23
April
2008
You may have been told that you need hemroids surgery, or you may just be wondering “Would surgery be worth getting rid of these hemroids?”
To help make an informed choice, there are a few things you should know about various hemroid surgical procedures.
Rubber band ligation of hemroids
First there are the non-invasive procedures such as latex banding or coagulation therapy. Latex banding involves placing a tight latex band around the hemroid, causing the hemroid to shrivel up and fall off. This is a relatively safe procedure, but it can take up to a week to complete the process, during which time the pain could get quite intense. Latex banding can only be used on hemroids of a certain size, as it’s not suitable for hemroids that are too small to get a good lock on nor for hemroids too large to get the latex band around.
Hemroids cauterisation - laser or freezing etc of hemroids
Another non-invasive procedure is cauterization therapy, which can be performed by laser, medication, or freezing. In this instance, the effect of the procedure is to cut off blood flow into the hemorrhoid at the source. All of these therapies are potentially quite painful, but carry less possibility of long term damage than full incisive surgery.
Hemroids Coagulation
Coagulation therapy, which also causes the complete stoppage of blood to the hemroid, is also an option. This is less effective than most, but also carries less risk and potential trauma, so it is frequently used for the elderly or for those who might not recover well.
The hemroids stapling surgery
The first invasive surgical procedure involves stapling the hemroids back up into the anal canal while excising as much hemroid tissue as possible. This procedure carries much less risk of trauma and permanent damage than hemorrhoidectomy, but does have a higher recurrence rate. People who take this option are about 3% more likely to experience a return of their hemroids. In addition, the surgeon needs to be specifically trained in this procedure for optimal results.
Hemroids hemorrhoidal arterial ligation
Hemorrhoidal arterial ligation is another alternative to full hemorrhoidectomy. In this procedure, the doctor finds the blood vessels feeding the artery, and closes it right above those vessels’ entry into the hemorrhoid. It is also less traumatic than a full hemorrhoidectomy, and boasts a 93% success rate regarding hemorrhoid return.
Hemorrhoidectomy
Then there is hemorrhoidectomy, which involves the total removal of the hemorrhoid and surrounding tissue by either a scalpel or laser. Neither has been proven in clinical studies to work better than the other, and while laser surgery might reduce the chance of scalpel-borne infection, it can also cause deep tissue burns if the surgeon isn’t sufficiently skilled.
A hemorrhoidectomy does carry the highest chance of permanent hemorrhoid removal. However, it also carries the highest chance of extremely bad side effects such as lifelong incontinence and permanent nerve damage. These side effects are fortunately extremely rare, but you should be aware of them. In addition, hemorrhoidectomy has the longest recovery time and usually a long period of pain and inflammation.
Hemroids Surgery
Knowing the risks is an important part of deciding whether surgery is right for you. Only you, with your doctor’s assistance, can decide on the hemorrhoid surgery right for you.
Posted: Hemroids Surgery
20
April
2008
A surgery going wrong has to be one of the worst medical nightmares most people will ever see. The bare possibility of this happening is enough to frighten anyone.
Therefore it helps to understand precisely what is going on, and to understand exactly what your rights are in any given medical situation.
Patient’s Rights
Most surgical theaters in the world have a patient’s bill of rights.
Always check to see if any given hospital has a patient’s bill of rights and, if they do, ask for a copy.
If they don’t have one, find a new hospital.
As long as the hospital has this standard in place, they hold all of their doctors to it, so your surgeon will be bound by it.
If, however, your surgeon operates out of an independent office, ask for the bill of rights directly from his or her office staff, and again, if it is not available, find a new surgeon.
On the patient bill of rights is a very clear right to informed consent clause. What this means is that as long as you are an adult of sound mind, you have the indisputable right to fully understand any medical procedure that is performed on you.
If the patient is not an adult of sound mind, then the right to informed consent reverts to the patient’s guardian.
No matter how many times you need it explained, or no matter in how much detail, you have the right to ask for it. In addition, you have the right to respect for your dignity.
No one should ever use your lack of understanding to make you feel inferior or as if you’re taking up too much time.
Patient’s Responsibilities
Concurrently with a patient’s bill of rights usually comes a list of patient’s responsibilities, and respect for medical staff is on that list of responsibilities.
