Adventures in Incisional Hernia Repair

Based on my infrequent Facebook status updates, I’ve gotten lots of mail about why I was in the hospital recently, why I’m on Percocet now, etc. So, rather than retype or copy/paste every time, I thought I’d just post the tale here.

In 2003, I had open RNY gastric bypass surgery. “Open” as opposed to laparoscopic, which means the surgeon made a 10-12 cm slice down the middle of my abdomen. (Answers to the standard questions: Yes, it was totally worth it; I lost about 130 pounds, although have gained back about 15; no, I wouldn’t really recommend my surgeon; no, you can’t see my scar; yes, I would totally do it again, but laparoscopically, not open… see below.)

Because I’m a moron, I didn’t follow the recovery instructions closely enough — didn’t take enough time off work, didn’t take enough care not to lift heavy stuff, etc.

So, between 2003 and 2008, I developed a nice CD-sized incisional/ventral hernia in the middle of my gut — a roughly circular zone, just below my ribcage where there was nothing except abdominal wall between my skin and my organs, most notably my liver (rather than the ripped six-pack of muscles I’d had before… ha ha ha ha ha). This was occasionally uncomfortable, always weird-looking and potentially dangerous — say, in the event of a car-crash. However, it did give rise to any number of impromptu performances of an adaptation of the Black Eyed Peas song, entitled “My Hump,” so it’s not like it didn’t have its upside.

Repairing the hernia was possible, but would require a long recovery with at least 3-4 weeks off of work and no lifting anything heavier than 5-10 pounds for about six weeks, and nothing heavier than about 25 pounds for, well, ever. (So don’t bother asking me to help you move.)

When my company announced it would close for a few weeks at the end of the year, Rachel and I decided the time was right to find a surgeon and finally get the humpectomy, over the holiday. Turned out that a guy we knew through Carolina Day School, Dr. W. Alan Bradshaw, was a national proctor for just this kind of surgery — the kind of doc who attracts students from around the country to come and learn at his scalpel. The schedules worked out perfectly, and on Tuesday, 12/23/08, I went in for the surgery.

The procedure is laparoscopic, which means there’s no big incision. As I understand it, the procedure was, roughly:

• Drill a hole in the abdomen
• Pump in a bunch of air to create space to work
• Drill another hole; insert a camera
• Drill another hole; insert a little robot-arm with various and sundry tool attachments
• Use a hot knife (or maybe it’s a laser) to remove any “adhesions,” or scar tissue that prevents a clean separation between the skin/fat layer, the muscles and the abdominal wall
• Pass a rolled-up sheet of polyester mesh, significantly bigger than the hernia, through the tool-hole
• Unroll it and fasten it in place with sutures to the abdominal muscles, and titanium tacks to the abdominal wall
• Take everything out
• Deflate the patient

They wound up using the largest possible sheet of mesh — 37 cm across, which doesn’t sound that big, until you do the math: that’s more than 1,000 sqaure cm of leisure suit in my gut, man! Sutured to muscle in eight spots, and with more than 60 thumbtacks fastening it to my abdominal wall.

Hence the Percocet, which I’m basically off now, dammit.

I was in the hospital two nights (one longer than expected), came home mid-day on Christmas, and will be recovering here until I return to work on Jan. 12, and the office two weeks after that.

In time, the mesh and the muscles and the wall should sort of meld together, creating a safer and more comfortable — not to mention sleeker and more aerodynamic — abdomen, and opening up all kinds of new career possibilities: model. Belly dancer. It dizzies the mind.

Can I just say that Rachel and Katie have been amazing throughout this process? Imagine being eight years old, and not only having your daddy in the hospital in a lot of pain, but also voluntarily restraining yourself from opening most of your gifts until he comes home at noon on Christmas day.

Noon? Heck, by noon on Christmas day when I was a kid, I’d already played through and forgotten about most of my gifts.

So, that’s my story. Feel free to ask your questions below.

(If you hunger for more detail, you can find tons of disgusting videos on YouTube. This one’s relatively short, and not all that disgusting, and narrated by a Brit, so it all just feels very genteel.)