9.08.2012

The Very Detailed Story of Why I Had Surgery Yesterday

Towards the end of my pregnancy with Adam, I complained about a very tender area in my abdomen. Dr. Heiner identified it as a hernia, but told me it was small and probably wouldn't cause any problems after my pregnancy. When I had my hysterectomy, he fixed my umbilical hernia and a number of other problems, but didn't bother to do anything about the other hernia.

Over the last five years, I have been semi-careful with what I completely assumed was a hernia. It was often painful when I lifted heavy things (like kids), was sore after strenuous activity, and caused excruciating pain when poked. Since my major surgery last year, I have also had a number of episodes, with symptoms consistent to intestinal blockages.

A month or two ago, I was extremely frustrated and sat down at my computer, determined to figure out what was wrong. Within five minutes, I had stumbled upon something I was unfamiliar with called a spigelian hernia. The symptoms linked my two problems and seemed to be the answer to what was wrong.

One Sunday evening, Steve took me to InstaCare. I told the doctor I thought I had a spigelian hernia and he grumbled, "That d@#% internet has made my job so much harder." He told me I had the stomach flu.
"But it's not the stomach flu," I said.
"I know you don't think it is, but I've seen a lot of these cases lately," he said with his Southern drawl. "I don't want to torture you by pushing on your stomach, and I don't have the technology here to look at anything. You should either go to the ER for a scan to put this issue to rest or go home and wait for it to pass."

We went to the ER. The doctor pushed on the area, and when my eyes instantaneously filled with tears, he ordered a CT scan. But the doctor couldn't see a hernia. He initially told me he thought it was a neuroma caused by last year's surgery, but then changed the discharge report to abdominal pain after I told him the pain had been there for years. He sent me home with some pain pills and suggested following up with a GI doctor.

I didn't want to go back to the gastroenterologist I went to last year because he told me that the next thing to consider would be to shorten my abnormally long and tangled intestines. So I made an appointment with Dr. Moesinger, the internal surgeon who initially diagnosed me with MALS.

Dr. Moesinger said that spigelian hernias are extremely rare. (They account for only 0.1 percent of all abdominal wall hernias.) And 90 percent of spigelian hernias are found below the navel; my tender area was just above my belly button. He thought it was more likely to be a neuroma (which can actually manifest without any relation to previous surgery).

Dr. Moesinger told us that small hernias aren't always visible in CT scans, especially in thin people, and spigelian hernias can be very difficult to diagnose. The only definitive way to know if there was a hernia would be to  perform a laparoscopic procedure and take a look inside. He said that even though he thought he was unlikely to find a hernia, it was the next step.

He first needed to confirm that the pain was originating from the abdominal wall, and not deeper in my bowels. I was given a cortisone injection right at the site of my pain. If it successfully blocked the pain, then we could deduce that it was a hernia or a neuroma. He also told me that in some cases, one cortisone shot was all that was needed to make the pain, if it was being caused by a neuroma, go away forever.

Within an hour or so after the injection, the pain was gone. I pushed and pushed on it over and over again to make sure I was certain. But by 8:30 pm at night, the pain was back. The next day, you could actually see a bulge in the area, so Steve and I were both certain it was a hernia. I was extremely sore from all of that pushing and prodding the day before and called his office to schedule surgery.

But yesterday's surgery proved that Dr. Moesinger is a pretty smart guy. (Our pediatrician in Logan told us that Dr. Moesinger is the very smartest doctor he knows, and by now I should know that for myself.) There was no hernia; it was a neuroma. Dr. Moesinger also discovered adhesions that had tangled my stomach and pulled it up out of place, connecting it to the abdominal wall. He separated the adhesions and got my stomach back down into the proper position. Hopefully, that will relieve my of some of my stomach problems.

The irony of all of this is that in December 2010, I was referred to Dr. Moesinger for treatment of adhesions. But at that point, I had no adhesions. That's when Dr. Moesinger diagnosed me with MALS. . . which led to surgery. . . which caused adhesions. . . which Dr. Moesinger eventually got to treat after all. (If you ever want to make yourself throw up, watch a YouTube video showing the separation of adhesions. . . or maybe I am just still a little queasy from surgery.)

Because there was no hernia to repair, my recovery should be a little easier. But, unfortunately, it is not nearly as conclusive; both the neuroma and the adhesions treatments are just wait-and-see how your symptoms improve type of deals. Steve assures me it's another piece of the puzzle. A puzzle that I'm, quite frankly, ready to be finished with.

In the meantime, I have two new holes in my stomach.

And I had a number of thoughts regarding my surgery:

My hospitalization and surgery history is getting absolutely ridiculous. I had to go over it orally with the nurse, and it took almost ten minutes.

Yesterday was the very first time a nurse used numbing medicine before starting my IV. Ummmm. . . why don't they do that every time?

If they can put air into your stomach for laparoscopic procedure, why can't they suck all of it back out when they are finished?

I woke up in recovery covered with a Bair Hugger. (The nurse told me I came out of surgery shaking and shivering. . . which is no surprise because I was was covered with no less than ten hospital blankets during the two-hour wait before I went into the operating room.) Where have those warming blankets been my whole life?

I used to look at each of my surgeries as my last surgery ever. But now I am starting to accept them as part of my life.

Maybe I am condemned with health problems to keep me living close to helpful family members, so I am not tempted to move to a faraway land?

Or maybe it's to give my husband a chance to be nice to me since I was really bothered with him before my surgery, but how can I stay mad a someone who is taking such good care of me?

Or maybe it's just to give me a chance to catch up on my blog?

And why did I ever cancel my supplemental insurance policies?!? I'm quite sure we could have paid off our house with the payouts by now.

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