Diagnosed with large inguinal hernia - Weight loss required before surgery (completed.) Need advice!

slmckenzie

Hello!

This is a bit of a personal issue and is quite difficult to open up about and ask, but I thought that this might be the best place to ask my question anyway, so here I am!

To make a long story short - I had an inguinal hernia (hernia through the abdominal wall) when I was a child. Fast forward a number of years, and I never had any issues. Recently, I've gained a (embarrassingly) large amount of weight. I don't know if it's related, but I noticed some dull pain in my abdominal region on the other side of where I had the surgery as a kid. Fast forward a bit, and I go to the Dr. and am diagnosed with an inguinal hernia, which requires surgery. I go into the surgeon for a consultation, and am told that I definitely need surgery, but they also need me to lose weight (10 lbs, to be exact).

For the record, at that time, I was 5'6, 259lbs. I agree, I most definitely was significantly overweight, and needed to lose weight. But, nothing I read online mentioned anything about losing weight before an inguinal hernia surgery. But, I took the Dr's advice, changed my diet, and started losing weight. It's been about a month and a half since that point, and I've lost 20 lbs so far! (Potentially more; I weigh myself on Mondays, so I'll find out tomorrow.) . So far, so good.

But, about 3 weeks ago, I became super sick with pneumonia-like symptoms, and had a horrible cough for a few weeks. Unfortunately, that severely exacerbated the hernia, and made it much, much worse. To the point where it's uncomfortable almost 24/7 now (but manageable). I'm at a point now where I could call in and get the surgery scheduled, and get it done.

Now, my dilemma...... In the last 6-8 weeks, I've lost 20 lbs. I'm doing well on the diet, trying to walk 2 miles a day, etc. Progress is wonderful. My question is, should I get the surgery now, and get it over with - or should I wait on the surgery, and deal with the struggles of the hernia, and continue working to drop more weight? Obviously, I understand that having surgery with less fat will ultimately result in a smoother, faster recovery, than someone even more overweight. But, does it really make that much of a difference?

Say, I waited 3 more months, and tried to drop another 30 lbs. Would surgery be even better? What if I waited until next year (and unfortunately started my insurance deductible over again!), and waited until I dropped 60-80+ lbs?

I know that I'm asking for advice through a crystal ball, and it's most definitely a case-by-case basis. But overall, I wanted to solicit advice, maybe to see if someone has the surgery while overweight, and how much of a struggle the recovery was? Or any doctors' advice on here about whether or not I should get it done sooner than later? I would love to have it done ASAP, because it's most definitely an annoying thing to deal with. But at the same time, I'm in the mindset now of losing weight, and I know that if I keep it up, I'll continue to lose weight (until I plateau, of course).

So, I guess, tl,dr; - Would I be better off getting surgery now, while heavier, or is it worth waiting until I drop another 10, 20, or more pounds? Will that make that much of a difference in surgery, and post-op recovery?

Thanks for any advice you have!

middlehaitch

This is something to talk over with your surgical team.
You are quite obese at the moment, and dropping more weight will reduce risk, but at what point the risk outweighs the benefit is up to your doctor and the surgeons involved.

Sorry I can’t help.
Cheers, h.

jenncornelsen

Agree with above. Your surgeon may want u to get it done sooner rather than later, and working out will be far easier once you heal and are without pain. But it really is a question for your surgeon who knows your full medical history

nutmegoreo

Third the recommendation to discuss this with your medical team. Some things (other than healing) to ask about: What dietary modifications should be considered to ensure that you are going into the surgery with the best chances (a referral to a registered dietitian who has experience with post-op recovery would be great) of a good recovery? If you are going to wait, what signs and symptoms of complications should you be watching for and report right away?

slmckenzie

Thanks for your responses!

I agree, I think it's best to just contact the surgeon next, and get their feedback and opinion, on whether it's worth getting it done sooner, or dropping more weight; and finding out what next steps I should be taking.

Also, thanks for the idea of asking what to watch out for if I hold out on surgery for awhile! Great thing to know, so I know I don't push it off too far.

