My surgeries with Dr. Kang and Shouldice Hospital
Hello everyone! My first post is going to be an epic tome, as just yesterday I joined the exclusive club of those who have had surgeries at both Dr. Kang’s Gibbeum Hospital in Seoul, and at the Shouldice Hospital in Thornhill.
Reading Hernia Talk this past month has been very helpful, so in following @Colin M.’s footsteps, I thought I would share my experiences, along with why I chose to travel to Korea even though Shouldice is in my backyard.
Early 2000s – Shouldice
Had a small inguinal hernia on one side that was causing occasional discomfort. It was manageable for 2 years, until suddenly it became aggravated nearly all the time. I live in Toronto, so my doctor recommended Shouldice. I was in my late 20s, physically active but with a BMI of around 27. Shouldice assessed me quickly, and despite being slightly heavy, they booked me in for a surgery within 2 weeks (it was supposed to be 2 months away, but when I reiterated my nearly constant pain, they were able to find a sooner date).
I don’t recall the entire experience, but here is what was most notable. On the morning of surgery, I was with maybe 8 other patients in the pre-op room. Oral sedatives were given to all, and everyone fell asleep except for me. While waiting for my turn in the OR, I felt far too alert and aware. Once I went in and they started slicing, I felt horrible pain from the blade. I yelled and tried curling up in a ball, but was held down. After more attempts at cutting, the surgeon told me that some patients need a little extra sedation, which he then instructed a nurse to administer. Soon after, surgery proceeded with much less pain, but there were still times I could feel them aggressively pulling layers together, as well as the stapling of the incision at the end. Overall, I recall those minutes in the OR as being one of the most horrible experiences of my life.
Despite this, I must admit that the ensuing days at Shouldice were quite pleasant. As many others have described, the meals were decent, playing boardgames with other patients was fun, and the grounds were a nice setting for walking. The only serious pain was caused by laughing too hard while watching movies with my roommate (I swear that Dude, Where’s My Car? nearly caused the staples to burst open). Some other patients who also lived in the Toronto area complained that the lengthy stay (especially the overnight stay before surgery) seemed like a cash-grab and a waste of resources, but I wasn’t too fussed by this at the time. I recall getting discharged on the 4th day. Recovery progressed over the coming weeks and months, with a very gradual reduction in tension, and only sporadic jolts of pain. One thing that took a very long time to resolve was a weird numbness in the area around the repair. The numbness didn’t cause any pain, but it was a disconcerting sensation that felt like the nerves in the area were all messed-up somehow. This persisted for at least 2 years, and eventually disappeared. The repair hasn’t given me any issues since then.
2022 – hernia #2
Now in my mid 40s, I experienced a second inguinal hernia on the opposite side. I didn’t get it checked, as I recognized the symptoms immediately, and it was quite tolerable with only brief instances of pain. All was good for 8 months until I was on a trip, and it started causing episodes of sharp burning pain while walking or doing athletic activities. Immediately upon my return to Toronto, I went for a walk-in assessment at Shouldice, as I thought they would be my best chance of getting treated quickly. A nurse checked my height, weight, and BP, and then a doctor did a physical exam. After weeks of over-indulgence on my trip, my BMI was now at 29, so the assessing doctor said that he would like me to lose 25-30lbs., and that I was to call in for a booking once I had dropped 15lbs. He told me about their process and procedures, which sounded the same as my previous surgery. I told him about the pain I had during the previous operation, and he assured me that they would account for it this time. I left rather disappointed that I didn’t have a date scheduled, but was surprised by an email later in the day indicating I was booked for surgery in 4 months, with a mandatory 4-night stay, and with the condition that my weight on admission corresponded with a BMI of 25. After some back and forth with the administrator, I was dismayed to conclude the likelihood of accelerating the timeline was slim this time. They appeared to be holding firm to this new weight requirement (even though my BMI was ~27 last time), and they said I could not even go on their waitlist for a sooner date until I met their weight target. I was having a hard time digesting the prospect of 4 more months with worsening bouts of pain, a bulge that was growing by the week, and a diminished ability to work. I set in-motion a crash diet plan to try to rapidly meet the Shouldice target (not so easy during the Christmas period), and initiated a hunt for other surgical alternatives. I sought a referral to a general surgeon, but the wait time for an assessment was 5 weeks, and his surgeries were being booked for 2024! (Not surprising, as this is the state of healthcare in Ontario). After further research, I concluded that I would prefer to stick with a non-mesh repair. Upon learning about Dr. Kang, and calculating that the total cost to go Korea would be more or less the same as going elsewhere in North America for a mesh repair, the solution seemed clear.
