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  • Having a Difficult Time Deciding

    Posted by stephent on November 17, 2016 at 9:14 pm

    At age 3 (in 1947) I had a right side inguinal hernia open repair that last until age 65 when severe coughing caused it to reoccur in the same location. At that time, and with no negative symptoms, a surgeon and I agreed that watchful waiting was likely the best course.

    For the last few years I’ve begun wearing a truss when performing stain inducing activities. Now at 72 the hernia has increased in size, but can be easily returned by light pressure.

    However, after living with the hernia for seven years it would certainly be nice not to have it, and not have to hear my intestinal contents gurgling by just below the surface.

    My dad had a hernia repair when he was in his 70’s and nearly died during the operation and never regained his full health, which creates an emotional resistance to surgery. Of course logically his experience has no impact on what my result may be. In addition, my only other hospital experience was having my tonsils removed at age 6.

    I’m very healthy, use no medications, 6’ tall, BMI of 21, BP 115/78, LDL/HDL is 1.7, TC/HDL = 3.0, TG = 80, and all blood work is normal.

    I’m really on a fence as to what to do, as I’m having a difficult time trying to calculate the risk reward ratio based on my age, health, and prognosis over hopefully the next 15 to 20 years of life. Any thoughts or experiences would be greatly appreciated. Thank you –

    dand replied 7 years, 1 month ago 6 Members · 8 Replies
  • 8 Replies
  • stephent

    Member
    January 13, 2017 at 6:45 pm

    Having a Difficult Time Deciding

    Hi dand,

    Unfortunately my Medicare HMO insurance company does not make the names of “Specialists” available to members. In addition, my Primary Care Physician has no input or control as to the “Specialist” the insurance company assigns.

    If I’m dissatisfied with their “Specialist”, my only option is to choose someone else at 100% out of pocket cost to me, but thanks, it was a good suggestion.

    Stephen

  • dand

    Member
    January 12, 2017 at 10:42 pm

    Having a Difficult Time Deciding

    Why don’t you do the groundwork… find a Hernia Surgeon in your plan & suggest it to your primary MD… he will probably go along with you. Even show him why.

  • stephent

    Member
    January 12, 2017 at 10:36 pm

    Having a Difficult Time Deciding

    I’d like to very much thank each of you for your thoughtful responses to my post, so here’s my plan:

    Because I’m in a Southern California Medicare Advantage HMO Plan I’m required to meet with my primary Physician to obtain a referral, which I’ll do on January 24th. That will be followed with an appointment to meet the referred surgeon within my ‘Medical Plan’. This will allow me to determine his/her experience and at which hospital the surgery would be performed.

    Following that appointment I plan to return here and share the results of my visit, as this blog has been very helpful in my decision making to this point.

    Stephen

  • drtowfigh

    Moderator
    January 9, 2017 at 7:16 pm

    Having a Difficult Time Deciding

    I brought your post back up, WasInTN… you’re right. it’s too good not to be left up top.

  • WasInTN

    Member
    January 9, 2017 at 7:04 pm

    Having a Difficult Time Deciding

    Stephen
    I was told of my IH in around 2008 and I gave no attention to it. I continued my usual life till 2013 when the bulge started interfering my life. It was around May/June 2014 I took action and went to Dr. Goodyear of PA. He has over 200 surgeries and is known as an expert. I was rolled in at 10 and walked out at 1. Since then no pain no feeling of mesh no nothing. I am happy I went to him. His mesh is ultrapro and worked for me and many of his patients are happy. So in a nutshell I played 6 years of wait and watch game.

    Having said that, mesh is not 200% pain free foe everyone. Remember the age old adage – God cures you, doctors take your money? It happens in 1% of those people unfortunately. So I would not worry about surgery problems if my surgeon is good. Choose your surgeon wisely. If you want to know how to choose wisely, watch the Indiana Jones movie where the IJ (Ford) was told “Your friend has chosen poorly, and you have chosen wisely.” Just kidding. Surgeon skill is UTMOST important in IH surgery. Period. Which area of USA do you live?

    This you may want to not read but I will say it. No offense at all. If I were at your age, I will gladly walk into surgery room and if that ends up with my death, I will be more than happy, than no surgery and stay in nursing home till age 95 and be under geriatric care. You have nothing to lose. Do you? I am not saying that you lived long but at 75, why bother waiting? Choose a good surgeon and go for it. If you get good results, yes you can play 20 years golf and if you do not, you have nothing to lose. That’s my personal opinion.

    Dr. pszotek, funny story about missing 5 years of golf. Wish I will able to stand erect by that age of 93 🙂

    Best, BTW I posted my experience, how to take care of yourself during surgery etc on this forum that used to appear on top of the posts but now I do not find them. You may want to search with my handle name.

  • Beenthere

    Member
    January 9, 2017 at 6:13 pm

    Having a Difficult Time Deciding

    Not sure if you have had your surgery but be very careful when deciding on a quote expert. If you can travel to have it done go with one of the doctors that come up over and over on this site.

    As a lay person I might be wrong but an open surgery you do not have to have general anesthetics. I know my mom was very concerned over getting a general at an older age.

    Good Luck and ask a lot of questions.

  • dand

    Member
    November 22, 2016 at 11:21 am

    Having a Difficult Time Deciding

    Stephent I was in similar position as you having inguinal hernia for over 13 years. Being fearful of the operation finally had it it done minimally invasive. Had great results. Make sure you choose to get the very best & experienced surgeon you can & get this hernia behind you to enjoy the rest of your life.

  • pszotek

    Member
    November 19, 2016 at 1:17 pm

    Having a Difficult Time Deciding

    Stephent,

    Very nice post and well thought out. I understand your dilemma. However, I believe you are young in the grand scheme. I often have this conversation with patients in your age group and even older. I find this story the best example:

    At 83 yo a patient of mine had a similar story as you regarding a bulge in his groin.

    His primary care physician saw him and told him that something else was likely get him before this small hernia would cause him a problem.

    At 87 yo this gentleman had to quit golfing, his only source of activity and his favorite thing to do, because his small bulge had grown so large that it was interfering with his swing and he could not get around as well because his scrotum was essentially hanging down to his knee.

    At 92 he presented to the ER with an acute incarcerated and strangulated hernia. I told him our two options are to fix you and you could die or you will die if we do nothing. He said well I have nothing to lose so fix me.

    At 93, and last I heard, he was golfing again.

    Moral: He missed 5 years of golf.

    I think you are relatively young and healthy and if your hernia is getting bigger then the natural history is for it to continue to grow. I would recommend getting it fixed before your golf game is interrupted and you out live all the other things that “will get you” before the hernia will become a problem.

    I hope this helps. Many thanks for your post. I think this is a common theme and will serve others well.

    Feel free to shoot me an email and we can discuss over the phone if you like.

    [email protected]

    Dr. Szotek
    http://www.indianahernia.com

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