Hernia Surgery Part II

This is part II of the day I actually got my gutpatch inserted. If you missed part I you can read it here.

Here I am at out-patient admittance dressed in my prescribed loose fitting sweatpants, baggy button up shirt and jacket.  My wife is dropping me off and helping make sure the payment agreement all makes sense. Basically, the hospital made me a deal that if I pay my deductible the day of surgery, they will only charge me that much no matter what.

Hopefully this includes the nurse anesthetist and all the other stuff that gets tacked on. It's only been 5 weeks since surgery and you can never be sure for a few months how it will all work out.

So, they tell me right away that the surgeon is running late because of some emergency that morning.  I ask about coming back in a couple hours and they don't want to let me go. Vee Dont Vant To Let You Go.  OK - I'll stay.  

Most important takeaways:

1. If the nurse getting the IV into your arm misses twice you can ask for a different nurse. I should have done this before she missed five times and I told her she was making me feel sick, didn't want to look like a heroin addict, and could not take her missing again. She cheerfully got another nurse who got it on #2. 
2. Take care of things that require clear thinking before they get the IV in you because there are drugs to "help you relax".  
3. It's not that hard to get up and go to the bathroom carrying your IV bag.
   
   Plus the bathroom has a place to hang it. If you have to go, then do it before surgery. 
4. Falling asleep in pre-op is good. It makes you forget the surgeon is running two hours late and you are laying around waiting to be cut.  
5. The surgery room was not like a technology manufacturing cleanroom.  If you have worked in cleanrooms like in a fab operation then a hospital cleanroom does not seem that clean.  Operating cleanrooms would probably be class10K in my old tech world though would probably test out around 1-2K with a particle counter is my guess based on many years in that world. Other people will probably just think it is a very clean room.  I was a bit taken aback myself.
6. A local anesthetic and drugs to put you in lala land really means you are out cold but not so far that the anesthetist has to shove a breathing tube down your nose or throat. My recommendation is go with the local and lala land drugs. A friend had a tooth chipped by the breathing apparatus down his throat. His dentist said it "happens all the time" because operating personnel don't care so much about your teeth.  
7. You will say and do stupid stuff when you come out of anesthesia. Don't worry about it. As we said in Part I about KYST and GYST, add NGF at this point.  Really, in your delirium if you start high fiving the nurses and the surgeon, telling the operating room nurse she has a cute outfit on really meaning it, and begging for chocolate cake it is OK.  They have probably seen and heard worse than that.  
8. The loose fitting clothing is super important NOW.  It is hard to move and having clothing that is easy to get into now is less painful. Slip-on shoes are a nice touch as well.  
9. Even though stuff hurts at this point, it is nothing like its going to hurt in a few hours or tomorrow morning.  

Try to sleep after you eat something.  You will probably be hungry from the overnight fast.  I did not get a headache from no caffeine because there was most likely two gallons of ibuprofen in me at that point.  I ate and then fell asleep on the couch.  

Next installment is about waking and getting up the first time and you can read it now by clicking HERE!  


Please comment below and I will answer all questions. This blog will only become useful if people comment and add their experience and ask the questions which other people share but are afraid to ask. Plus, everyone's experience is different. How did you find out you needed surgery?  Were you scared? How did you deal with it? Was it relief to know? Or, was the info a complete surprise? 

Gutpatch Hernia Repair Series
1. This Sucks! Step 1
2.  You Have A - I Have A - Hernia?! Step 2
3. Oh Man! Getting Surgery Scheduled - Step 3
4. Let's Have a Hernia Repair Operation - Step 4 Part 1
5. Hernia Surgery Part II

6. Post Hernia Surgery

Let's Have a Hernia Repair Operation - Step 4 Part 1

Why should you read this? Who should read this?

This post is going to provide some info about what it is like the day of surgery and is primarily for the novice surgery patient who, like me, had little experience with hospitals, doctors, nurses, hospital procedures, etc, and were nervous due to fears of the unknown and well-founded concerns about what can happen even during the simplest of medical procedures. If that is you then read on. 

