery. They are widely used world wide. Yes, the FDA and insurance companies do restrict it's use.
You may want to consider several holistic supplements as well- NOW brands has many of these items online... 1) n-Acetylcysteine (NAC) 600 mg daily. This is a good anti-inflammatory. 2) Inulin and Pectin supplements are prebiotic foods that can sup port the probiotic supplements suggested 3) L- Glutamine 500 mg is an amino acid your intestines like and c an promote more normal bowel function 4) Arnica montana, quercetin and zinc all help minimize bruising, take as directed on the bottle- Arnica is typically a topical cream, quercetin and zinc come in tablet form 5) Turmeric- a great anti-inflammatory- you can get at any grocery store, a medical grade version is made by Standard Process. 6) Boswellia can be found at many whole food groceries- Standard process has a medical grade boswellia which is combined with ginger and turmeric and is available online.
@@Skandiilicious Thanks for this helpful information. Can we take these all at once, and is there an optimatl time of day to take them? I've been dealing with a horrible (doctor-inflicted) anal fissure for 6 months and am finally scheduled for a hemorrhoidectomy, fissurectomy, and fistulotomy and hope to minimize pain as much as possible
Yes because one of the methods for dealing with them is banding and there structure versus external hemorrhoids which are more bumpy versus internal which kind of droop. The base of a internal hemorrhoid has barely if at all any pain stimulus which is where they band it to cut off blood flow to it, so it basically dies and just falls off when you go potty
@@drewcrawford447 warm hearing pad wont do it. You have to sit in waist level warm as tolerable water to get the muscle relaxation. Not everyone likes a cold shower- so I suggest cold packs to area such as zip lock bag with dry rice that is kept in freezer and used intermittently. But please keep in mind- as a legal matter, I am not giving medical advice right now
Wish I had seen this before my hemorrhoidectomy and you could have been my Dr.
I have internal and external hemorrhoids. Currently doing my research so i can have a successful recovery. Thank you for all the informative information.
Best video on hemorrhoids that I found so helpful
Glad it was helpful!
25:07 very informative I’m 2weeks after surgery, and was not told any of this!!! I now feel satisfied with knowing this pain, swelling is normal… thank you x
Goldmine.
I find it such a funny thought that im getting an awesome informative consultation from a texan, while sitting here in copenhagen with a broken butt.
I love your style, and your video has really put me quite a bit more at ease with this whole thing.
Gonna take your advice to heart.
Thank you for this.
Good luck! European surgeons sometimes leave all suture lines open, dont panic if that seems different than anything I describe. Outcomes are the same. I hope they can do something minimally invasive! Is Copenhagen known for its bicycles? It may be a while before you can do that after a traditional hemorrhoidectomy
@@drannatoker before i got outsourced to a private hospital (free of charge, god bless my country) my surgeon did say that they leave the wounds open afterwards.
Maybe the surgeon im being transferred to, will shift the plan, ill see.
Yeah, we love our bikes, but luckily we are spoiled with a fantastic metro system in the innermost city where i live. Gets you everywhere.
Perfect for a sore hiney.
Brilliant and adorably comical in a tough situation. I've heard that the mosquitoes in Texas are the size of helicopters, but right now I wish I lived in Texas so that you could be my doctor! Thanks so much for this very valuable information!
Ah shucks! That is very kind. An informed patient recovers well, so I try to make sure folks know what to expect. Thanks for watching
This is probably the best soothing video following my surgery, 2 days ago. Have had the piles since 89 after eating too many military ration packs. I was at level 4 in them bastards. Can't believe I waited that long. So far, the pain is the same I had before the surgery so I'm waiting for the other show to fall!!!! lol
Love this video! I know I have a stage 4 external hemorrhoid, got spoked, and canceled a surgery a few years ago. Going in for a new consult after talking with my primary doctor about colonoscopy life now that I'm in my mid-40's. I've never had a second consult so it'll be interesting if this surgeon says anything different. Dreading the idea of this surgery butt.... here we are. :-)
Hi, I loved your video! Quick question. I was avoiding using ice because I read it delays healing. Is that true? And in thst case, is it worth the trade-off?
I’m about to get maybe! Thank you
Howd it go?
Thank you I'm getting ready for surgery in a month
Howd it go?
