Living With Henry ( An Inguinal Hernia )

12/09/2003	Discovered a growing 'lump' whilst showering and suspected a hernia.
29/09/2003	Local GP diagnosed an inguinal hernia and referred me to a hospital specialist.
11/10/2003	Referral confirmation received in the mail.
06/11/2003	Discomfort and protrusion noticeably worse.
11/11/2003	I called the hospital about the posibility of speeding things up, but was told they do not operate a 'cancellations' system and I should return to my doctor if necessary.
17/11/2003	Returned to my local GP to express my concerns over the rapid deterioration of my condition. He confirmed I just had to put up with it and wait for my hospital appointment.
18/12/2003	Confirmation in the mail that I had reached the top of the hospital waiting list. Phoned as instructed and was allocated an appointment on Wednesday 28/01/02004 at 2:20pm at the General Outpatient Department, Frenchay Hospital.
28/01/2004	Attended Frenchay Hospital and after a brief examination, the diagnosis of an inguinal hernia was confirmed, and that surgery would be necessary - the waiting list for surgery could be up to nine months!
28/07/2004	Received a 'patients choice' questionnaire
30/09/2004	Confirmation in the mail that a surgery slot is available on the Day Ward at Southmead hospital on Thursday 28th October. Pre-op health check examination booked for 6th October at Frenchay Hospital
	waiting - bulging - waiting!!
28/10/2004	Attended Southmead Hospital and FINALLY, had my laparoscopic hernia operation!
- to date	No further problems. All fixed and sorted. :o)

What are the symptoms?
An inguinal hernia causes a bulge in the groin area, (yes!) which can extend to the scrotum in men (it's getting there!!!!!!!). This type of hernia is often painless, but may be tender and can cause discomfort during any type of physical strain, such as lifting or coughing. Men may feel a heaviness around the scrotum. The bulge may disappear when the patient is lying down, and be more visible when standing up. (yes!) A hernia can often be pushed gently back into place. (yes but sometimes with some difficulty!) This is called a reducible hernia. When a hernia cannot be pushed back into place, it means a piece of the intestine has become trapped, or incarcerated, in the inguinal canal. Symptoms include pain, nausea, vomiting, inability to have a bowel movement, and a bulge that remains even when lying down. When a portion of the intestine is incarcerated, its blood supply can be cut off, which means the intestinal tissue will die. This condition is called a strangulated hernia. Inguinal hernias usually increase in size with time and can occur on both sides of the body (bilateral inguinal hernia).

What is the treatment?
Patients with inguinal hernias can wear a special type of belt, called a truss, to support the hernia and keep it from bulging out. They should also avoid any activities that cause abdominal strain. However, most patients elect surgery to repair inguinal hernias and avoid the possibility of a strangulated hernia. The procedure to repair a hernia involves pushing the piece of intestine back into place and repairing the abdominal wall so the intestine cannot push through again. Hernia surgery, called herniorrhaphy, used to involve a large incision and a long recovery period. However, many hernia repairs can now be performed through laparoscopic surgery. The surgeon uses a special viewing instrument called a laparoscope, inserted through a small incision in the abdomen. The laparoscope is like a tiny video camera that gives the surgeon a clear view of the abdominal area. Other small incisions are made to insert the surgical instruments used to push the intestine into place and repair the abdominal wall. The surgeon may use a procedure called hernioplasty to reinforce the entire inguinal area with synthetic material, like a tire patch. Laparoscopic hernia surgery can be performed on an outpatient basis. Incarcerated and strangulated hernias require emergency surgery and hospitalization. Laparoscopic surgery may not be recommended for very large hernias.

Self-care tips

Although there is no way to prevent hernias due to a congenital weakness or family history, you can help reduce your risk for an inguinal hernia. Follow a healthy diet that is high in fiber and drink plenty of fluids to prevent constipation, maintain a healthy weight through diet and exercise, and avoid cigarette smoking, which can cause chronic coughs. (Oh dear! Pretty sure smokers cough caused mine!!) If your job requires heavy lifting, learn the proper way to lift and wear a support garment.

