Abdominal incisional hernia repair, with mesh

8[As I was doing some overdue housecleaning on my blog this morning, I came across this post that never got posted.  You’ll notice that it’s a little outdated, but what the hey…

So without further ado, here is “Abdominal incisional hernia repair, with mesh.”]

On May 15th, I had surgery to repair a large incisional hernia that turned out to be six hernias all in a row down the original incision from breastbone to belly button. I can imagine them all lined up in there like enormous peas in a pod.

The following is a message to my long-distance friend in South Carolina, to keep her up to date on what’s happening after that recent surgery:

Good morning, my dear!

How are you on this late-May Wednesday morning?  The hump of the week, it used to be called in my working days.  I hope it’s sunny and beautiful in your corner of the world.  Ours is drizzly and likely to remain so throughout the next week or so.

However, the grass and trees are the most splendiferous shades of green and healthy as can be from all the water – those glorious, rich greens that only happen in the springtime, looking all fresh and pure and new, so I’m looking on the bright side.

All’s basically well here on the home front, but we have had a bit of excitement in the past 48 hours.  I thought you’d like a change of pace today, and I have a bit of a tale to tell.

Monday morning, as I was napping, my dearly beloved took a call from the surgeon’s office to say that yesterday’s scheduled appointment for staple removal had to be cancelled, and I should have them removed by my family doctor.  When I woke up, he relayed the message.

Unfortunately, however, our family doc is away this week and the office is closed.  The surgeon’s office is also now closed.  And so began what turned out to be a rather lengthy process of finding someone else to do the job.

[A quick aside:  Here in God’s Country, we have something called Community Care Access Centres (CCAC’s). One of their functions is to arrange for follow-up care for post-surgery hospital patients once they’re released.]

The CCAC nurse at the local clinic where I’ve been going for incision care (home care nurses don’t come to the home anymore if you’re mobile) was willing, but needed a doctor’s signed permission form first.

A great flurry of phone calls ensued as I tried to get it all sorted out; and by the end of Monday afternoon, I had finally gotten an appointment at the clinic for the next morning and the assurance that the required form would arrive before my appointment.

[I spent more time on the blasted phone that morning than I had in the entire six months prior to it!  Have I ever mentioned that I’m not a phone person?]

That wasn’t the end of events, though.  That would be too uneventful, right?

cantaloupeYou see, since leaving the hospital, my lower belly had been growing ever larger, until by yesterday it looked as though I was gestating a cantaloupe – and my poor old belly button had become a bloated “outie” resembling nothing so much as a huge button mushroom. It looked as though it was about to explode, poor thing.

By this time I was getting quite anxious to have my belly looked at, because not only was it swollen, but it was becoming quite painful.

Well, yesterday at the clinic, I found out why.

After the nurse removed my staples and began to clean the area, a small opening appeared in the incision at a weak spot that hadn’t yet completely healed over.  And, to our mutual amazement (and my horrified fascination), blood began spilling out of that opening – quite a bit of blood, actually.  In fact, she estimated about a cup [!] of old, very dark blood that has apparently been trapped in there for some two weeks.

[Side Note:  Admittedly, all this information might not be exactly your cup of tea.  I happen to find this sort of thing interesting (albeit slightly more so when I’m not the case in point), but I realize not everyone shares my penchant for medical “stuff.”  Feel free to move on anytime.]

Having now given it some thought, I believe I know what happened. (Ahh, hindsight:  ain’t it a wonderful thing?)  During the operation, the surgeon inserted a drain into my belly, extending out into a small, expandable plastic container.  This is common practice.  The idea is that blood and excess fluids drain out the tube and into the container, which expands to hold whatever goes into it.  The nurses empty the container and keep track of the amount of blood being drained.

This tube and container normally go home with the patient, who empties it and measures the contents daily.  Once the rate of drainage goes down to a certain minimum, then the tube can come out.

[All well and good.  Been there, done that, actually; this was an incisional hernia, after all.]

My first night in the hospital after the operation, the tube had been draining well and the nurse emptied the container and got her measurement.  However, in the evening of the following day, I got up from bed to discover that there was blood all over the lower part of my pyjama top and down one leg.

Investigation showed that blood in the drainage tube had apparently clotted and blocked the tube so that nothing was actually moving into the container.  As a result, it had backed up and was seeping out through the incision itself.

Yerk!  I have a pretty strong stomach, but the thought of it all does sometimes make me a bit trembly about the knees.

The nurse cleaned me up, messed around with the tube to dislodge the clot, and got it working to her satisfaction – but that was the last time it was checked.  I left for home the following morning, and no one thought to check the drainage.

When I went to my first incision care appointment, that day’s nurse removed the drain.  After all, the expandable container hadn’t budged; there was clearly no new blood coming out. Since I had no idea how much blood was supposed to be coming out, I was fine with it all.

However, he did notice that blood was draining from the hole where the tube had been, which isn’t normal, so he spent some time palpating my belly, trying to move any remaining blood toward the hole so it could get out.  When he had gotten as much blood as he could out through the “drainhole,” he bandaged me up and I was on my way, sans drain.

All well and good.

However, as the days went by, I noticed some swelling in my belly just above my belly button.  And I was beginning to have increasing pain in my belly around the incision as well.  I had assumed the swelling was muscle tissue reacting to the foreign plastic mesh that was inserted during the operation.  The pain, I thought, must be nerve pain from the staples.  But it was hurting a lot, and I was getting very anxious to get those staples out.

Then yesterday morning, of course, we discovered what the mystery bulge actually was….

So now I’m back home with lots of padding on the tummy and plenty of supplies in the event that drainage continues.  I have steri-strips across the top and bottom of the open spot on the incision to prevent it from opening further, as well as instructions to go to Emerg if the opening does get any bigger, because then it’ll have to be packed.

And of course, the concern is for infection.

As you are fond of saying, my friend, Holey Socks!

However, that’s not all.  To add to the excitement at our house, my dearly beloved got hit by a car yesterday morning as he was walking across the grocery store parking lot.  In fact, he was bumped hard enough to leave a dent in the other guy’s car, but although he spun like a top, he didn’t fall to the ground (the man has reflexes like a cat, even at his age) – best of all, he wasn’t hurt, thank God!  He said an immediate crowd gathered around, checking to be sure he was all right.

And he wasn’t even annoyed!  He said he was so euphoric to discover that he wasn’t hurt that he simply told the horrified and apologetic driver, “Just don’t do it ten years from now, because then I might break.”  Which I thought was exceedingly generous of him.  This morning I checked, and he’s feeling no pain from the incident.

So all’s well that ends well.  Physically, that man of mine is as tough as old leather – and I think he’s actually got about as many lives as reflexes!

ostrichGetting old certainly isn’t for the faint of heart.

(And to think I was worried about boredom, sitting around doing nothing after my operation …..)

I’ve actually had about enough excitement for one week and am considering going the way of the ostrich and hiding in bed with my head firmly under the pillow for the rest of this one!

Love and hugs,
Your “bloody” northern neighbour