- First article in the new ‘Recovery!’ series about post-surgery
- Experts and patients help you get back on your feet after an op
- This week we cover haemorrhoidectomy and tonsillectomy
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THE OPERATION
HAEMORRHOIDECTOMY
This is an operation to remove piles –swollen and inflamed blood vessels that form in and around the rectum.
Around one in ten cases of piles need to be removed through surgery if other methods such as banding – placing a very tight elastic band around the base of your haemorrhoids to cut off their blood supply – doesn’t work.This is done under a general anaesthetic and should take about 45 minutes.
Bum deal: A haemorrhoidectomy is needed in one in ten cases of piles and is done under a general anaesthetic
THE SURGEON SAYS
Abhay Chopada is colorectal surgeon at Ealing Hospital in London, and BMI The Clementine Churchill Hospital in Middlesex.
He says: ‘The main problem after haemorrhoid surgery is pain which peaks between 12 and 24 hours after surgery, once all the anaesthetic has worn off. Make sure you discuss pain management with your consultant before the operation.
‘We don’t stitch up the wounds, which means less risk of infection – amazing considering the location – but there is more bleeding and seeping, for up to five days. The hospital should give you pads to wear but make sure you have plenty in stock before the operation.
‘If you bleed for longer, or have a sudden increase that doesn’t stop quickly, you must go back to your consultant or AE.
Constipation is a big issue – patients fear the pain of going to the toilet, and sometimes opiate pain killers can bung you up. Take a stool-softening laxative such as Lactulose – though be prepared as this can sometimes cause gas as well – and a soluble fibre supplement. Eat a high-fibre diet with lots of grains, fruit and veg. Drink lots of fluid, as this also combats constipation.
Power through: A haemorrhoidectomy result in weeks of pain (stock image)
‘If you can, plan your trips to the toilet. Apply a local anaesthetic ointment such as lidocaine 20 minutes before.
For the first four or five days, wiping may be too painful so use a shower on a very gentle, lukewarm setting.
It may also help to run a bath before going to the loo, so that you can sit in it immediately afterwards.
‘The less you stand up the better for the first few days, and if you have to sit up, use a cushion rather than a rubber ring.
You press down more on any kind of inflated cushion, which puts more pressure on the area. But as soon as you feel well, start walking as this helps prevent constipation.
‘You should be back at work in ten days, and the pain will be minimal, but you won’t be completely healed for at least two months.’
A PATIENT’S VIEW
Thomas Jacob, 35, a property consultant from Belfast, had the operation in June this year.
He says: ‘When you’re in the midst of the pain after this op it’s easy to think it’ll never end, but important to remember it does get better.
‘I was reassured I wasn’t being a wimp when I read on Mumsnet women saying trying to go to the loo after was akin to giving birth.
‘The discomfort kicked in on the evening after surgery – a bloated fullness like I needed to go, but very little sensation beyond a deeply sore, throbbing feeling at the action end of things.
‘I slept fitfully, discovering that lying on your left hand side with your left leg bent at the knee and the right straight made passing gas (difficult when you can’t bear the push in any way) easier.
‘I rushed to the toilet at about 5am. It was agony, but quickly hopping into the bath after felt incredibly soothing, and I did this even once the pain had subsided to a minor irritation.
‘Going was huge relief, and I’m glad I followed the instructions to take the laxatives, fibre supplements and eat lots of fruit and veg – I can’t bear to think what the pain would be like if you were constipated.
Lactulose gave me terrible wind so I switched to Movicol, and if I felt my system was becoming sluggish I doubled the dose on my doctors’ orders, which worked.
‘You can get a “sitz-bathâ€, like a little plastic hat you fill with warm water and put over the bowl to sit in and wash, but these are a complete faff and the bath was much simpler. I used the shower under the water to make sure I felt clean. I also got Water Wipes, which don’t contain chemicals like all the other moist wipes.
‘The bleeding and seeping faded to nothing after a week, as promised, and I was back at my desk ten days later, although I’m still using wet wipes three weeks later.’
THE OPERATION
TONSILLECTOMY
The tonsils are two small, infection-fighting glands that sit on either side of the throat.
They’re removed when someone suffers repeated infections.
The
30 minute operation takes place under general anaesthetic – surgeons
either cut tonsils out, or remove them using lasers, ultrasound waves or
heat from an electric current – a method known as diathermy.
Let them eat lollies: Ice lollies and chewing gum are good way to ensure you keep your throat cool, hydrate and swallow properly
THE SURGEON SAYS
Myles Black, Consultant Ear Nose and Throat Surgeon at the Royal Victoria Hospital, Belfast, explains: ‘This is one of the most uncomfortable operations you can have, with severe pain for up to 14 days, starting 48 hours after surgery because of the residual effect of the anaesthetic.
‘Take the maximum dose of painkillers from the word go before the anaesthetic wears off – and do so for two weeks. For the first month, the back of the throat looks white and messy, a bit like yogurt. But don’t go rushing to the GP for antibiotics – you may well pick up an infection in the waiting room (stay at home, to limit chances of catching anything). It can take nearly a month for the throat to look pink and normal again.
‘Patients worry about eating and drinking, but you should keep doing both.
‘Chewing can actually help you through the pain process – sugar-free chewing gum helps.
‘Don’t eat anything hot or spicy and drink at least one and a half litres a day, to avoid dehydration.
‘It’s also good for getting back into swallowing normally. If you don’t swallow properly, you get pooling of saliva or food debris in the mouth, leading to infection.’
A PATIENT’S VIEW
Fiona Todd, 22, an account executive from Farnham, in Surrey, had her tonsils removed in January after suffering repeated infections and severe swelling in her throat.
She says: ‘Pain relief is so important. I had four lots to take which involved about 18 tablets. I made a timetable so I would remember what I needed to take and when.
‘If I was going to have a nap, I set my alarm so I wouldn’t miss a dose. Putting a cold flannel around my neck gave some local relief and I had lots of ice lollies as they kept me hydrated and were soothing for my throat. I found soft noodles and spaghetti were best for slipping down easily.
‘However, eating was painful –and slow! So I made sure I was distracted, eating in front of the television or while reading.
‘I found it hard to talk for about two weeks and my voice didn’t fully return to normal until around four weeks. So I tried not to talk. I avoided answering the phone, using text or email. People wanted to visit, but I wouldn’t let anyone who had a cold or any other infection come and see me.
‘It took about four weeks to feel better – I felt so tired all the time.
‘I did go back to work after three and a half weeks, but should have taken more time off.’
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