This topic is about finding relief from pain and understanding the recovery timeline after undergoing Barbie Butt surgery, also known as abdominoperineal resection (APR). This procedure involves creating a colostomy and removing the appendix. The person who started the discussion is experiencing significant pain at the perineal incision site four weeks after surgery and is seeking advice on pain management and recovery experiences from others who have undergone similar procedures.

Here are some helpful insights and advice shared by the community:

1. Pain-medication strategies:
- Consider using extra-strength Tylenol or acetaminophen, and take it regularly.
- Ibuprofen, ketoprofen, and muscle relaxants can also be helpful.
- Cocodamol (a combination of codeine and paracetamol) may relieve pain and help with stoma output.
- It's important to stay ahead of the pain by not skipping doses, even if you feel okay at the moment.
- Be aware that some surgeons may limit opioid use, like Percocet, after the fourth week.

2. Seating and positioning:
- Use very soft, flat cushions such as microbead pillows, soft gel cushions, or waffle-style air cushions.
- Avoid donut or hemorrhoid rings as they can increase pressure on the wound.
- Carry a small pillow with you to use in the car, dining chairs, or office seats.
- Try to recline, lie on your side, or stand instead of sitting when possible. A zero-gravity chair can offer relief.

3. Sitz baths and hygiene:
- Take warm sitz baths 2–3 times daily using a toilet-top sitz bath unit.
- Shower daily or cleanse the incision area specifically, with some opting for two showers a day.

4. Wound care and products:
- Pack the wound with rolled gauze to prevent skin surfaces from rubbing, and change it several times a day.
- Use Triple Paste diaper-rash ointment to provide a barrier and ease pain.
- Open wounds may require daily dressings, a visiting wound-care nurse, or a wound-vac system if large or infected.
- Be vigilant for signs of abscesses, fistulas, or persistent drainage, and seek medical imaging or a surgeon's review if needed.

5. Activity and precautions:
- Walk short distances with small steps to prevent stiffness, but avoid heavy lifting, squatting, or using an exercise bike until cleared by a doctor.
- Gradually reintroduce sitting and core-strength exercises with guidance from a physiotherapist.

6. Nutritional and supplemental help:
- Vitamins that aid healing, especially vitamin A and zinc, were recommended by some members.

7. Typical healing timeline shared by members:
- Weeks 4–7: Pain is still significant, but many notice improvement around weeks 5–7.
- 10 weeks: Some begin to feel somewhat comfortable.
- 12–16 weeks (3–4 months): Most report substantial relief, with scars stopping weeping and a return to activities like swimming or full-time work.
- 5–6 months: Lingering tenderness is manageable.
- Outliers: A few needed 7 months to a year or more, especially if complications arose.

8. When to call the surgeon:
- Contact your surgeon if you experience sudden bleeding, wound opening, persistent pulling from stitches, high fever, foul drainage, increased swelling, or severe new pain.

9. Mentioned cushions, devices, and products:
- Some helpful items include the Ehob Waffle Cushion, Valley Cushion, Egg Sitter pillow, Boho cushion, microbead pillows, gel cushions, zero-gravity chair, Shewee for urinating without sitting, Triple Paste ointment, and Amphor topical product.