Personal Experience Of Bilateral Open Mesh Inguinal Hernia Repair
Research: Your Options, Screen Your Surgeon
Pre-Op (Before Hernia Surgery): What To Prepare For
Post-Op (After Hernia Surgery): What To Expect
Recovery: Tips And Personal Advice
On September 21, 2017, I went under the knife for bilateral open mesh inguinal hernia repairs. That’s both the right and left sides, open (scalpel), VS laparoscopic (scope), and the use of a mesh that supposedly has never been recalled. I learned a lot and experienced a lot, but wish I had learned more — and prepared more — before having my surgeries done. That’s why I wrote this article. My hope is that MY experience can help guide and prepare you or someone you know undergoing hernia surgery.
It’s amazing, really, how much we use our abdominal and groin muscles in our every day lives. Walking, sitting, twisting, turning, bending, urinating, bowel movements, stooping, reaching, coughing, sneezing, lowering and rising from a seated/standing position — all of these things are affected after open mesh surgery. Even passing gas is painful after hernia surgery! And it goes without saying that you’ll be ‘out of commission’ for quite awhile in the romance department too.
If you or someone you know is thinking of having open mesh hernia repair, here’s some personal advice from my experiences from my own hernia repairs that I’ll share with you. THIS IS NOT PROFESSIONAL MEDICAL ADVICE. It’s merely my own personal experience and what I went through. I wish I had been more prepared. Hopefully my experience will help you or your loved one.
You/they will probably experience these things too. I would think that the laparoscopic option would be a similar experience, but perhaps of shorter duration. I can’t comment on a female’s perspective, but much of this should also apply to a female as well. I’ll write this as if you’re the one looking at having the surgery done. Again, this is not medical advice…
Research Before Surgery
In my research prior to the operation, I read that open (scalpel) surgery is more successful than laparoscopic surgery the first time around. BUT, if there’s a re-occurrence of the hernia(s) after open surgery, then the laparoscopic is more successful the second time around. I would presume that that has to do with the scar tissue that occurs after the first surgery.
I had also read, after the fact, that there are alternatives to mesh, such as dissolvable stitches, and there’s also a biological mesh. WebMD has a good and fairly recent article (2014) on mesh surgery (see the link after this article). But research hernia repairs. Look at your options.
Screen your potential surgeon — the more surgeries they’s done, the better the odds of a good outcome. I’ve read that that’s especially important with laparoscopic surgery. Either way you’ll want a “tension free” repair. Don’t take your surgeon’s qualifications for granted. There’s a great article regarding this at facs.org. I suggest you read that. My surgeon is a FACS, which means Fellow of the American College of Surgeons.
I was told, and also read, that laparoscopic surgery has a faster healing period. But, you’re also more deeply under anesthesia during that surgery, come out of the anesthesia more slowly, and most likely will have a catheter inserted because the bladder takes more time to “wake up” then other areas of the body. Personally, I thought that there were more risks than benefits for me, so I opted for the open surgeries. But choose what’s best for ‘you’.
Preparing For Your Surgery:
Have Things Arranged Ahead Of Time!
First of all, I don’t care HOW tough and buff you may be, you WILL need someone around to help you. And quite extensively at first. There WILL be pain. AND A HELL OF A LOT OF IT. As my surgeon told me, surgery is no picnic, and she’s right. My significant other was even told that I couldn’t even do the dishes. So have your help arranged well before your surgery.
Have loose fitting sweat pants to wear home after surgery. Large enough to raise the (loose-fitting!) waistband at or above your navel. Yeah, I know. You’re thinking “Urkel”. If you have a large enough shirt no one will even know. Besides, you know what?? At this point you won’t even care. You’ll not want anything tight across your stomach or waist for quite a while after surgery. Forget about underwear too. You’ll be going commando for awhile.
Ice was my best friend for quite a long time. Go by what your doctor tells you. — whether ice for 24/48 hrs, or alternate ice then heat, or whatever — but pick up some combination ice/hot packs and have them ready for when you get home. You’ll want one for each side of your pelvis/groin if having bilateral (both right and left) surgeries. You’ll want at least an extra 2 (I’d recommend 4) waiting in the freezer.
Make sure they are light weight! You don’t want much weight/pressure on your incisions. I had picked up some small ones in Canada so already had some on hand. I’d put two into a gallon freezer bag, and so was able to place one on the left surgical area, the other one on the right surgical area. Place a light towel or something similar between the ice/bag and your skin. When the packs were no longer doing their job, they went into the freezer and out came two more frozen packs from the freezer. Constant, ready supply.
