Neil's story Rafaelo Procedure

I’m writing this overview in the hope that it inspires others to seek the right help and treatment for their haemorrhoid issues. Had I not persevered, carried out my own research and finally met Alex Von Roon, I would have either still been living with debilitating haemorrhoids or undergone what I feel would have been a hideous ‘sledgehammer to crack a walnut’ operation - painful and invasive.

I’ve lived with haemorrhoids, I understand what it is to have the burden of them - it’s not nice, it can be embarrassing to talk about, as mentioned it can be debilitating in certain situations, they play on your mind, impairing your comfort of life in so many ways. I understand that all cases of haemorrhoids are different, I get that, but mine were quite bad and this procedure really did work. I’m not a special case in any way - it is staggeringly effective.

I had Grade 3 haemorrhoids, a couple had started to show after using the toilet and sometimes I would feel the tips protruding and I would have to push them back in. Sometimes everything would be inflamed; the whole anus, especially after a big night of rich food and alcohol. I just seemed to react - I didn’t even know if this was due to the haemorrhoids but it seemed that the situation was getting worse and there were all manner of ‘things’ presenting in all sorts of ways. Added to this was what I would describe as an almost external-like, quite large lump that would sit on the outside opening of my anus. I thought perhaps that this was an external haemorrhoid and I had read that ‘Rafaelo’ was not suitable for external haemorrhoids.

So, my journey…finally, after putting up with them for a couple of years I went to see a consultant who told me I had severe grade three haemorrhoids. He told me the only course of action was a PPH procedure or Stapled Haemorrhoid Surgery - this, in basic terms, is where a device shaped like a rocket pushes your mucosal prolapse back up. This leaves a bunched-up ring of loose internal ‘skin’ that is then snipped off, with the pushed up ‘mucosal skin’ stapled into place. Search it on YouTube if you have any questions. The bottom line: It is a pretty big operation with a pretty big, and painful recovery time - and added to this I have learnt that the inside of your anus is a pretty complicated and sophisticated tool - it knows how to differentiate between water, gas and solids and it controls all decisions… so risking any damage to this delicate area was just not an option for me. The invasiveness coupled with the recovery time and pain and then the potential damage was too much to contemplate. I froze for a year and did nothing. My haemorrhoids got worse.

I then started to research other options and Rafaelo was one - but I didn’t hold out much hope due to my thinking… a) I have grade 3 and b) external complications too (I’d never been told this, just the evidence I could see and feel).

The Rafaelo website was where I found Mr Alex Von Roon. I’m a private patient, with all of my previous consultations covered via my health insurance, but I didn’t contact my insurance company - I just booked out of wanting to secure immediate action and not suffer anymore of my own procrastination. Note: The procedure is covered by health insurances, it’s fairly new and they do want additional information, but all costs were subsequently covered, past my initial consultation - very easy to retrospectively inform them of your appointments and move things forward with a letter from the consultant. It turns out that it was the best thing I could have ever done.

Alex Von Roon is excellent, that was my overwhelming feeling after my consultation. Why? Because he spoke to me at length, really, really took time to understand my particular set of circumstances. He then examined me and we sat back down where he proceeded to tell me exactly what I was experiencing, why, what could be done, what I perhaps should consider and not consider. He went into great detail, in a language I could understand - not medical, but human. He had a depth of social intelligence that is sometimes lacking (understandably) with doctors/surgeons etc. Knowing how to take time and properly consult, understand, put a person at ease, explain…these are attributes that I personally have rarely found. Safe to say I trusted him. And it is important to remember that he was not there to sell me this or any procedure, he is a consultant - we discussed it all, every option - it turns out that my research had paid off. I had found a consultant I trusted and the Rafaelo would indeed work for me - no guarantees of course, but a very balanced opinion and understanding. So I booked immediately, contacted my insurance company and the date was set.

The hospital:

I was booked into OneWelbeck in Marylebone. I usually attend private hospitals, but OneWelbeck was by far superior to any place I had previously been to. Excellent facility that was only upstaged by its staff - they were/are absolutely incredible. Super attentive, caring, communicative and ‘on it’ - nothing more to say really. Perfect experience in terms of care, and comfort.

I was hideously late as I hit traffic, but everyone was very relaxed about it, not even a hint of frustration - even Alex Von Roon came to see me and assured me that it was absolutely fine, informed me of my new time and put me at ease again.

