Doctor's Update on My CT and Upcoming Surgery Concerns

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161
infinitycastle52777
Dec 17, 2024 3:10 pm

I went to Dr. K yesterday to follow up on a CT. She admitted to knowing I had a parastomal hernia last January. She said they don't tell patients when they are small because it would only worry them. I think that is a stupid answer, but what do I know. She said I need to have an operation to fix the midline hernias, and she might fix the parastomal hernia at the same time. She said they use synthetic mesh because it has better, longer-lasting results. She said biological mesh absorbs in 3 years and the hernias can come back. She said with the synthetic mesh, after 4 weeks, I will be able to lift weights at the gym again with no problems. She said there is a less than 10 percent chance of the mesh traveling. She also said there were fewer infections than 10 percent. She said she will try to go in robotically, but if it doesn't work, she will have to cut me wide open. She said if done robotically, then I will go home the same day. She said unless she feels like my stoma has fallen asleep, then she would keep me overnight. She said that I will feel like I just did 1,000 sit-ups and hadn't done any for a while. That sounds painful. I don't want to do that. It's set for May 15. She is booked out until then. This is going to mean I have been healing for less than 2 weeks by my birthday. So, happy birthday to me. Not. I really hope she doesn't have to open me wide up. That will not be a same-day surgery. I can't imagine going home and being in the car for an hour after having a surgery that is going to make me feel like I did 1,000 sit-ups. And if I get an infection, I will have to go to my local ER where they don't know what I have been through. So, I hope I don't get an infection. I hope she doesn't nick my intestines either. She has to pull a loop of intestines out of one of the hernias. And she is going to be close to my ostomy, so she might fix the parastomal hernia as well. I feel like this is ambitious. Being close to my ostomy sounds scary, and am I going to have trouble with pouching? If she goes to fix my parastomal hernia, I mean there will be an incision then right near my ostomy. So, how will I deal with pouching? I don't want to have trouble with pouching. I am full of worry, and I have 5 months to worry about it. Has anyone else had robotic surgery for hernia repair? Is it very painful? I mean, I know it won't be as painful as if she had to open me wide up, but her analogy about the sit-ups makes me think it is going to be very painful. I don't know. It is not something to look forward to, that is for sure.

SusanT
Dec 17, 2024 4:46 pm

I had robotic surgery before. It was a complete hysterectomy. They kept me overnight because my surgery time was so late (came out of recovery around 8 pm) and I needed time to let the anesthesia wear off. It was not very painful. I mostly used Tylenol and not much of that. 

Doctors are trained to weigh risks and benefits. So your surgeon believes the benefits of the surgery in preventing complications from your hernias outweigh the risks of the surgery.  

In other words the chances of a problem with your surgery are less than the chances of serious problem with your hernias. 

Personally, I try not to focus on the "what ifs". (I know! Easier said than done!) My mother used to say when you worry, you suffer repeatedly over things that may not come to pass. I will interrupt my thoughts and redirect to something more pleasant. Give myself a task and keep returning to it no matter how many times the worrying thoughts interrupt.  Its a major pain to do but it works eventually.  

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Worzie
Dec 17, 2024 5:05 pm

My colostomy surgery was by robot.  My doc sounded like he wanted the opportunity to do this warning that it was rather new to him and could possibly need to go in like your situation.  The plus side of this was the healing time and time spent in the hospital being 3 days instead of 5 or more.

I'm watching your posts as I too feel I'm needing to talk to my doc about a gradual pooching out around my stoma.  I've been wearing a new hernia belt that seems to help but, I also don't want to get the false sense that I can lift more than I should.

AlexT
Dec 17, 2024 6:55 pm

Infinity, your mindset is absolutely horrible. You're upset the surgery is near your birthday, hope you don't get an infection, hope she doesn't nick your intestine, etc. You've already turned this into drama for the next however many months and that'll cause you stress for absolutely no reason. How about... it's a birthday present to myself so I can feel better about myself, exercise, etc. How about... I have confidence in my surgeon and I'm going to go into this with the attitude that everything will turn out perfect and there's nothing to worry about. You think negative, things come out negative. Think positive, things come out positive. It takes no more energy to think positive than it does negative. Geesh, give yourself some credit along with your medical team. The sun is always out and the sky is always blue, sometimes it's just covered up by a random cloud.