That means that no matter how frustrated you get with any medical person, you do not have the right to scream at them, insult them, or belittle them.
However, that is all that it means.
As long as you keep your questions phrased in a polite manner and reasonable tone of voice, you have fulfilled your responsibility of respect and can ask as many as you need to fully understand everything in your treatment plan.
Not Happy with the surgeon going to perform the operation?
If asking questions does not make you comfortable for some reason, such as you think that the surgeon is sharp with you or isn’t taking enough care, you have the right to not have the procedure done by that surgeon.
Unless it is a flat-out medical emergency, you can stop any procedure any time before anesthesia is performed, even if it’s the day of the procedure itself.
If it is a life or death emergency, then they have the duty and responsibility to save your life, even if you don’t want them to.
However, hemorrhoids are not usually a life and death situation, and you probably have the time to find a surgeon with whom you are more comfortable.
It’s not a terribly good idea to wait until the last minute before you make this decision, but if you must then you must.
Keep in mind that the hospital, in some places, may charge you, and your insurance may not pay because you went against medical advice.
Therefore, if you do this at the last minute you may foot the bill for anything the hospital did before you changed your mind.
High medical bills are not fun, but you may find them preferable to the fear of a botched surgery.
It is always more efficient and more helpful to everyone concerned if you ask enough questions at the beginning of your relationship with your surgeon to either be completely comfortable or to find another surgeon, but do not let that stand in the way of protecting yourself.
If you are afraid that your surgeon is going to screw up your surgery, it is much kinder to both yourself and the doctor to find another surgeon than to sue for malpractice.
If your discomfort is over something so elementary as you feel as though your dignity or person is not respected, you should find a new doctor immediately.
However, if you are uncomfortable for any other reason, such as a particular surgeon’s lack of practice with the particular procedure that you are having, or a percieved lack of knowledge or regard for your particular medical history, all of these are valid reasons to look elsewhere, no matter how far along in the process you are.
Posted: Hemroids Surgery
19
April
2008
When you find that you must have surgery for hemroids, the questions can come on so quick that it may as well be an incoherent storm in your mind. So many crash in that it can often be difficult to figure out the ones you really need to ask first.
In addition, it helps to discuss all questions you may have well before the surgery so you can go in with full confidence rather than worrying that you forgot to ask something that will prove to be of vital importance.
Questions for hemroids surgery to consider asking
The first and most important question to ask is for the surgeon’s credentials.
While any practicing surgeon will have degrees and certifications on hand, it is also important to inquire how many times they have performed the particular procedure they intend to do on you for your hemorrhoids.
Frequently they cannot give you references to past patients due to medical privacy regulations, but they should have professional statistics available for your perusal that have had identifying information removed.
Each procedure is different, and occasionally the tools are quite different as well. For example, you can have a hemorrhoidectomy done either with scalpels or with lasers. Each tool carries its own risks and must be specifically trained with.
You do not want to be the first laser surgery your surgeon has ever done, even if he or she has completed hundreds of successful hemorrhoidectomies performed with a scalpel.
Once trust has been established, at that point it is important to ask your surgeon to explain the procedure to you in detail. It may take a bit of time to explain in plain language instead of medical jargon, so be patient and schedule yourself a bit extra time.
The purpose of medical jargon is to convey a huge amount of information in very few words, so to unfold it all takes a bit of work, but any surgeon should be willing to take all the time you need in order to fully understand.
Also ask about potential risks from the surgery, and keep asking as long as anything is not perfectly clear. You have the right to know all of the potential consequences of any surgical procedure ever done on you.
Pre and post hemroids surgery
After you fully understand the procedure, you will probably want to ask about pre- and post-surgical practices. Most surgeons will tell you about pre-surgical procedures on their own, as you need to do those in order to be fully ready for the surgery, but listen carefully and ask about anything that is not perfectly clear or that you don’t understand the reason for.
Also, keep in mind that your surgeon does not necessarily know everything about your particular medical history. For instance, many surgeons ask you to take ibuprofen for a couple of days prior to the procedure to reduce swelling and inflammation. If you know that your family doctor has told you to never take ibuprofen, you’ll want to inform your surgeon of that so that you can find a suitable substitute together.
