Hi, I've just go discharge from hospital. All fees including gastroscopy, colonscopy and the surgery is around 1,500. My insurance pays 1,400 something, I paid 70 because I upgrade to single room plus other things. I stayed in the hospital for one night. They almost tahan me for another night because I was having slight fever.

For now the pain is still endurable but I have not bowel movement yet, so maybe will be worse later.

Dr Samuel Tay is actually my first choice, but he's on leave for 2 weeks. And I'm afraid Akhtar Qureshi will probably put me on medication too, so I decided to go to Tungshin. At least if I was put on medication again, it wouldn't be too expensive. Last time I went to Sunway (for other illness) my outpatient bill was 400 something. Also, I had spent almost 600 in the past week in and out KPJ. I'm broke now.

Tham, the stapler used on me is worse than yours - Made in China. As you said "The staple method doesn't really cut away the hemorrhoids, rather it retracts them further up the rectum, so that would explain the high relapse rate." But Dr Lim did cut away the hemorrhoid. They showed me the sample after the surgery. Quite big, the lump.

My colonscopy and gastroscopy found some burnt marks due to my previous gastric problem. The anesthesia brings the worse effect on me. I could not eat or drink for the whole day on yesterday. Very dizzy and puke out everything they gave me to eat. Can't even handle plain water.

The hospital staffs are all very professional and caring, so I have no complain. Let's hope my bowel movement will be not too painful. I am very afraid now...

This post has been edited by lowlowc: Dec 3 2013, 06:12 PM

It's good to know you had no major problems throughout and after the
surgery, that means Dr Lim did a professional job.

Are you sure it's $ 1,500 or $ 5,500 ?!?!

Colonoscopy, gastroscopy and stapled hemorrhoidectomy for just $ 1,500
in total, plus rental of the operating theater, anesthesiologist's fees, room,
supplies, medication and nursing ?!?!

A gastroscope alone these days, even in Tung Shin, should be easily $ 1,000 !

And as I said, do you know how much the stupid staple gun alone costs,
when I was quoted exactly 10 years ago in November 2003 ?

Tung Shin - $ 1,000
Pusat Rawatan Islam - $ 1,500
Pantai - $ 2,000

And the colonoscope would easily be another $ 1,000 !

Dr Ashim Nandy, general cum hepatobiliary surgeon, in Tung Shin (also
goes to Pantai) at that time quoted me $ 3,000 for the harmonic scalpel.
If I wanted the staple, it would be an extra $1,000 for that device.

Which would be around $ 4,000 for staple surgery, in 2003 !

Dr Lee Hock Bee in Pantai quoted me $ 7,000 for the staple at that time.


So how did it cost you only $ 1,500, moreover plus those two extra scopes ?



And a bronchoscope plus a chest drain for a pleural effusion in my right lung
in November 2011, done in Tung Shin by my schoolmate, Yap Boon Hung
came to some $ 3,000. Total cost of a one week stay there, $ 8,000.


Maybe take a photo of your excised hemorrhoid and post it here if you would like.

You're right. The payment clerk did mistake. She pointed at first page (which she mistook as second page) of the receipt and told me 1400 covered by insurance. I have to pay my own RM76. Actually 1400 is only for scopes procedure.

The instrument alone is 1200, anaesthia = 1100, surgery = 1800. Total including medication, pathlab (for the stomach sample) etc =8200. Strange.. I thought my GL only covers 5000, any more than that have to go through another GL.
They sent the hermorrhoid to lab, and it's all bloodied, so I didn't ask to give me back. The painkiller is to be taken in the morning only, now it's wearing off and I'm starting to feel sore.

Did you woke up immediately after the surgery in the surgery room? I heard them all calling me, calling me to wake up, but I could not open my eyes. I can only make noise through my throat.

How long did you MC last time? Dr gave me MC until next Monday only.

Going to buy Gamogen tomorrow so the wound can heal faster.

This post has been edited by lowlowc: Dec 3 2013, 10:11 PM

$ 1,400 for both scopes ? That's still very cheap.

