So, it appears that I have an inguinal hernia, self diagnosed, but confirmed by my PCP. I have an appt with the surgeon next week to confirm, but we are both pretty certain.
I was able to gently poke it back in, and it stayed put. While it was out, it was a bit tender and uncomfortable, but now I don’t notice it. I have been careful to not do any lifting or activities that might make it pop back out, but I don’t think I DID anything to pop it out in the first place!
This is what I know: hernias are usually always surgical especially when one sees a surgeon because they love to do some surgery. With surgery, we are at a minimum of 2 weeks late for Remicade and MTX, and OH GOD! I just remembered that they won’t let you take NSAIDs either! Okay, so two weeks without my top three drugs, at a minimum. Maybe I have a nice surgeon, and it is a minimally invasive surgery, after all, so maybe I get to start back with my friends a week post op? That’s still a three week delay.
Good things: I’ve been at my job 1 year next month. FMLA! I also have a kind PCP who is not afraid to dispense narcotics to me. (It helps that she has known me for 16 years, and has watched my disease process unfold)
Bad things: How am I going to work, take care of my family, do my ADLs?
I am not too worried about the surgery. Minimally invasive, minimal recovery time, little pain, etc… I do have an irrational fear of anesthesia though. I am very worried about being off of Remicade for a minimum of 3 weeks. I am worried that it won’t work when I go back on it (antibodies, etc.).
I do want to get it fixed before it become a problem. Any thoughts?
Well, fewer than 1% become a problem People go years popping it back in..... So basically you can schedule it at your convenience and at the best time for you med routine. The good news is for women because they are usually in the femoral canal, its almost always easier to do it through a scope. The bad news is it takes women a bit longer to recover. Your best bet (IMO) is the Lichtenstein repair. While I had my surgery in the morning and was at my desk at 3:00 that afternoon, you best plan a on 2 or three days maybe a week. The Lichtenstein is effective walking out the dooe so you dfon't have to "heal up" You can milk it a lot if you need some Diva time. Everybody knows what a wimp you are (not) I didn't use any pain meds as I had a spinal, by the time it wore off I was past the acute need. I wanted to keep an eye on the surgeon as it is usually a beginner surgery. Ask around as to who is good. Guys tend to get sloppy. Call the plumbers union (seriously)
You obviously have a hernia but FWIW PsA patients often get misdiagnosed because of those nasty little tendon running to the pelvis that typically when enthesitis sets in presents just like a hernia. The same things that aggravate a hernia aggravate the PsA pain in that area.
I didn't have to talk too hard for the spinal (like you I hate general) and there is a bonus....... Totally awake and conscious and totally pain free from my ribs down. It happens only every 10 years or so. There is a risk of peeing the bed, but you can't feel it..............
Never had a hernia, Grumpy, but I certainly can vouch for the spinal anaesthesia! It’s a weird feeling, having the lower half of your body “disappear”, but they will give you something to sleep if you want it. And then, presto, you wake up and you are clear-headed. No nausea, no scratchy throat from the intubation, no foggy head for days after. (And, apparently, fewer complications too.) I don’t ever want surgery done the old fashioned way if I have a choice!
As for the going off the MTX and bio, yes, I had two weeks of that before surgery. It was VERY unpleasant. They let me keep my NSAID, though, but I cannot remember whether they may have changed it to celebrex from diclofenac. Not sure.
I'm pretty sure about the dx, its nice and squishy. :-)
Thanks for all of the info. I am not at all worried about surgical pain...that heals. I just don't want to be without my good drugs. Anyway, I am not fretting as much now as when I posted it: whatever will be will be. I will hurt, it will suck, and we will all move on, right?
Plus I'm fighting with my neighbors about hacking off 1/3 of my river birch tree now! I need to move out near you...I was made to live far, far away from other humans.
tntlamb said:
Well, fewer than 1% become a problem People go years popping it back in..... So basically you can schedule it at your convenience and at the best time for you med routine. The good news is for women because they are usually in the femoral canal, its almost always easier to do it through a scope. The bad news is it takes women a bit longer to recover. Your best bet (IMO) is the Lichtenstein repair. While I had my surgery in the morning and was at my desk at 3:00 that afternoon, you best plan a on 2 or three days maybe a week. The Lichtenstein is effective walking out the dooe so you dfon't have to "heal up" You can milk it a lot if you need some Diva time. Everybody knows what a wimp you are (not) I didn't use any pain meds as I had a spinal, by the time it wore off I was past the acute need. I wanted to keep an eye on the surgeon as it is usually a beginner surgery. Ask around as to who is good. Guys tend to get sloppy. Call the plumbers union (seriously)
You obviously have a hernia but FWIW PsA patients often get misdiagnosed because of those nasty little tendon running to the pelvis that typically when enthesitis sets in presents just like a hernia. The same things that aggravate a hernia aggravate the PsA pain in that area.