I’m over 3 months post op now and have delayed healing. Still need gauze pads for drainage. According to my surgeon muscle spasms are what’s delaying things. I wish I saw this video before my surgery. Might have sped things up a bit. But even though pain is still disruptive after bowel movements, things are certainly more tolerable than they used to be as recently as a month ago. Currently applying Diltiazem topically 3x daily to relax things a bit, and going for another post op visit next week. I’m glad I didn’t wait to do the surgery for too long after hearing the horror stories out there, but boy I would be happy to finally get my life back soon.
It's been 8 months how's your healing? I hope it's fully😊 heal.
@@sawmyaj things gradually improved until the wound finally healed at the 6 month mark. But muscle spasms have persisted ever since. I started seeing a pelvic floor physical therapist and while the internal muscle function has improved slightly, things are still out of whack. Fortunately, even though I’m still not fully back to normal, this is something I can live with for a while. I’ve been told it’s okay that things are taking this long. If physical therapy doesn’t get me where I need to be by this summer, I may consider Botox injections.
@@duncanmcauley7932 ...as a sufferer, that is my man, a real pain in the ass!!! lol
Thank you very much. If I go to surgery, I would want a doc like you. I've been avoiding surgery for past 5 years - 4th stage haemorrhoids both external and internal. What opened my eyes is that 2 years back when I had both fissure and thrombosed roids togeather, I didn't go to the loo for a week. Didn't have food. Basically it was hell. I appreciate your advise that regularity is important even then. But the thought of it scared the hell out of me. Some time back i became anaemic due to the blood loss. Seeing this video has again opened my eyes to go under the knife.
Shortly, this is how I managed my roids -
Senna, docustate sodium, Psyllium husk, NAC, Turmeric, Daflon some times, rutin, vitamin c, vitamin b6, b-complex, moringa, keto diet and intermittent fasting.
I'm no longer anaemic. And I'm regular. Reducing the inflammation has solved 50% of the problem. But no matter what I do, the pile mass is not going away.
I'm trying an ayurvedic herb for reduction of the pile mass. Do you think I'm on the right track (I'm from Asia)?
I would have a doctor look to make sure the diagnosis is correct. But typically, if you have large hemorrhoids, there will always be tissue there- unlikely to go away with topical treatments. Have a surgeon do the exam - they will give you best options. Good luck
@@Skandiilicious Thank you Doc, appreciate it. I did go to a surgeon in 2019 and after examination, he confirmed "large piles" and recommended surgery. My haemorrhoids started at the age of 17 and I'm 49 now. My mother's side is prone to haemorrhoids. I'm not applying any tropical creams and i don't have pruritus nor pain or bleeding now. But i would like to stop the supplements and lead a normal life. Is there any way to reduce the pile mass without surgery? Thank you.
@@SkandiiliciousHello Doctor, have there been cases in the world where all 6 hemorrhoids have been removed, thank you
@@lior2551 yes. The procedure THD always removes 6 internal hemorrhoids. On occasion 6 externals are removed but that surgery sucks!
@@drannatokerThanks, but the question is whether a hemorrhoidectomy removes 6 hemorrhoids, have they done such surgeries?
Excellent video! Thank you so much for the valuable info that we all need to hear, but seems so simplistic to the medical world. Please recommend what Magnesium supplement we should take on a nightly basis for muscle relaxation?
I am a fan of whole food supplements. Standard Process makes a magnesium supplement that I use, but- it probably does not matter on brand. Always clear supplements with your doctor if you have a chronic illness, are pregnant, or are on other meds
@@Skandiilicious Hello Dr., I wanted to know if you inject exparel for pain?
@@lior2551 I like exaparel for pain but it does lead to increased urinary retention. Lately I have been using zynrelef instilled with in wounds
Glad I found you. I have the 3 that are a grade 3 and 4. Having hemorrhoid surgery in a few days for them. I am in a ridiculous amount of pain, have been in bed a week, and I don’t want to use narcotics. Thank you. Ps… how long would you keep a nurse off work who works 12+ hour shifts?
The first 10 days are the worst.
