My incisional hernia. A second opinion on a failed hernia repair surgery.

[CTyankee]

I just came home from getting a second opinion from another surgeon. Well, here's the thing. My hernia will, over time, become a problem. Not tomorrow, but eventually, ergo, I don't have much choice but to have it fixed again.

My new surgeon (recommended by my primary care physician) wants to wait until a year from the last surgery, which would be the end of February. So I am seeing him again in January and he will review my prior surgeon's (now retired) notes on my previous surgeries.

He reassured me that he had seen worse than my situation. However, I could have a serious situation on my hands (it's called an "incarcerated hernia") and he says it is not a good thing to deal with it in an emergency scenario (to say the least!). I told him my fears (wise ones, I believe) and he agreed and answered all my questions. Of course, I want to know the downside to this surgery ahead of time. He thinks post surgical pain is one big consideration. Hah! I didn't think that would be a problem if I had plenty of Vicoden!

Right now, I'm kinda resigned to this. I can only hope for the best. I just hope my luck will be better this time...

[Tammie]

1. It's not so bad

I had an incisional incarcerated hernia. When it was discovered my doctor would not let me leave her office until she got ahold of the surgeon. It did turn into a big deal in that I had to have surgery soon, real soon. I went for pre-surgical tests that day and surgery a few days later. Anyways, it was outpatient surgery and the pain was no big deal, at least for me anyways. I think I took pain killers that day and then by the next day I was only using tylenol. Don't get me wrong, there is pain and discomfort, I just didn't think it was a big deal. Guess it depends on your pain tolerance. I was off work for 3 weeks as I recall. Seriously, compared to a bowel resection, I was good with this. LOL

Good luck and best wishes.

[ThatPoetGuy]

2. Are you looking for advice?

I've been through a RUQ incisional hernia, and a series of unfortunate events. No medical expert but I could share some suggestions on what helped and what didn't, and so on. I recommend this book highly:

http://www.amazon.com/Columbia-Presbyterian-Guide-Surgery/dp/0312270925/ref=sr_1_1

[CTyankee]

3. Please, what is an RUQ incisional hernia?

Mine appears to be a regular one, only it is big and getting bigger.

I am stooped because of the weight of this thing. I can't exercise. I am gaining weight, which I shouldn't be, because I don't exercise (and I want to).

Please advise..thank you...

[grasswire]

5. RUQ = Right Upper Quadrant n/t

[CTyankee]

7. Thanks. I don't know if mine is a RUQ.

And thanks for the link. I had googled "repeat hernia surgeries" but got lost in all of the stuff on other types of hernias. I wanted to know more about the cost/benefit equation, but now that is pretty well settled. What I don't want is to arrive at the ER on a stretcher with an EMT from a 911 call in the middle of the night...

[Techn0Girl]

4. Nice hernia story...

I know that's why I personally come to the DU Health news section - to hear about people's hernia stories!

[CTyankee]

6. Well, I guess I would have had your attitude when I was young, too.

Maturity will change that.

[uppityperson]

8. Where is the hernia? Hoping it goes well for you

[CTyankee]

9. It's abdominal (ventral). And it's getting worse. No pain but enlargement.

The new surgeon said it was only a matter of time before it would be a problem so that's the deal maker for me. I am guessing that I'll be recuperating in the early spring and up to speed by early summer. As I age, it takes longer to get back from these surgeries. Hopefully, I'll be in good shape to go to Europe in the fall (I try to go to one place on my "bucket list" each year, altho I was hoping for a twofer this year and to sneak in an April trip to Florence for a week).

Thanks for the good wishes. If you have any advice, I'd love to hear it. I need some validation on this cuz I'm a little scared right now...

[uppityperson]

10. No advice since this is not where to get it (ask your health care provider) but some info

Ventral means the front of your body, as opposed to hiatal (stomach), inguinal (inguinal canal), umbilical (belly button), etc. A hernia is when part of your insides (intestines) protrude (stick out) through a muscle or between muscles where they are not meant to.

"When muscle or connective tissue (fascia) becomes weak, a hole is created, and an organ or fatty tissue can squeeze through it. Hernias are common." (copied from somewhere as it is well put.

It is not uncommon after a surgery for the muscles that were cut to not be as strong as they are along the incision, and for them to separate a little, letting your guts bulge through a little.

An "incarcerated" hernia means it can not be gently pushed back into place, back through the opening to where it belongs. This can cause stuff insides the intestine to not proceed on like it should, but just sit there. Blood supply can be cut off, leading to a serious condition (strangulated hernia) which is an emergency condition (surgery now before part of your intestine dies, breaks, etc). THIS IS RARE, but something that is always watched for with hernias.

http://www.wisegeek.com/what-is-an-incarcerated-hernia.htm
"In a reducible hernia, herniated material can move freely in and out of the hernial sack. This can cause pain and assorted complications, but it is not an immediate threat. Incarcerated hernias, on the other hand, involve tissue which becomes trapped, which means that the blood supply could potentially be cut off as the herniated material is squeezed. In the case of hernias involving the intestines, the intestines can become obstructed in an incarcerated hernia, causing nausea, vomiting, and other digestive problems."