January 2023 – Dr. Kang
Just before New Year’s I got in touch with Stephen from Dr. Kang’s team. I had already learned a lot from various postings and videos on here and elsewhere, so I had only a handful of emails with Stephen before I was comfortable with committing. On Jan 4th I proceeded with booking a flight for the 8th, arrival on the 9th, pre-op on the 10th, and surgery on the 11th!
This is my first time in Asia and I am travelling solo, so I am glad I had almost a full day to get settled in and explore Gangnam. At my appointment on the 10th, Stephen met me at the hospital entrance to guide me through all the paperwork and testing. Besides being a good translator, Stephen is just generally a very kind and reassuring presence to have by your side. After registering with the hospital, the first step was meeting with Dr. Kang for a physical exam and discussion. Dr. Kang answered my questions and allayed my concerns in English. He said my hernia was likely indirect. My scar from Shouldice is quite long, so when I suggested that I didn’t mind a matching one on the other side if it gave him space to add extra reinforcement to unaffected areas, he said that he was intending to do that anyways (and without the oversized incision). He said my weight was not a concern, and that he hasn’t turned away anyone else because they were heavy. After this initial meeting, the next step was an ultrasound, after which Dr. Kang came in again to discuss the results and confirm the gameplan. Subsequent steps involved going to other parts of the hospital for a bloodwork, urinalysis, Covid test, EKG, and a chest X-ray. I don’t recall Shouldice having such extensive testing during their admission (and they definitely didn’t do an ultrasound during their assessment).
During my entire pre-op appointment at Giddeum, I was impressed by what seemed like a thoroughly clean and modern facility, and the number of attentive staff at every station along the way. I was at the hospital for 2 hours in total, with minimal waiting time at each stage. This was a very stark contrast to my recent experiences at my local hospital in Toronto, and at Shouldice (I forgot to mention how if I wanted an actual assessment appointment at Shouldice, I would have waited for months, but they encourage people to show up on weekday mornings and wait hours in their “living room” for a walk-in assessment. Also, at my December assessment, they confused my file with another past patient, and the doctor tried to tell me they had already repaired both sides).
And that brings me to yesterday, which was THE day. I walked from my hotel to Gibbeum at 9am. It took maybe 45 minutes to check-in, get changed, and settle into my portion of the 4-man room. The 4-man room was perfectly adequate for a day or overnight stay. Each bed has a code-locked cabinet for personal belongings, and I barely noticed the presence of other patients. I was led to the operating room around 10:15. Right up until surgery, I was asked repeatedly by various English-speaking nurses for me to confirm my name, DOB, surgery type, and which side. I’m not sure if this is a typical protocol at home, but it was a reassuring check. After maybe 15 minutes of prep while I was in the surgical suite, Dr Kang entered and asked how I slept the night before, and how I was feeling. And that was the last thing I recall before waking up outside the operating room. It was like I blinked, and it was all done! After the painful ordeal of my previous surgery, this was a massive relief.
By 11:40 I was back in my room, and although I had been jet-lagged and underslept, I was feeling alert and only minor discomfort. Stephen came by for regular check-ins. A tasty Korean lunch was served at around 1pm, and Dr. Kang came by at 4pm for a follow-up before discharging me. Stephen accompanied me to the entrance and hailed a taxi from down the street. I had some discomfort from the bounciness of the taxi, but was otherwise perfectly fine with the trip back to the hotel. I managed to shuffle down the block to pickup some snacks at 7-11, and then retired up to my room. I didn’t feel any real pain; it was more like soreness and weakness that I might feel after a harsh abdominal workout.
24 hours after leaving the hospital, I’m feeling some pain with movement, but nothing severe. Walking in slow and hunched, but I don’t have the same tightness and sensitivity that I recall after my Shouldice surgery. While there is no way that I could tolerate flying home today, I’m hopeful I can play tourist in a few days. Since I’m staying for another week, Dr Kang suggested that I pop by Gibbeum to see him next week.
While it might have been nice to have someone accompany on this trip, it really hasn’t been necessary. So far, I’m very happy with my decision to come see Dr. Kang. He seems like a genuinely nice guy, Stephen has been an extraordinary help, and even though I’m not yet able to do the Gangnam horsey dance, the overall experience has been as good as I could have hoped.
I’ll add to my report if anything notable happens, or if recovery doesn’t proceed as expected.
In the meantime, feel free to post any questions on my experience, and I’ll try to respond.
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