After first waking up in the recovery room, don’t be afraid of requesting some more pain management (pain meds) right away. You might consider taking your at-home prescription pain med as soon as you receive it, or as prescribed by your doctor. All in all, keep ahead of the pain. There’s soreness right away, and it WILL get worse.
Right after surgery I was asked to sit up. I was groggy, and feeling a little numb because my surgeon numbed up the surgery areas a lot (although it was still extremely painful). I twisted while sitting up. DAMN did that hurt! And I think I may have pulled my right repair too much! So be sure that you, and whoever is working with you to help you sit up, are working together.
For example, my nurse grabbed my hand and pulled as I was rising. NO! The nurse should have took my hand and pulled, AND move my feet/legs sideways AS I was rising. Better yet, she should have used a gait belt such as this:
This would had been a good thing to have had at home as well. So if you get one, and I highly suggest that you do, ask your doctor about using it. If your doctor says it’s ok to use it, take it to the hospital with you. Have the nurse use it while helping you out of bed. Use it to get in/out of your ride home. Use it at home. Have a doctor, a nurse, a nursing assistant, or a physical therapist show you and your helper how to lift properly.
When you get into your vehicle for the ride home, have your helper or hospital staff raise and move your feet/legs (as mentioned above) as you turn in the seat. If the vehicle has a handle on the inside above the door, use it. DO NOT TWIST — EVER — while trying to sit in/out of a vehicle, chair, etc, or while standing up or sitting down. It’s natural to want to lift your feet/legs up into the vehicle. Don’t do it. You’ll regret it. I sure did.
Here’s another thing; be concerned with the type of vehicle you’ll be riding in on the way home after the surgery. You’ll be surprised how much you’ll feel each and every bump in the road. Vehicle turns seem sharper and faster too. Try to have your ride home as comfortable and plush that you can come up with. If you can recline some in a comfortable seat, so much the better.
On your way home, having a barf bag could maybe be a good idea. I didn’t need it on my hour and a half ride home. Man tho… I can’t even imagine how painful throwing up would had been. Have something to drink on hand too.
When you get home, remember to work in unison with your helper in getting out of the vehicle. I attempted to raise and move my feet/legs up and out of the vehicle, the reverse as I did when entering the vehicle. I should had learned the first time. That was dumb. I regretted it. A lot.
Below are some other aids that would help in your recovery. Have them ready before you get back home. You may be able to purchase or rent them locally. The nice thing about renting them is that the company will most likely install/set it up for you. Plan on a four week rental. If you buy, you can always sell it after you’re recovered:
A Head Of Bed Trapeze Bar, Something Such As This:
I didn’t have one of these, but sure wish I had! The hospital told me to roll out of bed. That is easier said than done! Because for one, I don’t sleep right on the edge of the bed, so had to move my body towards the edge. I would be on my back (couldn’t rest or sleep on a side), had to physically bend my legs with my hands so my knees were up and feet flat on the bed, use my elbows and hands to raise/balance my upper body, raise my lower half with my feet/legs, and move my butt towards the side of the bed inch by inch. And with each inch there was a mile of pain.
Secondly, there’s a nightstand right next to my bed, and I had to lower myself a bit towards the foot of the bed to clear it. I did this at the same time as explained above using feet, legs, elbows, and hands.
With the trapeze I could have raised my upper body off the bed, move to the edge of the bed using my bar and feet, and my significant other could swing my feet/legs to sit up as I rotated on my butt. And to stand, we should have had that gate belt.
By the way, when your helper is assisting you to stand from a sitting position, be sure that they are lifting, not pulling. There were a few times when I did most of the work. That hurt really bad. We should have used a gate belt as mentioned earlier. That would have been very helpful. Here’s some more items (aids) that helped me or would have helped me…
You’ll Need A Urinal
Trust me. You will not want to be getting up for ANYTHING for awhile.
You’ll Need A “Grabber”, A Reaching Tool, Such As This:
Any bending at all is painful. The grabber allows you to pick up things without bending. My surgeon prescribed one for me.
A sock Applicator, Such As This:
Remember, no bending at the waist. We use our abdominal/groin muscles while bringing our leg up to put on a sock. Sounds silly, but it’s a fact. My surgeon prescribed one of these for me as well. This is where slip-on shoes comes in too.
