My Bilateral Hernia Repair

[Oceanic]

Fantastic post Mark, I’m sure this will help many people faced with a similar decision.

[saro]

Your explanation is very interesting. Don’t worry about the timing, you’re too precise. You had a good ultrasound: mine saw a second hernia during the ultrasound and then lost sight of it, so on the report he wrote “nothing on the contralateral side”.

[Mark H]

Hi saro, to be honest, the timeline is vague. It’s only by looking back that I sort of worked it out as I’m not 100% sure when it appeared. I think it emerged because of a norovirus coughing attack but I may just be conveniently fitting the evidence to suit what I think I know. This was in June 2022.

However, initially it was just a small bump that appeared on my right side so I wasn’t unduly concerned. I didn’t even suspect a hernia on my left. It was only when I had an ultrasound scan that the scanner told my I had “twins”. I was still in the dark as to what type of hernia they were.

As time went on, it became increasingly troublesome and the right side grew to be the size of an orange when it popped out. I don’t know what the limits for a shouldice repair are but I felt that mine was quite large and becoming more difficult to pop back in. It was affecting my quality of life as I tried to minimise the frequency and severity of the lump. The left side still gave me no trouble.

So I realised that I couldn’t just ignore it or exercise it away and something had to be done. It was now September 2022 and I started down the path of assessing my options, vetting the different types of surgery and finding a surgeon who would be willing to accept a foreigner as the UKs NHS was “mesh only” according to my doctor.

I could have had the treatment earlier but had a number of issues with banks, etc that I’ve documented elsewhere. The operation was on 27th September 2023, a year after I first took the problem seriously enough to do something about it.

Now I’m on the other side of the repair I’m looking forward to getting back to all the good stuff I used to enjoy doing.

If I could change anything at all, it would be to have had the treatment in March 2023 when my wife was away in Hong Kong with family. Apart from this, I’m perfectly happy with the results so far!

[saro]

Congratulations Marco. Reading your story we can deduce that it resolved within a year of the hernia appearing. I’m not good at math
so correct me if I missed something: within about a year you had a doubled hernia, it also appeared on the left side. However, they were two small hernias. As with other surgeons who practice the Shouldice, the size (small) was decisive
to get approval for meshless surgery from Dr. Kang?

[Mark H]

Hi Max L, I had Norovirus in June 2022 which meant coughing fits as bad as I’d ever had. Shortly after this I became aware of “something” on my right side. I initially thought it was appendicitis so decided to keep my eye on it to find out where and when I felt discomfort. It soon became apparent that it was more likely to be a hernia. No pain, just a general discomfort.

Like most people I guess, I checked out YouTube videos to see if I could exercise my way out of trouble. I had a hernia so I must be weak, right? Well, that didn’t work so I went to see my GP (family doctor) who told me “yes, it’s a hernia. Don’t worry, I’ll book you onto the waiting list and they will put in a mesh to hold everything in!” “I don’t think so!” I replied. “You don’t have a choice” he fired back. “I ALWAYS have a choice!” was my answer.

I wasn’t told any details of my hernia, almost as though it was secret information that may be useful to the enemy! So began the quest for a surgeon who specialized in no mesh surgery. No hurry, an NHS waiting list meant I would be waiting for (on average) more than a year anyway. I wasn’t in pain and it wasn’t really causing me any problems.

Until it did. My wife had gone alone to Hong Kong for a couple of months to see family and I was able to experiment with all the things we men try to alleviate health issues – change of diet, weight loss, fitness and so on. I simply became a leaner, fitter hernia sufferer! Then I noticed that it was gradually changing my lifestyle. If I was going out for lunch I wouldn’t eat that morning so that I could walk without the bulge giving me problems. Still nothing I would describe as pain, but it WAS becoming a problem. I needed to make a decision so started to check out my options in earnest.

Long story very short, I chose Dr Kang. Read the forum and it’s quite easy to find yourself running around in circles coming back to the same problems and never progressing. As I’ve said in other posts, at this level, ANY of the surgeons you could mention would be a great choice. They are actively researching and tweaking their techniques to a level that the average journeyman surgeon would never ever comprehend. Choose a surgeon and stick with it.

