Large complex incisional hernia

I will keep you all posted Shirley, I'm off to Lanzarote on Thursday for some pre-op R&R in the Sun 😎🍸😆

An update:

Hi Shirley and Debbie,

I went back to my GP armed with the clinical report from Mr Hakky and various other bits of research but he steadfastly stuck to the view that it should not be repaired and even if it was repaired it would only reoccur. I pointed out that the rate of recurrence had been quoted at 5% - 10% by Mr Hakky and other published reports but still he said it would “probably” reoccur – I’m not sure what school of statistical analysis he went to but a 90% success rate sounds good to me! I also pointed out that the hernia will almost certainly get worse and that surely it will mean a more complex repair with an increased likelihood of recurrence. He remained completely nonplussed.  

He said that “hernia repair is a simple procedure”; that’s not the impression I have been getting. Does this imply that the procedure can be delegated to less experienced surgical staff? - How would I know who is doing the procedure I'd be unconscious. Maybe the high recurrence rate is due to the misplaced notion that hernia repair is simple. My worry is that if the original surgeon elects to do a repair he will more than likely be less experienced than, say Mr Hakky and may not be au fait with the latest thinking.

The GP also said that he could not refer me to Mr Hakky in London because it was outside, I think it was some notional geographic area or maybe outside the Gloucestershire bit of the NHS, if the procedure could be performed locally. He told me to wait and see what the surgeon who did the bowel resection had to say - my case had been referred back to him by my GP surgery.

Ten days (approx) later I had still not received an appointment to see the original consultant; that’s nearly three weeks since I was originally referred. So I checked on my Patient Record on my GP’s website and I find a reply to the referral letter, received prior to me recent visit, addressed to the referring doctor (I should clarify that and I don’t always get to see the same doctor each time and last time it was a different doctor) saying that there is a range of suitable support appliances that are available so try that but if the hernia gets worse to send me along for assessment. I wonder when they were going to let me know this!

I can’t express how frustrating I find this. It’s as though no one reads the correspondence or discerns that some action needs to be taken. The system doesn’t seem to be joined together; it’s not as if it’s difficult, it just needs someone to own the problem.

Anyway I’ve alerted the last doctor I went to see at the surgery to the fact that there has been a reply from the consultant and I await his advice …… I wonder how long that will take, if it happens at all.

Thanks for your time.

Regards,

Phil.

Hi Phil, I totally understand your frustration, it has taken 2 years for me to get my surgery, despite the fact that everyone was in agreement that surgery was a requirement for my situation. Having said that, I have had to "follow the path" so to speak. I was asked to wear a support garment for a few months to see if this would help before resorting to surgery. I would actually recommend this, you can get them made for you on the NHS and they do offer good support, I wear mine at work (I'm on my feet all day) and when I'm out walking. I'm being measured for a new one after my op as I will still need to wear a support. I've also found my letter refer to NHS funding - it was the Clinical Commissioning Group, they said "whilst we would be happy for your patient to be seen within the boundaries of NHS England we are unable to approve funding to Edinburgh Royal Infirmary". I guess each CCG has their own funding criteria. It's dissapointing that your GP is not supporting you, he is not a Hernia expert, it's not always a simple proceedure! I would continue to press him for a referal to a specialist, or would Mr Hakky provide you with a letter outlining his opinion as to the requirement and suitability of surgery in your case? Keep going and good luck. Only 6 days for me now and I have to admit to getting anxious about it!

Hi Debbie,

It's like pushing water uphill - if that's the way it's going to be, so be it. I'm like a dog with a bone once riled!

Actually Mr Hakky has sent the surgery a copy of his report recommending a repair and I did show this to the doctor. I'm not sure how much credence he put in it though.

I will consider pursuing the use of a support but if it looks like that will prejudice my chances of geting a repair then I would be more reluctant to go that route. Hey, ho, onward and upward.

Good luck with your op.

I'll be thinking of you.

Phil.

Hello Shirley, Jon & Phil

I'm now back home after spending 6 days in hospital following my surgery. I'm pleased to report the surgery went well - in fact better than expected - and there have been no complications. Obviously I still have some pain, particularly at the widest point of the hernia. I didn't get to see my surgeon after the surgery so I don't know how big the mesh is, but to give some idea, the incision is about 45cm long with approx 50 staples.

