Surviving Open Inguinal Hernia Repair Surgery

 

On 12/18/03, I had surgery for a right indirect inguinal hernia.  In the weeks before my surgery, I scoured the Internet for any information about this procedure.  I found firsthand accounts of this surgery (including Surviving Laparoscopic Bilateral Hernia Surgery and the Hernia Surgery Experience Guestbooks) especially helpful in preparing me for my surgery and assuaging my fears.  I decided to put a diary-style account of my experience online in the hopes of helping someone else going through similar surgery. 

 

Please email me at ablipman AT netzero DOT net if you have any questions or comments.

 

Note: This account is fairly graphic in nature and tone.  The surgical procedure and recovery period are explained bluntly and clearly.  If these topics make you nervous and/or nauseous, you may want to stop reading now.

 

 

Sunday, 11/16/03: Golf Ball Discovery

 

While getting undressed, I noticed a large lump in my groin on the right side, under the pubic hair.  It was hard and the size of a golf ball, and I wasn't sure what it was.  I felt it, was mildly concerned, and went to bed.

 

 

Monday, 11/17/03: A (Non-Medical) Second Opinion

 

In the morning, the lump was gone, but it came back in the afternoon.  At night, it was bigger than before.  My roommate Ariel felt it over my clothes and was very concerned.  She made me promise to see a doctor.

 

 

Tuesday, 11/18/03: Making the Appointment

 

I wasn’t sure what kind of doctor to call, but since I had recently moved to Boston and didn’t yet have a primary care physician and the lump was in my groin, I called my gynecologist.  I was told that my doctor didn’t have any openings for two weeks.  I asked to see someone else, and the woman on the phone told me that she didn’t think that they had any openings.  I told her, “I have a lump the size of a golf ball in my pubic region!  I’d really like to see someone as soon as possible!”  She told me that they could fit me in on the following Thursday.

 

 

Thursday, 11/20/03: Hernia Diagnosis

 

I saw a gynecologist at Massachusetts General Hospital, and she and another doctor examined my lump and said that they thought that it was a direct inguinal hernia.  They gave me a referral for a surgeon.  Over the next couple of weeks before my appointment, I was bothered by the lump.  It wasn’t painful exactly, but I was aware of a tight pulling sensation in my groin, especially after sitting or standing for long periods of time, or when I was wearing tighter pants.

 

 

Tuesday, 12/2/03: A Second Opinion

 

When I made the appointment with a surgeon, I requested a female doctor, but I was told that they couldn’t guarantee that, and it depends which surgeons are available.  I first met with a male third year Harvard Medical student, who asked basic background questions.  Then a female surgeon named Dr. L [I don’t want to print her name without permission] came in and asked some more questions.  She and the med student examined me, and Dr. L confirmed that I had an inguinal hernia.  She said that there's no way to know if it's indirect or direct until surgery. 

 

This information from WebMD explains the difference between indirect and direct inguinal hernias: “A direct inguinal hernia occurs when a weak spot develops in the lower abdominal muscles from the normal stresses of living and aging. Tissues push through this weak spot as pressure within the abdomen increases. An indirect inguinal hernia is the most common type of inguinal hernia. Normally, an opening in the inguinal canal closes shortly before birth. An indirect hernia develops when this opening does not close, causing abdominal tissues to push through the inguinal canal. Symptoms may be present at birth or may develop later in life.

 

My roommate Ariel went to the two and a half hour appointment with me, asked good questions, took notes, kept me company when they left us alone for a long time in the examining room, and comforted me when I had to give blood.  Both Dr. L and the med student were friendly and happy to answer all of our questions.  Dr. L said that she recommends open (not laparoscopic surgery) for hernias unless the patient has bilateral or recurrent hernias, but she said that if I wanted laparoscopic surgery for any reason, she could put me in touch with a laparoscopic surgeon (but that she doesn’t perform laparoscopic surgery).  Dr. L. told me that I had the option of having local (with a sedative) or general anesthesia during the surgery.  I told her that I preferred general since I didn’t want the chance of being aware of anything during the surgery.  She told me that the incision would be a couple of inches in length and would be below the bikini line.  She also told me that she had had the same surgery when she was 23 years old and that the scar wasn’t visible anymore, which made me feel a lot better. 