My first contact with Stephen Kwon was on the 29/06/2023, a year after my initial hernia surfaced, and he gave me the information (and reassurance) I needed from the Korean end to get things moving. Then came a slew of problems with banks etc that I’ve detailed above.

Right, now that I’ve made up my mind, I need to learn Korean. This turned out to be the best thing I did for the whole journey! Stephen Kwon speaks excellent English so you won’t have any problems getting registered and signed into the hospital. Dr Kang also speaks excellent English so you will never be in the dark as to what your treatment will entail. However, most of the extremely hard working nurses and front desk staff DON’T have the time or energy to learn English on the off chance you (or I) might grace them with your presence. And the great city outdoors CERTAINLY won’t speak English for your benefit. And why should they?

“If you talk to a man in a language he understands, that goes to his head. If you talk to him in his own language, that goes to his heart.” Nelson Mandela

While I agree with Mr Mandela, I had more pressing issues. I needed to eat! Being able to be polite will get you far in any language, but being able to handle a very simple conversation at a restaurant or food mall will tell the locals that not only do you want food, but you are not an axe wielding maniac looking to kidnap their children! You will most definitely need to know how to say you don’t want spicy food, are vegan or simply that it was delicious. Start learning now. The more you learn, the more you will forget…but ultimately the more you will be able to use when out on the street. Anything you miss can be filled in using body language.

Things NOT to worry about:
Your surgery.
You’re in a room with some of the cleverest people on the subject. Let them worry, not you.
Pain.
I FELT no (very little) pain. It was easily controlled I guess.
The travel.
You are going to an amazing country with friendly, non-threatening people. Open your eyes and enjoy the experience!

Things you CAN worry about:
Losing your stuff.
It’s an inconvenience. You will most likely get it all back eventually but it’s an issue you are better to avoid.
Trimming the Bush.
You’re a big boy now so do it yourself! Take things with you such as scissors, razors or hedge trimmers to make the job easier in a hotel room!
Exploring your Surroundings.
Chances are you will want to limit your exercise for the first couple of days so on your arrival to your accommodation, find out the closest/best places to buy food or supplies. Get to know landmarks such as McDonalds (EVERYONE knows McDonalds!) so you can ask locals, then find your way back to your room.
Language.
Have I mentioned the language? In an emergency you can use the Papago translator app but it is a poor substitute.
Coming Home.
At the end of your trip, they will kick you out of the country and send you home. You WILL fall in love with the safe, gentle but crazy pace of the people. You will miss the constant blaring of car horns as drivers forget where their brakes are. But you need to go home!

My final recommendation is to enjoy the experience. Every second of it. As they strapped me down onto the operation table a pair of beautiful, laughing eyes asked me about my last supper! See the fun everywhere because when you get home, they are the things you’ll remember.

Oh, and while you’re not looking, some clever bloke will sneak in and fix your hernia!

[Mark H]

Hi William, good questions!

I’ve briefly addressed pain in previous posts but it probably warrants a closer look. First off, I want to make a distinction – when asked was there any pain, my answer is a truthful and quite surprising no. This doesn’t mean that pain didn’t exist, just that I didn’t FEEL any pain. I believe it was well controlled.

Soooo, straight after the surgery I felt absolutely no pain at all. I was told to stay in bed for the first hour but possibly due to the sedation, or maybe jet-lag, I drifted off to sleep for a number of hours. My guess is that the pain was being controlled by the drip feeding into my left arm. Dr Kang came up to the ward some time in the early evening (I think) and asked about pain. I told him there was none. Must be pretty good stuff in the saline solution!

I had dinner and then plucked up courage to have a walk around. I could feel tightness in the general surgery area but I couldn’t call it pain. However, if I made a stupid mistake or got too cocky there would be a sharp pain or perhaps a burning sensation, most often in my left side where I had the smaller hernia but large lipoma removed. That pain died away within a minute of staying still and letting everything calm down.