Jon you will be pleased to hear that my treatment and care at the QMC was excellent the whole experience has been far superior than that I had to endure at Derby. You will be well looked after :-)

Hi Debbie,

Great to hear from you, I've been thinking about you and wondering how the operation went for you. Glad that things went well but 45cm sounds like an enormous incision. I've got a scar 30cm long from when I had a tumour removed from my chest but you've got me beat   Hope you mend quickly and completely and that all your troubles are behind you now.

I'm now have an appointment (13/12/16) to see the leading colorectal consultant, Mr Neil Borley, at Cheltenham/Gloucester (UK) with a view to having my incisional hernia repaired on the NHS, it was a consultant from his team that did my bowel resection last November.

Mr Borley has a good reputation as a colorectal surgeon and is highly thought of in this neck of the woods but I don't know what his experience of repairing hernias is. I shall be asking him lots of questions so we'll see what he says. I am hoping that he is not of the old school of doctors who believe that the less the patient knows the better. I have known doctors to get quite defensive and offended if you ask them penetrating questions. The trouble is the appointment confirmation letter says “Mr Borley or one of his team". Actually I want to talk to Mr Borley himself as he seems to be the most experienced surgeon and if he gives me the right answers then I'll want him to do the procedure. I understand I have the right to ask for a specific surgeon - I may phone up and see if it will be Mr B or not.

As for questions; I want to know what technique he proposes to use and why, how many times he has used that technique and when he last did a repair like that. I’m also slightly concerned about the possibility of trapped nerves and long term chronic pain if a mesh is used.

Debbie, you have now had a mesh inserted and from what you say you didn’t have much choice. Did you have much discussion about potential problems arising from using a mesh? I will be interested to learn how you progress.

So I am making some progress toward getting my hernia fixed on the NHS but there are several hurdles to jump yet. If I’m not happy with Mr B then I’ll be looking to see if I can get referred to Mr Hakky on the NHS. If that does not seem to be possible then I suppose I’ll have to face up to the cost of having the repair done privately.

Meanwhile I am wearing an abdominal support as suggested by Mr B and it does help. However it is very itchy from time to time and by the end of the day I am glad to get it off!

Glad you are on the mend Debbie. Please do let us know how you fare over the coming days and weeks. The trouble with forums like this is that it is often frequented by people like us that have problems and we don’t hear from too many folk who have had successful treatment. So it will be good to hear that your story has a happy ending

Regards, Phil.

Hi Phil,

Yes I'm surprised at how well I feel, obviously it's early days but I hope I continue to improve over the next few weeks.  My stomach feels tight - I don't know if its the mesh that I can feel, or perhaps the swelling has a part to play.  I also have a sharp pain deep in my right hip which I have a feeling is attributed to where the mesh has been anchored and hope that in a few weeks that will have settled down.   My immediate worry is infection, after my last surgery I'm a bit over anxious about it but I'm having my staples out on Monday so will be looking for reassurance then. It is a very large incision - I look as though I have been cut in half!

Your comment about defensive consultants made me smile - the one I was orginally referred to at Derby discharged me because he didn't like the fact that I had done some research and questioned his experience and results.  I'm so glad that he did lol.  Mr Abercrombie, the surgeon who has just performed my repair, was more than happy to answer my questions and actually encouraged me to do so.  We talked about the risks and possible complications and he was careful to ensure that I understood what a large undertaking my operation would be, the risk of recurrance for me is high at 30%.  He clearly wanted to ensure that I was making a considered decision and didn't have any unrealistic expectations. His open and honest approach gave me confidence. I do think I did drive myself a little crazy with all the "what if" seranario's.  In the end, once I had made the decision to go ahead (and I didn't think I had much choice), I tried to forget about it, and now that it's over, I'm trying to focus on the positives and banish the negative "what if's" - I will cross any further hurdles when and if I need to.

Your surgeon can state that he wants to perform the operation himself and request that you are not placed onto a "shared pathway".  This is what mine did. 

Your appointment will soon come round, let me know how you get on and I will do likewise once I have had my follow up.

Deborah

.

Hi Folks,

Here's a bit of an update on my hernia "project" (I have posted this elsewhere on the forum but said I would keep you informed).

