If Not a Hernia, Then What?

Dangit, Dex! Well, if it's the kind that doesn't get strangulated, I wonder why the "fix it ASAP" suggestion then. Unless it's just a nuisance at this point. I completely understand though what you mean about the thought of open surgery. Long sigh here. Well, I guess at this point, see what the CT shows and hopefully that will shed some light decision-wise. I go to meet the surgeon on the 26th, so we'll see what news I get. I'm scared. Thank you for the update. I'm with you, sis, hang in there. Hugs and prayers.

Thanks, 7dragonflies. He mentioned they just get bigger... probably why he wants to fix it as soon as possible. He said sometimes the skin can get very thin also in that area - so I'm sure surgery just gets harder for the surgeon the bigger it gets.

Colonic perforation... apparently the gift that never stops giving :(

Thank you for the wishes! Keep us posted with what you find out - and good luck!

Thanks, Beachboy. I was the same... the ostomy didn't bother me as much as the peristomal hernia. I felt so good once it was gone... now this hernia, in a new spot :( So, I'm getting my diet back on track and walking more, to see if it relieves my discomfort. I wear my belt all day - my favorite is the Brava, it's thin and holds great, keeping everything 'in' yet not making me uncomfortable. It is easier to hide my hernia without the ostomy appliance so I've been able to live with it, but it really limits me physically - I never realized how much lifting I was doing pre-ostomy/hernia. Now I am afraid to do anything besides walking. Plus, there are times when it creates an uncomfortable pressure - but luckily it always reduces as soon as I recline. That's the problem though... I now spend a lot of time reclining! Easy to put on weight when you reduce your activity like this and increase your eating. I figured I would go a little off the rails with the eating once my ostomy was gone... now I just have to get back on track.

In all your reading, what in your opinion would be the best mesh? And the surgeon mentioned he puts it between the layers of the abdomen - guess I have a lot more to research before I see him on July 18 (after CT scan), since I'm not sure what he means by that.

Thanks for your input and good wishes!!! Like you said, sometimes it's a step forward and 2 back!

Edit: Although I was referred to this hernia surgeon by my wonderful colorectal surgeon, I felt like I didn't really connect with him. He seemed a little arrogant, very rushed, and didn't really explain things well in my opinion. I mean, I might have caught him on a bad day - but when I researched him online, I came up with very little in the way of reviews - no good ones, and 2 terrible ones. One saying the person has suffered chronic pain since hernia surgery he performed (one of my biggest fears). And I know, there are always good and bad outcomes in surgery... but not seeing any good reviews bothers me. When I research my colorectal surgeon, I find many wonderful reviews. Maybe I'm wrong, but I don't think a second opinion will hurt me either. In fact, had I gotten one before being sent to a biopsy it turns out I didn't even need, I wouldn't be about to have my third surgery this year!

I'll keep you posted on what a new surgeon says!

Hi Dexie,

I had an "arrogant type" surgeon only one time... never again. He eventually, successfully removed a tumor from my clavicle. But I went through hell getting it done.

I was diagnosed with stage 4 thyroid cancer back in 1983. Then endured 3 surgeries removing various body parts. So I was surgically experienced by the time I dealt with Dr. Dimwit. Details below:

First, he tried to biopsy the large tumor in my clavicle... in his office, with only local pain medication. What a disaster. I ended up with blood everywhere, lots of pain... and no tissue sample. The tumor was too deep.

I was scheduled for surgery. On the appointed day, I was prepped, met the anesthesiologist, then wheeled into the holding area. Time passed. Other patients were taken away for surgery. Finally, I was there by myself. I got the attention of a nurse and said, "I've been here a couple of hours." She went to check my status. Came back and told me, "No one knows where your surgeon is." What!! They called his house, his office. The dude disappeared. This was before cell phones, so all they could do was ping his pager. No response. So I got dressed and went home. I told my wife he was probably on the golf course.

Was scheduled again. And this time he showed up and completed the surgery.

A couple of weeks later, my wife and I visited this ass for pathology results. He tells me, "Sorry, it's cancer... I can't offer you any hope." My poor wife, (we were married for about a year), starts bawling her eyes out. I told Dr. Dumshit... "I know exactly what type and stage cancer I have... you're WRONG." My wife was mad at me for yelling at him. 36 years passed since then. Guess I was right.

