do you 'push' or not when defecating?
normally i'd just let it flow with minimal 'push.'
and dont squat for the time being.
i kept taking daflon for a few months, even though hospital only gave enough for 3 weeks.

hospital will only take action if ur butt bleeds. i've been there.
i went to hukm though, private hospitals are too expensive for me, many2 years back.

Are they sure it is just a skin tag ?

It may be an external pile. That's what I have now, after surgery to remove
some pretty huge internal hemorrhoids in 2003.

An experienced and reputable colorectal surgeon is Dr Akhtar Qureshi in
Sunway Medical Center.

Hemorrhoids will tend to itch sometimes, even mine.

You also probably have some mild eczema there.

Yours prolapses, then goes back in spontaneously, so you probably
just have second degree internal hemorrhoids, quite mild.

If you see Akthar Qureshi, he will probably just give you Xyloproct
or Proctosedyl cream, something you can buy yourself anywhere.

These contains some mild steroid like hydrocortisone to reduce the
inflammation and itch, plus aesculin (from horse chestnut) to improve
the venous blood flow there a bit, and thus shrink it a litle.

Otherwise, go down to TM Shafi, a small homeopathic shop at the
row of shophouses opposite YMCA in Brickfields. They have homeopathic
pile creams which are usually quite moisturising, so may reduce the
dry skin and itch.
Another time and tested remedy is salt, i.e. sitz baths. Buy Cosway's
Zara Dead Sea Salts, blue in color. Sprinkle say two tablespoonsfuls in
a small tub which just about fits your toilet bowl,  add in fairly hot water,
then sit there for at least 15 minutes.

I am sure that will relieve the itch and pain somewhat.

That was what I did way back in December 2003, when, coming home
after the surgery (stapled plus diathermy), I was in really bad pain.

So my sister came over, prepared the above sitz bath, and luckily the
pain subsided after that.

If you can't get the salt, ordinary table salt, or those cheap rock sea salts
from the supermarket will do.

Dr Anantha also advised my father to do that after he had removed his
piles many years ago. Surprisingly, my father said he had hardly any pain
from the surgery, while mine, like many others, was like the end of the world.

I think those brownish colored Himalaya rock salts are also suitable.
My elder brother had an acute attack too not too long ago, after I thought
all the while that he was one of the lucky ones with no hemorrhoids.

He surfed the net, then made an ice pack and placed it there.

Also bought Daflon, took a loading dosage of 6 tabs the first day, then 4
the next two days, then 2 daily.

It subsided.

Yes, it's quite possible.

Probiotics are after all bacteria, and just like antibiotics,
can trigger off allergies or other reactions in some people.

Just stop them for a couple of weeks and see how it goes.

Even fiber doesn't agree with me very well. If I take Metamucil,
I will get cramps the whole night long.

So which surgeon did you see there ?

Was it Lim Chwen Loong or Muthu ?

Did you ask him which device he is going to use ?

Staple method.

If he does a good job, then good. If not, you'll have problems - bleeding,
intense pain, stenosis (narrowing of your anus).

The staple is made by Johnson & Johnson ...... in Mexico.

Looks very flimsy, plastic, like a kid's toy ray gun.

Costs at least ...... $1,000.

You should have asked for the harmonic scalpel, Starion or Ligasure,
but anyway, it's already scheduled.

How much is he charging you ?

Intense pain and heavy bleeding the first night. The pethidine injection
lasted me only an hour. Had to bear with the pain the rest of the night.

I had stenosis for the first two months. The stools which came out
were pencil-thin.

I also had fecal impaction twice the first two months. Had to dig it out
with my fingers.
Luckily, improved by the third month.

The surgeon was probably not too skilled nor experienced enough in
the use of the staple.
The staple also has a high rate of relapse.

Within two years, an external hemorrhoid came back.
But is Dr Lim is skilled in this method, you should have no problems,
reduced pain and faster recovery, I guess.
Reinterventions for specific technique-related complications of
stapled haemorrhoidopexy (SH): a critical appraisal.

http://www.ncbi.nlm.nih.gov/m/pubmed/18766410/
Stapled hemorrhoidopexy is associated with a higher long-term
recurrence rate of internal hemorrhoids compared with conventional
excisional hemorrhoid surgery.

http://www.ncbi.nlm.nih.gov/m/pubmed/17665254/
Obstructed defecation after stapled hemorrhoidopexy: a report of four cases.

http://www.ncbi.nlm.nih.gov/m/pubmed/20583519/?
Agraffectomy after low rectal stapling procedures for hemorrhoids and rectocele.

http://www.ncbi.nlm.nih.gov/m/pubmed/21695440
Obliteration of the rectal lumen after stapled hemorrhoidopexy: report of a case.

http://www.ncbi.nlm.nih.gov/m/pubmed/18670815/

Maybe you can try this.
http://www.rakuten.com.my/shop/caringpharm...HF0005_0191081/
Enemas may help, or maybe Dulcolax (bisacodyl), but if the impaction
is really bad with the stools already hard, that won't work.

This is why doctors have to do it for patients who come in with fecal impaction
- if the stools are way too far in the rectal area, obviously you can't dig it out
yourself.

Dr Anantha in Sentosa says he has to do it such patients who pay him an
emergency visit sometimes, even young people.

I didn't really change my diet, but as it is, everyone tends to get hemorrhoids.
I can't really tolerate fiber anyway, as I have IBS.

Stresses in life, including lack of sleep, can also cause or aggravate them.
The Chinese believe that lack of sleep (as in my case too) causes heatiness
to form in the liver ( ''kah foh'').

Lack of sleep can also result in a low ''Chi'' (life force), so your anus will
tend to drop out.
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.

How is it that you never even asked what device he is going to use when
he examined you and advised surgery during the whole consultation, after
I had given you all that info ?

Akhtar Qureshi uses the harmonic scalpel, and I think he also has Starion
and/or Ligasure. That was why I advised you to go to him. He also uses the
staple, but he said he is very selective, due to the high relapse rate and risk
of complications.

Otherwise, Samuel Tay in Sunway also has Ligasure, as mentioned earlier.
I enquired from the Ligasure distributors here some years ago, and they
mentioned that he was one of the doctors with this device.

I did not select Anantha at that time, even though he did an almost painless
job on my father with diathermy alone, because he did not use the staple,
which I thought was the ''in thing'' at that time. Sentosa was poorly equipped
too then, with no harmonic scalpel. They probably have now, as well as the
other devices.

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.

$ 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.

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.

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.