At long last I had my consultation with the local (Cheltenham) NHS colorectal consultant (Mr Borley) who my GP referred me to for repair of the abdominal incisional hernia that ensued after I suffered a volvulus of my small intestine in late November 2015.

I had done a certain amount of research but as I am sure you know a lot of the available data out there relates to inguinal hernias. I had already been for a private consultation with Mr Hakky at St Mary’s, Paddington as part of the British Hernia Centre and he had advised using a hybrid technique of using an inlaid mesh (part absorbable part, polypropylene) laparoscopically and open to close the wound.

Mr Borley advised me that he would recommend using a technique known as “Component Release” technique and not use a mesh at all. [Actually he said he didn’t think many surgeons were still using mesh – what he meant by that I am not sure since a lot of people on this forum have recently had procedures using mesh. Maybe he meant for abdominal incisional hernias. ] I was mightily relieved to hear this as I was getting somewhat concerned about the prospect of having a mesh inserted.

I have done some small research on this technique and I think it is known under a different name in the states as “Component Separation” technique (CST). This was first described by Ramirez et al in 1990 and is used to repair midline abdominal wall defects such as a large ventral hernia. [Search for “Indications and Outcomes of the Components Separation Technique in the Repair of Complex Abdominal Wall Hernias”.] Essentially it involves releasing one of the muscle layers of the abdomen by severing it’s anchor point in the area of the flank. This means that the muscle can then be pulled over the hernia and used to cover the hernia thus forming a tensionless closure. I think it comes under the banner of “abdominal reconstruction” which is probably why it is not appropriate for inguinal hernias. I note that some surgeons still go on to use a mesh as well but Mr Borley is not advocating that in my case. Phew! However this is no “magic bullet” reoccurrence of the hernia is not ruled out.

It was also brought to my attention by my partner that NHS Scotland suspended the use of mesh and tape implants in 2014, albeit for the treatment of pelvic organ prolapse and incontinence in women, conditions that can commonly occur after childbirth – search for “mesh implants NHS Scotland”. Apparently there has been a high incidence of painful and debilitating complications as a result of this procedure.

I am now on Mr Borley’s waiting list which is considerable but I think given, the very competent impression I have formed of him, that I want him to do the procedure despite that fact that he doesn’t do 100’s of them per year (he is really in demand for his colorectal experience)  but he has used this technique for some time.

All this must, I know, be of no solace to you Neil since it is a technique that is not applicable to inguinal hernia repair … as far as I can see … after all the foregoing is just a layman’s view.

Good luck for the future and do let us know how you are getting on.

Regards,

Phil

Ooops ... I included a comment to Neil (from another post in this forum) .. sorry for any confusion.

However the comment relating to the inappropriateness of CST to inguinal hernias is still valid.

Hello Phil, it's all sounding much more positive for you now, you sound happier too 😊. My surgeon is a colorectoral specialist. During my first consultation with him, he told me I wouldn't be a suitable candidate for the compartment separation technique as my muscles had detached from the bone. However immediately after my surgery, he said that he had managed to use my muscles after all and I now have 2 layers of support, (mesh and muscle). I was just coming round so wasn't able to discuss it further, but I do believe this technique was used. I'm still waiting for my follow up appointment and I will ask about this when I see him again. With regards to the mesh used in Pelvic floor repairs, this is very different to the mesh used in abdominal repairs - it is like a thin tape. I've had this operation myself and had problems from day 1. My surgeon said the tape had cut through my bladder like a piece of cheese wire and sat inside the bladder for 2 years causing all kinds of problems. Understandably, I refused mesh initially for my hernia repair, but, so far, I have had no problems with the mesh in my abdomen. Let's hope it stays that way. Keep us posted on how you get on, I hope tge wait isn't too long for you. Merry Christmas 😊

Hi Debbie,

Merry Christmas to you too.

Yes, I am feeling more sanguine these days or maybe more resigned to the slow pace of the NHS, ah well, so be it.

Thanks for clarifying the situation wrt pelvic floor repair tape. What happened to you sounds truly horrific!  It seems like you have really been in the wars. Hopefully now you are past all that and can look forward to a healthier future.

As for me, I'm trying to be patient but that's not something I excel at. My partner won't let me lift anything if she's around which is all very supportive (..... supportive ... hahaha ... get it?) but frustrating. I'm just unable to do the things that I'm used to doing and the many more things I had planned to do now I'm retired. I'll just have to wait. I'll let you know how I get on but it might be a while before I am able to report any progress.

