Ventral Hernia I am beside myself

You could go see a general surgeon for a second opinion. Find one who does laparoscopic surgery. It's easier to recover from. I've had it both ways and much prefer lap surg.

Do you have any reason you can't have surgery? OK, well maybe the endocrine issues. Ask both doctors if that's really a factor, and also how long to put off the surgery.

Red:
Tread cautiously in making a decision to have surgical repair of your newly discovered central hernia.

I have had several abdominal surgeries related to a perforated intestine. I have come to learn quite a bit about hernias - although I am fortunate not to have developed one.

A ventral hernia does not necessitate surgical repair in and of itself. Only if the intestine is at risk of incarceration (basically, a loop of intestine becomes trapped by the abdominal wall deficit that is the hernia) is surgery mandated. Many people have uncomplicated central hernias that are managed conservatively. Conservative management includes: wearing a Lycra or spandex “belly binder” that exerts an inward pressure gradient on the abdomen to reduce the hernia; weight management, specifically focused on easing excess weight carried around the abdominal midsection. Excess weight causes an outward pressure gradient that encourages a hernia; core strengthening of the central abdominal musculature and obliques, and back extensors. Weight reduction of excessive abdominal fat is essential.

Be aware that hernia surgery has a high rate of failure. That is, the hernia reappears. Failure rates are cited in the clinical literature at rates of 70%.

In addition, both artificial and biological mesh is prone to bacterial infection. The porous matrix is a welcoming environment for bacteria to settle. Infected mesh must be removed surgically. Additional abdominal reconstruction is no longer an option due to the risk of reinfection of additional mesh.

Chronic pain is an additional consideration. Hernia repair involves the placement of surgical tacs (similar to thumb tacks used on a cork board) to adhere the mesh to the abdominal fascia. Sensory nerve endings can and do become embedded by the tacs and can be a source of ongoing pain that is often dismissed by physicians.

Bottom Line: Do not rush into surgery for a central hernia. It is not a benign surgery. A person can be left in worse shape with surgery (hernia recurrence; mesh failure; bacterial infection; chronic pain). Hernia repair failure rates are high. A conservative approach to reducing the hernia is often the best approach.

Take your time and make sure that you research your options.
Karen

Red:
If you are having a cortisol study then you are likely being tested for possible adrenal insufficiency. I have Addison’s disease (primary adrenal insufficiency). Adrenal insufficiency is a relatively rare condition that is complex in arriving at an accurate diagnosis. It can stump even experienced endocrinologists.

I would encourage you to ask your endocrinologist for a copy of your test results (baseline cortisol and ACTH stimulation stidy, if ordered). Accurate diagnosis of adrenal insufficiency depends on accurate interpretation of test results. It is not uncommon for someone with adrenal insufficiency to languish for 5-7 years before an accurate diagnosis is made. Feel free to query me if you have questions/concerns with the testing process and results. As a result of my own experience where medical care failed me, I am active with the NADF (National Adrenal Disease Foundation) in helping individuals access endocrinologists with pituitary speciality.

A ventral hernia is one of the more common hernias. It occurs along the body’s central, front midline - called the Linea Aspera. The Linea Aspera is the fine line that you can often see or feel that runs lengthwise down the body’s thorax, abdomen, and pelvis. It represents the band of connective tissue that brings together the two halves (left and right sides) of the abdominal wall.

As an example of a central hernia . . .

During pregnancy, as the womb increases in girth, a majority of women experience central/ventral hernias. The growing forth of the abdomen during pregnancy causes the Libra Aspera to separate. The hernia tends to resolve/reduce post-pardum.

Individuals who have added abdominal fat that lies around the midsection are (like pregnancy) prone to central hernias that cause the Linea Aspera to separate.

Wearing an undergarment/underware that has a front panel designed to provide a “control top” full-brief is a good first option to reduce the hernia. Often, these underpants are made of Lycra or spandex or have a special front panel of compressive material. The key is to provide an inward pressure gradient to reduce the hernia.

Other options are use of a stretchy limbo-sacral wrap or belly-band.

I have an ileostomy and wear camisole tops and underware made specifically to prevent hernia formation. The company also makes hernia support garments. I highly recommend the brand, called ComFizz, which is based in England/United Kingdom. Feel free to browse the ComFizz website. I am a loyal customer.

www.comfizz.com

Sending you kinship and understanding,
Karen