Hernia Question

[mustangsally65]

I know that herniorrhaphies are among the most common surgical procedures being done these days. I was wondering if you guys could answer a question for me.

How do you know when your hernia is an emergency? Obviously, if you have a bulge that can't be reduced or are in extreme pain or have obstructed bowels, then it would be kind of obvious. But I'm talking about other, more subtle signs.

I had my first hernia repair in 2001, and then was diagnosed with a second inguinal hernia on the opposite side of my groin the following year. I've put off its repair, because of working and school and other stuff, and now I'm in the middle of the med school application process, so I'm kind of worried about being out of town on an interview and having a problem.

I'm a veteran when it comes to putting a hand over my hernia if I sneeze or cough, and I don't lift anything heavier than my cat. But I just have this fear of being in the middle of an interview and suddenly becoming an emergency. My surgeon is the best, and I'd hate to be in a strange place with no records of me and have to have emergency surgery. My mom woke up one morning with a hernia emergency a few years ago when she'd never been diagnosed with one at all, and she had emergency surgery a few hours later.

So does anyone have any tips for me? I'm female, so I don't have the more obvious symptoms that males often have with inguinal hernias. But I do have a spot of weakness that has gotten more painful over the years, and I'm wondering if I should go ahead and get it fixed once I get my secondaries done and before interviews start.

I'm not trying to solicit medical advice, I've seen my doctor twice this year about my hernia, and my surgeon also once a year since my dx. They always leave it up to me, and say I can elect to get it fixed whenever I want. Which doesn't help, because the most convenient time would probably be after interviews, but I"m not sure if I can wait that long without risking a problem. Thanks!

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[toofache32]

I've got an opening in the OR tomorrow...

 

[mustangsally65]

I've got an opening in the OR tomorrow...

Ha ha. I was hoping to illicit some serious responses, but I do appreciate the humor.

 

[pedsid]

I'd get it fixed sooner than later ... I'm a 4th year, not an actual surgeon. But in my experience (or lack there of) you described the emergencies correctly ... incarceration being the main one. If I remember correctly the procedure would be a bit different (or atleast with the GS I worked with). Laproscopy so they could check on the other side as well. Interviews don't start for atleast a month right? Not everyone gets early interviews either ... my earliest was in October. My opinion is there's no time like the present.

 

[mustangsally65]

I'd get it fixed sooner than later ... I'm a 4th year, not an actual surgeon. But in my experience (or lack there of) you described the emergencies correctly ... incarceration being the main one. If I remember correctly the procedure would be a bit different (or atleast with the GS I worked with). Laproscopy so they could check on the other side as well. Interviews don't start for atleast a month right? Not everyone gets early interviews either ... my earliest was in October. My opinion is there's no time like the present.

Thanks for your thoughts. I'm studying for the MCAT and would rather not add surgery into that mix, since I'm taking it August 20. But I guess it would be worse to have an emergency and not make it to the test at all. And you're right about the procedure, I've been told my surgeon will do the repair laparoscopically to also check the other side. Which is fine by me because the traditional repair was not fun to recover from.

But I still don't know what to do about it. Even if I went to see my surgeon tomorrow I probably couldn't get an appointment for surgery until after the MCAT, and I'd rather wait until the fall so I can have a better idea of how many interviews I might have.

 

[Winged Scapula]

A non-incarcerated, non-strangulated hernia is an elective procedure - as you know.

No one can tell you when or whether or not you should have it fixed. You may never incarcerate, you could do so tomorrow, or while on vacation. There is simply no way to predict it.

However, if you are THIS worried about it, I would suggest you get it fixed at your earliest convenience.

 

[mustangsally65]

A non-incarcerated, non-strangulated hernia is an elective procedure - as you know.

No one can tell you when or whether or not you should have it fixed. You may never incarcerate, you could do so tomorrow, or while on vacation. There is simply no way to predict it.

However, if you are THIS worried about it, I would suggest you get it fixed at your earliest convenience.

I guess I do know all this, and I was going to get it repaired last December but I had a cold I couldn't get rid of and knew I wasn't a good candidate for surgery so I put it off again. I also was in classes until May of this year 😡 I don't think there's ever a convenient time, but I hope to get it fixed by November or December.

I guess I was just wondering if there was some kind of average timeline from diagnosis to emergency. Probably most people don't wait two-three years to get theirs fixed, but I wanted to know if anyone had any experience with a situation similar to mine.

Thanks for your input!

 

[FliteSurgn]

You know the warning signs and you know that you need to seek care if you start having problems. You're what I call a "reliable" patient and I always offer reliable patients the option of watchful waiting for their hernias. There is no way to predict when, or if, you will experience problems. But, since you are aware of the potential, you will seek care before an urgent problem (incarceration) becomes an emergent problem (strangulation). In those patients that present within the first few hours of incarceration, most hernias can be reduced and spare the patient an emergent operation.

Despite all this, I agree with K.C. if it worries you this much you should get it fixed.

 

[mustangsally65]

You know the warning signs and you know that you need to seek care if you start having problems. You're what I call a "reliable" patient and I always offer reliable patients the option of watchful waiting for their hernias. There is no way to predict when, or if, you will experience problems. But, since you are aware of the potential, you will seek care before an urgent problem (incarceration) becomes an emergent problem (strangulation). In those patients that present within the first few hours of incarceration, most hernias can be reduced and spare the patient an emergent operation.

Despite all this, I agree with K.C. if it worries you this much you should get it fixed.

Thanks for the post. You made me think a bit, and I think what I'm most afraid of is not being able to have a laparoscopic repair with mesh, because if you are an emergency isn't is customary to do the traditional open repair? I had an open repair with my last one, and I still have a lot of neuralgia and spots of numbness below my scar, after almost 4 years.

Anyway, thanks for your input! I've still got a lot to think about. . .