BS: Hernia diagnosis

Subject: BS: Hernia diagnosis
From: Donuel
Date: 09 Sep 05 - 10:55 AM

After lots of incredible pain over 14 months and half a dozen hospital and doctor visits the CAT scan finally revealed an abdominal hernia.

Cheesh, I have been lifting compressors over 350 lbs. in the meantime.

I get to see a surgeon next week.

Anyone know how these things go?

Subject: RE: BS: Hernia diagnosis
From: Wesley S
Date: 09 Sep 05 - 11:02 AM

Snip Snip and a tuck or two. Some good drugs { perscribed } helped also. I was flat on my back for a couple of days and then had to take it easy for a week or two. No long walks for a while. Don't lift anything heavier than your TV remote. Get several good movies to watch - catch up on your reading and let someone pamper you for awhile. Streach it out as long as you can. Play the sympathy card. Take it easy on yourself now or you'll pay for it later.

Subject: RE: BS: Hernia diagnosis
From: John MacKenzie
Date: 09 Sep 05 - 11:06 AM

I assume it is internal otherwise you'd have found it for yourself. If it is a Hiatus Hernia [quite common] they can operate laparascopically, and pull the end of your aesophagus down and stitch your stomach a little way up the tube which stops reflux, but has odd side effects like not being able to vomit or pass wind up the way. If you have what I suspect a strangulated hernia, which would cause more pain than a hiatus hernia, then I can't advise on that as I don't know what they do to sort them out.
Giok

Subject: RE: BS: Hernia diagnosis
From: fat B****rd
Date: 09 Sep 05 - 11:53 AM

Get well soon, Donuel and do as you're told !!.

Subject: RE: BS: Hernia diagnosis
From: Donuel
Date: 09 Sep 05 - 11:56 AM

Nope, its just below the navel.

After a year it took throwing a fit to get a proper diagnnosis.

I think doctors get a bonus from their HMO's for keeping tests and treatments to a minimum.

Subject: RE: BS: Hernia diagnosis
From: GUEST,DB
Date: 09 Sep 05 - 12:08 PM

It sounds to me like an 'inguinal hernia' - I had one of those. It's something to do with the tubes that are connected to your personal bits-and-bobs - they have to pass through some sort of muscle wall (pelvic?) and they create a weakness there. As you have no doubt discerned my knowledge of human anatomy is a bit vague - that's probably why they're striking me off the medical register next week!
Anyway, these days they fix it using 'key-hole' surgery (laparo-whotsit).
'They' will probably tell you that it doesn't hurt - that's probably because 'they' have never had it done! Mind you my mate John had full blown surgery and he said that that hurt like hell - so I probably got off lightly (I'm talking about post-operative pain, you'll be relieved to know!).
My surgeon said that he knew someone who was playing golf a week after the operation. I asked if there was any chance of me turning into a golfer (horrible prospect!) but was accused of being facetious!
Anyway, it took me about 6 weeks to get over the operation - but I'm a bit of a slob. If you're fairly fit it should take less time.
My op. was in 1993 but about a couple of times a year I still get a bit of mild discomfort - probably the result of inflammation.
As operations go, not too bad - and, as I say, if you're fairly fit you shouldn't have too many problems - apart from the 'navel problem' - I'll leave you to find out about that yourself!

Subject: RE: BS: Hernia diagnosis
From: LilyFestre
Date: 09 Sep 05 - 01:22 PM

I had a hernia that bulged out from my navel. I had same day surgery and about a four inch incision. They knocked me out for the procedure, I woke up twice during the surgery but felt no pain, just some pressure like someone pushing down hard on your belly...not like I was being punched, just pressure. After the surgery, I spent about an hour or so in recovery where I am told I was beyond giddy...my husband thinks it was the drugs but I was SO damn relieved to have it over with that I think it was a combination. Anyway, I had a half hour ride home, went to the pharmacy, about fell asleep waiting for my meds, went home and slept the rest of the day. Thankfully, I didn't have any difficulties. I took it easy, followed what the doc told me to do, kept the incision beyond clean and let other folks do things I couldn't without worrying too much. I think I took a total of 2 pain pills. The worrying about the procedure was the worst part, I swear it.

I will tell you though, that for about a month after the surgery, your abdominal muscles will be really week. You will have little control of bathroom issues...don't think you will be able to wait that extra five minutes because you won't be able to.