Fixing an abdominal hernia is hard to do. There are different repair techniques with their own success and complication rates. Laparoscopic and open surgery. There are lots of variables. Patient age, general health, surgeon's skill and experience. And the hospital. Like everything... there are great facilities, mediocre, and passable.

You must be able to talk comfortably with your surgeon. They must listen patiently to your questions and concerns. Then take the time to explain everything until you're satisfied and you understand.

Usually, if the hernia is not life-threatening, it is considered a safe strategy to only observe and monitor its evolution over time without intervening.

Open repair surgery results in a longer hospitalization period and a higher risk of infectious complications, but it only necessitates local anesthesia and is an easier procedure to perform for a general surgeon.

Mesh reinforcement is generally required to ensure a durable hernia repair. Over the years, numerous mesh products have been made available, yet each of the currently used meshes presents certain limitations that reflect on treatment outcomes. Thus, mesh development is still ongoing. There is no single gold standard for the effective management of abdominal wall hernias. Mesh provides mechanical support and a structure for tissue to “scar” into, consequently reducing recurrence risks.

The optimal placement of mesh is important. But there is no absolute standard. It's a surgeon's decision. Prevalent choices include onlay, inlay, sublay-retromuscular, sublay-preperitoneal, and sublay-intraperitoneal. You should discuss this with your surgeon, based on your unique situation. Detailed imaging, CT scans, should help clarify your surgical path forward.

Mesh types and materials:

Synthetic meshes are generally viewed as the best option for abdominal wall-defect repair.

Polymeric meshes are considered advantageous due to their adequate elasticity and tensile strength that endow the textiles with the capacity to withstand intra-abdominal wall pressures and prevent re-herniation.

Resorbable meshes are made of degradable materials that remain intact only for a definite period.

Each of these mesh materials has advantages and disadvantages. You must discuss this with your surgeon. And if he makes a mesh choice, you need to know why, based on your unique medical condition.

So, a lot to consider. Placement of the mesh. Mesh material type. CT scan results.

Take your time. If need be: Seek out a different surgeon you're comfortable with. Ask about their infection rate. Hernia recurrence rate. Ask about the hospital infection rate.

I'm going to visit my surgeon soon. Have him take a peek at my hernia. See what he thinks. I really don't want to undergo repair. But, the best time to do it is: ASAP. Hernias usually get worse over time.

Good luck 😇

Thanks, BB! All wonderful advice! Very tempting to just let it go... but like you said, they only get worse... it's like a rock and a hard place. (Heavy sigh). I actually now have an appointment with both surgeons on the same day, July 18 - at 1:30 PM and 3 PM. Will see what they both have to say, and I'm sure it will all hinge on the CT scan results!

Appreciate your advice, thank you :)

Words of Encouragement from Ostomy Advocates I Hollister

Hey y'all. Well, I met with the general surgeon at Mayo and one of the other doctors who came in during each of my hospital adventures throughout the past year (I believe he's been interning or whatever the word is... I can't think straight at the moment because I have... COVID! But the point being, the guy has been there each time I'm in for surgery, along with my colorectal surgeon.)

So, the general surgeon pulled up the images from the CT and had me lay down/stand up, pushed and poked, had me strain and cough, and so forth, and said it's not a hernia. It is indeed diastasis recti. He showed me in depth on the images as he zoomed in and out that there is no "hole", it's a thinner area of the abdomen, which of course can become a "hole", and told me what to watch for. In the case of diastasis, the repair is basically to strengthen the abdominal core, although it will never be what it once was, it can get better. Now, and I already knew this from research as you all know - we have all become scholars throughout our journeys, careful abdominal core strengthening is key as not to make the situation worse! So... instead of sit-ups, crunches... type thing... I guess.

Just wanted to pop in and give the update. I hope everyone is doing okay. I'm in bed trying not to cough up a... hernia.

Hugs to all.

As Roseannadanna used to say on Saturday Night Live:

"It just goes to show you, it's always something — if it's not one thing, it's another."

Hernias... Diastasis recti... COVID

Couldn't have said it better myself, lol! And isn't it the truth.