@@barrymichaels2663 update it’s been 15 days since surgery and I had my two week check up. He said I will be off work 8 weeks because of my heavy workload. Although surgery is painful the pain before surgery was so much worse. I bought all the products you give your patients and I only took 1 Norco 5/325 on day 4 and 5. Your advise helped me so much. Thank you. The surgery is worth it and doable without Narcotics.
Avoiding constipation is critical after rectal surgery, but you must avoid diarrhea as well! Starting prior to surgery, you should take a fiber supplement (powder mixed in water such as citrucel), a stool softner, and a pro-biotic. You will want to continue these supplements after the surgery as well to improve your healing.
You may want to consider several holistic supplements as well- NOW brands has many of these items online...
1) n-Acetylcysteine (NAC) 600 mg daily. This is a good anti-inflammatory.
2) Inulin and Pectin supplements are prebiotic foods that can sup port the probiotic supplements suggested
3) L- Glutamine 500 mg is an amino acid your intestines like and c an promote more normal bowel function
4) Arnica montana, quercetin and zinc all help minimize bruising, take as directed on the bottle- Arnica is typically a topical cream, quercetin and zinc come in tablet form
5) Turmeric- a great anti-inflammatory- you can get at any grocery store, a medical grade version is made by Standard Process.
6) Boswellia can be found at many whole food groceries- Standard process has a medical grade boswellia which is combined with ginger and turmeric and is available online.
I’m 5 days PO with no constipation. BMs are becoming too active in one setting. My stools are borderline too soft. Yesterday I had 4 morning BMs. Today I had 3. I’m also weaning off pain meds and transitioning to natural supplemental anti-inflammatories that you mentioned. Not asking for medical advice here, but if you were me, would you take a bit less magnesium and fiber to balance things out?
Thank you!
Your video is amazing! So reassuring and knowledgeable. What kinds of foods should someone look to eat after a hemorrhoidectomy? And how soon can someone eat after surgery to ensure they have a BM fairly soon and stay regularly after surgery?
Eat a regular diet high in fiber and start immediately after surgery. The goal is normal bowel function to promote healing
@@Skandiilicious ok so don’t wait a day to eat? Like the morning after, so it as soon as you can, for example if it’s done in the morning can you eat in the afternoon or should you give your body some time to heal before a BM? Also are there any foods you suggest? And can you keep taking the supplements right after the surgery too along with the medication prescribed by the doctor? I know you said you do NOT want to take narcotics and get constipated and I think that’s great! Lord knows there’s an epidemic around those types of drugs too
@@KatoMac8888 start eating when you get home as normal as possible. Ok to take supplements. And any high fiber food you can normally tolerate. Fiber supplement you mix in water. As for suggested foods- kiwi fruit is good source of fiber
@@Skandiilicious thank you so much! The world needs more dedicated, caring and resourceful doctors like you!
Thank you so much for the info! I have gone to many docs and haven’t gotten hardly any information like this. How long should one take the supplements after surgery?
I would start 2 weeks ahead, continue 4 weeks after
@@Skandiilicious Got it! Another question, do you recommend and specific arnica Montana cream, and should it be applied internally like other hemorrhoid creams or just at the opening?
@@lashellora93 the best arnica are the little pearl tabs. The cream can be applied directly if that is what you have. Beware of skin irritation as some creams are water based and the butt likes oil based ointments
@@Skandiilicious super helpful. Thank you so much.
I did it 5 days ago still no bm
i took to many stool softener
still nothing the pain is awful just from passing gas i was about to faint everything was black the first time i went to the bathroom
i never thought i would envy ppl for having a normal bowel movement😥
You will want to be seen by a colorectal surgeon. If you are post-op, you may be developing scar tissue that needs to be broken up- your surgeon needs to see this and if that surgeon is a general surgeon go seek a specialist. This video is intended for my personal patients and with that complaint I would have a look to see how to intervene
Sit in sitz bath relax and poop...it makes it wayyy easier
Am 8 days after surgery, after watching this, i regret going to the general surgeon who didn't even check me and just said surgery..... Now am suffering, i even feel hemorrhoids were better than after surgery..... Am in South Africa and wish had seen this earlier.
I even feel most of the things are doing are based on the Internet as doctor didn't tell me anything to take care if this besides drinking water and eating fibre. Sharks!!!
I've been opening my legs while resting for a week now, I'll start closing and putting ice to make sure i don't swell.