 

She told me that during the surgery, she would find the inguinal ring, push the hernia in, ligate the hernia sac, and use stitches or a mesh patch to close up the opening.  She warned me of the complications of surgery: a risk of recurrence, wound infection, irritation of the sensory nerve, and some pain in the groin for a month or two.  She told me that the surgery would last about an hour and that I would go home the same day, that I shouldn’t do any heavy lifting (over ten pounds) or strenuous exercise for six weeks after surgery, and that I shouldn’t have anything to eat or drink past midnight the night before surgery.

 

She said there wasn't a huge rush on surgery, but that it was possible that my intestines or ovary would twist and get caught in the hernia, which would require immediate surgery.  The lump was really bothering me though, so I scheduled surgery for 12/18/03 at 12:30 PM.  Dr. L told me that since I have a desk job, I could go back to work whenever I was feeling ready.  I told Dr. L that I had a flight to Philadelphia planned for 12/24/03, and she reassured me that barring any unforeseen circumstances, I would be able to take my trip as planned.

 

 

Wednesday, 12/17/03: One Day Before Surgery

 

Someone from Mass Gen Hospital called and left a message to confirm my surgery for 7:30 AM.  I was confused because my surgery had been scheduled for 12:30 PM.  Thirty minutes later, someone called to ask if I wanted to switch my surgery from 12:30 PM to 7:30 AM.  Apparently the second call was supposed to have come before the first call.  I figured earlier was better, so I changed the appointment to 7:30.  I was told to be at the hospital between 7:30 and 8:00. 

 

On my way home from work, I went to CVS and bought four ice packs, chewable fiber supplements, and multi-vitamins.  These were all recommended for use post-surgery by various people.

 

That night, my mom came from New Jersey to help take care of me.  I felt bad because she was getting a bad cold, her train was delayed, and it was raining, so she was pretty miserable.  We had a late dinner, but I followed Dr. L’s instructions and made sure that I didn’t eat or drink anything after midnight.  (I thought that this was a bit strange, since apparently I wasn’t supposed to eat after midnight regardless of whether the surgery was scheduled for 7:30 or 12:30.  A nurse later agreed with me and said midnight was just an easy time to tell people.)

 

 

Thursday, 12/18/03: THE BIG DAY

 

My mom and I woke up bright and early and took the T to MGH.  We arrived around 7:45 AM.  I was thirsty since I hadn’t had anything to drink since the night before.  (I’m a big water drinker.)  I signed some paperwork, including making an inventory of everything that I was wearing.  Someone called my name within five minutes, and I was taken to a large pre-operative room filled with about ten beds separated by curtains.  A nurse told me to change into a hospital gown, pants, robe, and hair cover (like a shower cap), to leave my clothes in a garbage bag, and to put my clothes inventory list inside the bag.  She also told me to fill out some more forms.  I didn’t see any pants there, and I couldn’t figure out which way the gown went on, so I went out to ask some nurses for help.  They explained that I wouldn’t get pants since I was having hernia surgery, and they told me which way the gown and robe went on.  I went back to my curtained area, and I had just started getting changed when another nurse came in and said that they wanted to speed me along, so she asked me the questions on the forms and filled it out for me while I got dressed.  The questions were basic medical questions about medical history, allergies, etc.  She gave me ankle and wrist bracelets that were blue, then immediately took them off and gave me red bracelets due to my allergy to penicillin.  She gave me a marker and told me to write “YES” on the right side of my abdomen to indicate that the surgery would take place on the right side.  My mom came in to say goodbye, and she laughed at my outfit and said she wished she had a camera to take pictures of me. 