During the early night I had the now empty drip removed and I was on my own, or so I thought. Back to sleep. I woke up at around 2am with a definite feeling of discomfort. Inching out of bed I was extremely careful to make my way to the bathroom to empty my bladder. I noticed I was bent over trying to guard the wound sites and there was a pronounced increase in pain as I attempted to get back into bed. There must be a technique to this, I thought.

I asked a passing nurse about the “clicker” thingy wrapped around my wrist that was connected to a bottle in my pocket. She told me that is was self-administered painkiller so I gave it a click then back to sleep. I was woken by a nurse at about 5 or 6am to have my temperature taken and I felt noticeably better.

Once I was discharged from the hospital I took the painkillers (over the counter Ibuprofen) exactly as prescribed and never felt any pain again. The discomfort I experienced was always a result of doing something too fast, too far or too soon. Now I’m not stupid and I’m certainly no hero so I soon settled into a pattern of cautious testing before I made any new or sudden movements.

That was the sum total of any pain. As I said, I believe that the pain was well controlled rather than being non-existent so my advice to you young pups raring to get back on your feet is to take it easy at first and treat any pain as a warning.

When I got back home I bought a pack of Ibuprofen from the supermarket but kept forgetting to take them. If I forget, then I probably don’t really need them. That’s my theory anyway.

MONEY
I didn’t trust my bank. Sad state to be in but it seems to be accepted now, certainly here in the UK. My flight and accommodation had already been paid before I set off so I only needed cash for the treatment and whatever I would be likely to need for food, cheap beer, dirty women and so on.

The treatment was paid and I had $500USD left over as I’d taken $4,000USD to be on the safe side. I brought with me 300,000 KRW to cover the covid test, transport and food for the trip. I also had £200GBP in my wallet because, well just because.

Fortunately for me and my wallet, the fluid building up in my scrotum meant I didn’t need to spend any money on dirty women and I had no appetite for beer. Cheap trip!

There are a plenty of banks or exchange machines where I could have turned some of my surplus USD or GBP into Korean Won but I just didn’t need to. I wanted to eat at local places rather than large multi-nationals so the food was exceptionally good as well as very affordable. I brought all the $500 and £200 home and around 30,000KRW to spare.

If I had taken my wife with me on the trip I would have spent (very) considerably more on my accommodation and multiples of spending money for higher cost restaurants and trips out. As I was expecting to be little more than a bed-ridden invalid for my time there I thought it best if she stayed at home. I didn’t think it was fair to drag her across the globe just to keep her indoors as I slept.

We can go to South Korea again when we are both fully fit and healthy. We usually go to Hong Kong for a couple of months every other year to visit family so it would be good to make a trip up to Seoul for a week or so while we’re over that side of the world.

[William Bryant]

Hello Mark H, was there little pain immediately after as some other Kang patients seem to have had quite a lot of pain. Which I think settled down thankfully.

How much cash did you take approximately?

Once again it’s another satisfied patient for Dr Kang. That’s how many on this forum now? 12? It’s quite amazing and reassuring for those consistency a Dr Kang repair. Great endorsements. Not sure any other surgeon mentioned on here gets a 99.9 satisfaction score.

[Mark H]

Hi Seadred, because I was having both sides done I had the sedation. However, this only puts you under “lightly” so to speak. As I mentioned, Dr Kang brought the lipoma round the operating table for me to see! It does feel a bit surreal, like being asleep (in my case) but then also not being. While this cryptic explanation tells you nothing, it becomes obvious when you have it!

The beauty of this is that there’s absolutely no nausea. I had an operation with a full general anesthetic 23 years ago and once I had woken up in the recovery room I was sent back to the general ward where I promptly threw my guts up! None of this after the sedation.

With sedation, once I was fully alert I was completely awake, as if I had never been under. So no pain, no nausea and no groggy “hangover” as with traditional general anesthetic. I’ll take that!

[seadred]

Thank you for the updates! Did you have the local anesthesia without sedation?

[Mark H]

Hi MarkK. First off, all the opinions I spout here are just that, opinions. I’m pretty sure that at the level of surgeon we’re talking about here any one of them would have been an excellent choice over the mediocrity of (free) options back in my home town.

So why Dr Kang?