Regards,

Phil.

Hi Phil,

How are you getting on?  Have you received a date for your surgery yet?  I hope it isn't too much longer for you to wait.

 I just thought I would update you with my progess.  My pain has reduced considerably, although I do get a burning sensation in the area of where the widest point of my hernia was - I notice this when I have been on my feet for several hours or if I've overdone it!  Sitting down and resting for a while rectifies this though.  I have finally had my follow up appointment today with my consultant - he is delighted with the result of my surgery (as am I), he explained the burning sensation is probably due to damaged nerves - he said you have to break a few eggs to make any omlette lol.  Nevertheless, I'm very happy with the outcome and consider the surgery to be a complete success. I have now been discharged from the hospital. Just goes to show positive outcomes do happen, I can't tell you what a relief it is, I was dreading the possibility of a different outcome

Please keep us all up to date with your progress and I hope you too have a good outcome.

Regards

Deborah

Hi Debbie and all,

I’m so pleased to hear that you are progressing well and that your procedure was a success. Hopefully the burning sensation will subside over time. In the past I had a very serious operation to remove a huge tumour from between my lungs. This left me with some very strange effects to my nervous system, among other things. It was like my sock was balled up under my right foot all the time and putting weight on it was quite uncomfortable. It took quite a few years (the op was in 1995) for that to subside or maybe I just got used to it. I still feel it from time to time but it’s not as prominent as it was. The surgeon said that moving stuff around inside your body sometimes upsets the rest of the body!

I had a similar episode when I got sciatica down my left leg in late 2015. The pain’s gone now but it feels like I have very tight socks on or that my left foot is swollen. It’s not, it’s normal sized but presumable the trapped sciatic nerve is still recovering and sending some confused signals to my brain.

I’m guessing the same will be true for you Debbie. The nerves local to where the surgeon was operating will be complaining and it might be while before they settle down.

As for my hernia; well, I’ve been on Mr. Borley’s list since mid-December, not long I know but  I’ve rolled over the RTT waiting time by more than a couple of weeks now and no prospect of a treatment date just yet. I realise that triage-wise I’m in the “he can wait because he’s not critical” group and that the NHS are in an under resourced situation, so I understand that I’ll just have to wait …. So, I enquired about going privately and the cost is not prohibitive. I don’t have medical insurance but I figure this situation is just getting worse and meanwhile my abdomen is just getting bigger. My intestines are poking out either side of the linea alba as the hernia enlarges. It now looks like I’ve got two Galia melons in bra strapped around my waist!

On top of that we’re about to move house, well in the next three or four months, so what do I do? Struggle on with the support garment and lift things I really shouldn’t or wait for the NHS or have the surgery privately as soon as possible but not lift anything for 6 months for fear of recurrence?

So I’ve bitten the bullet and I’m going privately. It’ll cost me £3,843.00 and I can pay in six monthly instalments with no interest, so not hideously expensive.

I’m scheduled for surgery at The Nuffield in Cheltenham on the 26th April.

It can’t happen soon enough for me.

I’ll let you know what happens.

Regards,

Phil

Hi Phil,

I'm so pleased you are finally getting your Surgery, I too considered having mine done privately but my quote was £10k, there was no way i could afford that!  I think you have done the right thing, I was surprised at how fast my hernia enlarged, I definately would have had the surgery sooner if I could.  Please do come back and tell us how you get on, not long to wait now.  Good luck!

Deborah

Hi Phil I have been following this , to me its sounds like you made the right chioce not to wait any longer, my problem is quite new , i had a emergency bowl op in november I had adhesions which strangled the bowel but a bout six weeks ago i started to notice swelling at the top of my tummy, on top of this ive have had a perscistant cough (still have) which as you know does not help , ive just finshed anti biotics which hasnt helped as i feel like sh*** ,and I am sill wondering if the two things are related as i get wheezy when i eat ? the doctor disregarded this,  now its quite sore at times but after reading stuff on here I can now see things are not always to be plain sailing  good luck to you and lets us know how you get on

Hi Sue,

I had my pre-op assessment on Monday and today I am seeing the anaesthetist for assessment. I have a somewhat compromised lung function due to the damage caused when they excised the remainder of a tumour between my lungs. So I think the fact that the anaesthetist is being cautious is a good sign.

