[norton]

Andrew, very sorry to hear about the amount of pain you’re in! You refer to what “the doctor’s office” said. Have you actually seen your doctor about this? Given your level of pain and the symptoms you’ve described I would say that you definitely need to see your doctor without delay so he can try to determine what is happening. Do you have any pain medication you can take? If not, I’d be asking for a prescription for something that will at least provide some relief.

[norton]

Hi, Andrew. I certainly hear you and I understand about the pain. While I can’t claim any expertise about this, I can certainly relate personally to it, and can at least offer a few thoughts for what they’re worth:

I had my inguinal surgery 4 weeks ago for a small hernia on the left side. Like yours my surgery was also open. Sounds like you found a good surgeon, which is great!

Just like you, I did a lot of reading on forums, and developed extremely high anxiety over the stories of post-operative complications, chronic pain, etc. So much so, that it took me some time, and at least one cancellation date (when I had second thoughts), before I finally took a deep breath, and proceeded (with some trepidation) with the surgery.

At four weeks post-op I’m only one week further along than you are, and still experiencing some various pains and discomfort, though they’re diminishing. I still feel discomfort and various pulls and twinges getting in and out of bed and getting up and down from a sitting position. I still have occasional, very brief stabbing pains, though they’re getting fewer. I also still have some mild testicular discomfort, but again, it’s getting less. I notice in the evenings, in particular, I have various “sensations” of pulling or tightness in that area of the groin. Interestingly, my pains and sensations change somewhat from day to day, though, in general things are showing gradual improvement. There’s still some mild swelling in the area below the incision. All in all, I’m feeling “okay” about my progress, though I know it will be some time yet before I’m back to anything approaching normal.

Like you, I’ve read accounts of those who are mostly pain-free at the three week mark. At the same time though I’ve also read many, many stories from people whose recovery was much slower than this. From what I read and understand, it’s not at all unusual at the three week mark, and well beyond this, for there to be various pains and discomfort. I know the prospect of this may seem discouraging, but for me, it has also been somewhat reassuring to know that this isn’t unusual, and that recovery can extend well beyond the three, four or six week mark (and some say months for full recovery). Everyone recovers differently and at different rates. Healing – especially from this kind of surgery – takes time.

I can’t comment with any real knowledge about your question about nerve entrapment and at what point there may be indications of that Also I would never want to suggest that you or anyone disregard pain or other symptoms – particularly if they persist, get worse or if you are not experiencing progress. Obviously you’ll want to keep in contact with your doctor, regarding any symptoms, changes or concerns. The main thing I would reiterate, is that there isn’t a set timetable for recovery, and that it’s not unusual (unfortunately) for it to take much longer than what we are sometimes led to believe. I know it can be discouraging, but hang in there.

Again, just a few thoughts for what they’re worth. All the best to you!

[norton]

Not sure what to do – surgery or not

Thanks for your response and thoughts, MikeL. Appreciated!

I would definitely like to have my hernia repaired. Though it’s only mildly symptomatic at the moment, it’s a worry and almost always on my mind. As I mentioned I have a date for surgery in about a month. However I’m really undecided and nervous about hernia surgery given what I understand is the rate (up to 30%, if some of the accounts are accurate) of chronic pain after surgery. I think I could accept say, a 5 or 10 percent occurrence or chronic pain, but 30 percent?

I’ve enjoyed running, but am quite prepared to say goodbye to it if necessary, or if it would be too risky. It’s not a priority. Overall quality of life is, I think, more important.

Perhaps, as you say, those who’ve had pain issues are greatly overrepresented on forums. Still, the stories and some of the statistics I read … I don’t know if I’m overblowing this fear, but quite frankly, it’s the real issue I’m wrestling with as I consider whether or not to proceed with the surgery.

Concerning the type of surgery if I were to proceed, my preference if it’s possible, would be for a non-mesh approach. It was my understanding that a non-mesh (pure tissue) approach generally led to fewer post surgery complications. But I admit to being unclear about this. It just seems to me that regardless of the approach, there is real potential in any inguinal hernia surgery for nerve damage or entrapment.

I do understand that a pure tissue approach means more pain initially, as well as longer recovery (and slightly higher recurrence rate). I’d be prepared to accept that. But what I’m really not clear about is whether there is any evidence (statistically or anecdotally ) or support for a non-mesh approach generally resulting in less chronic pain.

I’m guessing I’m not alone in wrestling with this question of whether to have the surgery or to wait. I think I will schedule another consultation with the surgeon to ask some more questions, and hopefully that will help.

Thank you again for the reply, and if anyone has any other thoughts or perspectives on this, these would certainly be appreciated!

Norton

[norton]

Hernia surgeons in London,Ont, Canada area?

Thank you Dr. Towflgh! I really appreciate this and will follow up with one or both of these doctors.

Just a couple of follow-up questions, if I may:

My question I am still wrestling with (and I know there are no simple or easy answers to this) concerns a mesh vs non-mesh repair. My biggest fear with a repair is chronic pain and my ability to handle it.

I “think” that a non-mesh approach would be an option in my case, but I’d certainly be listening carefully to my surgeon’s advice on this.

I do understand that chronic pain can occur with either approach but am wondering if there are any statistics or there’s any overall evidence that chronic pain is less likely with a non-mesh approach even though the recurrence rate might be slightly higher.

And another quick question: In the process of hernia repair surgery, is it sometimes necessary to cut a nerve if it is somehow in the way, and what effect would this have?

Again, I am extremely appreciative of your response and perspective!

Norton

[norton]

Inguinal hernia – pls help with advice

Dr. Towfigh
Thank you so much for your reply. Much appreciated!

Would you say that the recurrence rate for non-mesh repairs (my hernial is small and I do not have a weight problem) is significantly higher or slightly higher?

Also, any thoughts on whether core abdominal exercises can keep symptoms of an exiting inguinal hernia in check?

Thank you again.
Norton