Toilet Support Bar Rail, Such As This:
I didn’t have one of these toilet support rails, but man oh man, it’s another aid that I REALLY wish I would have had. Getting on and off the toilet is very difficult (as in very painful), and having this would had been a tremendous help! The higher the hand rails the better. You’ll want to be able to stand and still have your hands on the handles to lower yourself down. Had I not had a bathtub to one side and a vacuum cleaner on my other side to use it’s handle in lowering and rising, I don’t know what I would had done. Again, remember that you can always sell this after you recover.
Speaking of bathroom, here’s another thing to keep in mind; you’ll be surprised how painful it is just to have even a regular soft bowel movement. If you get constipated, you’re going to be in for a very rough and painful time. So have some suppositories on hand ahead of time. And be sure to take in a lot of fiber, but nothing that causes gas. Because if you have lower intestinal gas pressure against your repairs, you’ll quickly — and painfully — know it.
Your helper may not be around every minute of the day. As you recover, have plenty of liquids handy. And I think it goes without saying to make sure that your remote controls have fully charged batteries ;). Keep frequently used light-weight items at arms reach. For example, I drank a lot of Powerade and fresh bottles were kept at arms reach without me having to bend over to get it. And my milk for my coffee was put into a carafe and left on the top shelf of the fridge so that I didn’t have to bend.
So now you’re prepared and know some dos and don’ts. Once home, rest, rest, and REST some more. Concentrate on resting, but get up and walk around a bit as often as possible to help avoid blood clots. And monitor for infection, rejection, and blood clots. Have a thermometer close by to check for fevers.
When you start feeling a little better, be conscience of going slow and taking things easy. Don’t overdue it, and don’t try to recover “faster”. Don’t lift more than what your doctor said you can lift. Your body knows when it’s ready and able to do more.
And if you have an active, physical job, don’t return to work until you’re FULLY recovered. Don’t go by what your employer says or what the insurance companies say or imply. Your doctor should be aware of your job requirements and your work environment, and should look out for you. Mine sure did.
After surgery and while recovering you can expect to be sore and/or bruised and/or swollen from about your navel to your thighs. Sorry to say, this also includes testicles and penis. Be conscience of that when attempting to sit down.
There’s always a chance of nerve damage with any surgery, and I encountered that. My skin is still numb on my right groin/thigh crease area as I write this. At one point I had a fairly continuous sharp pain from my right incision location to my right testicle that felt like it was in a vise. You may also have a “foreign body” feeling for quite awhile.
So, To Summarize…
Have help arranged
Wear loose clothing and slip-on shoes to/from the hospital
Have home equipment/supplies set up and ready to use (trapeze bar, toilet hand rails, grabber, sock applicator, gate belt, ice packs, suppositories, liquids, frequently used items arranged within EASY reach)
Immediately after surgery (in recovery room):
Ask for more pain meds if needed
Make sure the nurse lifts you properly when sitting up and standing up
Use proper techniques with helper for entering vehicle
Have as comfortable of a vehicle as possible
Have a barf bag, just in case
Have something available to drink
Use proper techniques with helper for exiting vehicle
At home (recovery):
Use proper techniques for sitting, standing, laying down, etc
Use ice, according to doctor’s orders (which might be to use ice for 24-48 hrs, then alternate ice and heat)
Don’t over-do it, don’t rush things
Monitor for infection, rejection, and blood clots
Some Additional Information, from mdtmag.com (I recommend reading that entire page):
“Nationally, we know that up to 20 percent of patients will have post-operative pain that lasts beyond the first 3 months of their hernia operation, the definition of chronic pain. This is much higher than the risk of hernia recurrence, which is typically well under 10 percent. The use of synthetic mesh has contributed to the low risk of hernia recurrences. Now, we must focus on improving quality of life after hernia repair by seeking mesh design to help reduce the incidence of chronic pain.
Some of the initial pain, swelling, and even bloating associated with hernia repair can be attributed to the inflammatory potential of the implanted surgical mesh. Macrophages, T-cells and mast cells each play a role the body’s inflammatory response and tend to proliferate when a foreign material is present. This
usually resolves, though in some patients, the inflammation does not resolve and may be transmitted to nearby structures, such as nerves and the spermatic cord. In these patients, their pain may be chronic and unrelenting.” (mdtmag.com)
So there you go. That’s my experience and my take on the subject of open mesh inguinal hernia repair. I bid you well in your decisions and recovery, and I hope this article will help you or another with a better recovery than I had.
Here’s that WebMD link I mentioned before: