I know this sounds gross, but when I had bad ones after the birth of ds, my dr told me to try pushing them back in. They are much more comfortable (and less likely to get worse) if they're safe inside. I did this in the shower. Once you get past the ick factor, it's really not all that bad. I also used prep H (the cream base, not the pertroleum jelly base, which is very slippery and uncomfortable.) And if they get really bad, there's a prescription steroid cream that works well. Try not to think about surgery. Odds are you won't have to do that.