TerryLT
Dec 17, 2024 10:16 pm

Hi Lee,  Have you ever heard the 'Serenity Prayer'?  "God grant me the Serenity to accept the things I cannot change, the Courage to change the things I can, and the Wisdom to know the difference".  There are times, after you have done the best you can, that you just have to let go and trust in the process.  There are many things here that are out of your control.  You have put your faith in the medical system and you need to remain optimistic that you will have a good outcome.  Worrying for the next five months will only increase your stress level unnecessarily.  It sounds like your surgeon is trying to prepare you for what is to come, and you are upset about it, and yet you were also upset that she didn't tell you earlier about the hernia, because she didn't want to worry you.  So, give her a break and give yourself a break.  If it's painful, that is what pain meds are for.  You will get through this.  I'm not trying to be harsh, just realistic.  We are all here for you.  You are stronger than you think.

Terry

 

Staying Hydrated with an Ostomy with LeeAnne Hayden | Hollister

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infinitycastle52777
Dec 18, 2024 12:53 am

I want to thank everyone for their replies. I am feeling better now that I am over the shock and calmed down. I accept that this surgery is going to happen. I know it will be painful at first, but that pain won't last forever. That I will, according to my surgeon, be able to move on with my life after 4 weeks. I should be able to lift without restrictions after the 4 weeks and I will be able to do more at the gym. Which is something I want. She seems to think the risks are minimal and the benefits are better. So, it's going to happen and I need to let go and let God. In the mean time I am going to enjoy Christmas and the New Year. I am going to just hope for the best and if it doesn't happen then I will find a way to deal with it. If I need to stay in the hospital and I need an NG tube or she has to open me wide up then like other things I have been through I will deal with it. I got through my original surgery that was emergency and was very painful and I was placed in a medical coma for 3 days. I am here to tell about it. So I know I can handle whatever happens. It just was a shock at first. Yes I have a tendency to think negatively. But that is just usually my shocked reaction. Once I get over the shock I do much better. She did my gal bladder surgery and that was microscopic she said this will be similar except for sewing my stomach shut. I lived through the pain of that. So I have already lived through a lot. And I will live through this too. And in the off chance I don't, I won't be in pain!! LOL That is just my try at sarcasm. Anyway thank you to all that read and all that responded. I appreciate every one of you. That is why I knew I could post here and share my shock and worry. Because I knew I would be heard. Thanks. 

Beachboy
Dec 18, 2024 1:40 am

Rather than waste time worrying about what could go wrong, spend some time educating yourself about the surgical hernia repair process. It's a whole lot more than Robotic vs Open surgery, or Synthetic Mesh will be used because "it has better, longer lasting results." Do you know what type of Synthetic Mesh material will be used? Here are 4 types; there are more.

Polypropylene/sodium

Polypropylene/polyglecaprone (Monocryl)

Polypropylene/titanium

Polypropylene/omega

Polyester and ePTFE are also materials used. All these materials are used in combination with each other or with a range of additional materials such as titanium, omega 3, monocryl, PVDF, and hyaluronate.

The most important properties of meshes were found to be the type of filament, tensile strength, and porosity. These determine the weight of the mesh and its biocompatibility. Large pores are associated with a reduced risk of infection and shrinkage. All Synthetic meshes have disadvantages. There is no perfect mesh.

Biologic mesh is usually used for infected/contaminated surgical environments. Parastomal hernia repair is considered a contaminated or infected environment. Biologic mesh does have rapidly diminishing mechanical strength. Your surgeon is correct about that.

Modern biomaterials used for Synthetic Meshes are physically and chemically inert. They are generally stable, non-immunogenic, and non-toxic. Despite this, they are not biologically inert. A foreign body reaction is triggered by their presence. This involves inflammation, fibrosis, calcification, thrombosis, and formation of granulomas.

