Piles (the globular form of external haemorrhoids-inaccurately named for their vague resemblance to carpet pile?) have been the butt of jokes for centuries. Bumper stickers declare “If You Were Any Closer to my Ass, You’d Be a Haemorrhoid,” while other wits question why it is called an asteroid when it’s outside the hemisphere, but called a haemorrhoid when it’s in your ass?
I
, however, refuse to respond quietly to this uncomfortable condition. Close to 50% of the population in Western countries will suffer from piles at some time or other, and my own recent experiences are offered as a warning to readers not to ignore the symptoms, as I did for many years.
My salutary tale is about someone who ignored the condition for some years, unwilling to take the time it might require to heal the condition. I was a man with a busy daily schedule, no time to be given to interrupting an active 12 hour day, which included two visits to the gym. Finally, through the urgings of my partner and naggings of a sister, I decided that it was time to do something about suffering a condition that wasn’t natural or necessary.
My first step was to book an appointment with a recommended surgeon, attached to my local private hospital. Convenience of location is always a good starter. However, lying on one’s side, pants off, and knees tucked into chest, while the specialist reaches for his latex gloves does little for one’s dignity. Having gloved hands probing one’s anus, while experiencing the sharp pains of inflamed tissue, was a suitable punishment for ignoring the condition for so long.
Final diagnosis indicated the haemorrhoids were serious and that no medication would improve matters. Surgery was necessary. The non-golfing days when the medical expert was available for theatre work were offered, and while bookings were made, the routine was explained. The patient books into the hospital at noon, the operation, after suitable preparation, is performed late afternoon, and two nights in the facility are necessary for post-surgery care and pain control.
In preparation, one seeks medical aid authorization for the procedures the surgeon specifies and for the hospitalization. One pays the surgeon +-R1200 pre-op. One contacts the recommended anaesthetists, to reserve their assistance for the operation and one then submits the hospital’s registration and booking forms, containing the medical aid’s authorization codes, to assure them that payments will be made.
My procedures were to be a flexible sigmoidoscopy and a hemorroidectomy. The former sends a flexible rod bearing a tiny camera up the nether passage, to explore the heart of darkness and probe the higher reaches of the Amazon. This is to check if there are any further potential problems in the colon and elsewhere. In keeping with the solemnity of the thought that worse could be lurking within oneself, it was reasonably easy not to ask jovially for copies of the pictures to be obtained from that exploration.
The second procedure would cut out the offending veins, stitch the wounds and restore the anal passage to its pristine glory. For at least 24 hours before entering the hospital one was to take in only liquids, no solids, to promote the emptying of the bowels before the op, done under full anaesthetic, when no conscious control of the functions are possible. Then, the final horror was pronounced. During prep, hours before the op, I should expect to be given an enema! An ENEMA?
Nightmarish memories of me as a 4 year-old came flooding back. I must have been constipated for days from the junk foods I craved. My mother loomed over me, holding in her menacing hands what looked like a large rubber-bulbed hooter from a vintage car. Filled with litres of warm, soapy liquid, this was shoved up my protesting ass, while I was pressed onto a potty. This invasion was followed, almost immediately, I remember, by an uncontrollable explosive release of a week’s waste into the inadequate receptacle. This is what faced me, again?
During the fortnight in which I got my affairs in order, found replacements for the exercise classes I teach and rescheduled seminars at the college at which I lectured, the image of the enema haunted me. Psyching myself up to encounter this ultimate act of indignity became my major focus. The op itself and the promised pain that would necessarily follow it faded into insignificance. Pain is something we all need to learn to tolerate, and I would cope with it when it was relevant.
Suffice to say, on the day, after hours of lying on my hospital bed in a comfy private ward, bath en-suite, as predicted, the best looking nurse in the hospital announced the moment. I assumed the position, and made it a supreme Zen moment. Spirit calm, I meditated on the infinite reaches of the universe, accepting that my anal passage was but one tiny, insignificant fragment of a huge entity, and then accepted that what must be, must be. And so, she did it twice!
She sent two sachets to their designated destination, murmured kind words of solace and then left discretely, mentioning that I should make my own way to the toilet bowl, whenever the mood moved me. This, I did, momentarily, and found myself empty, calm, ready for the scalpel, the worst already over.
Later, when I was wheeled down to the theatre, I met my cheery anaesthetist who asked if I knew about their payment policy. He explained that his fellows had opted out of all medical aid schemes as the latter paid so little of their fees, which were treble the medical aid rates. The option of going under the knife fully conscious didn’t seem attractive and I asked if we could haggle, perhaps give me a discount by using a later, vintage chemical?
In this convivial mood he placed the needle in my arm, gave me a taste from the oxygen mask, asked me to count to five, and I awoke to the sound of the theatre sister calling me back to consciousness 35 minutes later, aboard a gurney, about to be glided back to my comfy room, totally numb and pain-free, ready to be greeted by my waiting partner’s chortles at the stylishness of the post-op gauze nappy encircling my loins.
Apart from the later bleeding, which proved difficult to stem, necessitating the caring surgeon’s return later that evening, my 2 day stay in hospital was uneventful. I again assumed the foetal position while he administered a local anaesthetic and then hand-crafted some additional stitches to the wounded veins that were leaking. There were regular visits from solicitous, efficient and friendly nurses. They took temperatures and blood pressure, monitored the gauze for the wound, offered pain killers when needed, brought edible food and medication to ensure loose stools when the first bowel movement would occur, 24 hours after post-op condition wore off.
The first crap was everything they warned it would be! Like passing naked razor blades. For at least a week to 10 days after this sort of surgery, every visit to the toilet is fraught. The anal passage is disturbed and healing tissue is put under stress. One learns to live with the pain and suspends taking pain-killing drugs as early as possible so that one doesn’t become dependent on pain suppression. Best relief is found in a shallow, warm bath with added coarse sea salt (cheap, soothing, antiseptic and healing). A circular pillow does wonders for seated comfort, supporting and keeping pressure off the healing wound and looks cool as a fashion accessory whenever one goes to a restaurant or movie, and particularly handy when sitting behind the wheel of one’s car.
Two weeks after the operation and I was back teaching 3 exercise classes daily and lecturing to the college students again. The new backside is superior to the old, I’m telling proctologist jokes with the best of them, again, and I am no longer living proof that haemorrhoids are a pain in the ass.
Costs? {Note: South African prices}
Surgeon +-R3500.00
Anaesthetist R980.00 (bargain discounted price!)
Ward fees 2 nights R1906.60
Ward drugs R944.53
Theatre fees R1849.50
Theatre Drugs R1809.05
Theatre Extras R604.33
Dispensary Drugs R495.66
Hospital total R8615.83
