It was a Thursday. At 18 weeks pregnant, I was enjoying my first few weeks without severe nausea and vomiting. I'd gotten through a busy day, which included my husband's change of command ceremony and reception, followed by feeding and entertaining our visiting family. That's when I felt it — a painful, throbbing grape between my butt cheeks — the telltale sign of a thrombosed hemorrhoid. I grabbed my trusty hand mirror (a curious pregnant lady's BFF) and confirmed my worst fears. 24 hours later, I was under the knife for a hemorrhoidectomy during my second trimester of pregnancy.
This was not my first rodeo, hemorrhoidally speaking. I'd had some minor ones during stressful periods of my life, but my first experience with thrombosis occurred in my last week of pregnancy with my daughter. (For the uninitiated, "thrombosis" is medical speak for "sentient." OK, technically they're external hemorrhoids in which a blood clot has formed.) I landed my literal ass in urgent care because I couldn't take the pain, and they performed a delightful little procedure in which they injected me with a local anesthetic, proceeded to excise (or drain) the hemorrhoid, and sent me on my merry way with an ice diaper. In an unfortunate turn of events, they didn't get everything, and I was in general surgery a few days later. And then I pushed a baby out of my body and over my recently operated-on hemorrhoids. Yes, that's about as fun as it sounds.
It will come as no surprise, then, that I was determined to never let this happen again. I worked extensively with multiple doctors postpartum to try and figure out what the hell was going on. I tried the Squatty Potty and sitz baths with a side of Metamucil and Miralax. I got a special cream for my fissures. I had a CT scan and colonoscopy to rule out Crohn's disease, which we did. In the end, I wound up managing my constipation with a stool softener and laxative. When I found out I was pregnant again a few months ago, my midwife had me add a probiotic and, well, it was going pretty well.
I threw my doughnut pillow in the car, and drove my sad ass to the hospital.
Until last Thursday, that is. So if I wasn't constipated and only in my second trimester, why the hell did I have a thrombosed hemorrhoid? Well, as the doctor would later explain to me, my history made me more susceptible and even though I'm barely showing, the pressure from growing baby and uterus resulted in that little f*cker poking out between my buttocks (my words, not the doctor's). There was no way I was going to suffer any longer than I had to, so I was determined to be seen ASAP.
I'm super grateful to my active duty spouse, because we have good healthcare. However, anyone who's dealt with military insurance will tell you that navigating Tricare is not for the faint of heart. Because I live far from the base, I get my primary care from a private doctor of my choosing. My prenatal care, however, is done on post. My condition was not pregnancy related (although it was possibly caused by it), so I didn't know where I would be seen. After speaking on the phone to approximately 800 people, it was determined that I would see the midwife, who would refer me to the surgeon if necessary.
I threw my doughnut pillow in the car, and drove my sad ass to the hospital. The midwife was lovely and sympathetic, but upon examination she thought my hemorrhoid was not thrombosed but probably on its way there. She decided to bring the obstetrician in for a second opinion. I was in tears at the thought of having to treat my pain at home, and I think my water works may have influenced the doctor because he decided that the surgeon should see me.
Unfortunately, dude was in the operating room. I was able to see him after about two hours in the waiting room (with that long a wait, naturally, I visited the hospital Starbucks). He confirmed thrombosis and gave me some options: "wait and see" (read: treat at home) or surgery. "Please cut me open," I pleaded. I could have the excision surgery in the clinic like I'd had before, or a hemorrhoidectomy in the operating room. I didn't even know the latter was an option, but knowing it was the more likely permanent of my choices made that decision easy. We went over possible complications, such as pain, bleeding, and infection. I knew it was a doctor-patient match made in heaven when the surgeon told me I could add "FML," and I signed the paperwork.
It was that easy? Well, no. You see, I would pay for that extra hot no water chai tea latte. You can't have anything to eat within six hours before having anesthesia. Fortunately, the surgeon was on call that night and said he'd fit me in. The entire staff bent over backwards to make this happen for me the same day. As luck would have it, my mother-in-law had taken my 2-year-old daughter and visiting nieces for a sleepover. I had enough time to drive myself home and drop off my car so my brother-in-law could take me to the hospital (my husband would meet me after work and drive me home). Honestly, it was like the stars aligned in order for my hemorrhoid to have its date with destiny.
My doctor didn't want to Sharpie my ass, so he gave me a nice little bracelet with the word "anus" written on it instead. Awesome.