For me the travel was the least important part of the treatment. Two weeks after the treatment the distance would be just a distant memory. If I could have this level of treatment in my own area then I would have chosen it, otherwise I’m quite happy to travel.

So it came down to my age (60) and the level of tissue damage I would need to heal. As an aside, this can also mean less pain but again it was not an absolute priority as a month or so after surgery it would be just another hazy recollection. With hindsight, the pain was almost negligible so if I could go back in time I wouldn’t even consider it. Easy to say now though.

Hope that helps,

Mark H

[Mark H]

COSTS
First off, I’m from the UK. So while we have the fantastic NHS to cover the cost of most treatment in the British Isles, they won’t pay a penny to send you overseas for a procedure. I believe you may be able to get something back if you are American with health insurance but I’m no expert. As far as my case goes, I paid for everything out of my own pocket. Even so, I think the treatment was worth every penny to me.

I have listed several costs in different currencies. I was going to convert them all to one currency such as USD but now feel it’s better to leave each price in the original currency so you can do your own conversion when you need to make your own payments. More accurate in my opinion.

Hospital = $3,500
COVID test = KRW30,000
Flight = £792.23
* Accommodation = £132.79 (in total, really!)
* Insurance = £502.13

EXTRAS
Airport transport (Korea) = KRW 34,000
Airport transport (UK) = £10.90
T-Money card = KRW 4,000
Initial T-Money Card loading = KRW 20,000
Money for living = KRW You decide.
Get Talking/Keep Talking Korean Language Course = £11 from Amazon
Billy Go Korean = Free Korean course on YouTube
Talk to Me in Korean = Free Korean course online

Learn some Korean. Even if it’s just the basics, a little will go a long way. People are hesitant to speak English to strangers so if you know how to be polite in Korean it helps!

APPS
Naver Maps – Similar to Google Maps but Korea Friendly
Kakao Bus – Full featured bus app with real time updates. This proved to be more useful than I expected!
Papago – Korean/English translator. Lifesaver!

* A brief explanation.
I used AirBnB to find a room. It was only small, but had its own bathroom taking up one corner as well as air-con, TV and a host of other amenities (cooker, washer/dryer etc) that I personally didn’t need. I believe that their ideal client would be a student at the university looking for long term accommodation, but although it was only £11 or so per night it was ideal for my circumstances. It was perfectly located too, being just a comfortable walk to the hospital, transport and local eateries. Expect to pay considerably more if you want a fancy hotel.

*Insurance
Mmmm, what can I say here. I initially asked the forum for insurance suggestions as although the medical tourism market is booming (think Turkey Teeth!) there is a serious shortage of companies willing to insure. A lengthy Google search session revealed that most companies want travelers who simply live and travel with a condition and expressly refuse cover for someone traveling FOR treatment.

I found an American company that wanted to charge a fortune for very limited cover. Another option was ClinicHunter but after filling in the forms discovered that they currently do not cover travelers from the UK. However, they DO provide cover for travelers from the EU including Ireland so they may be an option for you. So my ONLY option was Medical Travel Shield, whose policy seems to be “Charge whatever we like as you have no other choice”. This is what happens when there’s no competition.

Problems At My End
Banks. Well, that’s it really. When I started to put things together for my journey, the mainstream media was filled with stories of a prominent political figure being “de-banked”. So the spotlight was on the banks and banking system. Nothing to do with me, I thought.

One Sunday evening I settled down to check my Google Flight recommendations and found an offer that seemed to suit my needs. I whipped out my debit card ready for action. But wait! Just take a look around to make sure everything seems legitimate. Trust Pilot ratings, Check. ATOL Protected, Check. Parent company listed at Companies House, Check! Seems good to go.

I swiftly entered my details, double checked that I hadn’t made any glaring errors and hit the submit button, then…nothing. A moment later, a new page appeared saying that my payment had been rejected. Huh??? Spotted the problem – I’m using Firefox and the Ad Blocker AND built-in tracker stopper must have blocked a Captcha or something. Reset everything and start again. Same problem, payment declined.
Quick switch to Google Chrome and start again. Payment blocked. No ticket, no flight.