Hmmm..what else....oh yeah, I had about 21 stiches or so....they were not an issue at all. The after part of the surgery, while you are still healing is a pain in the rear....you aren't supposed to lift stuff (obviously) but even little things like sweeping the floor, pulling wet clothes out of the washing machine...they pull and can be painful. The site where my hernia was still feels weird sometimes....but that's when I over-do something. Be a good boy for the first few weeks, rest, read and then get back into the swing of things as your body allows....you'll know...bodies are good about giving hints like that.

Good luck to you and if I can answer any other kinds of questions, feel free to PM me anytime. I don't know about you, but for me, this was a first time surgery, I was scared to death and would have given anything to have talked to someone who had had it done before.

Michelle

Subject: RE: BS: Hernia diagnosis
From: jacqui.c
Date: 09 Sep 05 - 01:36 PM

I'm having surgery for an incisional hernia, caused as a result of the internal hysterectomy incision giving way, so I am told. I get back from the UK on the 19th and go in on the 21st, stay overnight and will be home next day.

The surgeon says that they will be doing it laparoscopically and covering the area with mesh to hold the thing in.

I'll let you lnow how it goes.

Subject: RE: BS: Hernia diagnosis
From: Stilly River Sage
Date: 09 Sep 05 - 03:02 PM

Good luck with the surgery and recovery, Don. It's damned annoying having to wait so long to get an answer. I haven't made the HMO choice for many years with my employer's benefits, I go with the PPO. I may pay more up front, but I can go to the doctor I need to go to when I want to go. There's a lot to be said for that. It isn't perfect, though. My GP stopped taking Blue Cross/Blue Shield because they are so slow to pay and they're trying to reduce payments again. So I have to pay upfront and get less back by using an out of system provider or find a new doctor.

Maybe when Hillary becomes president we'll get American health care fixed.

SRS

Subject: RE: BS: Hernia diagnosis
From: John MacKenzie
Date: 09 Sep 05 - 03:12 PM

A friend had two hernia operations, one either side, both of which involved the use of mesh to repair the tear. Some time later he had to go in for a prostectomy and because of the mesh they couldn't get in 'through the front' the normal route. So they had to go in from behind, oops!
G..

Subject: RE: BS: Hernia diagnosis
From: Donuel
Date: 09 Sep 05 - 03:23 PM

Thanks. I'll be sure to ask for some super mesh.

Subject: RE: BS: Hernia diagnosis
From: kendall
Date: 09 Sep 05 - 03:29 PM

I keep getting this picture of someone patching a hole in an old fender with fibreglass and bondo!

Subject: RE: BS: Hernia diagnosis
From: akenaton
Date: 09 Sep 05 - 03:35 PM

Hi Donuel, I've had a double hernia due to my work, which involves lots of heavy lifting often from precarious positions.

The first operation went very well, a couple of days in hospital then a couple of months recouperation. Back to work in three months all in.

The second op was a nighmare.
I had left the hernia too long, and by the time I saw the doctor it was huge. The op was botched and I ended up contracting the "superbug" MRSA.
I wont go into the gory details, but it was very unpleasant.
Off work for over 1 year!!

I would advise you to have the rupture repaired by laser surgery if its not too large...This cuts down the risk of hospital aquired infection. If the rupture's small you'll have no bother and be up jumpin' about like a young un' in no time

Good luck Ake

Subject: RE: BS: Hernia diagnosis
From: Bill D
Date: 09 Sep 05 - 03:38 PM

I've had both sides done...once at age 11, and the other at age 38. Neither was a big deal....just no trampoline lessons for a few weeks. You feel lousy on day 1...bad on day 2..uncomfortable for a week, awkward for a couple more....and BOY do you feel better after that!

It is just sewing some weak and torn parts back together, so stuff doesn't protrude thru the hole and hurt, like you have felt.

Take it easy, plan some extra 'easy' graphic time after day 3, and reposrt in as you wonder why you waited so long.

Subject: RE: BS: Hernia diagnosis
From: Stilly River Sage
Date: 09 Sep 05 - 03:45 PM

My ex had a hernia when he was a teen, and had a note from his family doctor when he had to report to the draft board back in the late 1960s. Seems the army doctors "couldn't find it," so he went into the army. He tells stories about curling up in fetal position to get the intestines to slip back through the abdominal wall.