 

I lay down in the bed, and someone came over to wheel me to the operating room.  At this point, I was perfectly capable of walking by myself, so it felt pretty strange to be wheeled around the hospital on a five minute ride.  We stopped outside the OR, and I was greeted by Maggie, my OR nurse.  I was starting to get nervous at this point, and Maggie was great about talking to me and making me laugh and relax a little.  I told her that I was addicted to lip balm and that my lips had started to get dry, and she brought me some sort of lubricant to rub on them.

 

An anesthesiology resident came over to ask me medical history and medication questions.  He asked what kind of surgery I was having, and I replied “right inguinal hernia repair” and he told me that was excellent.  He confirmed that I wanted general anesthesia, and he told me that he would put a breathing tube in after I was already asleep, so I wouldn’t feel a thing.  He said it was possible that I would have a sore throat afterwards.  He told me that he was going to put an IV in my arm or my hand.  I told him that I’m a little needle- and blood-phobic, so I wanted him to put the IV in at the last possible moment (so I wouldn’t have to lie there for too long with the IV in), and he was very understanding.  He decided to put it in my arm, and I was a bit fidgety, and he asked many times if I was okay.  The thought of the IV made me nervous and nauseous, but the actual IV wasn’t that bad.  When I moved my arm, it was a bit uncomfortable, so I tried not to move my arm very much.  He gave me an intravenous sedative to relax me.  While we were talking, the anesthesiologist came over to introduce himself, and he said that the resident would be handling all of the intake and that they both would be present during the surgery.

 

While I was waiting to go into the OR, I talked to Maggie a little more, and then she told me that it was time for my surgery.  She and the resident helped me take off my robe, they strapped down my legs, and they wheeled me into the OR.  I think my impressions of ORs probably come from TV and movies, and it looked pretty much as I expected it to look.  I had originally thought that I would see Dr. L before the surgery, and I had made a list of questions that I wanted to ask her.  But as it turned out, the first time I saw her was in the OR.  I had left the list of questions with my mom, so I tried to remember all of them, but it was difficult to have a conversation after being sedated and while lying down.  I asked her how many hernia repairs she had done because I had read that the more repairs a surgeon has done, the more successful the surgery is.  She said that she had done hundreds, so I felt pretty good.  I asked if she was planning to repair the hernia using mesh or stitches, and she said that it depended on how big the opening was and how the tissue around the hernia looked.  I reminded her to tell me after the surgery whether the hernia was direct or indirect.

 

The anesthesiologist asked me my favorite vacation spot, and I thought really hard about what to say, since I have many favorite vacation spots.  I think he was a little worried about the time it took for me to respond!  I finally told him that I would pick London since I studied abroad there and would love to go back at some point, and someone else in the room agreed that London was a great city.

 

Next thing I knew, I was waking up, and Dr. L was telling me that the surgery was over and that everything had gone well.  I asked her if the hernia was direct or indirect, and she told me that it was indirect.  She said that she had done the repair with stitches because the hernia was small and the tissue surrounding it was healthy tissue.  The surgery took about an hour.  They wheeled me to the recovery room, which was basically the same as the pre-operative room.

 

Meanwhile, Dr. L went to talk to my mom to tell her that everything went well.  Since my mom had my sheet of paper with all of my questions, she asked them all, and she said Dr. L was very helpful and answered all of them.  Dr. L also commented that I had prepared very smart questions and that it was clear that I had done research.

 

My mom came into the recovery room to see me around 11:45 AM, and I started to tell her about the IV and the OR.  By this point, she was feeling horrible from her cold, and she doesn’t handle blood very well either, so she started getting nauseous and asked if she could sit down.  My bed took up pretty much the entire curtained off area that I was allotted, so there wasn’t much room for her.  One of the nurses told her she should go eat lunch and fill my prescriptions for a stool softener (which turned out to be over the counter) and Percocet at the CVS nearby.