Last time I came round from general anaesthesia the recovery team had hooked me up to an oxygen reflow system which is like those oxygen trickle nasal specs but they can closely control the amount of oxygen, humidity and especially the pressure (force) with which the oxygen is applied to the nose.

What happened to me was that they had dialled up the force to way beyond what I could comfortably manage, since my lung function is less then optimum. It was like trying to breath with a force 10 gale blowing straight in up my nose. The resultant effect was that I was gulping like a goldfish on the surface trying to breathe and my mouth and throat were so dry I could hardly swallow........ it took them 2 or 3 days to cotton on to the problem. In fact it was a very professional nurse who sorted it out in the end and had to tell the consultant in CCU that the settings were wrong! That set my recovery back several days.

So I'm hoping that won't happen this time.

I'll let you know what does happen.

As for you, well, it sounds to me like you may have an incisional hernia. Was the procedure for the strangled bowel done as open surgery? Is the swelling near to the operation site? Has the swelling been diagnosed as a hernia? Can you reduce the swelling by pushing it back into your abdomen?

It also sounds like you may have contracted a cold which obviously will make you feel less than tip top. It would explain the wheeziness and the cough but why the anti-biotics? Anti-biotics won't have any effect on a cold.

Sorry, lots of questions ..... it's just the way my mind works ....hope you feel better soon.

Kind regards,

Phil.

yes it is a incisional heria after open surgery so the gp told me,  I can't reduce the swelling by pushing it back it stays out?  is a bit sore not lots of pain  I say 4 out of 10 but it does look strange as its near the top of my tummy , you are right the antibiotics have not cured the cough which is week 4 now, I am glad you had pre op and can expland to the anaesthetist what happen last time

Hi phil you say your getting it done privately is that still with mr Borley? and is it with the component releases technique ?

Hi Sue,

Yes and yes. I'm due to go in on the 4th of May and it can't come soon enough for me. I shall be glad to get this done and dusted and hope, with a big hope, that the hernia will not reoccur. My partner is threatening to stand guard over me for three months to make sure I don't lift anything heavier than a cup of tea!

Regards,

Phil.

That's great I  haven't seen a surgeon yet but I am interested in this type of surgery as it seems a better fix, I am in somerset and will continue to research this as see it there are any nhs surgeon in,my area who will do this type of surgery but i could get a loan for £4000 I hope all goes well for you as I may follow your footsteps LOL Sue

just got the post   I have the choice of an appointment with Bridgwater hospital   Chard and district hospital   minehead community hospital and musgrove park where i had my bowel op so now i have to research the surgeons

Yes research is key if, like me, you don't have a medical background.

After a small amount of googling I found some great youtube clips (search for “anatomyzone abdominal wall” on youtube) explaining the structure of the abdomen. This prompted a few emails to Mr Borley to answer some questions which he was glad to do. It was at this point that I realised that I had misunderstood the Component Release Technique. I thought I had better confess and explain.

I had thought the technique involved releasing the anchoring of one of the muscle layers which is then freed it to be pulled over the gaping hole to form a patch, this wrong. The technique does involve releasing one of the muscle layers but the freed muscle is not used to patch the hole.

It’s really my understanding of where the hole actually is that is at fault. I thought it was through all the muscle layers of the abdomen. However the incision point for the majority of ventral procedures is in the midline, through the fascia of the rectus abdominis which I think is the Linea Alba a tough fibrous structure that runs north-south of the abdomen. It is the point where all three of the aponeurosis (similar to the tendons elsewhere in the body that join muscles to bones) of the underlying muscle layers join. It is this that is gaping open. So the original incision didn’t go through any muscle layers!

The reason the incision is gaping open is that the closing sutures have failed and the muscles therefore pull the underlying wound open. By releasing one of the muscle layers from it’s anchor point on the skeleton it relieves (hence component “release”) the stress on the hole in the Linea Alba and allows it to be drawn back together and sutured.

I hope that’s clear and more importantly correct! I’m just a layman struggling to understand.

Good luck with your research.

Hi Debbie, Shirley and All,

Well I had my abdominal incisional hernia repaired on Star Wars day (May the 4th be with you!). So far recuperation is proceeding well.

