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Suggest Treatment For Inguinal Hernia
Question: I’m a 60 year old male and work as a CNA in a large hospital and lift or otherwise assist many a 300 lb. patient day after day. I was diagnosed with an inguinal hernia in 2011 and told to “watch and wait.” Recently, however, my hernia has gotten out of control and I’m afraid it’s about to burst.
Two weeks ago, I experienced excruciating (10/10) pain when I sat on the toilet and had difficulty returning to work.
Last week, my whole stomach seemed to spontaneously, for no obvious reason, drop 2-3 inches as I sat down to dinner. It felt like I was going to have a baby. My hernia seemed to double in size and turn into a rock hard multi-lobed monster. Again the pain was intense, and it took me about 45 minutes to get it to relax even while lying on the bed.
This week, after a nice bout with a cold and cough, my hernia is noticeably bigger. My large? small? intestine seems to be always “out,” pushing all the way over to my inner thigh. As usual, I’m having trouble passing gas and even seem to be having trouble passing stool—nothing or little balls for a day or two, then lots with maybe a little diarrhea.
For years I didn’t have insurance, but now, effective this month, I have some with the VA. The wait time issue is no joke. I won’t be able see a surgeon for two weeks and they tell me everything is booked out months in advance. I can't see a regular doctor for another 2 1/2 months. People talk about “incarcerated” and “strangulated” hernias. I’m afraid my hernia is going to burst (the only thing that seems to be holding things in is my skin.) I’m normally a VERY active person, skiing, running, and bike riding. I’m afraid if this hernia is not repaired quickly and properly, my active lifestyle and my job may be ruined. What do you think I should do?
Two weeks ago, I experienced excruciating (10/10) pain when I sat on the toilet and had difficulty returning to work.
Last week, my whole stomach seemed to spontaneously, for no obvious reason, drop 2-3 inches as I sat down to dinner. It felt like I was going to have a baby. My hernia seemed to double in size and turn into a rock hard multi-lobed monster. Again the pain was intense, and it took me about 45 minutes to get it to relax even while lying on the bed.
This week, after a nice bout with a cold and cough, my hernia is noticeably bigger. My large? small? intestine seems to be always “out,” pushing all the way over to my inner thigh. As usual, I’m having trouble passing gas and even seem to be having trouble passing stool—nothing or little balls for a day or two, then lots with maybe a little diarrhea.
For years I didn’t have insurance, but now, effective this month, I have some with the VA. The wait time issue is no joke. I won’t be able see a surgeon for two weeks and they tell me everything is booked out months in advance. I can't see a regular doctor for another 2 1/2 months. People talk about “incarcerated” and “strangulated” hernias. I’m afraid my hernia is going to burst (the only thing that seems to be holding things in is my skin.) I’m normally a VERY active person, skiing, running, and bike riding. I’m afraid if this hernia is not repaired quickly and properly, my active lifestyle and my job may be ruined. What do you think I should do?
Brief Answer:
An early surgery is mandatory in your case.
Detailed Answer:
Hi XXXX! Good morning. I am Dr Shareef answering your query.
It is good to learn that you have got a active life style. However, due to your inguinal hernia, you need to go for a lighter work where there is no lifting of heavy weight leading to increased intra-abdominal pressure.
The present status of your hernia seems to be well advanced. It looks like getting irreducible and obstructed at times giving rise to the acute pain and distension like symptoms. If I were your doctor, I would advise you for an elective but urgent surgery for your hernia to prevent any further debilitating complications like a strangulation, and also to make you fit for your work early. Till the surgery is scheduled, you have to get yourself assessed by the team of doctors for pre anesthetic fitness. I would also advise you for a good scrotal support and an abdominal binder in the lower abdomen (or a truss) to prevent the hernia from coming out frequently till the surgery is done.Truss is an old way of treating conservatively the inguinal hernias not very popular now a days.
I am not well aware of the state regulations of your place on insurance and health matters. But to speak you the truth, early surgery is the only way for you to get rid of your problem and to become fit for your job.
I hope this information would help you in discussing with your family physician/treating doctor in further management of your hernia. Please do not hesitate to ask in case of any further doubts.
Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.
An early surgery is mandatory in your case.
Detailed Answer:
Hi XXXX! Good morning. I am Dr Shareef answering your query.
It is good to learn that you have got a active life style. However, due to your inguinal hernia, you need to go for a lighter work where there is no lifting of heavy weight leading to increased intra-abdominal pressure.
The present status of your hernia seems to be well advanced. It looks like getting irreducible and obstructed at times giving rise to the acute pain and distension like symptoms. If I were your doctor, I would advise you for an elective but urgent surgery for your hernia to prevent any further debilitating complications like a strangulation, and also to make you fit for your work early. Till the surgery is scheduled, you have to get yourself assessed by the team of doctors for pre anesthetic fitness. I would also advise you for a good scrotal support and an abdominal binder in the lower abdomen (or a truss) to prevent the hernia from coming out frequently till the surgery is done.Truss is an old way of treating conservatively the inguinal hernias not very popular now a days.