When he had about a month left he went into the military hospital for the surgery to repair it. Doctors said it was the largest hernia they'd ever seen on a young man his age. He was in the hospital for a month, getting out one day before discharge. The chore his commanding officer put him to? Lifting boxes. Good thing he had a note from his doctor to avoid that job.

SRS

Subject: RE: BS: Hernia diagnosis
From: LilyFestre
Date: 09 Sep 05 - 03:56 PM

Before I had my surgery, I had ended up in the ER. I had a bad cold and had been coughing really hard...that caused a lot of pain where my hernia was. So...I went to the ER and they gave me a shot in the rear, had me lay on my back on the table, tilted the table so that my head was well below my feet and the doctor PUSHED my hernia back in by hand. Didn't feel a thing...gotta love those numbing agents. It was, of course, a temporary fix.

Not to be grusome or anything but because I had had my hernia for a year or so (got it carrying an oak hamper through a farmer's market while we were on vacation). Because hernias tend to get bigger as time goes on, stuff tends to get all bunched up in there. Don't ask me what the "stuff is" but my surgeon told me he put mesh in to fix the actual hernia and then removed a ball of "stuff" that was the size of a softball from right beside the hernia. Weird. That didn't hurt either.

I feel like you are getting a lot of horror stories here but honestly, mine wasn't as bad as I thought it was going to be. Aside from the worrying, the most difficult part for me was turning over in bed at night....that pulled.

Michelle

Subject: RE: BS: Hernia diagnosis
From: Donuel
Date: 09 Sep 05 - 04:04 PM

Akenaton, sorry to hear about the bug. I guess what I have is small since it is not visible. I can feel a teeny bump and with pressure it talks to me in fiery tones.

The situation is not one in which I waited. I went to the Emergency room 3 times and the doctor 3 times. I did not get a refferal for a cat scan until I raised my voice to my doctor. But maybe it was just as well since having an operation while in the midst of moving to a new house would have been awful.

Subject: RE: BS: Hernia diagnosis
From: akenaton
Date: 09 Sep 05 - 05:08 PM

Sorry Don , I meant to advise keyhole surgery.....Not laser of course.
With keyhole the incision is tiny and healing time minimal .

Subject: RE: BS: Hernia diagnosis
From: Bill D
Date: 09 Sep 05 - 08:12 PM

When I first discovered my problem, I wore a truss for a few weeks to keep pressure on the spot, but one day I lifted a suitcase in preparation for a trip, and 'riiiippp'..then it HURT, and I had to find a surgeon. Barring complications, they now have you up & walking the same day, and usually OUT after one night.

Subject: RE: BS: Hernia diagnosis
From: LilyFestre
Date: 09 Sep 05 - 09:16 PM

Donuel,

   Some hernias start out small and stay that way, others get larger and at least in my case, the doctor said it was nothing to worry about, that it did not require immediate surgery but that eventually surgery would most likely need to occur. I'm sorry it took them so long to figure out what was going on and glad that you will be able to have it taken care of before it becomes even more of a pain.

Michelle

Subject: RE: BS: Hernia diagnosis
From: Mark Cohen
Date: 09 Sep 05 - 10:28 PM

Everyone's info is well-meaning, but probably not related to what Donuel is talking about. If it's "just below the navel" and in the midline, then it's not an inguinal hernia, which is the most common kind and the one most people tell their stories about. From his description I suspect he may have something called a ventral or epiploic hernia, also known as an epiplocele. It often can cause intense pain (unlike most inguinal hernias, unless they're incarcerated), and is notoriously difficult to diagnose. It's caused by a small amount of fatty tissue from the omentum protruding through a defect in the midline of the abdominal wall. It should be fairly easy to cure it surgically, and I wouldn't expect a very prolonged or difficult convalescence. But I'm not a surgeon, and my diagnosis may be wrong. Best bet would be to ask your surgeon.

Aloha,
Mark

Subject: RE: BS: Hernia diagnosis
From: Donuel
Date: 10 Sep 05 - 10:01 AM

Aloha, sounds good to me.

What a friend we have in mudcat.

Subject: RE: BS: Hernia diagnosis
From: jonm
Date: 10 Sep 05 - 06:00 PM

Been done twice, one inguinal, one ventral (yes, Mr. Cohen, you speak true...).

