STITCH INFECTION REVISITED

Infected sutures from my prior surgeries are creating a complication today.

My next surgery happens tomorrow morning.

Let’s back up.

The 3 weeks of antibiotics prescribed to me took care of the infection in my hernia area for a few days. Then it came back. GRRR! Well, I had to expect it would happen that way, as it was foreseen by the fates. So, less than a week after the antibiotics ended, a pimple formed where an old one was. Then over time a redness appeared in the hernia scar itself and grew to a large pimple and opened up again. Ok, we’ve got to take care of this. Now.

My hernia surgeon is not on my new insurance plan, so I scheduled consultations with two alternate surgeons to get their opinions. Their opinions were in agreement on the approach to clean out the sutures and mesh from the hernia repair, thank goodness, and I scheduled a procedure for tomorrow! Rest assured, it should be a minor procedure. My surgeon wants to put me under, so he can really get under the skin and make sure he understands the problem and gets rid of all infected material. Ok, I don’t really want to be aware during that. Very likely that he won’t replace the mesh.

The hernia may not come back, but it could. It could come back tomorrow or it could come back any time in the future. Then it can be repaired – again – at that time. But tomorrow it will be an in-and-out procedure. I will come out of OR (the operating room), then once my vitals prove stable I can go home, probably mid-afternoon, then back to business the next day. Ok, I can deal with that.

The surgeon who provided the second opinion cautioned, a full fix on this hernia could take “a while”. Yeah, I kind of figured. It’s quite amazing how complicated these hernias can be to fix. You could have a handful of surgeons review the same situation, and have a handful very different opinions on how to fix it. There are lots of material and technological options for surgeons to use, and there are a lot of body types among patients. Every patient will respond differently to a chosen treatment.

So, it seems to be a moving target.

Wishes of luck will be appreciated! I will update here once I am out.

PROGRESS REPORT

Remember in school when we got progress reports to show our parents how we are doing?

It’s time for a progress report!

All things considered, I can say that I am doing very well indeed. I wish I were closer to the end of my medical bill horror show, but alas, it won’t be finished by year’s end like I was hoping. Mostly the expected stuff I suppose; nobody wants to kiss off their money charged, but like I’m trying to make clear to the medical billing departments, “You can’t squeeze blood out of a turnip!”

It doesn’t help that the insurance company before the procedure was performed did not disclose to me that, “Oh, your hernia surgeon, medical team and procedure are all covered, *but* the hospital is not!” So, I owe a quarter of the bill on that procedure which *should* have been covered… argh! But I won’t bore you too much with the details.

Besides that…

…with a few minor modifications post-hernia, I am back to my old ways. The ‘modifications’ I am referring to are things like not using the torso for ANYTHING besides standing up straight. Don’t want to undo that new hernia mesh. Also not lifting anything. Sorry Matt, packing I can do, but moving boxes is up to you, Babe.

A follow-up blood test at my oncologist’s office gave a clean report, meaning I am still in remission and starting off on the right post-treatment track.

I had a bit of a horror the other night when I looked at my poor scarred belly, and noticed a new bump. Ohhhhh. That’s not good. Even Matt had to admit that it looked new and a little unusual. This is the paranoia I referred to in this post. Well, since that day, nothing has changed, fortunately. I go on wearing my “belly bra” and hoping that it won’t get worse, or that it was just angry that day and will go away.

plumbing_post_cancer

New Plumbing

Bowel habits are, well, different forever, but I will definitely grow into them. The list of inconveniences in order of ‘annoying’:

– stains in the panties!
– I don’t know whether gas means *just gas* or if something comes with it.
– I have to “go” soon after a meal… 2 or 3 times.
– prickly butt when I’m hiking (for some reason thorough wiping isn’t as effective as it once was). Matt suggests a toilet paper barrier.
– bladder infections: a new phenomenon to me! Arrgh! And dang if it doesn’t happen just before a long road trip, every time so far.

So, in regards to the new plumbing, there is nothing that I can’t live harmoniously with, and there is nothing to say that it won’t get better with time. Still the evidence shows that I have experienced life-long changes this year that the average Joe/Jane does not have, and now I am among an elite group of ‘special’ individuals who have to do laundry more often than average.

The rose-colored short story is: Life is good, and every day is a bonus!

HERNIA SURGERY: GOOD / BAD NEWS

Hernia surgery results showed good news and potential for bad news.

The follow-up visit with my hernia surgeon went as well as can be expected.

Dr. Reger explained that there was a split in the ‘posterior muscle wall’ (the inside layer) which allowed my guts to push out between them. Those muscles tensed and scrunched to the sides. The ‘anterior muscles’ (the outside layer), however, did not break, but stretched and gaped with the pressure of my guts. Voila, the pot belly. Through the incision, Dr. Reger had to reach in and grab the contracted muscle and forcibly pull each side back together, stitch, and reinforce with a strip of mesh. He illustrated all of this with his hands in the air, so I do not have a good visualization myself, let alone a diagram to share with you. However, I do trust Dr. Reger did an excellent job.

I got two pieces of news, good and bad.

The good news first– Healing from the surgery is on track and everything looks as it should by now. Activities I can participate in include walking, hiking, taking it easy and wearing a compression belt (affectionately referred to as my girdle or belly bra) to keep my guts in place. After one more week I can add:

M&M-Light-Hike

Light Hike

– more walking and hiking
– light swimming, to keep muscles stretched
– light stationary bicycling, again to keep muscles stretched
– light weight lifting
– taking it easy some more

In six more weeks, I will add activities as my body tolerates like bike riding, lifting, strengthening and other exercises light on abdominal use.

