Not quite wonder woman

Surgery post #5 and life goes on

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.

11 months later,

Me this week.

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.

Above bellybutton (yes I still have a bellybutton) scar. I’m suddenly shy about my ‘problem area’ below the bellybutton.

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 still have what the doctors like to call an apron. My plastic surgeon said if it doesn’t go away with weight loss he would take it off. (I’m not sure I ever want another surgery!)

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!

Extras:

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!

Abdominal Wall Reconstruction Treatment and Management

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10 thoughts on “Surgery post #5 and life goes on

  1. Holly

    I happend on your blog by accident. I cant tell you what a wonderful accident it is. My story is very similar to yours prior to your repair. I am in tears. There really is someone out there that has gone through it too. I am still on the fence trying to decide if i should have the surgeries or not. Thank you thank you for sharing your story.

  2. Michelle Schumacher

    Holly. My name is Michelle Schumacher. I thought I was the only female with a giant ventral hernia caused 1. By my poor bossy being overweight for 20+ years. 2. Poor surgical care (1st dr nicked my small bowel and STILL put in biggest mesh possible and sent me home without any antibiotics. ) two surgeries later I am 8 months prego silhouette. I am guilty of being overweight yes. If you wish to email each other to share. mmshoe@me.com

    1. April Post author

      My hernia definitely caused by the sub-par surgical care with the colostomy reversal. Small town hospital, ancient doctor, and no insurance.
      I was asked several times when I was due (don’t people have any manners?) a few times during the period that I was wrapping up life details so I could focus on what I knew would be a big ordeal. The doctors looked surprised at the ct scan but I was not at all surprised.
      The best thing I did was research the doctors and the hospital. I made sure the hospital had an underinsured patient program and Emory is a research hospital. One of my doctors teaches component separation and the other wrote a published study on hernias.
      Have you had your hernia fixed yet? Hope all is going well!

      1. Michelle Schumacher

        Multiple step pre-op process one of which wasnt told to me (like a secret test) -communicating with the office and the ability to follow directions. Lose weight to 30% BMI. Cognitive therapy with notes released to surgeon. Nutritional counseling. The nutritional counseling andnlosong weight working hand in hand. August 2018 is D Day. Everything planned around it. My dr is also a highly regarded specialist on hernia repair with a very one on one approach both pre and post op.
        Hard to wait. Trying to do mindfulness every day. Can I ask what kind of binder you wore before and after.
        .

        1. April Post author

          No binder beforehand, I had the one they sent home with me from the hospital but I wore a spanks type girdle that came up to my bra strap over the hospital binder. I still wear that combo if I’m doing something strenuous like the yard work yesterday.
          The 12 weeks before hand were focused on surgery, being in the best health going in, and having clean body (medications and processed food).
          You sound like you’re on a good path.
          It took a good 9 months to feel pretty normal so it’s a whole year of surgery stuff. So plan on a long ‘recovery’ even though you go back to normal activities. I’m still having weird sensations in my abdomen that is probably nerves and feelings returning.
          And I’m pretty sure this is the binder. If you put a girdle kinda like this one over it, it smooths the binder out and looks better under clothes. Hope that helps. 🙂

          1. April Post author

            I don’t know why the links aren’t showing up so scroll over words to turn them blue to link. Sorry!

  3. Anne Caruso

    Thank you for your candor. I had a hernia repair that failed about a year and a half ago, and last month had surgery to repair it with both mesh and abdominal wall reconstruction. The original hernia was for a ventral incisional hernia that was from an open surgery to repair an internal hernia caused by my small intestines being trapped in the Peterson’s defect post my RNY Gastric Bypass procedure from 2012. Basically my hernia resulted in a hernia.
    Finding information out there that is useful for my complicated surgical history is a challenge to say the least. My recurrent hernia repair involved removing existing mesh and moving the defect back inside my abdominal cavity while closing a four inch hernia cavity with realignment of my upper abdominal muscles, so like you I had to cross reference tummy tuck, abdominal wall reconstruction, and hernia repair sites to get a better feel for what to expect on recovery and outcomes. I was very lucky to find a surgeon that had experience with both bariatric surgery and also specialized in recurrent hernia repairs using robotics surgery, so I was able to have my repair done with the DaVinci with a minimally invasive technique. Took about 3 hours and was by far the most painful recovery I have had, however my recovery seems on track. I am 4 weeks post op, and while sore, I am slowly getting full range of motion and less pain on a daily basis. I’m scared to death of pushing myself too hard. I’ve had 14 surgeries since my initial gastric bypass surgery for complications from the gastric bypass, so I am desperately praying that this one is the last. I was very successful with my weight loss, lost and kept off 150lbs since 2012, now I just want to get back to working out so I can continue to maintain my weight at a healthy level. I’m walking and moving to swimming I hope soon. Any advice anyone has on getting back to exercise I’ll take!!! Thank you so much.

    1. April Post author

      Wow, you have been through a lot! Here’s my disclaimer “Do not start an exercise routine without consulting your doctor”. With that being said, good ol’ walking is always a good place to start.
      It’s been a year and a month since my surgery and I still have a fear of pushing myself too much. I did strenuous yard work yesterday and survived. I’m always expecting my whole tummy to split open. I’ve been told my new muscles and mesh are way stronger than I think.
      I have been working on building back some core strength and using low impact videos from this Pinterest board.
      They were supposed to do laparoscopic surgery but decided otherwise when they saw what kind of scar tissue and stuff they were dealing with. Either that or they have to say laparoscopic surgery to get insurance to sign off on it and then do what they knew they were going to do.
      I’ve had 3 surgeries that I’ve been cut from breast bone to pubic bone and hope I never have another one! I hope the same for you too!!!

  4. Jaime N

    I am in the position you were. I have 2 hernias. 1 above my belly button (4″) and 1 below my belly button (6.25″) and i look huge with this big hard part at the bottom. I have seen 3 different surgeons and none of them will do my surgery because i am too fat. Did you lose weight before your surgery? If so, how? I also have Crohn’s Disease (these hernias are the result of a bowel resection), lactose intolerance, diverticulitis, bile malabsorption, and diabetes, so my diet is already quite restrictive. I have pain when i walk, stand too long, cough, sneeze, sweep, or carry anything over 10lbs. I am a former Marine, so i am pretty well versed in exercise, but im stumped. If you have any experience with this, it would be great to hear it.

    1. April Post author

      I did lose about 25 pounds before surgery. I’ve gained and lost several times since- typical yo-yo dieter. But I’m really not dieting I just go through periods of being very hungry versus days of “Oh I haven’t eaten lunch and it’s 4:30 pm”. So I don’t know what my problem is.
      Before my surgery, I went off all medications that I could (Ambien, Prozac, and omeprazole). I did the Whole 30 diet for about 40 days before and took extra supplements including this one. I don’t know if the supplements helped but I don’t think they hurt.
      My plastic surgeon told me under normal circumstances he would insist I lose weight first but since the hernia was interfering with my life and the gastrointestinal surgeon wanted to go forward that he would do it.
      So I don’t think I am being much help. I went into surgery with a BMI of 30 and I still teater between 29-31. A year has passed and there haven’t been any issues with the reconstruction coming apart or anything. You do have many more health problems than I do so that might factor into the decision.
      Let me know what happens, hope you get what you need.

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