I selected epidural anesthesis, which was a mistake, so I was already
awake by the time they were wheeling me out of the operating theater.
The anesthesiologist just gave me a sedative to knock me out.

No bleeding in your case ?

I must have bled a lot after he had used diathermy to cut off one of the hemorrhoids
which was too big to be grabbed by the staple.

That night itself, I started bleeding, and those lazy Malay nurses wouldn't answer
my calls. I had to call the surgeon, Zain Al-Rashid, who in turn called those lazy
b****es to screw them up.

The next morning, going to the toilet for what I thought was a bowel movement,
a big mass of clotted and dark blood stained whole bowl red.

On discharge, I ended up with a high fever a few days later, and my brother admitted
me to Sunway for four or five days. My hemoglobin had dropped to 10 grams/dL, but
the chest physician there, Usha Rani, didn't note it either.

In the end, plus the duration of the two hospital stays, I was out for a whole month.

1,400 just the procedure and there are other charges for medical supplies etc...

Two months? That means you have very bad inflammation after the surgery? Did the first doctor give you antibiotic to take at home? Actually your doctor is Dr Zain or Dr Mohd Anis? I see their biodata, they are general surgeons. Dr Akhtar, Dr Samuel and Dr Lim are general surgeons with specialty in colorectal surgery.

As for bleeding, I think got but the doctor stuck a bandage inside my anus plus another bandage outside my anus, so I think the bandage absorbed the bleeding for the first night. There's not much stain on my bed. But the bandage is very uncomfortable, it made me wriggle here and there on the bed. They removed the bandage yesterday morning before prepare a sitz bath for me. I found it very hard to urine for the first few time.

Nurses came into my room every 2 hours to check my blood pressure and temperature.

I had bowel movement yesterday night and this morning but very little and watery. Yes, there's a blood clot coming out but already coagulated, and some bleeding after the bowel movement. Doctor said it's normal. I clean up using bidet and immediately do sitz bath.

I experience on and off pain like suddenly pricked by razor but lasted for seconds only. Taking deep breath helps. This morning I notice I was given painkiller for 3 days only.. now I'm very worry

This post has been edited by lowlowc: Dec 4 2013, 10:02 AM

I think you will have a bowel movement in a few more days, nothing
to worry about.

The bowel has naturally gone into spasm after being cut, so will take
some time to relax again.

Moreover, the scarring part there will narrow somewhat (stenosis), so
the stools will have trouble coming out initially.

My case is worse than yours because I had both diathermy and staple,
the diathermy causing the major scarring and stenosis.

That is why I said I made a mistake and should have chosen Ashim Nandy
in Tung Shin with the harmonic scalpel.


My surgeon was Zain Al-Rashid, attached to Pantai and Pusat
Rawatan Islam, where I went.

Mohd Anis was a general surgeon at Subang Jaya, but I think
he's probably retired by now. He ran a clinic at Taman Pertama
in Cheras in the late 1980s to early 90s. He just did the rubber
band ligation for me twice, the first time in Lady Templer nearby,
in 1986, where he was also attached.

Not inflammation, I had a high fever and URTI infection after the surgery,
as I had lost so much blood and immune system had plummeted.
Both Usha Rani, the chest physician, and Akthar Qureshi attended
to me in Sunway.

I had no insurance at that time, and had to borrow money from my
brother to pay for both hospital stays.

I was conned by AIA, which I had ''credit card shield'' insurance with,
''guaranteeing'' to repay your monthly card payments for the client in
case sickness kept him out of work.

They only compensated me a few measly dollars, after I had to pay
the surgeon $80 for the medical report, twisting their story around
that they would only pay for the period of medical disability AFTER
ONE MONTH. How many people will go on MC more than a month ?

I cancelled their fake policy immediately, and lodged reports with the
Finance Ministry, the Domestic Trade Ministry for mispresentation of
products under the Trade Description Act, 1972, as well as a police report.

Not only that, I shot a letter to the Inland Revenue's Investigation Unit
suggesting that they check out their entire board of directors' previous
years' tax background for possible evasion (I'm in the tax line).