 

I met a nurse named Karen, who took care of me for the rest of the day.  She made me feel really comfortable and made me feel like she was really looking out for me.  She called me names like “Toots” and “Sweetie” which usually bothers me coming from strangers but was strangely reassuring coming from her.  Karen and another nurse helped me move from the bed to a reclining chair, so I was a little more upright.  Karen brought me water and apple juice, and I guzzled them down.  I hadn’t had anything to drink in about 12 hours, so I was really thirsty (although I was getting what seemed like bag after bag of fluids through the IV)!  Immediately after finishing the liquids, I felt nauseous, and I told Karen that I was going to throw up.  She brought me a hospital-style “barf bag”, and I threw up all of the liquids that I had just drunk.  She told me that that was a normal reaction to the anesthesia and the liquids, and that I should try to drink more slowly.  She brought me Saltine crackers, Lorna Doone cookies, and Graham Crackers and said that if I ate enough, she would give me a Percocet for the pain.  Dr L had given me a lot of local anesthesia at the site of the incision, but as all of the anesthesia wore off, I started feeling more pain.  I started eating slowly, and everything started to hurt more.  The crackers and beverages were on a table on my left side, but the IV was in my left arm, and whenever I moved my arm to get the crackers, the IV hurt.  But if I moved my right arm, my incision area hurt, so I had to make a decision about which pain was better. 

 

By this time, I felt like I had to urinate, and Karen thought that urinating might reduce the pressure on my abdomen, which would reduce the pain.  Another nurse helped me get into a wheelchair, but she did more watching and less helping than I would have liked.  She wheeled me to the bathroom, hung my IV bag on a hook on the door, and left me alone, and I sat down to try to urinate.  Pushing with my stomach muscles hurt a lot, so my urine came out in little spurts.  I sat there for a long time.  Finally, I got up, slowly walked to the sink to wash my hands, and met her outside the bathroom.  She wheeled me back to my chair, but she didn’t help me get back into the chair.  Every movement hurt.  I finally got back into my chair, and asked her for help getting it to recline.  She didn’t want to help at first because she said it would hurt her back, but I was so helpless that I think she pitied me, and she finally crouched down to help me recline. 

 

By this point, I was exhausted and in more pain than I had ever been in before.  I also started getting really cold.  Karen brought me a blanket, but it didn’t do much to warm me up.  The cold and the pain made me miserable.  I tried to eat more of the crackers, and drink more water, but every movement hurt too much to even think about eating.  I started to cry.  Another patient across the room was looking at me.  I like to think she was trying to console me with her eyes, but perhaps she was just staring.  Karen came over, and I begged for some painkillers.  She arranged for someone to give me Demerol through my IV.  For a minute, the pain melted away, and I felt great.  Suddenly, I felt nauseous.  I told Karen, who told me that I looked green.  She brought me another “barf-bag”, which I immediately vomited into.  Karen held back my hair and comforted me, and told me that nausea and vomiting are common side effects of Demerol.  She told me that I shouldn’t drink any more liquids for a while to reduce the chances of my vomiting again.  She told me that if I finished all of my crackers, I could take a Percocet.  I still had about 4 Saltines and 2 Graham Crackers.  The prospect of eating them without water was daunting, but pain medication seemed like a good enough reward to try.  I slowly started eating the crackers, one small bite at a time.  I thought of an old game I used to play with my friends when I was little to see who could eat five Saltines in a minute without drinking any water.  I finally finished all of the crackers, and Karen came over to give me a Percocet.  She said that my skin color looked a lot better. 

 

I felt like I had to urinate again, and Karen said that she would take me.  She was much more helpful than the first nurse.  She gently helped me get into a wheelchair and wheeled me to the bathroom.  She was prepared to wait in the bathroom with me in case I had any problems, but I told her it was okay to wait outside.  Urinating was just as difficult as the first time, and it took a while.  When I got outside the bathroom, Karen was gone!  I sat down in the wheelchair to wait for her.  Another nurse came up to me and told me that I wasn’t allowed to be there without a nurse.  I told her that Karen had been with me but had disappeared and that I was waiting for her, but she told me again that I wasn’t supposed to be there.  I thought that it would be clear that I wasn’t going to go anywhere, considering I was sitting in a wheelchair, but she seemed to disagree.  Then Karen came back and cleared up the situation, and she wheeled me back to my reclining chair.