I drink movicol for. Stool softener,, i think it works as i have no diarrhoea. The only thing is its so paonful when i poop that i can end up poop 3-4 times in an hour. But once done, i can only poop next day. But still would take me an hour to get evrything up, like sit 2-3min, standup, then starts again!
Thank you once more
I am about to have the surgery next month 😢‼️
Great video Doctor!! On day 5 and the gauze has now caused a painful "diaper rash." Any advice? Thank you.
Switch to non woven gauze and make sure you are not putting neosporin on the area. Vaseline or zinc oxide are fine
@@drannatoker I've been using non-woven gauze. I also tried Desitin, but that doesn't help. I'll try your other suggestions. Thank you so much Doctor!
Sorry I missed this! Nonwoven gauze works best and keep area dry. Avoid neosporin!
I had the milligan an Morgan done 6 days ago, yesterday was my first BM and I have diarrhea for years now, and I can't seem to get rid of it. Sometimes it's better but I can't seem to find the source of the problem. No food allergies, no parasites,...
Pain is starting to get better but more annoying and therefore might even say worse because of the duration. .. waking up with pain is heavy for me, might set an alarm just to get my painkiller on time...
For diarrhea- take fibercon tablets (compressed psyllium fiber)and for the surgery- as much hot baths and ice alternating as possible- it helps. Diarrhea and this operation are a bad combo
@@Skandiilicious thanks ! I just bought Kamilosan solution to add to my sitz baths, I heard it helps with the healing. For now I've only been able to rinse well with the shower head bc of the pain when sitting or bending over, then I always feel like a wound opening up again and needs to grow new skin all over again... I'm guessing healing seems to be fine for now, but I have no reference to compare. Just had my second BM, a lot less blood loss compared to two days ago! No fever so far. I'm gonna look into the fibercon tablets! Wondering why none of the doctors I've seen so far recommended me something similar as I've had 2 gastrointestinal exams so far, recently one and one 1,5 year ago... The main reason being diarrhea and second time also for the pain and they couldn't point anything out to be wrong as for the diarrhea, second time I had a polyp and a very inflamed fissure removed !! Blood work also came in pretty normal except for low iron and something else but that was to be expected if one is struggling with diarrhea the GP told me... I am now looking into going to a physio therapeute to check out my pelvic floor if that's not too tight as a friend recommended me to do so. If that doesn't help, maybe a dietitian. I don't eat processed foods, I eat fruit and veggies almost daily, I drink sufficient amounts of water and I have an intensive labor forestry job and am pretty fit. I consider myself above average healthy. I rarely use any kind of medication... only for things like after surgery or something, never for a cold, which I rarely ever had in my life. ...and limit my soda and sugar intake... It's been a struggle but I do have had an aneurysm bursted back in 2019 and after a month and a week in the hospital it just got worse, before it was 50/50 chance of diarrhea now it's 100% of the time I have a BM. I never have to run to the toilet, but I noticed it's always yellowish or oker colored. usually it also floats but not always.
anyways, again thank you so much for responding before! 🍀 have a nice day!
What do you think about doing the surgery with tools such as the ligasure? Supposedly its a quicker and less painful surgery
I use the ligasure, I also do THD. But pain is pain. Follow the instructions
@@Skandiilicious thanks for your response. I know its hard because i am not your patient and you have no looked at my condition. But if i had a choice of a doctor who uses the ligasure and a doctor that uses the traditional method, will going with the ligasure greatly reduce the pain and healing time? Or in the end it doesnt matter?
@@Yalbou good question. The pain is actually more related to the part you do in the skin and that part is not done with ligasure. So- your best approach would be to find a board certified colorectal surgeon who is over the age of 40 but younger than 60. That would likely ensure a surgeon who uses latest tech (although not necessarily-ask)
Hello thank you for sharing your knowledge. I am almost 6 days post and this am i did my second bowel movement and i saw a bit a blood. Tonight i have started bleeding first time.. is that normal? Thanks
When in doubt go to ER, call your doctor
What is a good concentration of arnica montana? Is 6c any good?
