I realize this is the first post in a while and like the title says life goes on. It’s been about eleven months since the big Ventral Hernia Repair with Abdominal Wall Reconstruction. So almost a year out.
I left the blog hanging with a post about fluid spewing from my drainage hole. I’ll just pick up where I left off. The fluid had pretty much stopped draining by the time I had my doctor appointment. But I was scanned once again and there was a pocket of fluid in the void left by the hernia.
When you have a large ventral hernia, the intestines are on the outside of your abdomen muscles right under your skin separating the skin from the muscle. When they put everything back where it belongs that skin is still unattached for a time period leaving a void. This seems to be the perfect place for fluid to hang around.
I was scheduled for a fluid removal on May 16th which they did with the guidance of ultrasound. It was a bit unpleasant but they removed about half a cup and sent it off to the lab. This was in May. Then some 3 to 4 weeks later I was like, “They never called me about the fluid results.” Which was strange because I have been on top of all my care and options and also strange because Emory has been very methodical.
It turns out the fluid had Staphylococcal present but I did not have any symptoms, no fever, nothing. This was already June. They scheduled an appointment for July 13 and everything looked fine and I felt fine. The first Monday in August I went back to work. Now I don’t know if the seatbelt over the hernia site had anything to do with what happened next but I started having a pain like the pain that happened before my colon rupture that caused the emergency surgery that I almost died and the colostomy and the second surgery reversing the colostomy cutting from breast bone to pubic bone which in turn caused the hernia.
At any rate, it was a pain I didn’t want to ever feel again. I went immediately to my GP who ordered a blood test and put me on two broad-spectrum antibiotics (a gram-positive and a gram-negative if that means anything to you). This was on a Wednesday, by Friday, August 11th I decided I wasn’t playing around with this and we went to my surgeon’s office at Emory.
My surgeon is only in office on Thursdays, and I know that already. When I get there the receptionist says that he’s not in and recommends I go to the emergency room. The ER wait time was about 6 hours. So, I went back to the desk and asked if I could at least speak to a nurse or NP. Within seconds a nurse appeared and I said, “I know Dr. Loskin isn’t in today but is there someone back there that could possibly see me?” You know that old saying ‘it never hurts to ask’? Well, I was seen by a fellow surgeon who ordered a scan.
This office has an amazing lady that can make appointments and extra test appear out of nowhere. She said if we could get to Emory Midtown in the next 45 minutes I could get in. We sped over there and made it in time. I didn’t know that the only opening for a scan was in the oncology radiation department. So I was sitting with people who I considered to be way sicker than I was. A little lady asked me what I was in for. I told her I was embarrassed to tell her but then I explained the situation after having just seen her husband with pancreatic cancer taken back in a wheelchair. She was so very sweet and told me that a staph infection or ruptured colon could kill you just as dead as cancer. Funny but not funny.
The scan showed “persistent inflammatory changes within the subcutaneous fat at the hernia repair site with increased non-drainable fluid associated with the mesh. Correlate for superficial and/or mesh infection.” I’ve looked up mesh infection and I assure you no one wants that to happen.
Let me back up to my lab results from my GP for just a minute. My C-Reactive Protein was 173.8 (normal is below 3.0) and my white blood cell count was 12.4 which is also high. Anyhow these lab numbers were with me when I barged in that Friday and saw the fellow surgeon.
My follow up visit after the scan was on August 22nd. Now as great as I think my surgeon is, I think he saw the words ‘associated with the mesh’ and resigned himself to a mesh infection. The fellowship doctor that ordered the scan recommended lab work to see if those numbers had come down since I took a two week round of antibiotics. Dr. Loskin said he ‘didn’t like to chase numbers’ and started talking about a hospital stay with intravenous antibiotics. So I asked if he recommended another round of the oral antibiotics. He said it couldn’t hurt and wrote a prescription.
This is where our opinions parted ways.
I did want numbers. Numbers are solid and logical and understandable. I did not want intravenous antibiotics if I didn’t have to. So the next week I went back to my GP and had lab work done so we could see the numbers. By August 29th, my C-Reactive Protein was 4.4 and all the other numbers were in normal range or very close. He gave me one more week of antibiotics (ugh, if anyone is counting that is 31 days of two broad-spectrum antibiotics for someone who hasn’t taken but a handful of antibiotics in my whole life).
So now all is well. I had my last visit with Dr. Loskin who was very happy my infection wasn’t all in that mesh. I will go back in 6 months from September 21st for the final follow up.
This is my advice: If anyone does a test on you, find out the results. If they don’t call you, you call them. If you disagree with an avenue of care, question what is going on or get another opinion.
In my case, it was easy because I always kept my GP up to date and he had all my results from Emory and vice versa. He ran the labs to start with so it was easy to go back, although I did tell him I disagreed with not taking labwork at the surgeon’s office so he would know I was going rogue.
So how do I feel almost a year removed?
- I am highly aware of anything happening abdominally.
- I still do a mirror check nearly every day where I start at the top, feel all the way down both sides of my stomach, and look for any changes or irregularities.
- I am just now starting some core strength exercises mainly because after all that has happened it freaks me out to feel any pulling, soreness, or discomfort.
- I still frequently Google ‘Ventral hernia repair with full abdominal reconstruction’.
- Laughing, coughing, and sneezing still scares me a little.
- I feel more or less normal, whatever that means.
- I think any big event in life causes a readjustment in what normal is, the new normal.
- When I go walking I feel the inner urge to jog/run. That’s good but I haven’t the courage to give in to the urge yet.
- Life and routine resumed after about 10 weeks except for that infection scare.
I still wear my binder parts of most days. (I now have three- the one I came home with, this one, and this one) The support makes me feel more secure and some people advise wearing it until your body has quit ‘remodeling’ which can last a year or more.
I need to lose 30 some odd pounds to be at a BMI that is recommended for someone who’s had abdominal wall reconstruction.
I hope this little journey has helped anyone with similar problems. Like I said before, there is very little online about this specific surgery. You can find a lot about full tummy tucks which does give some good advice but my surgery resulted from other surgeries and that means previous problems.
If you are reading this because you have had the same surgery please leave your story, experience, or advice in the comments because I have had a pretty big response to these post.
Now I hope to go back to posting about life and home matters!
Personal experience 3 years later
Personal experience 2 years later
Academic article about Acellular Dermal Matrix in Abdominal Wall Reconstruction-Keep scrolling on this site for photos!