Ran to the bank branch for doors opening the next day (Monday) to be told that my bank card had been frozen and I must call the Fraud department. I was informed by a stroppy School-ma’am at the other end that I need to be more careful in future who I wish to send money to. She then began to interrogate me on the steps I took to verify if the company I wished to pay was legitimate!

“Mother, is that you?” I asked. “You’re not usually this strict with my pocket money!” I complained.

At this stage, the lady changed her attitude and agreed to unfreeze the card THIS time, once again giving ME access to MY money, on condition that I understood I would get nothing back if I paid anything to a scammer. I returned home to discover that my bargain flight ticket had now been sold.

A few days later I booked a more expensive flight (+25%) with Turkish Airlines that I was happy with.

However, there was just a slight doubt in my mind. So I went back to the bank the next day to clear things up. My bank asks me to inform them if I plan to go out of the country. This will “protect me” and my money. So, if I make a large payment using my card sometime during the night (as I’m 8 timezones away!) will the bill be paid or do I run the risk of having my card blocked again. Quick answer, they would block my card and I would need access to my home phone in order to unlock it. From 7,000 miles away?

Short answer, I took cash!

I confirmed with Stephen Kwon that I could pay a lump sum with cash and that’s what I ended up doing. My cash didn’t get blocked by a bank and I didn’t need to beg them like a naughty teenager in order to access the currency.

The moral of this tale is to find out BEFORE you go that the bill will be paid.

PS. I recommend you also take Korean currency to pay for your Covid test and day to day living costs. I was never refused service in Seoul shops or restaurants with cash, despite many online travel blogs informing me that South Korea is pretty much a cashless society.

[Unknown Member]

Thanks for your report. Can I ask why you selected Kang over the German surgeons given that they are much closer? Also why Kang repair over shouldice which has a much longer track record in terms of recurrance? Clearly if pain is an issue Kang seems superior –but his pain stats were not that great.

[William Bryant]

“I plan to follow up with an addition to this thread detailing costs and a few problems that I had at my end with flights, banks and insurance. This was nothing to do with the hospital so it warrants a post of its own.”

That’s brilliant. I was just going to ask about the costs and insurance etc so look forward to that.

In the meantime good luck and hope swelling improves..it all takes time.

[David M]

Good read, MarkH! You’re a talented writer. Thanks for sharing your experience.

[Mark H]

I could have worded things better!

My surgery was all competed on Wed 27th. I stayed in the hospital overnight and was discharged on the morning of Thurs 28th. My only other visit was to the outpatients clinic for a final checkup and consultation on the Monday 2nd Oct before being allowed to fly home very late Wed 4th Oct.

On Sat 30th I was chasing a lost backpack. Something I just couldn’t do any earlier because of national holidays and my surgery.

Now I feel very well. There was never really any pain, in the beginning it was controlled by painkillers and after the flight home I haven’t needed to take a tablet. The only fly in the ointment is the fluid in my scrotum is taking longer to drain than I would like. I’m not 25 any more so I should stop complaining I suppose!

I plan to follow up with an addition to this thread detailing costs and a few problems that I had at my end with flights, banks and insurance. This was nothing to do with the hospital so it warrants a post of its own.

[Good intentions]

That is quite a story Mark H, thanks for posting it. I have found that you can only put three web links in a post otherwise the forum software just throws all of your work away and goes back to the main page if you add four or more.

I went through the details and am a bit confused. Did you have both surgeries on the same day? You wrote that September 27 was treatment day and reported a lipoma removed. But then on September 30 you wrote that you had to go “for” surgery. Did you mean that you had a follow-up appointment? It might just be a linguistic issue, like the reversed date code usage.

“Couple of days later I had tracked down the bus company but couldn’t do anything more as I was due to go for surgery.”

Here is a summary, I think, assuming that everything was done on the 27th.

September 26 – first visit to Gibbeum Hospital, extensive diagnostic work performed
September 27 – both sides repaired surgically
September 30 – first follow-up (American term)
October 2 – final follow-up

Long flights from England at beginning and end.

So, it’s been 17 days since surgery. How do you feel now?

And, besides the lipoma, did you learn any more details about what Dr. Kang did? Did he just find two enlarged internal rings and tighten them up? Did he find other weakness that needed work?