The bad news – The fix should be sturdy and strong, however, we do not know what caused the incisional hernia in the first place. Dr. Reger cautioned that the stoma incision next to the hernia incision (closed up on July 14, 2012) could give way to another hernia. In other words, I should watch for signs of a hernia over the next two years. When the hernia repair was done a few weeks ago, the tention added to bring the split muscles back together could add to any weakness at the stoma incision. If, he says, a hernia is caught early, it is an easy fix. If it does not happen in the next two years (!!), then it probably won’t happen.

ACK, I say! That’s two years of paranoia! Ie. “What’s that I feel?”, “Is this normal?”, “Should I call the doctor about this, or will it go away?”, etc. When I thought all of this worry and anticipation was over, it has been delayed! Well, it is nothing new given the past year’s worries. Besides, I will take that over cancer concerns anytime.

Dr. Reger has a very conservative approach. I admire this and chose him for that reason. Therefore I will stay on the conservative side of recovery because to face another surgery is unappetizing, and, boy, I do not want to start over on insurance deductibles if I can help it!

Recovering from hernia surgery takes sometimes years of incredible patience. When you feel good, you still must resist strenuous activities.

FOURTH AND FINAL SURGERY – DONE!

This was my fourth, and hopefully final surgery – EVER!

Disclaimers: Silly me, one of the things I left at home was my cell phone charger, so I’m on limited phone use at the moment. Also, since my first surgical hernia consultation I have been so busy that I have not done an update on the second.

Well, the second consult went well, and I scheduled a date with Dr. Vincent Reger at St. Vincent’s hospital for October 15. Quickly, Dr. Reger had a whole different approach to solving the hernia problem than Dr Tseng. He had a plan A, B and C, depending on the condition he finds upon entry.

A) No mesh – he would enter with a full incision, clean up scar tissue and hernia, then stretch the abdominal muscles together and stitch them up. Least invasive, least amount of material. He believes the muscle material will heal together

B) Thin strip of mesh – if muscles do not come together, or if they come together too tightly, or the quality of the muscle is too hard to work with, he would introduce mesh on the outside of the abdominal wall. Using little material, this would allow a looser muscle closure and use mesh to reinforce the closure.

C) Bridging – If the muscles will not come together, or the quality of muscle tissue is too poor and will not come together at all, the mesh would be used to bridge between the two sides.

The surgery date was yesterday:

Well, it was a roller coaster ride. Matt & I began the day at 5:30am and were out by 11:00pm! The facility was very nice, everything looked new. The nurses were very slow with any request, which I have come to expect in a hospital setting. The surgeon was energetic and quite darling, the anesthesiologist was delightful in his rainbow-colored cap. It is good to be first procedure of the day!

The plan was that I would be put under a twilight anesthesia, so I could witness parts of the procedure. Well, I don’t remember a dang thing, and I was kind of looking forward to that experience.

The procedure went smoothly, although the surgeon found the hernia hole larger than expected, and so had to move to “Plan B”, involving surgical mesh. In recovery, I told Matt, “You have four eyes,” He asked me how many nostrils he had. I said four. My eyes didn’t want to focus, nor want to stay open. I also had a bit of trouble keeping things down when I moved around, ie. getting to the bathroom & back.

So I slept through the afternoon and evening. After that, I felt that I could make the move home. I could finally keep my pain pills along with a couple of crackers down, so Matt & I arrived on my parents’ doorstep at 10:30pm. No more $750/day insurance copay, whew! Woke a few times with terrible pain and soreness, but was able to get on top of it with the assistance of prescription pain pills, and in the morning felt fine again. How quickly things can change!

Matt & I woke in the morning to my mom’s Swedish pancakes, and what HEAVEN!!!

Things are progressing well thus far. Thank you all for your thoughts!

 

HERNIA OR DIA-WHA-?

Pot belly: Is it a hernia or a diastasis, or… BOTH?

The look of it is like a bowl that was slid underneath my belly button. I’ve had a good month and a half to wonder about, and fret over what is happening inside my belly to cause this. I finally scheduled a surgical consultation to find out what the heck…

Matt & I met with a surgeon at St. Vincent’s in Portland, and got the lowdown on my disfigured tummy. The verdict: A hernia… AND diastasis!?! Well, why choose between the two when I can have both! That has been my fundemental philosophy since birth, mainly when it comes to desserts, but it also seems to be true for medical conditions. For example, many years ago my dentist informed me that rather than the standard four wisdom teeth, I had six, which would all be removed at once. (A little extra Percodan for me!) There are some ways which you DON’T want to be special.

Hernias

A hernia happens when the delicate lining of the abdomen pushes through damaged abdominal wall, as how an inner tube pushes through a damaged tire. About 600,000 hernia surgeries are performed around the US every year. The two methods used to treat hernias are “open”, where a full incision opens up the abdominal wall; or “laparoscopic”, where small incisions allow the surgeon to perform the fixes through small tubes without a large opening being necessary. Hernias will not get better over time. Here’s more on hernias.

hernia_laparoscopic_surgeon

Laparoscopic Surgery

hernia_laparoscopic_equipment

Laparoscopic Equipment

hernia_laparoscopic

Laparoscopic Equipment

hernia_mesh

Hernia Mesh

Diastasis

A diastasis happens occasionally during pregnancies or rarely after an abdominal surgery. When the abdominal muscles separate down the center, due to access during a surgical entry, and the delicate facia tears, the muscles spread apart allowing organs to push between the muscle wall. This is not my tummy pictured, but the doctor was able to do this to my belly. More on diastases.

diastasis_rectus_abdominus

Diastasis

This procedure will be painful, I am told, it can be out-patient, but I will likely stay over night in the hospital, then it will take two to four weeks before I will be active again. It is a simple and quick procedure, and it is covered by insurance. Very likely I will schedule it for late October

There goes Halloween!

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