 

At this point, I had been in the recovery room for about five hours.  I looked around and noticed that everyone who had been in the room when I first came in was long gone.  Even people who had come into recovery hours after me were gone!  Karen told me that she thought I looked great, and she thought that I was ready to go home.  She removed the gauze from the wound and replaced it with a clean piece of gauze.  As she changed the dressing, I looked down and saw blood oozing out from under the Steri Strips, but this surprisingly didn’t make me nauseous.  The wound was weeping a lot, so she secured the gauze with a water resistant sticky cover, and then covered the area with another piece of gauze and another sticky cover.

 

Karen asked if I needed help getting dressed, but I told her I thought that I could handle it on my own.  I was able to put on all of my clothes by myself, except for my shoes, which Karen helped me with.  I said goodbye and thank you to Karen, and she wheeled me into the waiting room where my mom was waiting. 

 

My mom wheeled me to the main entrance of the hospital, where we tried to find a cab.  There was a cab stand outside, but no cabs were lined up.  It was freezing outside!  A cab pulled up, and we started to get excited, but another woman took it.  Finally, we were able to get a cab!  We instructed the cab driver to drive slowly and carefully and to try to avoid bumps.  Unfortunately, the road outside of Mass Gen is under construction, so the ride was a bit bumpy.  Fortunately, I only live about five minutes away from the hospital, so the ride wasn’t too bad.  I got home a little before 5:00 PM and immediately got into bed.  Climbing into bed was torture.  I basically had to grit my teeth, sit down on my bed, hoist one leg up on the bed, and roll onto my back while hoisting up the other leg.  The pain was the worst pain I had ever felt in my life.  But on the bright side, once I relaxed and got comfortable while lying down, I wasn’t in a lot of pain.  Ariel brought me toast with jam (my favorite food to eat when I’m sick) and ice packs and wanted to hear all about my day.  I talked to Ariel and my mom for a while, checked my email wirelessly on my BlackBerry, and tried to go to bed.  After lying there for a while, I realized that my body was exhausted, but I didn’t feel tired, so I got up and lay on the couch in the living room and watched TV for a while.  Ariel brought me some homemade quiche, which I was able to eat in small bites.  Again, getting up and back down was torture, but the pain subsided once I got comfortable.

 

Once I felt tired, I got into bed again, but I didn’t sleep very well.  I usually sleep on my side, and I found that I could actually sleep on both my right and left sides without a problem, but any slight movement would send pain shooting through my body.  I also had to get up to urinate every hour, which I suspected was due to all of the fluids that they gave me in the hospital through my IV.  My mom slept on the futon in the living room.  She still wasn’t feeling well, so she didn’t sleep well either, and we kept hearing each other get up to use the bathroom.  At one point in the middle of the night, I lay down on the futon with her, hoping that a change of scenery would help me sleep, but it was futile.

 

 

Friday, 12/19/03: One Day Post-Op

 

When I woke up, I instinctively stretched my entire body, like I do every morning.  That was a huge mistake!  Searing pain coursed through my entire body.

 

My mom and Ariel took good care of me throughout the day.  They brought me high-fiber snacks, ice packs, reading materials, and anything else I needed.  I took one or two Percocets every four hours.  I was able to sit up, but walking around and moving still hurt a lot.  I found stooping over while walking eased the pain a little.  I responded to some emails on my BlackBerry and watched a lot of TV.  Urinating was still challenging and took a lot longer than usual.

 

While drinking water, I swallowed too quickly, and it went down the “wrong pipe”.  I started coughing, and I felt the pain radiate throughout my abdomen area.  I tried to stop coughing, but if I did, I couldn’t breathe.  For the next week, every time I coughed or sneezed, I experienced similar pain.