Wear loose fitting clothing ✅
No food and drink since midnight ✅
Something to read ✅
Fully charged Smart phone ✅
Patience ✅
Driver ✅
Living Will - draft (hmm.. bit of a fail here) ✅
Advised brother and dad and kids ✅
Prayed for doctor and nurses ✅
Credit card ✅
Identification (drivers licence) ✅

These are some of the things you need on the day you go in for out-patient or what is more correctly known as ambulatory surgery. Some of this checklist is provided by the Ambulatory surgery center (ASC) or surgeon, and some of this is what you need to maintain your equanimity or possibly more colloquially known as KYST and GYST. See picture or click links if you don't know these FLA's.

There really is no way around the fact that unless this is the second hernia operation you are having, you don't know what is going to happen, you are extremely nervous, and anything to help you feel prepared is going to increase your feeling of control which helps you relax. There are probably a few readers that can surrender to the situation - my hat is off to you and I salute you and am envious. Most likely though you "surrender folks" are not even reading this because you have evolved past the need for this kind of banter, dry humor, and detailed information.

For the rest of us, doing something to prepare ourselves for the unknown the best we can, lets us relax a little. We have something familiar to fall back on when in a new situation.  For example, when waiting around to be admitted, or laying in the gurney prior

Hospital Gurney

to surgery, having your smart phone that you know how to use, gives you a familiar pattern to engage in which is relaxing.  A book can do the same thing. Or, reciting a prayer you know. Any of these activities engage you in something you know how to do and that will help you concentrate on what you know and forget a little bit about what you don't. That brings us to fear of the unknown.

 In order to help you, the reader, feel better I am painting a picture of what you are likely to experience so when it happens, you will remember and possibly say to yourself "oh yeah, I remember Gutpatch talking about this". That alone will let you calm down because it then becomes a shared experience between you and me.  And, the surgery thing can be a lonely experience. Gutpatch might be one of the few people that understands what you are going through. Check out this article in The Atlantic about extraordinary experiences both good and bad.  I believe that though this article talks mostly about extraordinary positive experiences that it applies equally to something that is usually perceived negatively like surgery.

People who had extraordinary experiences, meanwhile, had “little in common” with those who had run-of-the-mill experiences, and the resulting combination of strangeness, jealousy, and abnormality caused the extraordinary people to feel left out. In other words, you had to be there. Apparently, though, we don’t anticipate the social rejection that might ensue when we try to regale our acquaintances with stories from our trek across New Zealand.

Hey, hopefully you have lots of friends who will call you up, come see you, send you flowers, listen to you talk about how much it all sucks, and bring over food. All I can say is - don't count on it, and if it happens, count yourself really fortunate and say thank-you a lot. But mostly, even if our friends and family know about what you are getting ready to do, they will think it is not a big deal, or they don't want to be too involved because you don't want that, or for a billion other good reasons give you lots of space. If that is case, you are back stuck with Gutpatch. 

Sorry to get a bit psychological here. I think if you understand how things might go, you will have an easier time. And, it is OK to talk to yourself and imagine Gutpatch is there actually telling you this stuff to your face and you are arguing with me and telling me I'm full of it and to go screw off. That is OK!

This is getting a bit long so I am going to break it into two parts.  Part II will be coming soon and cover what is gong to happen once they open the door of the waiting room and escort you back.

Read Part II by clicking HERE!


Please comment below and I will answer all questions. This blog will only become useful if people comment and add their experience and ask the questions which other people share but are afraid to ask. Plus, everyone's experience is different. How did you find out you needed surgery?  Were you scared? How did you deal with it? Was it relief to know? Or, was the info a complete surprise? 

