Between Us: I had my piles banded so that you don't have to.

Photo by Clay Banks on Unsplash

It has taken me a couple of weeks to prepare this highly scientific post about piles banding (haemorrhoid ligation, for those who prefer to use proper terms) because I wasn’t quite sure how to approach it.

One of my friends told me it might be a bit of a turn-off to write about haemorrhoids, that people might never look at me in the same way again:

‘A lot of your content is about beauty and fashion,’ she said, ‘I’d just be very, very careful about your tone if you do decide to talk about it.’

To which I say a) has this friend ever met me? and b) how does one be careful about one’s tone when they’re about to describe how a man in a surgical gown spent five full minutes firing tiny elastic bands at the inside walls of their rectum?

And that was just at the drinks party I went to the week before! Hohoho.

Anyway, what my friend has missed is that I am mostly doing this post as an act of public service. Because millions and millions of people have piles, but they’re not really something that gets discussed in polite society.

(Possibly because what you’d be discussing would be the “swollen and inflamed blood vessels in and around your rectum and anus”, which has to be the least appetising ice-breaker known to humankind. Even if you’re on friendly terms, no ice-breaker needed, talking about the inside of your rectum has to be up there with the boldest of subjects. It’s the mental image it conjures up, isn’t it?)

It makes me wonder: how many people suffer with their piles and never do anything about them? How many women sit there wondering what solutions are on offer for getting rid of their little downstairs “friends” but are too embarrassed to go to the doctor?

Photo by Clay Banks on Unsplash

And I am here to tell you, categorically, that unless your piles are causing you frequent stress and pain, unless you feel they are ruining your life in some way, you should absolutely just get used to them being there and/or popping them back in when they make the odd appearance in the outside world because oh my GOD I found the alternative so grim and painful and not in the least bit balanced out by the benefits, which for me have been nil, and which we will come onto in due course!

Now by all means go and get your arse checked out. It isn’t pleasant and feels ten times more undignified than having your vag prodded about, but if you are really inconvenienced by your haemorrhoids, or they are very painful, or they are massively affecting your life to the point where you’re unhappy, or you are having any other symptoms in relation to your bowels that could be serious, then please do go and discuss options. I am all for staying on top of things and knowing my normal and asking for help if things seem off.

But if you, like me, are more concerned with just the odd alarming piles episode, the infrequent appearance of multiple external piles that make it look and feel as though you are prolapsing your entire colon out into the toilet, but then the rest of the time the thing that bothers you the most is, erm, the aesthetics of the whole thing, I can with confidence say that the alternative - even the “entry level” procedure - was not worth the trauma.

Due Diligence

I cannot believe that I didn’t do my due diligence on the whole situation, on the piles banding and the laser treatments and on the most dramatic of the solutions, the pro-level surgical option, the Haemorrhoidectomy; because if I had done a bit of online research then I would have noted that the common denominator in almost every comment thread and forum post for all types of piles treatment was…drumroll… pain.

When I was writhing around, fifteen hours post-ligation, an ice cube wedged point-first into my emergency exit and a hot water bottle between my legs, I felt so incredibly naive and silly not to have anticipated any pain. I mean, someone was going to go into my back end with a camera, fill my rectum with air and then snap tiny elastic bands around living, growing things that are on the inside of my body that would then be starved of bloodflow and gradually fall off leaving an open wound that poos would have to graze past on their farewell tour: what part of this did I think would be completely pain-free? Why would I ever, in a million years, not prepare myself mentally and physically for what would so obviously be a highly uncomfortable situation?

I’ll tell you why. The following is from the information that I was given to read beforehand. I’m cherry-picking, obviously, but for our purposes here I’m giving you the significant bits, the bits that jumped out at me and that told me, indirectly, the whole procedure was nothing to really worry about.

“You will not need an anaesthetic as there are no nerves that sense pain at the top of your anal canal.”

Marvellous.

“A silicon band will be placed onto the lining of your anal canal. The band should block the blood supply to the haemorrhoid, causing it to shrink back up your anal canal.”

Splendid. Seems straightforward.

“It should fall off itself after 7 to 14 days. MOST PEOPLE DO NOT NOTICE THIS. (MY CAPS.)”

I mean for the love of God, this sounds easier than a wisdom tooth removal, doesn’t it?

Other pertinent hard facts from the brochure: “pain is usually easily controlled with simple painkillers such as paracetamol” and my favourite, “you should be able to return to work the next day.”

Top Trumps of Orifice-Related Procedures

I want to give you a brief run down of the procedures I’ve had in other orifices: not to show off, this isn’t Top Trumps of undignified orifice explorations, but to try and describe to you where on the scale the pain and discomfort from the Sigmoidoscopy (the camera) and Banding (the piles-shrinking bit) seemed to sit.

