Inguinal Hernia Repair

NHS Fashions & Hairy Legs

Undergoing an operation, and being cut open by a Surgeon has always been one of my lifelong fears. Forget being trapped and unable to move in a small, dark, space, or scaling vertigo-inducing, mountainous heights, or even allowing hundreds of little spiders to crawl over you in a small, dark space, this has always been the ONE-the one nightmare that could always guarantee to leave me in a cold sweat. It's not just the fear of waking up mid-operation in excruciating pain but unable to tell anyone because of anaesthetic paralysis, it's that complete loss of control-that complete dependence on not just another human being to keep you alive, you even have to rely upon a mechanical ventilator just to breath!

An inguinal hernia is where part of the intestine starts to poke through the intestine wall which has become weak over time, (usually through age) forming a bulge in the abdomen in an area called the inguinal canal. Aside, from the pain this creates, the real danger is if the hernia becomes strangulated and the intestine gets trapped. Whilst this is rare, when it does happen, it's very serious. It instantly leads to the intestine's blood supply being cut off; and requires emergency surgery which can result in death-a high risk of death actually (50% don't survive when a rupture occurs) so the consequences of not doing anything aren't really an option. The hernia will keep growing, and getting bigger, and at some point, an operation will be required-even for tomophobic people such as myself.

My GP diagnosed my hernia back in November and told me he would be referring me to their surgical team as soon as possible. Given the often quoted lengthy NHS waiting times, I conveniently just blocked the impending operation out of my mind. Maybe, it would never happen? That's what most people would think, right? Wrong! The paperwork requesting me for the necessary surgery arrived just four months after referral, and this was after a weekend of extremely bad weather where hundreds of operations had reportedly been cancelled nationwide, so it was with increasing anxiety I arrived at the hospital at 7:30am on the 5th March, 2018.

Following registration I was immediately assigned a bed & then prepped for my operation by a Nurse who handed me surgical stockings (which she helped me to put on) & a gown to change into, before being asked to fill out a questionnaire. Fortunately, I was also allowed to keep my dressing gown on. (It's very difficult to maintain any dignity answering questions, when your bum is hanging out the back of your surgical gown!) The Anaesthetist spoke to me first & gave me a brief overview of the procedure from his perspective and answered a couple of my questions, followed by the Surgeon who would conduct the operation. The Surgeon also went through the actual process involved and described the particular type of hernia repair he would use. He would be using open surgery (rather then keyhole), and he'd make one cut, which would allow him to push the bulge back into the abdomen. A mesh would then be inserted to prevent it re-occurring before closing up the wound with dissolvable stitches.

After, the Surgeon had finished talking to me, he drew a large arrow on my body pointing to the left side of my groin to remind him where the hernia actually was, just so that no mistakes would be made, which I certainly appreciated. Though, I suspect in hindsight, this is done more to reassure the patient they would be cutting in the right place, then to genuinely remind the Surgeon where the hernia was...

During wait for my surgery I had the misfortune of having to listen to the man in the ward next to me arguing with the Surgeon against the use of a mesh repair, saying that they 'contributed to organ degradation.' The Surgeon replied, 'Where's the proof? What scientific evidence do you have for suggesting such a thing?' To which he replied, 'All my friends...' At that point I lost interest. Anyone who bases his entire argument on what his friends think, obviously, carried no substance, and all at once I was on the side of the Surgeon. Nevertheless, it was slightly unnerving, since I was having the exact same mesh repair that this patient was complaining about! I did wonder why the patient was there in the first place if he didn't actually want the surgery?

Eventually, my time came, and I was asked to walk down to the theatre with a nurse. I was then led into the theatre, which was a really brightly-lit, tiny room, occupied by several men all squashed in around the bed. I climbed onto the bed, while they kept me talking about my work in a vain attempt to distract me  I felt different sensors, a heart monitor and a blood pressure sleeve being attached. A mask was placed over my face, & I was told to breathe deeply. I felt a needle go into my hand, then nothing,...everything went very dark, very quickly.

The Surgeon told me later, the operation took 1 hr 15 minutes-instead of the 45 minutes planned because of the size of the hernia. I came round from the anaesthesia quite suddenly, remembering nothing (this was of course one of my fears), hearing someone's voice long before I could open my eyes-the voice being that of an Irish nurse who I remember kept smiling & asking me how I was. I just felt so incredibly tired. A porter then wheeled me back to my ward & I got dressed.  After spending a further 30 minutes or so, recouping some of my strength, helped by some marmalade on toast, ( I hadn't eaten for 18 hours) I picked up my very important 'Not fit for work certificate,' but at the same time, forgetting to take the equally important change of dressings, leaving the hospital at about 5pm.

Looking back on the operation now, almost a week later, leaving aside my current recovery plan, and the pain management issues I'm still struggling with, I'm left with the feeling that all my fears proved entirely pointless. When you're under general anesthesia, you are literally aware of absolutely nothing. At No point, did I ever not feel I was in safe hands.

When you stop to consider that the NHS deals with over 1 million patients every 36 hours-just thinking about the sheer numbers involved, and managing to operate from within such a tight budget, the fact that it doesn't collapse, or implode, I believe is entirely down to just how hard working and dedicated its staff are-some of whom I met that day. How can anyone not feel admiration for such an amazing institution?