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How to overcome fear/anxiety and make yourself accept that you need surgery?
hello friendly members,
I am curious to learn about how you overcome fear/anxiety about the hernia surgery, especially open incision ones like Shouldice? I was recently confirmed to have inguinal hernia (reducible golf size) I am strongly favoring the non-mesh repair and my BMI is 19.6, good enough for a Shouldice type procedure, but I am struggling with potential large incisions (3-5 inches), surgical complications and/or post-operative pain and swelling etc. I feel that I am quite nervous and worry that I could faint on the operation table.
Has this been discussed in the forum before? Does anyone have gone through similar struggle but eventually went for surgery successfully? I would love to hear about how you build your strength/courage and what you did to get yourself mentally ready?
Thanks for your comments.
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22 Replies
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I put it off for years. Then one day I basically said it’s time. Mine was more annoying and not visible. Also once I made the surgery appointment I felt I couldn’t back out. Obviously I could. Pain is short term even if you have a couple miserable days think about the big picture. I had a decent amount of uncomfortable ness but it subsides.
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Just to the question in the OP,we have a country here in Ireland where they will look after you to the best of their abilities no matter how much money you have.
I had just left my hernia for a few years until ,one day it would not “go back in” and I knew then that I had to see the doctor.
He examined me and sent me to the hospital with the instruction to wait there until I was seen to.
In the middle of Covid the waiting queues were very bad but I was lucky to get a bed and so my operation took place the same day.
Had I not got that operation there and then I am sure I would have had to come back again quite soon as it already felt a lot different and it was an excruciating process for the surgeon to push it back in manually and forcefully during the pre surgery examination.
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I agree with you AJM, I think it takes longer with tissue repairs to recover. And it does sound as though Watchful’s pain improves as each day goes by. I think I read Desarda cash take 2 years to come to full strength.
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Also, I do think there is a real benefit in getting things repaired sooner rather than later while they are still on the smaller side. More healthy tissue for surgeon to work with. Dr Kang has suggested the same on here.
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I suppose there could also be a benefit to expecting a high level of pain for the first few days or a week and then pleasantly be surprised. I think mild to moderate pain is the most common for the first few days with it getting better shortly after. Severe or very uncomfortable pain is probably a small percentage in the right hands, or with a particularly challenging surgical situation.
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It could be different for local anesthesia compared to general, but I just had surgery yesterday for an open tissue repair (and it’s my third hernia surgery in 5 years – first was mesh, second was mesh removal, both robotic, which I hated because of the whole body swelling), and at my hospital I got some gabapentin when I first arrived which tends to help with preop anxiety and makes you a little sleepy and loopy (but only a little). And shortly before they roll you into the OR, they give you a very nice cocktail of meds to immediately relax you and make you feel good. It usually hits you almost instantly and makes you happy and chatty. Then they start the stuff that puts you to sleep, and that’s it. It’s very easy. Next thing you know you’re waking up after surgery. I’ll also add that it’s been about 17 hours since my surgery and I have almost no pain. I am alternating Tylenol and ibuprofen, but no opioids. So severe pain shouldn’t necessarily be expected. Everyone is different, and it can also depend on surgeon and hospital. But it doesn’t have to be a bad experience. Someone on here recently said they had no pain at all after open tissue repair, and another said it wasn’t bad at all with OTC meds. So it seems common enough that it’s only a mild or moderate pain experience. And any pain you do have even if high tends to improve quickly – 2-3 days and then it starts to quickly fade. I think it’s good, once you’ve decided on surgery, to accept you’re making a good decision and that the surgery is a necessary thing to get you all fixed up, and to try and feel excited and focus on how you will ultimately feel as you heal once you’re past this first few days. And that you might not even experience much pain in the first place. I assume they also give you some feel-good meds if you don’t get general. So either way they’ll likely chemically relax you which honestly is a nice thing. So far (but it’s still early) I’ve much preferred the open tissue repair to the robotic lap experience. Will update when/if that changes.