6 c is best dose- follow directions on bottle as to frequency
Thank you for the video!!! Have any of your male patients reported genital pain following a BM post surgery? Every time now
I have a BM, I get this horrifying pain on my left testicle and I don’t know what to do
Disclaimer: because I am not able to examine you I can not comment to your situation. As a general statement, Pain after this surgery is driven by muscle spasm which can affect all pelvic structures. You should see your surgeon to make sure there are no other issues before assuming muscle spasm is cause of this issue
@@Skandiilicious thank you for the reply doc!!
@@sebastianleon1244hello how are you now still have pain?how long time full full recovery take for you?
Is the nasal spray called Sprix?
Yes. Ketorolac nasal spray is sprix.
Is Mayinglong Musk cream good to heal internal hemorrhoids? My surgeon said that I need to have a hemorrhoidectomy. I’m losing a lot of blood when trying to have a bowel movement. Sometimes I’m not even trying to have one and the blood just flows out. But I honestly don’t want to have the surgery. I’m hoping that the cream will help. What should I do?
Colonoscopy followed by surgery if the above advice is not helping
@@matthewtokerclassof24dline36 I’ve had multiple colonoscopies. I’ve had hemorrhoids banding at least 7 times. The last time I had a colonoscopy the surgeon banded off 2 hemorrhoids. That’s when I was told to have the hemorrhoidectomy
Sorry i missed this. That type of bleeding often needs surgery
Another quick question I got to ask I heard from another doctor is X Parell I heard that they can inject you with that before waking up from surgery and it’s supposed to not let you have pain for two days would you recommend that if so I wonder why doctors never tell Us patients that
I use it on all patients. If exparel is used you can not put any topical lidocaine to the area for 72 hours.
@@Skandiilicious Whoever has you as a surgical is a very lucky person cause you’re awesome thank you so much for answering my questions
@@nathanieldeans1226 my pleasure. My generation of surgeons is a dying breed. Before I retire I want to at least educate folks on what the hell is going on. Docs just wont tell you. In their defense- they dont have the time. We are expected to see a triple load of patients so education goes right out the window
This was great advice. I had the surgery but 1 week later I had an external hemorrhoid come out and now I am trying to heal from two incisions and an external hemorrhoid. Is there anything I can do about the external hemorrhoid while I continue to heal? I am on week 4 from the surgery. Thanks.
It is possible this external hemorrhoid is just severe swelling in an incision (most commonly is the case) have surgeon look, but, ice, pressure, ibuprofen and time are the best approach. Consider a clean non inflammatory diet. Go to cleanflex.kyani.com and shop for the nitro nutrition 21 day challenge. This may help calm things down. If that is too complex, get the triangle of health whole food supplements- should improve healing process
The more research I do…I think it might be a skin tag from the surgery. Is there anything I can do for that or just want to heal and see my specialist on August 30 which is another 4 weeks. Let me know. Your help has been greatly appreciated.
@@ellenahodder4148 wait 3 months before making any decision, most of those inflamed tags calm down snd never need removal. Your surgeon will know what to do
Thank you so much. Just hard waiting when there is constant pressure and pain.
@@ellenahodder4148 how are you doing
Already I enjoyed your video I I have a question and that is I'm having this procedure done in 5 days from today and with that same procedure they're going to do an upper GI and a colonoscopy and then this surgery do you recommend that
The main difficulty with this approach is that bowel preps can cause bowel habit changes for a week or two. Both diarrhea and constipation are bad for the healing process. For this reason, I try not to do surgery the same day as colonoscopy- unless the surgical plan is hemorrhoid banding or HET. An excisional hemorrhoidectomy will struggle to heal if you have diarrhea or constipation. You can try to avoid this issue by maintaining a high fiber diet, probiotic, and stool softener (if needed). Avoid narcotic pain meds.
From an insurance standpoint, your colonoscopy will no longer be considered screening if combined with surgery. This will not change the surgeons fees, but the facility fees will increase as a result depending on your location of service. Tempting as it id to make one trip to the OR, the decision can cost several thousand dollars and worse yet, lead to a couple weeks of post-prep diarrhea that may cause anal stenosis, chronic pain, and potentially the need for more surgery.
The main difficulty with this approach is that bowel preps can cause bowel habit changes for a week or two. Both diarrhea and constipation are bad for the healing process. For this reason, I try not to do surgery the same day as colonoscopy- unless the surgical plan is hemorrhoid banding or HET. An excisional hemorrhoidectomy will struggle to heal if you have diarrhea or constipation. You can try to avoid this issue by maintaining a high fiber diet, probiotic, and stool softener (if needed). Avoid narcotic pain meds.