In a similar fashion, only you know the circumstances you will have to live in after your surgery, so there are several questions you will want to ask about post-surgical treatments and restrictions. How long before you can go back to work? Is there a limit on how much you can lift, and for how long? What effects will post-surgical medications have on you? Will you need someone to stay with you around the clock, or will you be fine by yourself or with daytime visitors? If you have special conditions, again, you need to mention those. Most post-surgical procedures are designed for normal, healthy adults. If that designation does not apply to you, you and your surgeon will need to adjust accordingly.
Hemroids Surgery in Conclusion
Surgeons will be patient with all of these questions because they want you to have the best outcome possible. Statistically, people who fully understand their treatment are willing participants in their own care, and have much higher success rates than those who do not.
Therefore, because your surgeon cares primarily about you, and also about his or her professional reputation, he or she will be happy that you are taking so much time to be a partner in your own health care.
Posted: Hemroids Surgery
18
April
2008
When to see a doctor about hemorrhoids.
If hemorrhoids have started bleeding, are too painful to get on with life, have developed a purplish or bluish tinge, or have started protruding through the anus, it’s time to see a doctor.
Embarrassing to see a doctor about hemroids, but this is what you may experience
However, this can be a quite frightening, not to mention embarrassing proposal at the best of times. Getting all the information on what you can expect from your initial examinations is a good idea, and will both help to bolster your courage and let you make informed decisions on your care.
The first doctor you’ll be going to see will, in all likelihood, be your family physician.
Your family doctor knows you and your medical history. Through knowing you better, he or she can often explain complex things to you more easily, and will be on the lookout for your well being throughout the entirety of your treatment plan.
When you go in for your hemorids appointment with your family doctor, he or she may not physically examine you at that time. What is sure to occur is a detailed conversation in which your doctor will want to know exactly what has been going on.
To make the most out of this initial appointment, it helps to write down every single symptom at a quiet time and place prior to going in to the office. This way, you won’t have to worry about forgetting anything, and your doctor is sure to get all of the information they need to help you. If your family physician has the facilities and equipment on hand, he or she may want to physically examine you as well, but some family doctors don’t stock specialized equipment due to space concerns.
Seeing as they are the first people everybody comes to in the event of an ailment, if they kept all of the specialized medical equipment in existence on hand, there would be no room for people in their offices! So, in all likelihood your doctor will then refer you to a specialist and help you make an appointment.
The hemorids examination and what it typically entails
Whether your family doctor or the specialist does the examination, the procedure is pretty much the same.
After your vital signs are taken and noted by the attendant or nurse, you will be let into a private room, asked to replace your clothing with a hospital gown, and draped completely for your and your doctor’s comfort.
The draping serves to both make you more comfortable and to provide your doctor with the visual context for proper clinical detachment.
Rest assured that your doctor is not judging you, nor does he or she find the physical exam in the least bit embarrassing but rather a normal process.
He or she will visually inspect the area, and then probably insert an anoscope to check for internal hemorrhoids.
An anoscope is a tapering hollow metal tube that has a visual portal cut out of one quarter of the wall. Because it only allows the doctor to see one quarter of the anorectal canal at a time, a total of four insertions will be necessary. In addition to the anoscope, your doctor may palpitate the exterior of the anus to check for lumps that are deep within the tissues.
After the physical examination for hemroids
After the physical examination, you will be given time to redress, and then the doctor will come back in to discuss what was found with you.
At this time you should ask any and all questions you may have so that you are fully informed.
During the discussion, the doctor will make recommendations for your treatment plan, which may range from instructions to follow at home all the way up to surgery.
If the physical examination was done by the specialist, you should feel free to discuss everything with both the specialist and your family doctor. In addition, further referrals to other specialists will be given to you at this time. After that, you should be well on your way to getting rid of your hemorrhoids for good.
Your rights re hemroids surgery and doctors
Every doctor should respect your dignity, your privacy, and your right to be informed at all times.
If any doctor does not, feel free to ask your family doctor about the problem.
Perhaps your general practitioner may be able to help resolve misunderstandings, or can refer you to a different specialist who will be better suited to you.
If your family doctor falls down in this regard, it’s time to find a new family doctor.
Feel free to interview general practitioners to find the best fit for you. Be respectful of their time and education, but remember that they are there to help you. With patience and respect on both sides, you should have no more troubles.
Posted: Hemorrhoids Hemroids Doctor, Hemroid Health, Hemroids Surgery