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@ Watchful, thanks!
Like you said that it will be different for different people. To accept a non-mesh hernia surgery is to embrace a big visible scar or two for the rest of one’s life, but good to hear that skin heals quickly.
Sorry to hear about your lying down the street due to the hernia, was that without any hernia belt/support or did you ever try hernia belt?
In the days leading to surgery and/or on the night before the surgery, did you do anything to help ease your anxiety and get good sleep?
Thanks
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Hi William,
I’ll post another update in a month or so. There has been some improvement overall. It takes time with these things to discover what heals quickly, what takes longer but still heals, and what (if anything) you’re stuck with for the long run.
This surgery is pretty traumatic on a number of fronts, and the rate of healing is different for different aspects of it. I hope my groin feels completely “normal” at some point in the future, but I’m not there yet.
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Hello Watchful, it sounds as though you’re continuing to improve, reading through the lines, I hope so and good news if so.
Pain after surgery does longer for quite a time even with less serious surgeries.
Also I recently burnt myself quite badly, and although recovering, I get sporadic pain over a month later. During periods of burn pain. I did think that considering what’s involved in hernia surgery pain for weeks and months after is not perhaps unsurprising.
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I’m sure it’s different for different people, but the only thing that worked for me was simply waiting until there was no choice but to do the surgery. While I was able to live with the hernia, I stayed away from surgery.
Once it started bothering me significantly on a daily basis, I was able to pull the trigger on surgery (Shouldice). It was so bad that I sometimes had to find a place to lie down by the street or on the grass in some park when going for a walk. It would bulge way too much, cause pain when that happened, and was debilitating too frequently. One time I had to ask my wife to go get the car to pick me up while I was lying down on the street. I remember another time when people were asking my wife if I was ok when I was lying down on the grass in a park.
All the surgical methods for inguinal hernia scared the heck out of me. I was actually less scared of open surgery than lap or robotic for a number of reasons, including the ability to avoid general anesthesia. Recovery from Shouldice isn’t a walk in the park, but it isn’t actually too bad unless something goes wrong (like nerve damage).
The incision does take a few months to heal fully, but it’s not a big bother typically. The skin heals very quickly. The layers underneath take a much longer time. You get this hard “healing ridge” under the incision which takes months to soften fully.
There are sporadic aches and pains that you may deal with for months as well. Again, unless something went wrong during surgery, none of this should be too bad.
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First of all I would like to say I am grateful for this website. I have learned a lot form all the contributions people have made.
I to had a RIH and worn a belt for over 4 years until I was comfortable getting it taken care of. I did end up having Dr. Yunis do my repair about 3 weeks ago. He did a shouldice repair, he also had to take of another minor one by the main hernia along with that he said I had a lot of tissue swelling around the area.After about eight days i was really starting to feel better and mobility was returning especially when sleeping. As of now I am very happy i had the surgery starting to feel like I got a part of my life back. I was also pleased with how Dr Yunis and his staff answered my questions and really helped to put me at ease.
On top of that Sarasota Florida is a really nice area during the winter months for recovery. -
Thanks. Taking something every 4 hours basically. Alternating between the two.
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@watchful a special hernia truss to wear immediately after the surgery at Shouldice? That’s interesting. I thought that they use clippers on the wound for 2 days, and you can put a hernia truss on top of that? with this special hernia truss, can you use bathroom with the truss on or not?
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@ajm222 thanks for sharing your experience! this is quite helpful to know the little details and you seem to have almost no pain so far. how much Tylenol and ibuprofen are you alternating? every 3 or 6 hrs or? hope your recovery continues to go well.