I didn't have to talk too hard for the spinal (like you I hate general) and there is a bonus....... Totally awake and conscious and totally pain free from my ribs down. It happens only every 10 years or so. There is a risk of peeing the bed, but you can't feel it..............
You and me too! Perhaps we could move somewhere remote together.
My neighbours set fire to their garden shed this afternoon ..... the explosion from goodness know what shook the whole street. Fire service still here damping down .... hour three. Thankfully we were upwind .... downwind neighbours have got smoke damage. Thankfully nobody hurt "but couldn't have happened to nicer people"?!?!?
GrumpyCat said:
......... I was made to live far, far away from other humans.
You and me too! Perhaps we could move somewhere remote together.
My neighbours set fire to their garden shed this afternoon … the explosion from goodness know what shook the whole street. Fire service still here damping down … hour three. Thankfully we were upwind … downwind neighbours have got smoke damage. Thankfully nobody hurt “but couldn’t have happened to nicer people”???
GrumpyCat said:
… I was made to live far, far away from other humans.
Surgery is scheduled for 8/21 at 430pm, because of course it is.
I spoke to the surgeon wh encouraged me to continue all of my meds. He stated that this is a low risk procedure with a low risk for infection. I decided to check that out with the rheumatologist, who stated,“two weeks off of Remicade and 1 week off MTX before hand and then we can resume when the sutures come out. It doesn’t mattèr how low risk the procedure is. We need to make sure there is no infection before we allow you to resume.” sigh I wish I had left well enough alone.
I’m kidding. Dr. Shaw (my rheum) knows what he’s talking about. I do worry about a surgeon who is so laisefair about things like that.
I’m also not sure which procedure is the best, but he is doing the technique with the mesh. Lamb, I thought you mentioned a better technique? Anyway, he says most surgeons are using that same technique today.
I need to make that same phone call to my rheumatologist. I just scheduled trigger finger surgery. The surgeon says I can stay on Enbrel, but I'm not so sure about it, so I'm going to double check with my rheumy.
Yes. In and out. However, the point is, that anytime we have an procedure that breaks the protective skin barrier, we should worry about infection. That’s my thinking anyways.
Stoney said:
I need to make that same phone call to my rheumatologist. I just scheduled trigger finger surgery. The surgeon says I can stay on Enbrel, but I’m not so sure about it, so I’m going to double check with my rheumy.
Good luck, Grumpy! I’m guessing that the two weeks without your meds will be the most difficult part of the whole thing. But you’ll get through it. Any idea what kind of anaesthesia they are going to use?
I had orthopedic surgery yesterday. The surgeon said I could stay on my Orencia, but to quit the meth a week before and stay off it for three months! I wasn't surprised when the rheumy put the ixnay on that plan. No biologic for two weeks before and two weeks after. I'm counting the days. Joni Mitchell keeps running through my mind: "Don't it always seem to go, you don"t know what you've got 'til it's gone."
Interesting that surgeons don't fear the risk of infection from the biologics.
Heavy sedation; the surgeon said Propofol and versed. And you’re right. The time without my meds is definitely the thing I am most worried about. I get my dose every 4 weeks. Last was on 7/2. My next dose should have been on 7/30. I will be without it for 3 weeks by day of surgery. I forgot to ask how long they typically wait to take out sutures, but I am guessing a week minimum…maybe two. So, I’ll be without for 5 weeks at most as long as things go well.
I used to take Remicade every six weeks and started to feel really bad by the end of week five, but I’m not so bad yet and I am at week five. I’m hoping that the weather, and my stress levels cooperate, and I will not be a weenie about everything! Stress and worry definitely increase my flare risk!
I went for my preop clearance this week (I’ll have to tell you that story some day!) my doc was kind enough to give me a whopper dose of Xanax for the morning of surgery. I have that irrational fear of anesthesia to deal with. He asked me a couple of times if I am sure that I will be conscious with that dose, and I assured him that I would, and I’d probably still be freaking out, but not enough to embarrass myself.
Seenie said:
Good luck, Grumpy! I’m guessing that the two weeks without your meds will be the most difficult part of the whole thing. But you’ll get through it. Any idea what kind of anaesthesia they are going to use?
I’ve had to take the day off of work, I am in a lot of pain. This morning reminded me of the old days and I just wanted to curl up and die. My husband got me all of my drugs and helped me sit up to take them. Now I feel halfway human. This sucks, and I have some pretty good pain meds. I want my Remicade back though. That is the story that I wish every new patient could hear: how much relief the bios actually give. They are so much better than just limping along controlling pain. Honestly, there is no amount of pain medication that will get rid of this pain safely. You’d be in respiratory arrest first.
And you looked so well in that picture! Of course I know, that has nothing to do with it. I remember developing an unexpected appreciation of MTX before my surgery last year. And I agree, Grumpy, at the moment you’re the embodiment of our “fear the disease, not the drugs” motto.
Think positive thoughts and look forward to the day that the surgery is behind you!
