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  • Frustrated – trying to get proper diagnosis

    Posted by GKM on June 14, 2014 at 11:28 pm

    I recently noticed a grape-sized painless bump on my upper left groin area. I was undergoing IVF treatment at the time so I assumed maybe it was just some swelling related to that so I went to my IVF doctor who was sure it wasn’t anything IVF related and suspected I had a hernia although she admitted she was not a specialist. The next morning I woke up and noticed the bump had gone down. I told myself maybe I had imagined it but after some google research I decided to test it out in the gym with some deadlifts. I had only recently returned to heavy lifts after recovering from some shoulder/elbow strain. Sure enough, on my fourth set I peeked down there and my bump had returned. Over the next few days it would go away while resting and return after repeated lifting. Chatted with my trainer and sports doc and we’ve put together some modified training for me with no lifting and nothing that will enhance abdominal pressure. Huge bummer as lifting is a big part of my life and add to that the fact that trying to get pregnant seems like a bad idea if abdominal pressure is something I should avoid! So I feel like some major life stuff is on hold. I decided I would get this sorted ASAP before defrosting any frozen eggs and trying to get pregnant – so I went to my GP. unfortunately the lump wasn’t protruding but she took a look did some pushing and guessed it was a hernia as well given that it came out with heavy lifting. She sent me for an ultrasound and referred me to a very well known hospital here in Canada that specializes in hernias. I live close and went to this hospital yesterday. I literally left in tears after being told that unless I could show them a bump that pushed out when I coughed or beared down, they wouldn’t recognize it as a hernia. Unfortunately it operates on a walk-in basis and it takes about 2 – 3 hours of waiting before you see a doctor (so it’s not like I can deadliest at the gym and then run in and see them) I asked whether my ultrasound results should be sent to them and the doctor told me not to send him any results and even if I showed him an MRI, and ultrasound and a CT scan indicating a hernia he would not diagnose a hernia unless I met his aforementioned criteria. I told him if I could go deadlift some solid weight for a few sets he would see the lump – he said I should therefore continue lifting heavy weight into the future because if it is a hernia it will make it a bigger and permanent bulge so he can then diagnose it. I really couldn’t believe that he was suggesting I seek to make it worse for him to possibly maybe diagnose me in the future. The whole experience was unnecessarily cold, disconnected and insensitive from the chatting to the exam and he could care less about any lifestyle or life planning impacts. Needless to say, regardless of the reputation of this place I will not step foot in it again even if it means seeking private healthcare outside of Canada. Today I was moving a lot of stuff around while cleaning my house and the bump came out again – it’s not painful, more uncomfortable. I’m going to follow-up with my GP regarding the ultrasound. Before I jump on planes, trains and automobiles for a foreign consult, is there any other testing I should seek – MRI, CT Scan or anything else? I can get either of those fairly quickly by just driving across the border but as I’ll have to pay for private testing (to avoid the glorious wait lists that come with universal health care) I’d like to make sure I’m focusing in on the tests that will be most helpful.

    drtowfigh replied 9 years, 10 months ago 2 Members · 1 Reply
  • 1 Reply
  • drtowfigh

    June 15, 2014 at 12:04 am

    Frustrated – trying to get proper diagnosis

    That sounds like a very unfortunate consultation.

    As you may have read on other posts and also online, a hidden hernia is a phenomenon that is well described and known for decades. It is most common among women. Surgery is a cure for the pain associated with it.

    That said, it seems yours is not truly a hidden hernia because you actually see and feel a bulge, though only after your workout. This is not uncommon among healthy, young patients with strong abdominal core muscles: they have a hernia, which is a hole in the muscle or fascia, but the hole is maintained and supported by strong surrounding muscles. I.e., you do not have a gaping hole with contents flowing out easily. Your abdominal muscles are trying to keep the hole as closed as possible.

    An ultrasound, done correctly with multiple maneuverings, should be able to prove your hernia, though, if the surgeon can feel the hernia or see the bulge, I do not recommend imaging.

    Perhaps you can try other surgeons at the same facility. I recommend Dr. Michael Alexander, who is a very talented surgeon at the Shouldice Hospital.

    That said, the Shouldice technique would be a great choice for you to repair your hernia, and the Shouldice Hospital in Toronto has published the best results from this technique. Other options are to cross the border or go to Montreal, where I also know reputable hernia specialists, such as Dr. Melina Vassiliou.

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