Hysteroscopy without pain relief or sedation, circa 2011: camera through the cervix into the womb. Grim at the time but no pain afterwards, just felt I couldn’t speak to another human without crying for approx eight days and spent a fair while rocking back and forth hugging my knees in the bath.

Laparoscopy without pain relief or sedation, circa 2012: as above, but cried during the procedure because they left me in the room on my own, because it was a camera into the womb but then my womb and tubes were filled with dye and then I had a giant X-ray done, and I felt very alone as they all watched me through a protective window. Grim x2.

Colonoscopy without pain relief or sedation, Jan 12th 2012: excerpt from diary “had to go for my colonoscopy today and it was awful! Had an enema (WTF!) and had to wear a backless gown!” This is a camera up the bum (I used to have IBS type symptoms when I was a model, probably was the fact I lived on Diet Coke and Marlboro Lights) but it goes much further up than the little one I had during the piles procedure. Pain: uncomfortable at the time, no pain at all afterwards.

Cystoscopy without sedation or pain relief, 2019: small thin tube up the urethra (wee hole) aka my actual worst nightmare, aka when I had to go again I paid to go privately and be put to sleep because I couldn’t handle the idea of being awake again. It was actually more psychological than acute pain, the pain was more of a weird discomfort, but I am FUNNY about anything in that area due to years of frequent UTIs (now thankfully not a thing) and it took me days and days to get over it.

Where did the banding pain sit?

In short, none of the above caused me actual pain beyond the time of the procedure. Because I wasn’t expecting the pain (mainly with the womb stuff) I think it was just a terrible shock in the moment but then I staggered home and cried, staring at a wall, and then carried on with my life. The difference with the flexible sigmoidoscopy (the camera I had before the piles were banded) and the piles banding (pipe put up that sucks the pile into the pipe and then shoots an elastic around the base of it) was that a) the pain seemed worse at the time, but was mostly from the air trapped inside me, but then b) the pain afterwards was excruciating. And I wasn’t expecting either.

The pain, I think, was a combo affair: pressure inside from the banding itself, which makes it feel as though you’re going to unconventionally give birth to a massive cactus, but then all the pain - which is intense! - from the trapped air, coupled with the fact you’ve had various implements in and out of your back passage for half an hour. I just found it unbearable, pretty much from the minute I got into recovery.

I had been told that I’d be able to drive myself home, which I think must have been another indicator to me that I needn’t worry about the procedure at all: thankfully Rich had dropped me off, taken the kids to the park, because I thought it was a 45 mins in and out job, taken the kids for lunch, taken the kids to the park again, taken the kids to B&M to buy pool noodles and then taken the the kids to the park again, and then there he was at the end to pick me up.

Zombie Arsepocalypse

I walked out of the hospital like a zombie. I could barely stand up straight. I had almost fainted in recovery, where I had to beg for even a paracetamol, and my entire stomach felt as though it was trying to push its way out of my body. The pain just got worse and worse over the course of the following hours, making me think that something had gone seriously wrong because why would I be experiencing so much pain when it was, essentially, according to the literature, a relatively painless procedure?

When I called the hospital outpatients number the following morning, having not slept, I spoke to two different consultants who both said that - I quote - “your level of pain and discomfort is entirely normal.”

Excusez moi?

How can they say that pain is manageable with paracetamol in one breath but then describe that same pain, which was excruciating, as normal?

I decided to take a look online and do some pain research. Bit “shutting the stable door after the horse has bolted” but I needed something to distract me from the fact that something the size of Jeff Bezos’s Blue Origin rocket felt as though it was trying to launch its way out of my rectum.

Photo by Markus Winkler on Unsplash

Though some websites and online sources did seem to acknowledge the existence of significant pain after banding, lots appeared to base their patient pain expectations on the following statistic, which I managed to squirrel down to source and find in this National Library of Medicine guide to complications after banding, here, that at “1 wk, 75% of patients reported themselves as being pain-free.”

No shit! A week! Who measures things by a week? Of course things are going to be better after a week! You could probably get ravaged by a tiger and feel mildly better about it a week later!

‘Oh don’t worry Mr Beakers: we’re going to amputate your arm now, and we’ve actually run out of anaesthetic so you’re going to have to make do with this quarter of a bottle of vodka, but don’t worry! 80% of patients feel no pain at all five weeks after procedure, you’ll be absolutely fine! Maybe not to drive yourself home afterwards, but we expect you’ll be able to manage to get back to work tomorrow if you keep on top of the paracetamol. Just call us if you bleed more blood than can be collected in a wine bottle.’

Photo by Navy Medicine on Unsplash

The thing that some of these advice pamphlets and website sources miss out, is that the guide also says “pain was the most common symptom occurring in almost 90% of patients, with the pain scores higher 4h following the procedure.”