AIA is not an American company, as I was under the impression all the
while, but run by a bunch of conman Honkees.





This post has been edited by Tham: Dec 4 2013, 05:25 PM

I had bm this morning, and it's no fun. It feels like something is blocking and and I have not clear everything yet. And I know I cannot push or it will exaggerate the wound. It was not awfully painful but the fear of going to toilet itself, is horrible. I hate seeing the blood clots and i keep imagining blood will come gushing out, although it's not. I cannot be sure whether I have totally emptied my bowel or not. I fear Monday when I will have to go back to work and probably need to BM there.

Tham, I'm sorry about your AIA insurance. Do you know that they're still selling this scam when people applying for credit card these days? When I applied a credit card last year, they really hard sell this to me. I told them I don't really spend much on CC so this is unneccesary. I'm not sure it's under AIA or not.

A little question; how much salt did you put for your sitz bath? I put half tablespoon only for a 50cm diameter pail, half full of water. Should I put more? Is it normal for the skin around anus to be irritated?

2005 had a heated cutlery surgery for mine, and a small banding on the other.

I did not go for the stapled as Tham (who might have forgotten me), provided his advise to me via email some years back then.

Appreciate him for his medical inputs as always.

For TS, the first few months would be a challenge. Whilst if you are younger at age, the healing would be faster, and depending on how good the surgery went.

I had blood stained almost on every BM, and some anal stricture feel. Nevertheless... I say this...Life needs to go on.

What you can do it get yourself Sitz Bath. Which I assume you might know this. Do it 3 times a day perhaps, get some gauze and replace them during the time of healing, as there might be pus during healing, and slight bleeding as well.
I usually put about 5 tablespoonful , enought to soak me to the waist.


If require to go outside...wear those women's sanity towel.

As for diet...I had loads of papaya, water and other fruits that reduce the hardness of the BM.
Prunes (don't go for the juice...it's rubbish), would help reduce any constipation.
Have a bigger fiber intake.

The work for me was timely, as I was a contractor back then...so, I was to be renewed the next 2-3 months...and that gave me time to do the surgery...and that was also timely, when the clot was bleeding, and I had them done overnight.

I wish you speedy recovery TS. Brave it, and don't rush things....
It will be a 2-3 months healing at least ...sometimes perhaps more...but honestly...DIET is everything.

Thanks finkl1 for your encouragement. It's really great to have people who have the same problem and surgery to come together and give advises in this forum. I have not have fruits yet since I discharged, just oat, vegetables and rice, and today I had snakehead fish porridge to see if it can heal the wound faster. I will start adding papaya to my diet tomorrow but the rest of the fruits I do not dare, as I was afraid will trigger itchiness which I had prior to the surgery. I had papaya in the hospital, so I think it's okay.

5 tablespoon? Then I think I'm not putting enough for my sitz bath, i will put more. Actually I am doing 15 minutes sitz bath for twice a day, and additional 5 minute sitz bath for every bowel movement.

Now I have another problem. The medication makes me sick. As always, antibiotic make my stomach turns , dizzy spell and itchy dry skin for me. I still have another 2 days of antibiotics to go, so hopefully I can make it through. Dr Lim told me surprisingly most of his older patients recover faster than younger patients probably because the muscles doesn't constrict that much in older people.

Now I am thinking whether to go back to doctor and ask for extra MC. My office's toilet hygiene level is and I'm afraid to use its dirty bidet. And I can't imagine no sitz bath after bowel movement.

This post has been edited by lowlowc: Dec 5 2013, 11:14 PM

You said you had your surgery in 2005 - perhaps you could refresh my
memory - did I meet you on another forum then, as I joined this one only
in 2007 ?

Anyway, it's good you had your surgery and fully recovered. Hopefully
you had no complications then, and no relapses after that.

You mentioned ''heated cutlery surgery''. Did the surgeon use diathermy,
Ligasure, Starion or bipolar scissors ?

Half a tablespoonful is way too litle, I mentioned two tablespoonfuls.


