Day 1.  Day of Surgery

My pre-op instructions were relatively easy.  No food or drink after midnight the night before, and take two fleet enemas in the morning of my surgery.  One when I woke up and one one hour before I was to report to the hospital.

I was OK with the no food or drink.  I had a light meal the night before, drank a few glasses of water, and went to bed.

In the morning, attempting to take the Fleet enema was something of a problem.  My hemorrhoids were pretty bad.  I had both internal and external hemorrhoids, and attempting to insert the 'comfort tip' and use the enema solution was next to impossible.  The hemorrhoids were so large that it was next to impossible to find my anal canal.  And of course, it hurt a bit as well - seemed somewhat counterintuitive to stick a tube up my butt given that I was heading to the hospital to fix that exact location!  In any event, I did what I could upon waking up and tried again with little success later that morning.

I got to the hospital around 9 AM and by the time I had gone through all the usual check in and preop procedures it was about 11 AM.  They had me put the standard gown on, gave me an IV, checked my vitals, and started the anesthesia drip.

They rolled me into the operating room and I remember just seeing the lights in the ceiling before falling asleep.  The procedure took about 1 hour during which the Dr. performed an exam under anesthesia and removed 3 hemorrhoids.

I awoke feeling a bit groggy but not terribly uncomfortable.    My pain scale was about a 1 on a scale of 1 - 10; about the same as when I went into the hospital.

My wound was dressed minimally with some gauze around it, and some gauze rolled up and packed into the anal canal.  It did not feel terribly uncomfortable.

Recovery in the hospital was easy.  I was able to eat some crackers and have some soda and water.  I was able to sit up in bed and talk, and slowly the grogginess wore off.   I could get up and walk around the room with little issue.

Towards the later part of the day, the nurse gave me a good shot of painkiller into my IV that should have lasted me for a while (and did).

As the day wore on, they told me I could not be discharged until I could urinate.    This was important (as I later learned) because anorectal surgery causes spasm not only of the anal sphincter, but of the muscles that control your ability to urinate.  If you are unable to urinate for a prolonged period of time, you may need to go to the emergency room for a foley catheter.

This was frustrating, as I must have had 5 or so large styrofoam cups of soda, water, etc. and could still not go.  The nurse said this was normal, as my body was likely just absorbing liquid lost during the surgery.  Although I didn't feel like I had to go, I did feel like I 'could have gone' - sort of like when you make a quick pit stop on a long drive because you don't want to have to stop again down the road.  In any event, feeling like I 'could have gone' did not work for a number of frustrating hours, even after trying every 15 - 30 minutes.

Finally, the nurse recommended not trying until it felt like I absolutely had to go.  I gave it another hour or so, and then finally was able to produce.  They have you urinate into a measured container - and, although she didn't tell me beforehand, I produced just enough - 200ccs of fluid - to allow me to be discharged.

All in all, the time from awaking in recovery to discharge was approximately 5 hours, mostly due to the need for that 200ccs.    Discharge was simple.  I was provided with some detailed instructions, a set of prescriptions, and a wheelchair ride down to the exit.  Even at that time, the pain was moderate (about a 2) and I was able to sit on the chair while waiting for my ride.