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Doctors think I might have a hernia at my ostomy site and that my small intestine is poking into it. I have a ultra-sound scheduled. . .I don't know if I can deal with another surgery so soon.

How serious is a hernia at an ostomy site? He seemed concerned that my intestine might get in their and twisted. I don't know if he's really concerned or just legally covering his butt.

Thoughts?
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I will. Thanks! The only problem I have now is that after being unemployed, I have exclusions for pre-existing conditions.

I'm guessing that I will have to fork over $$$ to take care of this b/c insurance will not.

Man, nothing like becoming and indentured servant to be able to afford access to needed healthcare.

*sigh*
I think preexisting is anything that has been diagnosed or present before your coverage began. I would think that you could delay surgery until after the waiting period is over for the preexisting conditions. Usually it is something like 3-6 months.

If it is not causing you a lot of pain, discuss letting it go a while. Usually, these hernias are OK to watch for a while (or even indefinitely) as long as they are reducable. That means that if the intestine enters the hernia, you can easily push it back inside. In the meantime, avoid lifting anything over 10 pounds or any activity that involves straining.

Jan Smiler
Dog,
DO NOT DO CRUNCHES! Period.
A hernia is a tear or weakness in the wall and just like a pair of pantyhose with a tiny run in it...if you pull on it...or put excess pressure than it will get worse, not better.
In the 'good ol'days' people wore hernai belts or Trusses...a sort of support belt that they reinforced with a soft cotton pad that they placed over the hernia site...To hold things in. You can try wearing one of those exercise belts with a velcro attache so that you can loosen or tighten at will...you need support not crunches.
When I had my k pouch revision in '07 I was do great until I got on the stair master and apt bike...I saw a protrusion and didn't understand that it was a hernia (in my defense, no one else figured it out either)...I just kept working out harder and harder...bottom line? My stoma totally prolapsed on me (I ripped my hernia right open). If I had known that it was a hernia then I would have cut out the exercise gone strait to my surgeon.
Sharon
Back home(yeah) from my surgery. This is so much different from my previous 3 surgeries. Compared to the J-pouch construction, my hernia surgery was like having a splinter removed.

Only problem I am having is bowel movements. . .the incisional hernia was at my old ostomy site. When I try and push (even a little) to have a bowel movement, my intestine wants to push on the surgical site. . .which is painful, but makes me fear I might push my intestine passed what the surgeon just fixed!

Hospital told me to eat lots of fiber. . .namely oranges. Does that makes sense to bulk up my stool?
For what it's worth, when I had my incisional hernia repair about 6 months post take-down, I asked my surgeon, "Is there anything I can do that will ruin or damage the work you just did to repair my hernia?" He said no. I was still careful for a while, and actually experienced more soreness long term from the hernia repair than from all my jpouch surgeries, but even though it's uncomfortable, a BM doesn't seem like it should do any harm to your hernia repair.
You should be fine, but no heavy lifting and no straining. But, I think you already know that. Pretty soon you'll forget about it and things will seem more normal.

Not sure if you need to eat a lot of roughage like oranges, since those instructions are for people with a colon and they don't want you to get constipated after a hernia repair. Oranges are not dietary fiber, but insoluble fiber- roughage. Just be sure that things are moving through and you don't have to strain. Especially important if you are still taking narcotic pain pills.

Jan Smiler
Jan,

Thus post interested me to read into it. I remember ny surgeon telling me he put a mesh over the stoma site where hernias tend to develop after takedown.

I have been having sharp pains lately in the stoma surgical site and it hurts when I get up from laying down in that area too... This is new, it hasn't hurt like this since right after my surgery
I had that feeling more with an adhesion. Or at least, they said it was an adhesion. . .it went away on it's own though, which makes me question their diagnosis.

My hernia - my small intestine would push up into my old stoma site. I could push it back in, but it caused me no pain.

I had the surgery b/c the Docs said one day, I might not be able to push it back in and then I would be in serious trouble.

Still on the narcotics, although the pain isn't anything like my previous 3 surgeries. They gave me 5 days worth and I'm going to use them all. . .no sense being in pain, as long as I take it easy I'll be good, I think. Wink

Did a bit too much moving around today.
So you think it might be an adhesion I'm feeling? Nothing to do about it but let it go away on its own? I don't have insurance right now so I haven't discussed it with a Dr.

I think to prevent a hernia, my surgeon put a mesh over the stoma area. I do recall him saying before I went into surgery that most ileostomy patients will have some sort of a hernia, naturally.

Heidi
My surgeon repaired the hernia WITHOUT mesh. Everything I've read says that mesh is always recommended when repairing a hernia. Anyone know why and when not using mesh is called for?

I also read that no matter what is used, the recurrence rate of incisional hernia is from 20-50%. WHAT?!?

In other news. . .
I was not expecting my digestive system to get messed up with this surgery.

My output reminds me of when I first got my j-pouch. Thick and burns. . .guess my system really doesn't like anesthesia.

Ohhhh the butt burn!!! Wink
No, mesh is not always recommended, and in fact, if the repair can be done without it, THAT is preferred. The reason? Mesh is a foreign body and stimulates more adhesions than regular repairs. That is part of what makes it a stronger repair, because of the additional scar tissue that incorporates into it. This additional scar tissue can make future surgeries more difficult.

What determines whether or not mesh will needed is determined by the status of your abdominal wall structure around the hernia. If the tissues are in good shape without any tension to bring the edges together, you should be able to have a decent repair without mesh. But, if the fascia edges are raggedy, thin, or otherwise weak, then mesh is necessary to have something to hold everything together. Sort of like the difference between a split in your pants (easy to repair) as opposed to a gaping, shredded hole (like you see with jeans with blown out knees- that require a big patch to fix).

Recurrence rates for all sorts of hernias can be "up there," so I would not worry about it in your case. But, in the meantime, take it easy with the lifting or anything else that would put strain on your belly.

Jan Smiler
Saw my surgeon today. He said he placed sutures in my fascia, and the spot he had to repair was 1/2 to 3/4 of an inch long.

I don't understand how sutures don't pull through the fascia, leaving a new hernia, but I guess they don't.

He also explained that my small intestine was to close to the repair. Mesh would have had the potential of causing future problems (adhesions, etc), so that is the reason he opted not to use mesh.

Pretty happy with the procedure and the outcome so far. . .definitely a much simpler surgery than my previous 3! Still leaves me mentally exhausted though.

Anyway, just wanted to post this information in case someone else might find it useful in the future.
Yeah, that is a pretty small repair. How well the sutures hold largely depends on the condition of the fascia, if the edges can be brought together easily, and if it is in an area that will not be exposed to undue tension. My incisional hernia was midline, the size of a grapefruit, and actually a defect of where a suture had stretched out the fascia to that size. So, you see, a totally different situation. This is why each case should be evaluated individually.

Jan Smiler

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