I feel like I want to tell you the whole story, so here goes……

Went in to the Nuffield hospital in Cheltenham at midday on 4th of May and met with the anaesthetist and Mr. Borley the surgeon. The plan as I understood it was  to use component release to restore the core strength of my abdomen by releasing one of the muscle layers from it’s anchor point on the skeleton thus relieving the stress on the hole (i.e. the hernia) in the Linea Alba and allowing it to be drawn back together and sutured. I had been told by the Nuffield that this would be done laparoscopically which I thought odd, so I asked them to confirm that this was the case which they did.

Mr. Borley however said, “No, I’ll be doing it open.” - well he’s the boss so that’s what happened!

I went down for surgery at about 16:00 and came back at about 17:50 … I think, I’ll have to ask my partner for the exact timings. The anaesthetic was like I’d never experienced before and I have had a few ops …… actually I quite like the feeling of drifting off. This time though, one minute I was talking to the nurse about where I used to live and the next I was waking up, bright and alert in recovery! It was just like a switch; one minute you’re awake, the next your unconscious and then you’re back again and it’s all over. To be fair the anaesthetist did tell me he might do it that way.

Was there any pain? No. They’d got me hooked up to something called a pain-buster and I felt nothing other than the odd twinge. I had a couple of paracetamol for that and now and then one capsule  of tramadol if it felt worse.

I had two drains in to evacuate the fluid build-up, an eight inch scar running to the right of my navel which was sutured and super-glued. Mr. Borley had excised the old scar so it all looked quite neat.

I was out of bed the next day, Friday, but that was a bit too adventurous really because I was violently sick three times that day! They gave me a number of anti-sickness drugs. Don’t ever let them give you cyclizine – very bad side effects for me at least. I started slurring my speech in seconds, my head felt like it would unscrew and fall off, I found it very hard to control my movements – picking up a glass of water was a major challenge and the whole of my left leg took on a life of it’s own and would not stop twitching or jumping about.

After that it was all plain sailing. I stayed in hospital Saturday and Sunday and was sent home on Monday afternoon with the two drains still in. I went back daily to have the drains checked. One drain was removed on the Tuesday and the other one was removed yesterday, Saturday. I did have a bit of weeping from the wound since I sneezed at one time and it started a slight bleed. It’s ok now though.

Mr. Borley told me he only had to release one layer of muscle, the external oblique, and showed me how I can actually feel where he has done that each side – fascinating! It all feels pretty tight down there but I am trying to take it very carefully which is not easy. My intension is not to lift anything of any weight for at least six weeks and ideally ten weeks but it’s so hard to judge what is safe and what is not. I don’t want this hernia to reoccur.

I have to say that Mr. Borley was excellent and extremely professional. I would recommend him to anyone. Actually the anaesthetist. Dr Goodrum, was extremely experienced also and I felt completely safe in the care of both these gentlemen.

So, that’s where I’m at today. Mr. B. asked me to continue to wear the support belt, that I had been using, for a while longer and I think I’ll continue with that for a while. My partner, bless her, fusses round me like a mother hen and won’t let me do anything but it’s for the best and she does it so well!

I hope the above was of interest and I’ll probably post again as recuperation progresses.

Regards to all,

Phil.

Hi phil I pleased all went well apart from the anti sickness drug , I had one particular sickness drug after my bowel op that caused hallucinations lol I am glad the anaesthetist was good , i booked a referral to my local hospital but i have now cancelled that one as i can not see anyone there i want to do this operation so after getting in touch with several I am now getting referred to peninsula plymouth hospital and a  surgeon called Kenneth Hosie ( i hope ) they have a very short waiting list , wishing you a good recovery think before you lift.. and looking forward to your progression posts

Hi phil how are you getting on now I hope you are feeling better but not lifting anything yet,  I have my repair on 6th july i'm getting nervous as it's a patch repair and my hernia is quite large. I got the appointment very quickly as it at a treatment centre so they don't do emergencies its a long drive so I booked my husband in a local b &b , at my appointment i saw another surgeon he says he didnt know who would be performing the op slightly worrying , any how I hope you are well sue

Hi Sue, hernia repair is a nightmare. It seems to me there is no panacea for hernia repair, even the medical profession admit there is no “gold standard”. The best you can do is research, choose a surgeon that sounds like they know what they are doing, seek confirmation by some measure of the surgeon’s experience and try to get a personal recommendation…… then there’s the biggest factor; hope that you are allocated a huge dollop of good luck!