Feel bad day one, better day two, a fraud by day four for doing nothing, they let you drive after a fortnight and back to normal after a month.

Eighteen hours after the second op, the other half of my semi-detached house caught fire! So there's me in my pyjamas in the iddle of the afternoon and the fire brigade asks me to empty any valuables from the adjoining upstairs rooms. So that would be piano accordions, guitars, other instruments..... Fortunately it was swiftly under control. Chav parents whose kids play with matches and cigarettes at age eight.

Subject: RE: BS: Hernia diagnosis
From: GUEST
Date: 11 Sep 05 - 07:40 AM

Dounel, hi ole buddy....

IF this is an inguinal Hernia, look for a Surgeon who does the Schoeldist Technique. I went thru 4 failed operations with long recovery periods to no avail. Found out about a Doctor that does this style, was operated on starting at 2 PM Tuesday, went to a Hotel that evening, WALKED for about 3-4 hours the next, then on the next day drove 75 miles home on Thursday morning and was at work Friday AM.
The company nurse didn't beleive I had it done.

This was a 6 inch incision due to previous damage being so great with a previous infection, etc so the room was required to insert a large piece of mesh.
This was 10 years ago and I do not know if American Surgeons perform this type or not. They did not back then and my personal Physician had sent many patients to Canada. I went to a Canadian Doctor who had relocated to Cleveland, Ohio. Oh, I forgot the hour plus plane ride home. I walked to the operating room and walked back to the recovery area. Speaking of walking, the Surgeon stressed that walking was an integral part of recovery. I have since done it all, loading large decorator stones, landscape work, you name it.

Subject: RE: BS: Hernia diagnosis
From: GUEST
Date: 11 Sep 05 - 07:51 AM

Donuel, shpiold have mentioned I am sure this type of surgery works on any type of Hernia.
An interesting aside, they more or less have you doze off while the Doctor does a 'nerve block', then you are brought back to awareness due to the Sureon having you do things like lefting your legs up a little or sticking your stomach out so he can get everything into balance. You are never completely under and have a great awareness at the end of the procedure which allows you to slide off the table and walk.

This is exactly the way it went down. Five hours after the start of the surgery, I sat down to the usual dinner one would have.

Subject: RE: BS: Hernia diagnosis
From: bobad
Date: 11 Sep 05 - 11:16 AM

Schoeldist Procedure should read Shouldice Procedure.Info here.

Subject: RE: BS: Hernia diagnosis
From: GUEST
Date: 11 Sep 05 - 05:09 PM

bobad is correct and Donuel, the procedure is done all over Canada.
Why we don't use this in the US defies belief. My Surgeon said that in most Hernia repair, an NFL player could be back on the field in a couple weeks.

Subject: RE: BS: Hernia diagnosis
From: Mark Cohen
Date: 11 Sep 05 - 08:29 PM

Guest, the Shouldice technique IS used in the US. It's one of the two common techniques for repairing inguinal hernias. (Which, by the way, Donuel does NOT have...so you can ignore all the discussion about Shouldice, Donuel!) The other, newer, procedure, is called the Lichtenstein technique, which uses a prosthetic patch and/or plug to close the defect. And, according to a prospective randomized study published in the British Medical Journal, the Lichtenstein is better than the Shouldice:

BACKGROUND: The aim of the present randomized trial was to compare the Shouldice procedure and the Lichtenstein hernia repair with respect to recurrence rate, technical difficulty, convalescence and chronic pain. A further aim was to determine to what extent general surgeons in routine surgical practice were able to reproduce the excellent results reported from specialist hernia centres.

CONCLUSION: Lichtenstein hernia repair was easier to learn, took less time and resulted in fewer recurrences. It was possible to achieve excellent results with this technique in a general surgical unit.

Now, the Shouldice method, as opposed to technique, means doing what Dr. Shouldice did in the 1940's: dedicating an entire hospital to one surgical procedure. The Shouldice website, linked to by bobad, likens their hospital to a sort of "medical factory." They state, correctly, that factories of any sort which specialize in one procedure or product generally do a better job at it than those which do or make many different things. Here's a quote from their website:

For over a decade professors at Harvard Business School have been teaching the merits of focus in business to their MBA and EMBA students. Harvard's concept of the "Focused Factory", a business that concentrates on the practice to perfection of one clearly defined process, is so well regarded that over 75 of the worlds leading business schools have adopted it in their own teachings. The philosophy is capsulized and highlighted in a service oriented case study about Shouldice Hospital, written by Harvard professor James Heskett and Mr. Alan O'Dell, the managing Director of Shouldice.