And... I might add, BB, you had some very insightful info on the mesh. Actually, very helpful things to consider.

Trivia fact: Herniorrhaphy is another name for hernia surgery.

3 kinds of repair surgery: Open, laparoscopic, and robotic laparoscopic.

According to the FDA, surgeons perform more than 1 million hernia surgeries in the United States annually. Each year, about 20 million hernia surgeries are performed worldwide.

Hernia surgery may take as little as 30 minutes for simple repairs and up to five hours for more complex repairs. It depends on your hernia and the type of surgery you need. Generally, robotic surgery repair takes longer than open or laparoscopic hernia surgery.

Does it work? According to a recent study, approximately 16% of people need additional surgery because of hernia recurrence within 10 years.

Possible complications: Erosion or breakdown of the surgical mesh. Infection deep inside the tissue where the surgical mesh is.

It's good to know the facts and surgical lingo before you make a decision.

Such great information, and thank you for it. That word - infection - is absolutely terrifying, I'm sure for all of us. Definitely things to keep in mind and have knowledge of in the case of having to make a decision. I'm praying not to have to make that decision. I'm feeling better post-COVID over the last couple of days. Got out and mowed the grass and am back to work. Now I continue on my mission of scar gel and trying to somehow shrink this diastasis. Whether any of my attempts will pay off is yet to be proven, but I'll keep trying; after all, it's the only thing we can do.

I had my CT scan on Saturday... it was ordered without contrast, but I ended up getting the contrast. Ugh. They said the radiologist stated it is the best way to see what's going on, and the doctors are not always cognizant of this fact. So, it was a longer test than anticipated. I saw my results come in on MyChart... too scared to look... PTSD is real! I see the doctor on Thursday.

Oh, it's real alright. Heck, I had a stomachache the other night and went into a panic! Okay, Thursday isn't far away, and it'll be good to have someone explain anything anyway instead of you looking and maybe not understanding and then spiraling into something that could not even be the case whatsoever. Besides, the CT was ordered just to see about the hernia, right? Whatever the case, it's what needs to be done; we know better than to go with the ignorance is bliss thing. I speak from experience. Hugs, Dex, you're going to be good!! ❤️

Glad you got the CT. Always best to let the doctor explain the images and findings.

I used to get a CT every 3 months for a couple of years due to my Stage 4 thyroid cancer that spread to my lungs.

I had to drink a bottle of some sort of prep stuff. The nurse always asked what flavor I wanted. One time I chose banana. Next time, cherry. They all tasted the same, like chalk. The third time I told the nurse, "These flavors must be psychological; you just think it tastes like cherry or banana." She winked and gave me strawberry flavor. Tasted like chalk.

After drinking the chalky crap, I had a CT of the chest without contrast, then one with IV contrast.

Results were always the same... numerous tumors in both lungs. I eventually stopped doing the CTs; they upset my wife too much. I have many of the CT films from the old days before modern computers turned everything digital.

Good luck on Thursday.

Thanks, Dragonflies! I had a migraine in the days leading into it... I'm sure just dreading it all. Wondering if there are 2 hernias instead of 1 and if I will have to have the 'big open surgery' instead of the robot.

Yes, the CT scan was just for a hernia - but having had colon cancer, I am always scared to get any results now of any kind. It did something to my mind... made me fearful. Like, I felt perfectly fine and had no symptoms - but I had cancer?! Just how insidious cancer is... chilling. I had my colonoscopy in April and it was clear, but I don't think I'll ever be not afraid to have a scan or test LOL.

When I was in the hospital for 21 days, I kept having to have CT scans because they could not get to the root of my fever - never did... but they turned up a cyst on my kidney and a few other things, making me forever scared of "what else" will show up! So... I did not want to ruin my week by reading things I am not educated on - best left to the doctor, I guess! Thanks for the support.

Thanks, BB. You are a very lucky (and strong) man to have beaten cancer and everything else that has come your way!

My contrast was through an IV, so luckily I only had to drink water - but in the past, I have had various tests where I had to drink the chalky crap! The IV contrast burns from my eyes down to my middle for a few minutes and makes me feel like I peed my pants LOL. Ugh, can't be good for me - but I felt I had to get it done and see what's going on in there if I ever want to take care of it.