As Finkl1 also said, he used 5 tablespoons, but that was to soak up
to waist up, so maybe he used a large basin or sat in the bathtub.

If you are using enough hot water just to cover and a bit above the
bum area, so that your anus is fully immersed, then two to three
tablespoons should be enough.

Use Cosway's Zara sea salts as I advised. It's really soothing, and
does have healing and pain reducing properties. Costs about $19,
but they usually give you the 20 % member discount, even if you
are not a member. Just tell them you have just been discharged
from hospital after surgery.

Use one of those shallow baby's tubs about a foot across, just
enough to sit on top of the opening of your toilet bowl. The water
would then be above 4 inches high, just enough to cover your bum.

Try taking dragon fruit and/or beet root juice - that will be sure to make
your stools watery or at least much softer. I tend to get some mild diarrhea
within two hours after drinking mixed beet root/carrot juice. Papayas don't
really help much for me.

Your stools will just turn dark after dragon fruits and beet roots.

Another juice which will make me run to the toilet shortly is yellow pear.


I think you should ask the doctor for at least another week's leave.
Otherwise, I am sure your employer will let you have extra compassionate
leave, if you explain that you are having some post-surgical complications
with bleeding, much pain and still can't pass out anything due to rectal
stenosis.


If you email your boss and show him this was how much the surgeon's
''grenade launcher'' streched your anus, I am sure he will understand.

http://www.sages.org/meetings/annual-meeti...morrhoidectomy/

HI Tham, we just emailed around 3-5 mails to each other.
I just read your experience from another webpage, and got in touch with you.

YEs, I had a bipolar scissors, the heated ones, that seals and reduces any blood lost.
Back then, laser was only available in Pantai, and it was expensive. Almost 3-5k i believe.
You told me about your staple experience...and I decided to forgo that procedure.


TS,

Please do not use the "consumer" sugar that you buy from sundry shop. Get those sea salt , that cannot be consumed by human, but used for other means....

After the healing starts...around 1 month or so...buy some antiseptic cream....

Also maintain cleanliness in that area....ie: dry.

Try not to push stools...I know it's difficult, so, drink lotsa water, and maintain a good diet.

Oats and cereals bulk...so be careful....Have to test a bit.
I forgot the diet I took , but mainly lotsa papaya alternate days....





Well, now I am plagued by H.pylori....and after a few rounds of antibiotic therapy failure, I decided to do some home treatment.

Life's ups and downs... Even through good diet..and being a workforce... we cannot control much of the food we eat outside....regardless if it looks clean and cooked hot.

Today, I'm feeling a bit weird sensation there. The anus feels like tightened a bit, some little tingling pain, swelling a bit (but no pus or bleeding) and my buttock feel a bit numb.

I'm using organic sea salt (unrefined, unbleached) right now (but it's food grade)because previously the cosway branch I went, is out of stock for the Zara sea salt. Will try another branch soon since the salt is finishing soon anyway. I also have Epsom salt at home but I decided not to use it in the end after reading mix reviews online.

"Your stools will just turn dark after dragon fruits and beet roots."
This reminds me, is your yellow and contain undigested food (in my case, vegetable leaves) after the surgery or colonoscopy?

http://www.sages.org/meetings/annual-meeti...morrhoidectomy/

Holy crap.. this is what happened to me in the surgery room? I didn't search for the actual picture prior to the surgery, in order not to get chickened in the last minute. But now looking back, it still .. urgh
I'll call up the doctor tomorrow to ask for another MC.

Finkl1, I can't have antiseptic cream, because the skin there is already seriously irritated prior to the surgery. Right now... ahem.. I don't think you and Tham might approve of this but I dab some coconut oil (organic, pure, unrefined type) that I bought from pharmacy. I decided to try this last week (2 days before the surgery) since the itch was awful and preventing me from sleeping. This was recommended by "itchy hemorrhoid" and "post hemorrhoidectomy" forum. I did not apply it directly to the anus but the skin around it in very small quantity. It seemed to work but very slowly. Prior to this, I was prescribed protosedly, zarticorn (anti fungal), steroid cream but all works for only 1 day then worsen the condition.

that's fine. There is naturally no right and wrongs as each body reacts differently.