When choosing a mesh, the surgeon must decide which properties are the most important for the specific situation. For example, materials such as ePTFE have a good profile for adhesion risk but a high risk of infection. In contrast, Polypropylene meshes are durable and have a low infection risk but they have little flexibility and a high adhesion risk. So... choices... choices. But which is best for your unique situation? Ask your surgeon. Ask about infection rates, complication rates. This is not stuff to worry about, but information you should know.

As you can see, there's a lot to learn about repair mesh type and material. And it's good to have at least a little knowledge before you have surgery.

Next up, mesh placement. Laparoscopic intraperitoneal mesh placement has led to increasing concern regarding mesh-related adhesions. Adhesions result from the fibrin exudates that follow any kind of trauma. All meshes produce adhesions when placed adjacent to the bowel, but their extent is determined by pore size, filament structure, and surface area. It's a problem. We want the mesh to adhere to the abdominal wall, but not to the bowel. There are other ways to place the mesh. Just be aware, placement matters, based on your unique situation.

So, lots to absorb and think about. There are many studies and clinical trials you can research on the internet. The more you know, the less you'll worry.

And one huge factor to consider: Surgical skill plays a huge role in preventing hernia recurrence.

IGGIE
Dec 18, 2024 5:39 am
Reply to infinitycastle52777

G-Day Miss Negativity,

What if this and what if that. I have never met a more negative person. My father once said to me, "Never worry. If you worry and nothing happens, then you have worried for no reason, but if you worry and something does happen, then fix it."

Also, if you start going to the gym and lifting, in 4 weeks you will be back again with another hernia.

Regards, IGGIE

warrior
Dec 18, 2024 9:41 am

Don't do it, hon. It's a trap!

History repeats itself. The doctor sounds knife-happy.

infinitycastle52777
Dec 18, 2024 10:30 pm
Reply to warrior

What do you mean it's a trap?

infinitycastle52777
Dec 18, 2024 10:36 pm
Reply to IGGIE

I told my therapist today that people were saying I am so negative. She said it is natural for human beings to think the worst. Then she told me to name 5 things that I am grateful for that I can't touch. I did it, but it took me a little time because I had to think about what I can't touch. Then she said, "What if I did that several times a day?" She said I could make it habit-building and it will help me in the long run to have a more settled thought pattern. So I said I will give it a try. And I am going to give it a good go. Maybe it will get me out of my negativity. She also said it's natural to worry. I shouldn't feel bad about that, but just recognize that it doesn't change anything. She said don't "what if" myself unless I want to say "What if it goes well?" "What if I am glad I did it?" "What if I feel better in no time?" Stuff like that. Food for thought. Productive session today. I am released now until Jan. 2nd. Lol

infinitycastle52777
Dec 18, 2024 10:38 pm
Reply to Beachboy

That is a lot of information to take in. I am not sure the doctor can answer all of that. I think she just knows what they do where she works and what the success rate is for them. She did tell me I need to watch out for infection. So I will be on the lookout for that.

 

Beachboy
Dec 18, 2024 11:30 pm
Reply to infinitycastle52777

Hello,

My main point of detailing some of the repair methods, materials, and processes was this: Hernia repair is complicated. Parastomal hernia repair has further complications because the surgical site is considered a contaminated environment.

Having some knowledge about repair mesh, types of mesh, placement, adhesions, and infection will allow you to be involved in your care and would alleviate some of your concerns.

Please continue to post your pre-op experiences, repair surgery, and recovery. Many ostomates have parastomal and incisional hernias. I'm living with mine for now, but who knows what the future holds for me?

Cheers

 

warrior
Dec 19, 2024 12:25 am
Reply to infinitycastle52777

You know... these doctors will sell or tell you anything because you've got this bulge. And you know how much lack of information is out there. Although your recent visit to the doctors really got you answers. I'm glad you poked them for answers and got them. Worried less? Worried more?