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Thanks – I hope you’re right and I’ll manage to recover fully. It feels like I still have some tissue that needs to recover from the surgery. There’s pain in a number of places which feels like injured tissue. Also, an irritated or damaged nerve. None of it is severe enough to be debilitating, and it’s not constant, although when I press in certain areas, there’s pain that’s always there. Regardless, it’s certainly bad-enough to be quite annoying on some occasions every day. The overall picture is better, but not each and every symptom. Some areas still have as much pain as after the surgery, and some are better. The nerve issues actually got worse until recently, and then improved a bit. Since I now reached the 3 month mark, I guess I’m officially in the “chronic pain” category, although it’s not severe in my case thankfully.
By the way, they aren’t particular at all about patient selection. At Shouldice, they have a BMI limit, and they refuse patients with some comorbidities. That’s about it. Kang and Tomas have an even lower bar. As I mentioned before, I think the top German surgeons handle this better using careful ultrasound imaging in advance to make an initial assessment of the best approach, and then also taking into account what they encounter during surgery. It doesn’t make much sense to subject the patient to an overly traumatic surgery which can be avoided with the use of mesh. Having said that, who knows what would have happened if I had used mesh. I would have most likely had an easier surgery, but maybe I would have suffered from mesh-related issues.
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Hopefully in your case it may just mean a longer recovery, but ultimately the same positive outcome. I’d have to think they’re the experts, and so particular about patient selection, that they wouldn’t have taken you as a patient if they didn’t think you’d come out of this anything but 100%. Even in uncomplicated cases, some patients take months and months to fully feel back to normal. As long as there is slow and steady improvement.
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Probably true for tissue repair. I don’t recall Dr. Kang saying this, but Dr. Towfigh said in one of her videos that if you want tissue repair, fix the hernia early.
There are cases where tissue repair is problematic, yet places like the Shouldice Hospital, Dr. Kang, and Dr. Tomas will still do tissue repair even in those cases. I personally don’t think that’s wise. For example, my case would have been fairly straightforward with Lichtenstein, but was a difficult long surgery with Shouldice.
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Oh, and there was no lipoma lol.
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Thank you. So I don’t know what he did yet. He went in expecting nothing more than a lipoma on the spermatic cord and some weakness, but I told him I was certain I had a full hernia. I asked if he’d be doing a two layer Shouldice if he found a full hernia, which is what he suggested before. He basically said that all these tissue repairs have a lot of similarities and essentially suggested it depended on what he saw and what made the most sense based on the condition of my tissues. So my wife found out he did find a small indirect hernia (even though bulge seemed big to me). He repaired it with absorbable sutures which we agreed to beforehand because he believes they would be sufficient for my patient profile. But I don’t know precisely what he did to repair it. Awaiting the surgical notes which should be coming soon.
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ajm22,
Sounds like it went well – glad to hear that.
What kind of tissue repair did you end up having? What type of hernia did the surgeon find?
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The scar for these open inguinal surgeries isn’t really noticeable unless you shave the area. It’s pretty far on the side.
I wasn’t wearing a hernia truss. Not sure how well these work for large indirect hernias. Maybe they work – I didn’t research it much or try any.
Wearing a truss can actually help with swelling and pain after the surgery. A nurse told me that it’s best to wear “tighty whities” and a truss on top of that. They give you a special truss for that at the Shouldice Hospital. It does help in my experience. Boxers let gravity pull everything down which may increase pain.
Surprisingly, I didn’t have much anxiety during the days leading to surgery or even during the night before. Not sure how to explain it. I was mentally very ready for surgery, and I figured (correctly or not) that I was going to be in good hands for this particular surgery.
Paradoxically, I think going far away for the surgery, and staying the night before in the hospital actually reduced anxiety and improved sleep the night before. There’s so much going on that you don’t have time to dwell on the surgery and freak out too much. I think I wouldn’t have been able to sleep if I had been home, but I did manage to sleep 5-6 hours before surgery at the hospital. They wake you up before 6am. I was lucky to be alone in my room that night.
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thanks mwmcdonald3, hope your recovery goes well.
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