As long as you don't develop any rashes, excessive pus and infection.

That will set you to more long term healing. ...

The "stricture" feeling is normal for me. Because it;'s tightening....hence, stools should not be entirely liquid, but still having some "form", but soft for you to pass through.

This is to allow your "muscles" to not completely close. ( As Tham puts it in term stenosis)

I know it sounds worrying, but it's NOT.
Healing will take place , just need some light exercise...walking a bit, less sitting...and more warm sitz bath.

Speedy recovery to you.

Which hospital did you go to, and which surgeon did it for you ?

Yes, I think only Pantai had the laser then, Lee Hock Bee there said
he normally used it for first and second degree hemorrhoids. He was using
the harmonic scalpel for third and fourth degree beforehand, but had since
switched over to the staple when I called him at the end of 2003, for which
he quoted me $ 7,000.

$3,000 - $5,000 for the laser isn't really expensive for Pantai, even at that time.
Ashim Nandy quoted me $3,000 for the harmonic scalpel in Tung Shin.

Zain Al-Rashid, attached to both Pantai and Islamic Medical Center, did the
staple for me in the latter hospital for $4,500. He didn't even realize that Pantai
had the laser !

Actually, I wonder why you didn't select the harmoic scalpel ?

Which grade were yours, by the way ?

Mastic gum and zinc l-carnosine (Pepzin GI, Polaprezinc) would be
the supplements for you.


Zinc l-carnosine was developed in Japan and marketed as a drug (Polaprezinc)
there, but licensed to supplement manufacturers in the States as Pepzin GI.

It can also be used for bed sores, or pressure ulcers, although l-carnosine
itself is also effective.


http://pepzingi.com


The development of Polaprezinc research.


https://www.jstage.jst.go.jp/article/yakush..._3_271/_article



The effect of polaprezinc on gastric mucosal protection in rats with
ethanol-induced gastric mucosal damage: comparison study with rebamipide.

http://www.ncbi.nlm.nih.gov/m/pubmed/23743168



Polaprezinc (Zinc L-carnosine) is a potent inducer of anti-oxidative stress enzyme,
heme oxygenase (HO)-1 - a new mechanism of gastric mucosal protection.

https://www.jstage.jst.go.jp/article/jphs/1...9056FP/_article



inhibitory effect of polaprezinc on the inflammatory response to Helicobacter pylori.

http://www.ncbi.nlm.nih.gov/m/pubmed/12464972/




Applicability of zinc complex of L-carnosine for medical use.

http://protein.bio.msu.ru/biokhimiya/conte...l/65070961.html



Effects of L-carnosine and its zinc complex (Polaprezinc) on pressure ulcer healing.

http://www.ncbi.nlm.nih.gov/m/pubmed/23835365/



Studies on anti-ulcer effects of a new compound, zinc L-carnosine (Z-103).

http://www.ncbi.nlm.nih.gov/m/pubmed/2113032/




Mastic Gum Kills Helicobacter pylori.

http://www.nejm.org/doi/full/10.1056/NEJM199812243392618



The effect of mastic gum on Helicobacter pylori: a randomized pilot study.

http://www.ncbi.nlm.nih.gov/pubmed/19879118




Now's Ulcetrol.

http://www.iherb.com/Now-Foods-Ulcetrol-60...=6&sr=null&ic=1



Natural Balance's Peptic Soothe.

http://www.iherb.com/Natural-Balance-Pepti...4&sr=null&ic=15


Jarrow's mastic gum.

http://www.iherb.com/Jarrow-Formulas-Masti...44&sr=null&ic=4



Doctor's Best PepzinGI.

http://www.iherb.com/Doctor-s-Best-PepZinG...44&sr=null&ic=6

Dark, virtually black, presumably from all the bleeding.

As mentioned earlier, pencil thin, due to the stenosis. Gave me quite
a shock - I thought the stenosis would be permanent.