As for me, well, I’m coming up to seven weeks post op, got a follow up appointment with the consultant tomorrow afternoon. So we wait and see what he says ……. Trouble is I think I know what he’ll say …….

The wound took a while to heal; there was the odd weepy bit and the odd scab but that’s all healed up in the last 6 or 7 days. It was not unexpected since I am on warfarin and thus my INR is higher than normal and my blood thus thinner. All meaning that I am more likely to bleed. I’ve had virtually no pain at all, the odd twinge and a general soreness but then there are large areas of my skin which are completely numb! Again not unexpected; the surgeon lifted the three layers that make up the skin from the underlying abdominal muscle layers in order to be able to release a section of my abdominal external oblique muscle. So, it is inevitable that some of the smaller nerves giving the sensation of touch/feel of the skin will have been damaged or severed and it will take time for these to heal. I’m not expecting that to happen quickly and in some areas may never heal. I know this from previous surgery rendering some small areas of my body with no surface sensation at all.

The bad news, yes, there is bad news, is that I think I can feel a small section, or maybe two sections, of the repair that feels to me like it has come apart. There is no intestine poking through and no bulge but I can feel the edges of what to me feels like a hole.

I have tried to limit what I have lifted up and tried to keep to the 2lb of flour rule and most of the time I still wear that support belt that I wore before the operation. The surgeon suggested the latter and said if it were he he wouldn't lift anything for 6 weeks.

However I have found it incredibly difficult to know what is too heavy, apart from the obvious things like full shopping bags and such. Of course often you don’t realise that an object is too heavy until you have already hefted it and by that time it might be too late. I don’t lift a full kettle of water, my partner will make me a cup of tea/coffee and when she’s not around I’ll put just enough water in a measuring jug and microwave it but on a couple of occasions (there may have been more but I can’t be sure) I have got caught out. Once I was cooking a stir fry (I do most of the cooking and my partner washes up …. works for us!) and of course the individual ingredients are quite light but after all the ingredients  have been added and it’s serving up time the wok weighs a lot more! On another occasion I was preparing a pasta sauce; the empty sauce pan was quite light, the tomato and mascarpone was light as were the chopped frankfurters but combined it was too heavy really!

When I realised that the repair might have partially failed I did some analysis (carefully) with the weighing scales and I reckon the maximum weight I might have lifted would be in the order of 4lbs or 5lbs compared with the stated maximum of 2lbs.

The other problem I have had is that I have sneezed quite violently on a number of occasions (and continue to) and in the early days it pulled the wound apart and it started to bleed. That happened at least twice. So I guess it might have been that which caused the repair to part.

Anyway I feel pretty depressed about it all but if it is as I suspect then, even though it is not causing any problems at the moment, I will get it repaired as soon as I possibly can before it gets significantly bigger. I know that the likelihood of success for re-repairs is reduced and that it will probably cost me once again (it's no good waiting for a slot on the NHS) but I want to get this fixed and get it fixed for good ……. if that’s even possible.

So there it is, I feel really guilty and feel I have let my partner down and Mr. Borley the surgeon, but I’ll just have to wait and see what he says and take it from there. I’ll let you know what happens.

Hope all goes well on the 6th. If I were you I’d insist on knowing who the surgeon is and what his track record is. If you don’t like the answer then tell them who you want to be doing the operation, after all that is your right ….. if you are in the UK. It would be better to wait, if you can and get the best surgeon than to get a less experienced surgeon.

Anyway, here’s wishing you a huge dollop of good luck!

Regards,

Phil.

 

Hi phil i am so sorry the hear of your ordeal, but don't feel guilty how can you avoid a little bit of lifting like you say it's not always possible to gauge the weight of things , I am going for the op as i didn't have  to wait very long and as you say there is no panacea for a hernia repair , i was very stupid after my initial bowel op[ i carry heavy shopping after a few weeks and did the gardening after six I thought I was healed  i'm staying off work till i feel better. i will keep you informed , the doc said i will be in 2 days im not looking forwards to the long drive home I know this will be painful