Thanks for the words of wisdom, it makes me feel much better :)

Hi Dexie,

I've counseled many coworkers and patients undergoing tests or chemotherapy. I'm always asked, "How do you remain calm waiting for test results?" I don't have a definitive answer. I truly don't worry about it, which doesn't really help someone who does worry about it.

When I went to counseling prior to chemotherapy, I learned about mental imagery. Forming a detailed mental picture of one's battle against cancer or a major disease. I formulated one, and it has brought me peace during trying times, and bolstered my spirit while extremely sick.

For me... I'm running. Every day. Fast and easy. As long as I keep the pace, dark storm clouds on my horizon can't catch me. I will not falter or slow down. Nor feel pity for myself or gripe. I gotta go... head up with a smile... skipping to the beat... running.

Like I always say: Every day a holiday.

Thanks - love this! I have always been a 'worrier', even though I know it doesn't help. 20 plus years ago, right after we bought our home, we had an issue with it that needed urgent repair. Well, as a first-time homebuyer, I worried incessantly about it all week until I was exhausted. I finally decided when I went to bed one night that I was going to imagine putting the whole situation into a 'box'. So, I literally imagined a sturdy box, forced my worries about the situation in there, and quickly put a padlock on it. I had never heard of anyone doing such a thing to help them - I just did it, and I don't know how or why, but it worked. I never worried about it again (and of course, the issue worked out fine).

I like your imagery! I will have to try something along those lines when the fear creeps in - something different than the box. Thanks!

Test results. I've had some memorable ones.

1987. Reality bites. Underwent my first CT scan of my chest. Prior to this, I had only had radioactive iodine type scans. Those scans highlighted "hot" spots where radioactive iodine was being concentrated by thyroid cancer cells. All those tests came back negative.

I had developed a nagging cough. So the doctor ordered a CT scan. I got it done at 4:00. At 9:00 that night, the doctor called me. He told me to come to his office right away. I said, "Now?" The first thing my new wife says: "You're gonna die." At his office, he shows us the films. Not good. Lots of tumors throughout both lungs. That's when I realized I probably didn't have much time left. It turns out my cancer cells had stopped uptaking iodine. The prior radiation tests were wrong. The doctor referred me to an oncologist and bid me farewell. It took many, many years for my wife to get over this.

Putting worries in a padlocked box. I really like it. Chemo counseling taught me: Keep it simple, effective, live it.

For me... I stay up until 11:00 or 12:00. Get up at 4:00 am. I used to work 7 days a week, 10-12 hours a day for 40 years. Took two, 3-week vacations every year all over the world. My wife gave up on trying to keep up with me, says I'm an alien. I always reply, "Time is short." So that's me... running through my life. Not worrying, not scared. But fully aware of the gift of each day.

Hello. I saw the surgeon yesterday regarding the CT scan. As suspected, it's an incisional hernia, with a 7.1 x 5.5 wide opening - so it's a large one! He also said I have a little diastasis. It is a complex surgery - about 4 hours or more, depending on scar tissue. He would use a technique called Transverse Abdominus Release (TAR) to reconstruct the abdominal wall.

I do not have 2 hernias - the one that was fixed when I had my reversal is good. He said he can do robotic surgery, which is a plus. The robot would make 3 cuts on each side and I would have mesh covering my whole abdomen.

Everything with my stoma site and reconnection looked good on CT. No obstruction with the hernia at this point, and it's easily retractable.

I have a second opinion set up for August 9th with another surgeon to see what he says, as I know they all use different techniques.

Surgery is set tentatively with this doctor for October 1st, since this is the hospital system I use - but as I told him, I am not sure if I am ready for another one, so I can always cancel (plus it will depend on what the other surgeon says - this date is basically just to get me on the books). I will just have to think about things for a while - the multiple surgeries I have already had have been mentally, financially, and physically draining. Plus, I have already used up most of my FMLA for this year, so I'm not sure if I can do it. It would be nice because I have already met my Out of Pocket Max on my insurance this year (been hit with that 2 years in a row now), but I am not sure my employer will be okay with a third surgery in this short of a timespan...ugh.