 

We watched some TV and the “Kissing Jessica Stein” DVD.  My mom left in the mid-afternoon, since she was going on vacation with my dad the next day.  I was sorry to see her go, but Ariel promised to continue taking care of me.

 

That night, our friends B and Elliot came over to keep me company.  We usually laugh and have a good time when we hang out, but unfortunately, laughter caused me to be in inordinate amounts of pain.  I kept calmly telling them, “I know that laughter is the best medicine, but it hurts to laugh, so please do not say anything funny.”  They thought that that was the funniest thing that they had ever heard.  Pretty soon, we were all laughing, which hurt a lot, but was also a lot of fun.

 

I slept a lot better this night than I had the night before, and I didn’t wake up as much.

 

 

Saturday, 12/20/03 and Sunday, 12/21/03: Two and Three Days Post-Op

 

During the weekend, I was able to sleep late, and my friend Sara came over and spent most of the weekend with Ariel and me.  We watched every romantic comedy that Sara’s roommate had on DVD or that was on Comcast OnDemand: “America’s Sweethearts”, “How To Lose a Guy in 10 Days”, “Two Weeks Notice”, “About a Boy”, “White Oleander” (not a romantic comedy), and “Kissing Jessica Stein” (again, since Sara missed it the first time).

 

I took Percocet less frequently over the weekend.  I mostly took two or three Advil every four or five hours.

 

Despite taking two (or more) stool softeners a day, multiple fiber supplements, and eating a lot of high fiber food, I had not defecated since my surgery.  As a result, I had uncomfortable gas pains and a bloated feeling.  At times, I felt like this pain was worse than the pain from the surgery!  Luckily for Sara and Ariel, the gas seemed content to stay inside my body.  Ariel bought me some gas medication, but it didn’t do anything to ease the pain.

 

Dr. L had told me to remove my bandage on Sunday.  I was a bit nervous about doing this due to my aversion to blood, but I took it slowly, and it wasn’t as bad as I had feared.  The Steri-Strips covered the entire incision.  I could see some dried blood under the strips, but there wasn’t much else to see.

 

I was able to walk around a little better, but I felt a horrible burning sensation in the incision area whenever I stood or sat up for longer than five or ten minutes.  The pain subsided when I lay down or iced the area, but it made me not want to get up very often.  I emailed my co-workers and told them that I was planning on working from home on Monday.  The thought of having to get up and take the T to work was not a pleasant one.

 

 

Monday, 12/22/03: Four Days Post-Op

 

One of my clients was having some technical problems, so I worked for a couple of hours on my laptop while lying down.  I still had some pain, and I was still taking Advil, but I was able to work without too much difficulty.

 

I finally defecated!  It hurt a bit in the incision area, but it cleared up my gas problem.  For the next few days, I went to the bathroom regularly.

 

I still had the burning sensation every time I walked or stood, which was beginning to concern me.

 

I called Dr. L’s office to schedule a follow-up appointment.  There was some confusion about her hours, so her office told me to page her.  When she called back, I decided to ask her about the burning sensation.  She asked if I was eating normally and moving my bowels, and I told her that I was.  She asked if the incision was weeping, and I told her that it wasn’t.  She told me that many tiny nerves were cut during the surgery, and she reassured me that a burning sensation was simply a sign of the nerves in the incision area regenerating.  She encouraged me to follow my daily routine and activities; “get outside, go shopping”, she said.  She reminded me that she had prescribed me painkillers, and she told me to take them if I needed them and not to be “macho”.

 

Ariel mentioned that she wanted to buy a pair of jeans at the Gap, so I decided to take Dr. L’s advice and go shopping with her.  Of course, that meant that I had to take a shower, since I hadn’t showered since my surgery.  I was avoiding the prospect of standing up for any length of time, but I decided that the time had come.  Thankfully, the burning sensation wasn’t that noticeable in the shower.  I was scared to touch the incision area, so I tried to wash it without actually touching it.