Gutpatch Hernia Repair Series
1. This Sucks! Step 1
2.  You Have A - I Have A - Hernia?! Step 2
3. Oh Man! Getting Surgery Scheduled - Step 3
4. Let's Have a Hernia Repair Operation - Step 4 Part 1
5. Hernia Surgery Part II

6. Post Hernia Surgery

Oh Man! Getting Surgery Scheduled - Step 3

Gutpatch Sees the Surgeon

When writing this post the first time, I tried to be humorous and witty and light-hearted. After reading the draft and realizing it was anything but those things, I left it on the shelf a few days. While getting mad at a file cabinet and trying to undo my stitches and thinking back about this time (yea - random actions and thoughts coalescing at a weird moment) , I realized there was just nothing humorous going on at this point. I was scared and in the unknown.

Yea, I had consulted with a couple doctor friends long-distance, my local nurse friend and others who had the operation. But, at this point, I'm thinking have I jumped too fast? Should I get a 2nd opinion? What am I doing? Here is what was going on at this point. Sound familiar to anyone?   

There is a protocol most of us have to follow in order to keep the insurance company happy. First you have to go to your general practitioner (GP) and then they refer you to a surgeon.

The office where my GP (who is a nurse practitioner) works could not get me in for about a week and a half. I did a little studying up on inguinal hernias since I was fairly certain that would be the diagnosis. After a drop your drawers exam, he confirmed that indeed that was what I had. He had assisted one of the local surgeons (Dr H) many times and he said that guy was a very confident surgeon. He also mentioned there was a new, younger woman who recently moved to town that was highly skilled.

One of my river rafting friends has been a nurse for 30+ years and recommend Dr H without me even asking. Another friend had used Dr H the year before. And, I found out Dr H had been doing something like 50 -70 hernia operations a year for several years. So, I made an appointment with Dr H. A couple weeks later on a Thursday I see Dr H who confirms the hernia diagnosis with a physical exam, says x-rays and/or ultrasound are not needed, and asks when I want to do this. I'm thinking these things always take forever to get scheduled and say the sooner the better. He asks. "How about Monday at noon?".  OK, I stammer out, and off he goes to the next patient. I get a booklet of dos and don'ts for before the surgery, and a pre-op test request I need to have done at the hospital: EKG and blood work for various things, and some kind of questionnaire to fill out and submit when checking in to outpatient. They send me over to the hospital which is next door and I spend 15 minutes getting the blood drawn and the EKG done.  

One of my main concerns was anesthesia because I had a step-mom and step-dad and father-in-law all develop dementia or Alzheimer after undergoing a general anesthesia (GA). I wanted a local and not GA if possible. He said bring this up with the anesthesiologist when admitted for the surgery.  He said with the local they numb out the area being operated on and put you into lala land. With GA you are put out completely.  I forget to ask what type of surgery he is going to do - laproscopic or standard though he did confirm the insertion of a mesh material.  

The mesh is used like a tire patch, left in place, and your tissue grows in and around this stuff providing a hopefully permanent fix to a hernia on that side. Hence, my post-op nickname now of Gutpatch.

I also found out post-operation there is another option using a "da Vinci" tool which is a robot-assist device.  One friend had a very good outcome with this going back to work in a couple days and almost fully recovered in a couple weeks.  If, God forbid, my right side ever needs repair I am going to seek out someone who uses this technology.   

I get a call on Friday from the hospital regarding a couple things. First, my blood work and EKG look good. Then they interview me over the phone about medical conditions, current prescriptions, what vitamins do I take, etc. Then I get instructions about not eating or drinking after midnight the day of the operation. Also, someone from the financial side calls to say if I pay the day of the operation I can get a discount. In a daze I agree and then realize when talking to my wife later, I am not really sure what I've agreed to.  

Then of all things I'm talking with a good biking buddy telling him about what is going on and he says, "I would never let Dr H cut me! He messed up some kid by getting him infected and went back in and that didn't work and then they had to take him to another hospital 60 miles south, blah, blah, blah.  Oh, and by the way, I shouldn't tell you this now, so forget what I just told you. Besides, it is all third hand."  