Good luck for the long-term. Try to stay in touch with the forum if you have time.

[Mark H]

Hi William, I’m English. I come from the wet and windy north west, not far from Manchester. To be honest, the first part of my monologue was causing the post to be rejected, presumably because I included links to services I used for my trip such as the insurance company etc.

I had also included a link to Ivans Kang repair post because my experience was very similar and I didn’t want to simply repeat it here. So if the “diary” starts as though it’s mid story then this is the reason!

[William Bryant]

Thanks for updates Mark H

I’ve forgotten which country you are from though.

[Mark H]

…Continued

Monday 02/10/2023
The swelling continues to go down with each passing day but I expect it to take some time still. I take a shower and afterwards I risk looking in the mirror. The glue covering the wounds is starting to flake off so I put new dressings on to protect the area as I enjoy a slow stroll around town. At 2pm I enter the hospital for my final consultation, take a ticket and sit down. Well, technically it could be called sitting, but to be accurate my backside briefly skimmed the seat before my name was called.

Dr Kang had told me to go between 2pm and 3pm and I certainly didn’t want to keep him waiting. However, I had an ultrasound appointment at 3:10 so I just wanted to let the counter staff know I was around and would wait outside.

Not a chance!

I was sent along the corridor and sat outside the ultrasound room. For a full minute and a half. Called in, the radiographer explained what she was going to do. Right then, Dr Kang came in and we exchanged a few words.

Ultrasound finished, I went into Dr Kang’s office for the final consultation.

By 2:20 I was back out on the street heading for something to eat.

That’s it – all over bar the long trip home.

So what did I learn? What did I experience? How did I feel about the trip as a whole?

My head is spinning after such a massive culture shock as only Seoul and South Korea could deliver. I’ve traveled extensively through Asia, including Hong Kong, Macao, Mainland China, Thailand and the Phillipines and each place has its own unique feel and culture. When I look around during my stay, a lot of things started to make sense.

As I had a coffee in McDonald’s (yes, I know!) I watched the world going by. Everybody seemed to be running! A salesman from a nearby motor showroom ran to a woman to give her a bag. McDonald’s staff on the customer side of the counter ran to clean the returned trays. It’s actually part of the pali pali culture and they laugh and joke with each other and seem to be always smiling. If they are stressed you couldn’t tell by looking.

It looks to me that they achieve so much not by rushing the important stuff, but by reducing the needless waiting or wasted time. And I must confess that it seems to work!

I loved every minute of the entire trip, from watching people use their iPhones to reserve tables (really!) to seeing a teenage boy bow to the bus driver as he climbed aboard.

South Korea is a unique place with a superb hernia surgeon dedicated to his craft. He is supported by a world class team including first rate nurses, expert technical staff and an efficient front desk, not forgetting the security guy at the door who showed this bewildered fool what to do.

However, I couldn’t leave out the other star of the show, Stephen Kwon. He was the first person I contacted via email and was the first person I met at the hospital. He steered me through the necessary minefield of registration and tests with fun and enthusiasm. I’m truly thankful for his help.

But what about the pain? Well, as I’ve said through this rambling recollection, there wasn’t really any pain, certainly none that couldn’t be controlled with simple readily available meds. Unless I do anything silly.

So with the benefit of hindsight would I still do it? Well, except for the bag on the bus thing, an absolute yes.

[Max L]

@mark-h, I followed your informative thread with great interest. Glad to hear you are doing well in your post op recovery. It seems like you are on your way to a full recovery. Just wondering, were you experiencing any pain with your hernia and for how long before you scheduled your surgery with Dr. Kang? Also, were you aware if you had a direct or indirect hernia prior to your scheduled surgery? I have exchanged a couple emails with Stephen Kwon and am working up the courage to schedule the surgery with Dr. Kang. Reading about your positive surgical experience greatly reduces my anxiety and provides encouragement to proceed. Other than an annoying reducible hernia, I am currently not experiencing any pain. However, I know it’s something I will have to address, and the sooner the better. Wishing you good health and thank you for your very informative and useful updates.