Symptoms to watch for are nausea and vomiting, severe pain or changing levels of pain (may come and go), if you notice the hernia is harder/firmer, bowel movement pattern is not like it usually is (if you quit pooping). If these happen, get help.

Again, hernias are very common and just watch yourself. I imagine your doc told you to not strain on the toilet and to avoid lifting heavy things (both of which increase pressure inside your abdomen). They are finding different ways to repair them, using different mesh for your body to incorporate in its tissues to prevent the weakened area from opening up again.

[CTyankee]

11. Thanks for your info. Not really asking for medical advice here but

if anyone can share their stories or information.

I thought I had done everything right after the first (failed) hernia repair surgery but the mesh did not hold evidently. Since my former surgeon retired I had no place really to go and only went to this one only after seeing my primary care provider who said I should follow through and recommended a surgeon he knew and respected.

I don't like the idea of another surgery for obvious reasons. However, I live in an area where there is an excellent medical facility (Yale-New Haven Hospital). At some point, you have to make your peace with your situation and I am tired of wearing a binder and feeling heavy and tired so much of the time. I'm lucky in that I can afford some help to come in and do heavy cleaning and my husband can help with cooking and laundry (we are both retired).

Thanks for taking the time to respond here. It's nice of you, really...

[uppityperson]

12. Surgery is never easy if it is you or a loved one going through it

Sounds like a good idea, hopefully will be able to get you up and going and feeling better afterwards.

Been a nurse a long time, massage therapist a while, now back to nursing due to the economy and am happy to talk with people about health care issues. It is never easy when it is yourself, I know that and much prefer to be on the provider side. Hang in there.

[CTyankee]

13. Thank you! I appreciate your wisdom on this. nt

[ckittle28]

14. Need Help

Hi CTyankee,

It's been a while since you posted your message...I'm new to forums, so I don't even know if you'll get this...or anyone else reading this forum for that matter. I'm trying to get help for my husband. Not getting much help with the doctors that he's had surgery thus far....so before we just research more doctors to "fix" his condition....I wanted to find a forum with a related issue. Although you may not have the related issue, I think you might know about how to find a good forum?? Here's his issue: He had a very small (1 cm) kidney mass on his right kidney. The doctor said "no problem..we'll just snip it out via laparoscopic procedure". Well, during surgery, they couldn't reach the small mass with the scope & decided to cut a 9 inch incision into his right flank. (this was in August of 2007). Immediately we saw a large bulge in his right flank. We asked the doctor about it & he said it was just swelling. Well, the swelling never went down & we asked about it again on follow up visits & the doctor said "don't worry Dan, it's just swelling, but if it doesn't go down, there's doctors that can fix that". p.s. 2 years later & the bulge still there, we were referred to a very reputable hernia doctor who said he'd seen these bulges from incisional surgeries before & he could fix it. so in October of 2009 he had surgery to repair the bulge. The doctor put in a "sandwich mesh", meaning one in the inside of the bulge, one on the outside...said he wasn't going to cut through the muscle either (which I still can't figure out how he did that)...anyways, here it is June of 2010 & Dan still has a large bulge ....basically looks the same size as before the October 2009 surgery. He is extremely depressed & now has 2 large incisions on his right flank. Any suggestions on what the next move will be? The doctor that did the October 2009 surgery said "he's never had a failed surgery"....I would really appreciate finding the next move if you can offer some assistance....or at least direct me in a better forum? I did find a forum with the exact same condition as my husband, but it was so old that I can't even reply to it.

If anyone can help, I'd really appreciate it !!

Sincerely,
Cheryl

[supernova]

15. Hi Cheryl,

Welcome to DU!

Since you are new, you need to be aware that we cannot offer personal health advice since we are not professionals.

It seems like your husband has been through very much in the last couple of years. Please consider getting a second opinion or try to find a local support group for your concerns. They are most likely to know who the best clinicians are for your situation.

[ckittle28]

16. Thank You

OK thank you supernova. We're in the process of searching for doctors that can handle his situation....just a bit scary, because the last doctor, who was highly recommended, said that his bulge would be greatly improved with his procedure. so basically, we're at the mercy of the next doctor. I'm finding some that look really good (out of state, but that's ok), so we'll go from here. I also would love to find a local support group, just don't know where to look...I'll rely on my trusty friend "Google". Thanks Again.

[Warpy]

17. There is always Goretex

and they've done some studies doing it laparoscopically in some patients, meaning it's a bandaid surgery. I have no idea if you'd be a candidate for either, it's up to the surgeon.

The risk of an incarcerated hernia you have right now is a significant one and can be reduced somewhat by the use of an abdominal binder. You'll also have to avoid lifting heavy objects and the usual activity restrictions they give you.

Post surgical pain is a small consideration, actually. The larger consideration is the shock to your system and some damage to your lungs from repeated anesthesia. Your surgeon wants your body to repair itself before he shocks it again. It takes about 6 months for anesthesia gases to clear your system completely, which is why they don't do repeat surgeries unless you're at death's door.