Well, Holy Jesus, Yikes, Oh My God and now I am physically sick to my stomach scared.  And, thinking back to the conversation with my GP was he saying something in code not wanting to overtly say anything negative about Dr H who does 50 - 70 of these operations per year? "He is a confident surgeon".  He didn't say he was a good or excellent surgeon. He sort of sounded upbeat when talking about the new, young woman surgeon and then sounded serious talking about Dr H as "confident". Oh man, did I miss something here I should have asked more about? Should I delay and get a 2nd opinion? 

I decide to call the hospital and ask for infection rate data. They ask me to leave my name and number and say someone will call back. Indeed, the Infection Coordinator calls back in under an hour and I quiz her. They have had no infections in the last year. There were 90 hernia operations done last year and Dr H did 80% of them. I ask what were the infection rates of previous years and get a run-around answer like either she doesn't have the data or does not want to share it. 

After sharing all this with my wife later in the day, she asks what are you going to do. I've already decided that all this doubt is like the negative self-talk that tries to stop me when kayaking or rowing my cataraft through a Class 3+/4- rapid. And, it feels like the pit in my stomach at the top of a 40+ degree snowy slope before I ski down. The correct course feels like I should do what I do in those circumstances. Put the fears aside, relax into the situation, and freaking go for it! One thing I have learned is that if fear freezes you up, then the worst will probably happen. If you stay loose and reasonably confident yet still careful and not over-confident, things usually and always up-until-now work out alright.  So, I'm going forward with the operation next Monday and just a weekend to fret my way through. 

Click HERE to read the next exciting post about hernia repair!

Please comment below and I will answer all questions. This blog will only become useful if people comment and add their experience and ask the questions which other people share but are afraid to ask. Plus, everyone's experience is different. How did you find out you needed surgery?  Were you scared? How did you deal with it? Was it relief to know? Or, was the info a complete surprise?  

Gutpatch Hernia Repair Series

1. This Sucks! Step 1

2.  You Have A - I Have A - Hernia?! Step 2

3. Oh Man! Getting Surgery Scheduled - Step 3

4. Let's Have a Hernia Repair Operation - Step 4 Part 1

5. Hernia Surgery Part II

6. Post Hernia Surgery

This Sucks! Step 1

Hey, Gutpatch here to talk about Day 2 after hernia surgery and while brushing my teeth I decided to brush my tongue and got the brush a little tiny eensy bit far back and induced a little gag. Did you know that when you gag it makes a muscle down in your gut contract? I didn't either. And, when it contracted it felt like my guts were coming up because they had just been stabbed with a white hot knife.

Welcome to the world of hernia surgery recovery.  How did I get here and where am I going?  We are going to explore the world of people getting surgery who have little experience with it. Hopefully there will be resources that will help you. And, if you just had hernia surgery we will not induce gut laughs. That is another story.

What is an inguinal hernia?  Check out this link to the U.S. Library of Medicine.  Here is their intro paragraph if you are too lazy to click.

Inguinal hernia repair is surgery to repair a hernia in the abdominal wall of your groin. A hernia is tissue that bulges out of a weak spot in the abdominal wall. Your intestines may bulge out through this weakened area. During hernia repair, this bulging tissue is pushed back in. Your abdominal wall is strengthened and supported with sutures (stitches), and sometimes mesh.

This stuff is sickening isn't it? Yea, and it gets far, far worse. This is just the start.  

There is a video that does a good job of explaining and showing more if this has not been enough info.  Check this link.

Are you wondering what the odds are you have a hernia?  This checklist of symptoms will give you an idea of your risk factor and what can be done to reduce your chances.... http://colorectalsurgeons.sydney/

Since this blog is for people who are getting ready or convalescing from surgery,  your comments are extremely important. Please share you experiences because everyone is different.  

Read the next step in this adventure clicking HERE!

Gutpatch Hernia Repair Series
1. This Sucks! Step 1
2.  You Have A - I Have A - Hernia?! Step 2
3. Oh Man! Getting Surgery Scheduled - Step 3
4. Let's Have a Hernia Repair Operation - Step 4 Part 1
5. Hernia Surgery Part II
6. Post Hernia Surgery