Frenchay Hospital, Frenchay Park Road Bristol, BS161LE
DAY CASE UNIT -
You are currently on the waiting list for a hernia repair operation.
We have a slot available for you to be held at Southmead Hospital.
Admission Time : 07.30AM
Ward : DAY WARD
On arrival at Southmead Hospital, please report to MAIN ADMISSIONS, from there you will be directed to the Day Surgery Unit.
You must stop eating 6 hours before and drinking 3 hours prior to your admission time. IF YOU EAT/DRINK AFTER THESE TIMES YOUR OPERATION WILL CANCELLED..
On the day of admission, please bring dressing gown and slippers but leave any valuables at home.
If you suffer from DIABETES or ASTHMA, please inform me, when ringing to confirm. If you are taking medicine to control EPILEPSY or BLOOD PRESSURE, take your normal medication in the morning with a small sip of water.
PLEASE CONFIRM IMMEDIATELY that the above arrangements are convenient for you by telephoning me.
It is essential that you arrange for a friend or relative to collect you from hospital and to be at home when you return and remain with you overnight.
Yours sincerely
Day Case Unit Co-ordinator

NORTH BRISTOL NHS TRUST. SOUTHMEAD HOSPITAL.
INFORMATION SHEET FOLLOWING HERNIA REPAIR OPERATION
Following repair of your inguinal hernia you should be able to go home after a few hours. You should find that there is a clear dressing over the wound in your groin and you should have been given painkillers to take with you. On return home you should take the painkillers as prescribed for the next twenty four hours and after that you should continue to take them if required.
You should not drive for at least twenty four hours following surgery and not until you are able to comfortably perform an emergency stop. You will find that your recovery is quicker if you resume normal activity.
While the dressing is in place you may shower but do not rub the dressing as it will become detached. After seven days, remove the dressing. There are no sutures that need to be removed.
You may resume full activities including heavy lifting one week after surgery. You do not require an out patient appointment but if you experience any problems following your operation please telephone **** ******* and an appointment will be arranged.
D M CONSULTANT SURGEON 22 October 2003

NORTH BRISTOL NHS TRUST. DAY SURGERY UNIT, SOUTHMEAD HOSPITAL.
ADVICE AND INFORMATION AFTER DAY SURGERY
FOLLOWING AN ANAESTHETIC:
Although you are being treated as a day case patient, you will receive treatment to the same high standard as elsewhere in the hospital. We expect that you will go home the same day, but if there have been complications you may have to stay in hospital. If you had a general anaesthetic, please remember that anaesthetic drugs stay in the body for several hours - during this time you will react more slowly, which means you are more likely to have an accident. You should have a responsible adult with you for 24 hours after the operation and you may need some days off work and help at home.
Remember that for at least 24 48 hours after the procedure:
l. You must not drive a car or any other vehicle.
2. You should not cook, boil a kettle or operate machinery.
3. You should not drink alcohol or take sleeping tablets.
4. You may eat what you feel like - light diet, nothing too greasy or spicy. Drink plenty of fluids.
5. You should take things gently until you feel fully recovered.
6. You should not take any important legal or financial decisions, or sign any documents.

WOUND CARE
We will tell you and give you written advice on how to care for your wound. For most operations there are booklets giving information, such as when you can return to work.
You need to have your dressings removed in 7 days. Please arrange this with your GP Practice Nurse.
Your stitches are dissolvable.

PAINKILLERS
There are many different types of painkillers available – we have selected those which we feel will be most effective and safe for you. Please use them to relieve pain resulting from today’s operation only. If you have pain from other conditions, your GP or Pharmacist will be able to advise you on the best choice for that problem. Each box should contain a patient information leaflet, which you should read.
CO-CODAMOL
30 Tablets CO-CODAMOL 30/500
ONE or TWO to be taken every 4-6 hours when required for pain. Do not take more than 2 at any one time. Do not take more than 8 in 24 hours. Do not take with any other paracetamol products.
The active ingredients in Co-codamol Tablets BP 30/500 are Codeine Phosphate Ph Eur 30mg, and Paracetamol Ph Eur 500mg.
Codeine Phosphate belongs to a group of medicines known as opioid analgesics which relieve pain. Paracetamol is a non-opioid analgesic which relieves pain and reduces fever.
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