I am not well aware of the state regulations of your place on insurance and health matters. But to speak you the truth, early surgery is the only way for you to get rid of your problem and to become fit for your job.
I hope this information would help you in discussing with your family physician/treating doctor in further management of your hernia. Please do not hesitate to ask in case of any further doubts.
Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks, Dr. Shareef!
I’m not quite sure I’m following you.
1) Do you mean I should go on light duty at work until I see a surgeon or get an entirely new, non-lifting type job? Similarly, I wonder what the long term implications are for this hernia repair. Will I be as good as new--and can I continue to run, lift weights, ski and bike--or will I be permanently disabled or less functional? I understand that a laparoscopic procedure has a quicker short-term recovery, but what is the most robust, least likely to fail surgical approach for an athlete? I believe a mesh is essentially mandatory equipment.
2) Finally, given your recommended repair technique for my (formerly) active lifestyle, how do I find a skilled, highly experienced surgeon that might specialize in hernia repair?
Thank you sooo much for all your help so far!
I’m not quite sure I’m following you.
1) Do you mean I should go on light duty at work until I see a surgeon or get an entirely new, non-lifting type job? Similarly, I wonder what the long term implications are for this hernia repair. Will I be as good as new--and can I continue to run, lift weights, ski and bike--or will I be permanently disabled or less functional? I understand that a laparoscopic procedure has a quicker short-term recovery, but what is the most robust, least likely to fail surgical approach for an athlete? I believe a mesh is essentially mandatory equipment.
2) Finally, given your recommended repair technique for my (formerly) active lifestyle, how do I find a skilled, highly experienced surgeon that might specialize in hernia repair?
Thank you sooo much for all your help so far!
Brief Answer:
My replies are as follows.
Detailed Answer:
Hi XXXX! Good morning. Nice to listen from you.
I understand your apprehensions and compulsions before undergoing a surgery, which are but natural. Similar questions would have come to my mind also if I were to go for a surgery. Following are the reply to your queries :
1) Going for a light duty till you see a surgeon is a must. Also it would be advisable to avoid lifting heavy weight at least for six months post surgery. Getting your job changed entirely would be an option for you. If you could, it would be far more better.
2) There are no long term implications with the present availability of modern techniques and appliances. However, you must understand that every doctor's effort would be to give the best to his patient, but no one can guarantee a 0% complication from surgery which could occur in a very few cases though not mandatory. At the same time I would also say that the complication rate has come down to a minimum with experience of the surgeons in a well equipped centre. Rather if you do not get operated, the complication could be more serious which might not be in your favour.
3) Post surgery you can go for all types of activities after a particular period as advised by your operating surgeon. The earlier restrictions are reduced to a minimum specially after a laparoscopic hernia repair. You are very much correct that laparoscopic repair gives you an early recovery and mesh is the routine in almost all hernia repair.
4) Finding a skilled experienced surgeon in your place would not be difficult for you. You can talk to your friends who had undergone hernia repair, or could interact with hernia forum members, or could talk to your family physician to know which center is performing maximum number of laparoscopic hernia repair procedures.
I hope I have provided you with the information what you desired. If you have any further doubts, you are welcomed to ask. At the end, I would advise you again to undergo your surgery at the earliest opportunity. Good luck.
My replies are as follows.
Detailed Answer:
Hi XXXX! Good morning. Nice to listen from you.
I understand your apprehensions and compulsions before undergoing a surgery, which are but natural. Similar questions would have come to my mind also if I were to go for a surgery. Following are the reply to your queries :
1) Going for a light duty till you see a surgeon is a must. Also it would be advisable to avoid lifting heavy weight at least for six months post surgery. Getting your job changed entirely would be an option for you. If you could, it would be far more better.
2) There are no long term implications with the present availability of modern techniques and appliances. However, you must understand that every doctor's effort would be to give the best to his patient, but no one can guarantee a 0% complication from surgery which could occur in a very few cases though not mandatory. At the same time I would also say that the complication rate has come down to a minimum with experience of the surgeons in a well equipped centre. Rather if you do not get operated, the complication could be more serious which might not be in your favour.
3) Post surgery you can go for all types of activities after a particular period as advised by your operating surgeon. The earlier restrictions are reduced to a minimum specially after a laparoscopic hernia repair. You are very much correct that laparoscopic repair gives you an early recovery and mesh is the routine in almost all hernia repair.
4) Finding a skilled experienced surgeon in your place would not be difficult for you. You can talk to your friends who had undergone hernia repair, or could interact with hernia forum members, or could talk to your family physician to know which center is performing maximum number of laparoscopic hernia repair procedures.
I hope I have provided you with the information what you desired. If you have any further doubts, you are welcomed to ask. At the end, I would advise you again to undergo your surgery at the earliest opportunity. Good luck.
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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