From an insurance standpoint, your colonoscopy will no longer be considered screening if combined with surgery. This will not change the surgeons fees, but the facility fees will increase as a result depending on your location of service. Tempting as it id to make one trip to the OR, the decision can cost several thousand dollars and worse yet, lead to a couple weeks of post-prep diarrhea that may cause anal stenosis, chronic pain, and potentially the need for more surgery.
why aren't more surgeons using laser hemorrhoidectomy instead of cut and stitch?
Because there is no “laser” for hemorrhoids. There are minimally invasive procedures. The operation is guided by anatomy
@@Skandiilicious I don't understand your response. there is laser surgery for hemorrhoid's.
The only laser for anorectal surgery in the US is an adler micromedi ablative laser for fistulas. You can use that laser for pilonidal cysts as well. You can Yag laser condylomas and skin lesions but as of now, there is no FDA approved hemorrhoidal laser that has insurance approval or long term outcomes trials. There is a IR device which does not work. There is a bipolar device I love called an HET. The mainstays of hemorrhoids then are THD, PPH (losing favor) and excisional. Rubber banding like IR is short lasting, limited by anatomy. So which laser do you use in your practice that is covered by insurance and effective?
@@drannatoker Never said I was a doctor. Just asking why lasers are used in hemorrhoid surgery. They are widely used world wide. Yes, the FDA and insurance companies do restrict it's use.
Could you list in the comments the anti-inflammatories that you mentioned in this video? Regards
You may want to consider several holistic supplements as well- NOW brands has many of these items online...
1) n-Acetylcysteine (NAC) 600 mg daily. This is a good anti-inflammatory.
2) Inulin and Pectin supplements are prebiotic foods that can sup port the probiotic supplements suggested
3) L- Glutamine 500 mg is an amino acid your intestines like and c an promote more normal bowel function
4) Arnica montana, quercetin and zinc all help minimize bruising, take as directed on the bottle- Arnica is typically a topical cream, quercetin and zinc come in tablet form
5) Turmeric- a great anti-inflammatory- you can get at any grocery store, a medical grade version is made by Standard Process.
6) Boswellia can be found at many whole food groceries- Standard process has a medical grade boswellia which is combined with ginger and turmeric and is available online.
@@Skandiilicious Thanks for this helpful information. Can we take these all at once, and is there an optimatl time of day to take them? I've been dealing with a horrible (doctor-inflicted) anal fissure for 6 months and am finally scheduled for a hemorrhoidectomy, fissurectomy, and fistulotomy and hope to minimize pain as much as possible
Do internal hemorrhoids have an easier healing process?
Usually yes
Yes because one of the methods for dealing with them is banding and there structure versus external hemorrhoids which are more bumpy versus internal which kind of droop. The base of a internal hemorrhoid has barely if at all any pain stimulus which is where they band it to cut off blood flow to it, so it basically dies and just falls off when you go potty
I've had the surgery done whenever I have a bowel movement the pain is pure hell.
😢 please get well 😢‼️
@Debbie I'm fully recovered now. Everything's absolutely fine.
@@barrymichaels2663 how long it takes to start feeling better?
@oussamadjabali9306 After 10 days, things start getting a bit more easier it's not as painful.
@@barrymichaels2663 i am now 11 days little pain at bowel but some discomfort after
Dunno but joke about bible just blew me 😂
What about cold showers do they help
Am 3 days in and extremely sore
Some people do swear by cold immersion. Pain from this procedure is a combination of inflammation and muscle spasm. Treat both for quickest recovery
Skandii MedSpa many thanks so I could sit on warm pad for muscle and cold showers for Inflammation
@@drewcrawford447 warm hearing pad wont do it. You have to sit in waist level warm as tolerable water to get the muscle relaxation. Not everyone likes a cold shower- so I suggest cold packs to area such as zip lock bag with dry rice that is kept in freezer and used intermittently. But please keep in mind- as a legal matter, I am not giving medical advice right now
Skandii MedSpa Thanks for your time will stick to hot baths and will get ice pack
Bad parents