When I arrived in surgical waiting that evening, I was immediately taken back for — you guessed it — more paperwork. I'm pretty sure I filled out the same form multiple times in different ways each time. (Oops. Forgot about my wisdom teeth extraction. Oh, yeah. I'm taking a prenatal vitamin.) Once I was in my hospital gown and jaunty silver surgery cap, I was visited by multiple doctors. If you've never had surgery, be prepared to give your name, birthdate, medication allergies, and type of surgery a zillion times. I get why they do it. It's a precaution. It's like when you have knee replacement, and they write "not this one" on your other leg. My doctor didn't want to Sharpie my ass, so he gave me a nice little bracelet with the word "anus" written on it instead. Awesome.
My next visit was from the surgery VIP: the anesthesiologist. Again, I had more options. They could sedate me via IV and give me some numbing in the butt region, but he informed me that the safest option for pregnant women was spinal anesthesia. I wasn't thrilled that I'd be awake for the procedure, but if you tell me something is best for the baby, that's what I'm going to pick. I was a little worried because I'd had an epidural during labor with my daughter, and it took three tries. Although I appear to be a spinosaurus, my vertebrae are actually really close together.
They could sedate me via IV and give me some numbing in the butt region, but he informed me that the safest option for pregnant women was spinal anesthesia.
I was wheeled into the OR, which is located in the Arctic, apparently. The kind nurse placed heated sheets (OMG, please come to my house and do this) over my front side while I sat curled over on the edge of the gurney. The anesthesiologist did his thing, and it was much easier than the epidural (a spinal is supposed to be more straightforward anyway). I lost feeling in my tush first, and then my legs felt like logs. It's a weird sensation, and I was grateful to have baby give me a reassuring kick at just that moment. Silly me, I assumed I'd be in the pelvic exam position, but no. Instead, giant yellow candycanes with stirrups were wheeled up next to my hips. With my feet up, I resembled a dead bug, and yes, that is an extremely vulnerable position, but I guess it provides the best access.
Luckily, the doctors, team, and I were able to keep things pretty light. Humor is my defense mechanism, so after the whole "anus bracelet" debacle, I made sure to ask my surgeon to double check that he had the right butt. We brainstormed baby names, and my anesthesiologist serenaded me with Ed Sheeran's "Perfect" (because nothing says hemorrhoidectomy quite like the wedding song of the year). Seriously, though, if you haven't experienced a singing anesthesiologist, you're missing out.
Humor is my defense mechanism, so after the whole "anus bracelet" debacle, I made sure to ask my surgeon to double check that he had the right butt.
The surgery took a grand total of 21 minutes. Waiting for the spinal to wear off took... a lot longer. I was transferred to the post-anesthesia care unit, where the nurse used a kebab skewer to poke and scrape my legs to test for feeling. Funsies. She also had me try to move my floppy squid legs and, well, you can imagine how that went. As I started to get more feeling, I was moved to recovery, where my goal was deceptively simple: pee. In case you were wondering, it's hard to "go" when they've numbed the crap out of your "saddle area." Plus, as my husband pointed out, my bladder wasn't winning any awards for control in the first place.
After an unsuccessful assisted trip to the potty, I felt pain in my lower abdomen. The nurse wanted to check my bladder level. She used a scanner that is basically an ultrasound, except instead of a cute little fetus you see how full your bladder is (in yellow, lest you forget that you're looking at a bunch of pee). Mine was at maximum capacity. The doctor didn't want me to lose any bladder function, so the nurse catheterized me, emptied my bladder, and we were back to square one. I just wanted to go home, but you have to pee after a spinal because if you leave and find you don't have bladder control, you'll end up right back in the ER.
I got Percocet for pain, but it has a side effect that is almost poetic in its irony: constipation.
My time was up in recovery, so I was moved again — this time to the intensive care unit. With my husband with his cap over his face fast asleep on the bench, I decided to watch some TV. After a few episodes of Friends, I placed my hand next to legs, and it felt damp. Yep, I'd wet the bed. So embarrassing, but at that point, what I cared more about was that I wasn't going home anytime soon. Fortunately, after about an hour, I was able to walk to the bathroom on my own and relieve myself. Within 15 minutes, they'd removed my IV, punched my ticket for discharge, and wheeled me out to our waiting car.
It was over. You know, except for the recovery part, which is, I'm sorry to say, a total b*tch. I got Percocet for pain, but it has a side effect that is almost poetic in its irony: constipation. And let's just say the first bowel movement rivals the first postpartum poop. It's been painful, and there are moments when I wonder if the treatment wasn't worse than the condition itself. However, I know in the long run (and especially later in my pregnancy), I'll be glad I did this now. And I rest easy in the knowledge that I can someday torture my son with the story of the time he made mommy's butt explode.
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