He said the big hernias like mine rarely cause obstruction, but they can...so if that happens I would be in an emergency situation and be at the mercy of whatever surgeon is on call - likely not one with experience doing complex hernias.

I don't really know what to do yet - just need to think for a while I guess! So that's the scoop!

It's good you know what you're dealing with. A second opinion will hopefully mirror the first.

Doing a little research, this is what I found.

TAR is a modification of the posterior component separation (CST) technique that involves cutting the transversus abdominis muscle, the innermost oblique muscle, to create space for mesh placement. This allows the body's own tissues to stretch and cover large hernia defects without tension. The incision doesn't significantly affect core function after healing.

I would ask: What type of mesh? Also, the surgeon and hospital's infection rates for this type of surgery.

Insurance and your costs are a real concern. It's no good to get physically fixed and be broke. My company laid me off shortly after my hospitalization/surgery; I was the only old guy in my department who was booted. But, we have to be surgically fixed. Few options for us worker bees.

You're getting closer to getting this resolved. Hope all goes well.

Ooh, good question - I will send him a message to ask what type of mesh. It is the same hospital I've had all my surgeries at, so that's good. Yep, that sounds like the technique he was describing. All the medical jargon is confusing to me, and he used a lot of it...but you summed it up better than him, I think - LOL.

Yes, worker bee is exactly how I always describe myself. And I didn't ask for any of this - but my employer only sees that I am gone all the time, and probably sees me as a liability at this point. My mom says - if they want to fire you, let them. Easy for others to say... not so easy if it happens and there are bills to pay! Thanks, BB.

Hi Dexie,

My company was self-insured and used Anthem Blue Cross, Blue Shield to manage claims. I was "max out of pocket" when I underwent 46 rounds of radiation treatment for prostate cancer... then, 3 months later, I got sick with sepsis, spent 28 days in the hospital. Had 7 hours of exploratory surgery resulting in a colostomy. I never got a bill. Every procedure/scan/test/antibiotic was approved. I can imagine the cost was substantial. I also received company-provided disability insurance payout. 3 weeks after surgery, I returned to work full time, 10 hours a day, 6 days a week. I could have recovered longer, but felt I should get back to helping the company make money. But... I'm sure I was flagged as a liability. A year later, the company laid me off after 28 years. I was the only older senior R&D engineer laid off. The WARN act requires companies to provide us (laid-off employees) with a list of laid-off employees and employees not laid off. There are no names. Just age and job title. Everyone was stunned when I got the boot.

Unfortunately, my experience and skills are difficult to replace. I got a text last week asking if I would consider consulting. I told them... NO. Once pushed off the working merry-go-round, I'm not getting back on. I'm sure they will continue with offers, upping the cash. Coming back as a consultant means they get my skill without having to provide medical insurance. I've seen this happen quite a bit. Coworkers retire and vow to never return. A couple of months later... they're back.

It's a "between a rock and a hard place" dilemma we face. We must have expensive medical treatment. But at the same time, it puts our job in jeopardy.

Hernias just suck. I don't mind my colostomy... but dislike that damn bulge under it.

Take care.

Hey Dex, I've been meaning to check in on you sooner with this, so I'm sorry for the delay. Definitely things to think about here. I wonder if you could talk to HR maybe to see if they offer anything beyond the FMLA. Mine made a stretch and allowed me an extra 30 days of just leave. It had to be approved by multiple people, of course, but thankfully they did. I felt like I was really pushing my luck, but the good Lord made a way. It was within the same year I had already exhausted all of my FMLA. It's worth a shot to ask if you haven't already. And I certainly understand wanting to get it done (if that's what you choose to do) within the year after already meeting your deductible. Good call getting on the books at least so you've got it reserved should you decide to move forward with it. You've got some time to think. I hope the answer comes to you so clear that you know exactly what you should do. Above all, take care of you. Hugs

Hi Heather, I'm going through the same thing, and I'm scared to death. I feel like my stomach is going to explode again. That's what happened, and I lived with a bag for about 6 or 7 years. I now have had a reversal and feel like it's so heavy on the left side. I'm not that big, but I'm in pain, and it feels like I weigh a thousand pounds on the left side. What do you think is wrong? Please help with anything. I'm lost.

                                 Thank you

                                  Robin