Subsequent to the case study, two books have been written by Harvard professors which feature the Shouldice example for the same purpose. The books are "Market Driven Health Care" by Regina Herzlinger and published by Addison Wesley and "The Service Profit Chain" by James Hesker, Earl Sasser and Leonard Schlesinger and published by The Free Press.

We haven't generally approached medical procedures this way in the US or Canada, with the exception of the Shouldice hospital, and the more recent example of specialized centers for ophthalmologic procedures like Lasik. It does make sense, and I have nothing against it, but it's not for everybody, and certainly not for every problem.

So don't get your knickers in a knot about an apparent "conspiracy" by American medicine to limit the use of a successful surgical procedure. It ain't so...and in fact, the procedure isn't any more successful than the alternative.

The most important thing is to have a surgeon whom you trust and with whom you can communicate...and who does your particular operation with some frequency.

Aloha,
Mark

Subject: RE: BS: Hernia diagnosis
From: Peace
Date: 11 Sep 05 - 08:34 PM

Luck to both you and jacqui.c.

Subject: RE: BS: Hernia diagnosis
From: open mike
Date: 11 Sep 05 - 10:57 PM

"unless they're incarcerated"---and they all should be incarcerated..
it is a crime how much trouble these gol danged hernias cause...
equal to assault battery, I say, and all that stolen time,
inclluding pain and suffering...

Subject: RE: BS: Hernia diagnosis
From: Donuel
Date: 11 Sep 05 - 11:15 PM

Repair is mandatory since I have had 3 episodes when my waist expanded 11 inches overnight combined with a 90 % loss of energy.
Three days later I would be almost back to normal but none the wiser as to what was causing it. When I find out exactly what kind I have I will still wonder how I could have done some of the physical feats this year without further injury. Lucky I guess.

Some of you should write the book "Abs of carbon fiber mesh"
When people have had carbon fiber to repair ligaments and tendons, the carbon was so strong that the bone would break before the tendon would.

Subject: RE: BS: Hernia diagnosis
From: Donuel
Date: 16 Sep 05 - 10:27 AM

I went to the surgeon and he said he could not feel anything there or read anything in the cat scan report regarding the tiny area of firery pain so he could not offer any surgical cure. However he did provide an explanation of the secondary episodic swelling due to fluid retention caused by a large prostrate. Recommendation: a Colonoscopy* exam and urologist appointment.

I am still encouraged by the insights of Mark Cohen. My surgeon really didn't know the name of the "ventral or epiploic hernia, also known as an epiplocele". "notorious for diagnostic difficulty"

The doctor did speculate about an inflamed Eurakus which is a vestigal fetal organ that was part of the umbilical structure.

My next step is to get the actual pictures from the Xray, sonogram and cat scan in hand so a specialist will not have to rely on the abbreviated reports of these tests.

Current treatment only consists of a prescription for 100 pain pills.
The Rite Aid Drug store was unable to fill it and although they were ordered for this Thursday they were still unable to completely fill it. Perhaps the prescription was forwarded to DEA for investigation and a new can of worms may be developing.





* sounds like the advice I have gotten for years from donuel bashers :^)

Subject: RE: BS: Hernia diagnosis
From: Bill D
Date: 16 Sep 05 - 11:14 AM

good grief, Donuel! Symptoms like that and no clear answer? That is tedious. You deserve more than that. I'd hope that just curiosity would make your doctors look harder and find someone who WOULD figure it out.

I sure hope it gets solved soon!

Subject: RE: BS: Hernia diagnosis
From: Donuel
Date: 16 Sep 05 - 11:27 AM

Whether you are a back pain or headache sufferer, or virtually anyone who seeks medical attention, the respondsibility is always your own to determine the best doctor and strategy to pursue.
The exception to this rule are trauma victims.


No clear answer is superior to snap unecessary surgury.

Educating a physician to your particular complaint and suspicions is a collaborative process. It is best to discard a physician who is unwilling to be educated.