Alex Von Roon came to see me and we discussed the options of sedation or no sedation - as he has reminded me, I apparently am quite stoic - he told me a couple of things a) the operation was circa 20 minutes and b) I would be fine to even go shopping after - that’s how non invasive it was. But, having the sedative meant no shopping, being driven home, groggy etc… I chose no sedation. For me it was the right move. I wasn’t worried, I wanted this done, I could endure 20 mins and I had been assured it was not painful. It wasn’t.

I was wheeled down to a brand new theatre with some more very nice staff, I got on my side - knees up and we proceeded (they did chat and put me at ease of course, but we were there to get this done and I appreciated that).

They put something into the rectum; a tube with a slot cut out - this isolates the haemorrhoid enabling them to inject some local anaesthetic under each one they are working on - it doesn’t hurt at all. They then use a probe to heat the haemorrhoid. Again it doesn’t hurt, it gets warm - and when it gets a little too hot he stops and that one is done. I don’t know how many he did, perhaps 5 or more.

Was there any discomfort?

Yes, the tube they insert - it was understandably alien to me, the sphincter muscles got a little sore from clamping. But it’s nothing, 20 minutes and it’s done - and it’s not in there the whole time, it is inserted with each treatment, so in my case - about 5 times. It is bearable.

As a note - I have a slightly enlarged prostate and this did feel uncomfortable - so nothing to really do with the procedure, more of a side effect of the tube pushing the prostate - but again 20 minutes, in short bursts.

Would I have sedation if I had known, or if I was to have the procedure again? No. Because, for me, after 20 minutes I was done. I had to sit on the bed as a precaution for an hour or so, but I was 100% back to myself.

"Total end of my problems from haemorrhoids - gone. Instantly. Not in a few days. Immediate."

I booked into a hotel just down the road as I was fearful of all sorts of things: bleeding, pain and so on… I had nothing like this. I walked to the hotel, booked in and then went shopping in Regent Street - I walked about 3 miles that afternoon - I was fine.

I got back to the hotel a couple of hours later, ladened with shopping bags (presents for my daughter mainly) but did treat myself because I had finally done it - I deserved it. Then I found I needed to use the toilet - so I went, it was fine - a tiny bit sore, like a 3/10 - but not as bad as how the piles had been on occasions. Easy.

Alex had given me a prescription for Co-codamol, something to relax the sphincter and told me to get ibuprofen and paracetamol (and had given me instruction as to how to back-to-back these for optimum effect). I also had a pain relieving suppository - so my immediate pain post op and for the next day, was never more than a 2 or a 3/10 - very, very manageable.

That night I also walked to Oxford Circus for a Five Guys burger and chocolate milkshake - I say all this to show just how relaxed the whole situation was, I wasn’t unable to be me physically or emotionally. I wasn’t worried about eating and what would come - everything was fine.

The week that followed:

I had some pain as it healed, but never more than a 5/10 and that was whilst having a bowel movement. Normal life was just that - normal - you wouldn't notice anything really at all.

I had some prostate issues I think, blood in my ejaculate, but this could have been due to the injection - either way, zero pain and it cleared up within a week - I didn’t call Alex, it wasn’t necessary.

The result:

100% completely instant, total end of my problems from haemorrhoids - GONE. INSTANTLY. Not in a few days. Immediate. The one on the outside is gone, nothing at all - I cannot believe that I was living with them for 2-3 years. This surgery is incredible and nothing short of life changing, because if you’re living with haemorrhoids, you actually now don’t have to.

I can’t really say any more - I can now eat what I like, do what I like (I run, play tennis, work out - and did all this within 3 weeks of the procedure). I didn’t feel I needed to refrain, but did so because I wanted the best possible healing. I am writing this almost exactly 2-months after the procedure. I feel great and I am so very happy I did this. My life is different. Better. Normal again.

The procedure just works - simple as that, but like anything - pick your consultant well. I used Alex Von Roon, and in my estimation, he is a seriously good person. I meet a lot of people in my profession, most are professionals or business leaders, you get to be able to tell a lot about people - he stands out as one of the most empathetic, yet seriously focused and committed people I have ever met. A very good guy. I wish him the best of luck and hope anyone reading this finds the strength to get this done; reach out to Alex and know you are in extremely good hands.

I have to add: Alex did not ask me to write this, I felt compelled to do it to help others. Don’t suffer with haemorrhoids, you don’t need to. Don’t waste a minute, book an appointment.