 

I got dressed, and Ariel and I headed to the Gap, a five minute walk away.  We walked very slowly.  I am usually a fast walker, but I kept finding myself asking Ariel to slow down.  I was still stooping over a little while walking, but not as badly as before.  I started feeling the burning sensation as we reached the Gap, but I tried to grin and bear it.  When we entered the dressing room, I happily sat down and slouched, hoping that the pain would subside if I reclined a little.  It worked a little, but I was still in pain.  Ariel tried on about ten pairs of jeans, and we picked the pair that looked the best.  We walked home, and I was happy to be able to lie down and relax.

 

 

Tuesday, 12/23/03: Five Days Post-Op

 

I was getting a little nervous about my trip to Philadelphia; if I could barely walk for five minutes without being in pain, how could I expect to get to the airport and fly to Philly on my own?  I hadn’t taken any Percocet the day before, and I hadn’t taken much of it over the weekend, but I decided to try taking a pill and running a few errands with Ariel to see if it made a difference.  It turned out that it made a huge difference!  I showered, and then we went to the bank and to CVS, and the burning was barely noticeable.  When we got home, Ariel took a nap, and I moved around the apartment for a couple of hours cleaning up, checking my email on my desktop computer for the first time, and packing for my trip.  I felt the best I had felt in days!

 

 

Wednesday, 12/24/03 to Friday, 12/26/03: Philadelphia

 

I took two Percocets in the morning and hoped for the best on my flight to Philadelphia to visit my brother and sister-in-law.  I experienced some pain, but it wasn’t too horrible.  I continued taking Percocet sporadically throughout my trip, which made moving around and sitting up manageable.  I still had the horrible burning sensation, but it only came after sitting up or standing for about an hour, so I made sure to lie down and relax frequently.  My brother and sister-in-law were very accommodating and made it easy for me to relax (and my brother cooked excellent meals!).

 

 

Friday, 12/26/03 – Tuesday, 12/30/03: New York City

 

I left Philadelphia and traveled to New York City to visit friends.  I took less Percocet and more Advil and started to feel more like my old self.  Most of my days in NYC were busy, as I traveled around the city and got together with various friends.  I felt pain most evenings, but it was manageable with painkillers.  One night after being out all day and most of the night, I felt unbearable pain and found myself without any more Advil.  I stopped into a bodega to buy Advil, which helped with the pain a little, but I was still uncomfortable.  Still, the trip was a lot of fun, and I felt ready to head back to my life in Boston.

 

 

Tuesday, 12/30/03 - Thursday, 1/1/04: Back to Boston

 

After my surgery, I tried to stay away from the incision area while showering, getting dressed, etc.  When I got back to Boston after my trip, I decided to touch the area to right of the incision, near my upper right thigh, and I found a small numb area, which made me uncomfortable.  I decided to ask Dr. L about it at my follow-up appointment.

 

I started to get worried that numbness in my groin might interfere with my sexual functioning.  I had the opportunity to “test” this hypothesis, and I luckily found that the numbness was not a problem and that my sexual functioning was perfectly fine.

 

 

Friday, 1/2/04: Post-Op Appointment With Dr. L

 

Ariel went back with me to Mass Gen to meet with Dr. L.  First, we met with another doctor who answered some of my questions and looked at the incision area.  She reminded me that the lifting restrictions continued for a few more weeks and recommended that I not lift anything heavier than a phone book.  I asked her what kind of stitches had been used to close both the inguinal canal and my skin.  She told me that the stitches used in the top layer of skin dissolve, but the deep stitches never dissolve.  The deep stitches are made of prolene, a strong synthetic material, and they are used to sew the fascia (fibrous connective tissue) together.  She said that Dr. L used stiches to sew up the hernia (as opposed to mesh) since the hernia was small and surrounded by young, healthy tissue, so stitches wouldn’t put any additional tension on the stitches (one of the reasons for using mesh).  I asked why the hernia would have appeared all of a sudden if I was born with it, and she told me that no one really knows why this happens.  I asked about the numb area on my thigh, and she said that numbness was normal, and that there were only superficial, not major, nerves in this area, so it wasn’t a big problem.  She that that it would hopefully get better gradually, but that it may never get better.  She said that the recurrence rate for hernias isn’t very high but that having strong stomach muscles can help.  She looked at the incision area and said that it looked great.  She told me that the scar tissue would remodel itself within six months to a year, and that the ridge over the incision would eventually go away.