Thank you, yes, and I’d say increasing exponentially until approx 12-24 hours later when the only thing to do is pace deliriously and wait for the next round of paracetamol.

Gnarly

It just feels weird to me that so many outpatient procedures are so unbelievable gnarly - in this case someone literally shooting elastic bands inside your rectum, like a builder with a nail gun or something - yet you’re advised to just take paracetamol, drive home and go back to work the next day, and given no pain relief or sedation options at the time.

Oh bloody hell, I do feel like I’m moaning a bit now, but equally I am really trying to play it down because I found the whole thing quite awful and the memory has not faded with time. I think it’s all made worse because I’m cross with myself: had I researched properly, and not just read the stupid leaflet from the hospital, I would have seen that the majority of people talking about it online had been in lots of pain and not had a good experience and that for a whole load of them it hadn’t worked anyway (5 in 10 procedures don’t even work! HALF!) and I would have weighed this up against the minor inconvenience of my piles and thought

not on your absolute Nelly.

Of course had my piles been more painful, or much more inconvenient, or life-ruining, then I would have weighed it up differently as should you or anyone who is thinking about banding, but the thing is is that you can’t weigh up the facts if the facts you have are inaccurate!

Photo by Kiran CK on Unsplash

For Your Delectation…

And here’s the worst part for your morbid delectation: I had three piles banded, and as the consultant talked me through it I thought, HURRAH! Now I won’t have the equivalent of a bunch of muscat grapes launching out of my rubbish hatch every time I go to the toilet!, but as he collected his tools and whisked off the dust covers, my construction worker, I mean surgeon, said, “oh, by the way, the one on the outside is a skin tag.”

SAY WHAT?

I almost passed out with dismay. The “one on the outside” was the only one I knew about! That was the thing I’d gone to the GP about, the thing I’d said was really bothering me, that I felt was just unhygienic but also kind of embarrassing, never really painful but sometimes uncomfortable and guess what friends?

IT IS STILL THERE!

Could you even make this up? I could not. It’s the most ridiculous, annoying, upsetting twist in the tale. I didn’t even know the other three existed. I could have lived with them for a lifetime none the wiser. I almost feel sorry for them: living peacefully up there, harming no-one, staying in their lane, waving around like fronds of seaweed in the ocean (I imagine?), and then bam. Strangulated with rubber bands around their very necks. Slowly starved of life-force. Eyes bulging as they withered and died, falling off like spent barnacles.

And even they have a 50% chance of coming back to life.

Bloody hell.

Silver Lining

So basically, the only beneficial thing to have come from this experience is that I can tell you about it, so that if you, like me, were weighing up your options, you’d maybe take some time to do a little more research. The aim isn’t to discourage, but to demystify. If you feel as though you might read up a bit on it, ask around, see what options are available for better pain relief post-procedure, or perhaps sedation during, if you know you’ll find it distressing.

The other beneficial thing that has just occurred to me is that the whole farce has been a 9/10 on the comedy rating scale, mainly because I got to wear something called Modesty Shorts. I could barely contain my glee, quite honestly.

These bermuda-style shorts were made out of papery stuff that was slightly see-through, but that wasn’t the best bit: over the bum crease, there was a square door, a peekaboo flap, that was fastened on with velcro!

Oh, the joy. How many times during my one hour wait did I open and close that access hatch! I’ll tell you: eight. Which is why when it came to the actual procedure, the velcro had stopped working and the flap just hung open, like an invitation.

Shame, because I was looking forward to someone having to noisily rip it open at the start of the procedure, really dramatically, and then I’d be able to crack some kind of massively inappropriate joke, like, “ooh, everyone loves an easy access!” or similar.

Alas, I lay on my side on the operating table/pleather bed and it just flopped open behind me, revealing the bright side of the moon before anyone had even asked for it. Embarrassingly forward, borderline crass.

Mind you, the consultant was chatting away to his colleagues about his house renovation, and I’m not sure you really notice bare arses much if you spend the whole day looking at them?

I cannot write the word arse again, today: I’m starting to worry that my friend is right, and that I shouldn’t be telling you any of this at all, even though my archived post Accidental Penetration and the Fibreglass Cow is one of my most-read posts of all time and also Topple, Tipple, Grab my Nipple, both of which go in deep with overshare and inappropriate content. But anyway, in case she’s right this is where I stop, and I now open up the comments for all of your own piles-related anecdotes and private parts experiences.

What a time to be alive.

Hit the heart button on your way out and do share this with anyone who might find it useful, just preferably not any of my relatives, my husband, or people I have to deal with in a professional capacity in any way, shape or form.

Thanks in advance.