I think the frustrating part for me in this whole process, is that when I spoke with the surgeon initially, I specifically asked him about my weight, and whether or not it would be an issue for surgery. He very clearly stated that it wasn't an issue (he's quite an overweight guy himself). It wasn't until after he left the room, and someone else came in to schedule the surgery, that it suddenly became an issue. So, I've already lost trust on what I even need to have done for the surgery, since the surgeon himself wasn't even concerned about it initially.

Ugh! If only I hadn't let myself gain the weight to begin with. Things would've been so much easier! Thanks for your advice!

NorthCascades

Consider a second opinion or even a different surgeon, if you've lost some amount of trust.

Ask just how much losing X pounds would improve your recovery, what kind of difference at we talking about? It sounds like you're in pain, and have the option to not be. That's a pretty compelling option. That's what I would do.

Are you at risk until the surgery? Can it get worse?

nutmegoreo

Second opinion. Anytime you feel less than completely confident in someone you are working with, it is important to follow that gut instinct. Another question to ask is if there is anything to help in the meantime. I'm not sure if hernia belts are still a thing, but something to help support your abdomen could help manage some of the pain. If you are still coughing, putting a pillow over the hernia site and applying some gentle pressure can also help.

aokoye

I agree with feeling free to seek a second opinion. That's never a bad thing. At the same time, I wouldn't be surprised if part of the issue here is how comfortable the anesthesiologists feel in their ability to keep you safe during the surgery. It's not just the surgeon who is playing a role. For my last two knee surgeries, I had a 40ish min long appointment with pre-surgical medicine that was specifically about gathering data for the anesthesiologists, determining my ability to safely be under general anesthesia, and giving them an idea of what they may or may not have to do to keep me safe (alive).

BarbaraHelen2013

Completely agree with the above re anaesthesia.

The reason you were only required to lose the 10lbs initially is probably because that would have dropped you below the 250lb marker for anaesthesia and surgical risk.
Your surgeon would not be concerned because 10lbs is neither here nor there in terms of the actual surgery procedure he has to do but the anaesthesiologist will very much care about your risks and his positive outcome record! It’s not that they don’t know what they’re talking about it’s that they’re coming from different perspectives.

Obviously, the healthier you are the smoother the process from start to finish but you’ve done really well so far with your weight loss so there’s no reason to expect you cannot continue to succeed throughout recovery and into the future.

I would 100% have the surgery ASAP, get out of pain and discomfort. No sense in suffering and possibly creating further health problems by delaying any further. Your intestines are meant to be protected inside your body for good reason!

I wish you well!

pinuplove

A close relative of mind had a hernia that strangulated. He was also aware of his and was putting off surgery because it "wasn't that bad." It got very bad, very quickly, and he wound up having emergency surgery after a trip to the ER.

Certainly get a second opinion if you have doubts about your initial surgery consult. I agree the sticking point was likely anesthesia, which people tend up overlook the seriousness of. If you are cleared for that, my (non-medical) advice is don't put it off. Good luck!

slmckenzie

Thanks everyone, for the follow-up advice!

I never thought about it much from an anesthesia perspective. I know when I had surgery in the past, it was pretty mild, and that never bothered me. But I hadn't gained as much weight as I had before. The point of putting me under the 250lb category makes a lot of sense, if that was their reasoning as well. Especially with the fact that it makes no difference to the surgeon, but that it could make a huge difference to the anesthesiologist.

I have wondered about a second opinion. But I did really like the surgeon when I spoke with him, and he definitely made me feel comfortable, so I am putting quite a bit of positive in that as well. Plus, I don't know how far back I really can afford to start over with a completely different medical chain in order to get a second opinion!

I agree about the strangulated hernia concern as well. My mother actually had that a number of years ago. It's definitely been on the top of my mind throughout all of this as well. Especially with a larger one like mine, I'm having to weigh (pun intended!) that on my mind too with what direction I need to take.

I think the best step is just to call back and give an update on my progress, and get their opinion on the next steps. See if they think I should hold off and keep trying to lose weight, or if I should get it scheduled and taken care of sooner than later.

Thanks again, all!