Like Beach Boy explained, it's complicated.

I believe you mentioned yours hurt, which means it needs attention. If you can't fix it non-invasively - like, better belts or wraps - it feels like you're trapped.

Stuck between a rock and a hard place.

If yours hurts so badly and can't be controlled without surgery, then get your answers and go for it.

Many of us do have a hernia. Frankly, I'm scared shirtless to get mine repaired hearing these failures. But it doesn't hurt me. So if it ain't broke... don't fix it.

I think yours is broke. I'm sorry I forgot your backstory on this procedure. Trappy. Tricky. Tough decisions ahead for you, kiddo.

IGGIE
Dec 19, 2024 1:15 pm
Reply to infinitycastle52777

G-Day Lee, 

I am so glad you are giving it a go to be more positive. You know it takes the same amount of energy to say "I can do that" as it does to say "I cant do it" 

Your a very sensitive Lady Lee and I love that in you but start being positive for your health's sake. 

Good luck Lee and have a Very Good Christmas and a really fantastic New Year.

Love and best wishes IGGIE 

infinitycastle52777
Dec 19, 2024 3:23 pm
Reply to Beachboy

I have lived with mine for about a year now. I would be happy to live with them for another year but the surgeon thinks it is better to get it fixed now since there is a loop on intestines poking out through the hole and she is afraid of complications with that. The fact that is is a loop and not just a piece of intestines poking through. She feels if we wait it is more likely to be emergency surgery and it won't be done by her because I live in a different city. She knows the inside of my body pretty well she has been in there enough times. She did my initial emergency surgery, my ileostomy placement, my relocation surgery and removed my gallbladder. So she has been inside my stomach a lot. She would rather she do the surgery if at all possible. I think you are right that I need to be informed on things having to do with the surgery. It's a little overwhelming all the details that go into it. I do want to know about infections and adhesions because she told me I will need to look out for infections after the surgery. I am scared about getting an infection because I have read other peoples' experiences with that on here. It sounds just awful. I hope I don't get an infection. I hope all goes well and according to plan. I hope I recover nicely. And that there are no further repercussions. If there are then I will have to deal with them. Thank you for giving me the info you  did it gives me a starting point for my own research.

infinitycastle52777
Dec 19, 2024 3:31 pm
Reply to warrior

Yah I know. I think I have to get the incisional hernias fixed for sure. Getting the parastomal hernia fixed depends on weather she can get to it from the holes she will already be putting in me to get the incisional hernias fixed. She said it was so close to that site that she though she might be able to do it. I have my doubts because it's on the right upper and she will be going in on the left side. So I don't know that she will be able to reach the parastomal hernia. It's going to be a tough road ahead. Like I was telling someone else I have to get the incisional hernias fixed because my intestines have formed a loop in the hole in my abdominal wall. That loop could cause problems down the road if not fixed. So that is why they are all about fixing it. She is not so concerned about the parastomal hernia because i don't have pouching issues right now. Though I do have some pain. It isn't always intense pain but sometimes it is. Sometimes it's more like a dull feeling of don't move like that. It depends a lot on how I am bending or moving.

 

infinitycastle52777
Dec 19, 2024 3:34 pm
Reply to IGGIE

I know I need to work on being positive. It is something I struggle with because I am a born worrier. And due to some things in my past I am deathly afraid of pain.. but you are right saying I can do this is much better then saying I can't. And it is more hopeful to say that I can do it. Merry Christmas to you as well and a Happy New Year as well. Have you any special plans?

IGGIE
Dec 21, 2024 10:23 am
Reply to infinitycastle52777

Hi Lee,  No special planes just the normal Chrissy Lunch with friends and get ready for the New Year parties. I hope you get every thing you want and more. Enjoy the moment.  Regards IGGIE 

infinitycastle52777
Dec 21, 2024 4:00 pm
Reply to IGGIE

I already got one big present. Some new clothes in a smaller size. Yah me. All that weight loss work is paying off. I am down to a size I haven't been in since I was a teenager. So merry Christmas to me.