That was how it was for the first month after the surgery.

Beet root is good not only as a laxative, but a blood builder, high in iron.

I was taking this after an I & D (incision and drainage), by an orthodedic
surgeon in Sunway December 2004 (one year after the hemorrhoidectomy !)
to drain out a cellulitis abscess in my left big toe.

http://www.iherb.com/product-reviews/natur...-capsules/1842/


Reduces blood bressure, improves stamina, due to the nitrate content,
converted to nitric oxide in the system.



'' .... as little as one cup of beet juice has dramatic effects and may be a natural
alternative to blood pressure medication for some people and just 2-3 ounces
per day can be a natural approach to preventing constipation. ''

http://www.webmd.com/food-recipes/features...-beetroot-juice



Acute ingestion of beetroot bread increases endothelium-independent vasodilation
and lowers diastolic blood pressure in healthy men: a randomized controlled trial.

http://www.ncbi.nlm.nih.gov/m/pubmed/23884387


Inorganic nitrate and beetroot juice supplementation reduces
blood pressure in adults: a systematic review and meta-analysis.

http://www.ncbi.nlm.nih.gov/m/pubmed/23596162



Effect of beetroot juice on lowering blood pressure in free-living,
disease-free adults: a randomized, placebo-controlled trial.

http://www.7ncbi.nlm.nih.gov/m/pubmed/2323177



Blood pressure-lowering effects of beetroot juice and novel
beetroot-enriched bread products in normotensive male subjects.

http://www.ncbi.nlm.nih.gov/m/pubmed/22414688



Nitrate supplementation's improvement of 10-km time-trial performance
in trained cyclists.

http://www.ncbi.nlm.nih.gov/m/pubmed/22248502




Another good blood builder and laxative is blackstrap molasses.


'' Molasses Health Benefits and Natural Cures ''

http://www.earthclinic.com/Remedies/molasses5.html



'' Constipation Remedy – Blackstrap Molasses ''

http://www.poopdoc.com/articles/constipati...natural-way.htm



'' It’s best to eat or drink blackstrap molasses in the morning, as it makes
a good laxative and will give you energy.

This black goo, the bi-product of unhealthy white sugar, has ironically one
of the highest mineral contents compared to other foods. Blackstrap molasses
is quite extraordinary, containing these excellent sources of iron, magnesium,
calcium and potassium and other trace minerals and vitamins. I think it’s so sad
that this fantastic healthy sweetener, is used as the bi-product, and the
unhealthy sugar lines our supermarket shelves. ''

http://www.2baware.net/healthy-foods/blackstrap-molasses/




http://whfoods.org/genpage.php?tname=foodspice&dbid=118

http://spiritfoods.net/health-benefits-of-...strap-molasses/

http://whfoods.org/genpage.php?tname=foodspice&dbid=118




Total antioxidant content of alternatives to refined sugar.

'' Dark and blackstrap molasses had the highest FRAP ''

http://www.ncbi.nlm.nih.gov/m/pubmed/19103324

Thanks Tham.
I did mine in Assunta, under Mr.Liew Fah Kong.
I believe the equipment is harmonic scalpel...and the cost was about 1.5k -2k range, adding the rest, brings up to around 2.8k range.

1x 4 degree, prolapsed external
1x 3 degree, prolapse external
1x 1 degree, banding.

The 4th was bleeding, before he decided to cut me the next day.
I was LUCKY I believe, that he did it well, and less complication, and less pain since I had a strict dieting regime before the surgery.

This post has been edited by finkl1: Dec 8 2013, 01:26 PM

Will you describe the kind of itch you encounter during healing? Inside or outside? Prickly or wriggly itch? Yesterday night I had a very bad itch that I am now paranoid that I might have worms. The skin around the anus (I don't know if it's eczema or what) is still irritated that I've become very depressed now. Plus I'm very concerned about the undigested food in my stool.

My friends advise me to just go to work if it's not painful because I've been thinking too much.

This post has been edited by lowlowc: Dec 8 2013, 03:47 PM