 

Next, we met with Dr. L who answered some more questions and also looked at the incision area.  She told me that my primary hernia was an indirect hernia, but that I also had signs of a direct hernia.  She said that she cut out the fluid-filled sac and sent it to pathology and closed the indirect hernia using the Bassini repair.  (This information from Men’s Fitness Magazine explains the history of the Bassini repair: "In 1896, you would have contacted a doctor by the name of Bassini, an Italian surgeon and the father of what's called herniorrhaphy. He would have put you out with ether; sliced through your skin, fat, muscle and inner-abdominal lining; pushed the bulging intestine back into place and sewn the muscle and skin back together.  That's the traditional hernia operation, and it has been performed for the past 100-plus years. But not without problems. One difficulty with the Bassini technique is that there's tension on the stitches, especially where the bulge creates pressure, and this results in moderate to severe pain for several weeks (or months) after the procedure. In addition, about 10 to 15 percent of the time, excess pressure that appears before the wound is thoroughly healed can cause a recurrent hernia. About 60 years ago, a doctor developed an ingenious multilayer closure technique that shrunk the recurrence rate to about 2 percent.")  Dr. L also reinforced the weakness in the abdomen (the sign of the direct hernia) with sutures. 

 

Dr. L told me that the incision looked great and that I could peel off the Steri-Strips if I wanted to (my original instructions were to let them fall off in the shower).  I asked if she recommended putting anything on the wound to help the healing, and she said that some people recommend Vitamin E.  (I later read an article on WebMD that advised against using Vitamin E, so I decided not to use it.  For a few weeks, I tried using Mederma on the incision, which is supposed to help reduce scars, but I didn’t notice any improvement, so I stopped using it.)  I asked about the risk of getting a hernia on the left side, and Dr. L told me that since I had one on the right side, I have a higher risk than the average woman of getting one on the left side.  But she said that since women have a pretty low risk of getting hernias compared to men, my risk is nothing to worry about.

 

 

Monday, 1/5/04: Back To Work

 

My first day back at work in two and a half weeks was surprisingly uneventful.  I was fairly comfortable sitting at my desk and doing work all day, and I was glad that I had had the opportunity to take a vacation and relax after my surgery instead of going back to work right away.

 

 

Wednesday, 1/7/04: Numbness Discovery

 

This morning in the shower, I tried to shave my right bikini line in preparation for my trip to Florida, and I found that the upper portion of it was completely numb.  (I had found a small numb area on my upper thigh the week before, but this was a much larger area than I had originally thought.)  I got nauseous and everything started going black, and I exited the shower and dry heaved a bit, and then went to lie down.  I decided that the numbness was probably there since the surgery, but that I didn't actually have to touch that area until the shaving incident.  I think that the nausea was psychological, and once I lay down for a while, I felt fine.  Still, the whole situation was scary.

 

 

Saturday, 1/10/04 – Wednesday, 1/14/04: Florida

 

After three days back at work, I took a vacation to Florida to visit my grandma.  (I had this vacation planned before I found the hernia or scheduled the surgery.)  The trip was relatively pain-free, but I continued to take Advil as necessary.  I swam, went in the hot-tub, walked around, and felt 95% healed.

 

 

Wednesday, 2/18/04 – Present Time

 

Two months post-surgery, I feel 99% better.  I still have a scar and a some numbness to the right of the incision area, but I no longer feel any pain.  Overall, I feel that my experience with surgery was a positive one.  I had a great experience at Massachusetts General Hospital, and I would highly recommend it to anyone looking to have hernia surgery.