Internal Hernia

So I posted back when I had my 1 year follow up appointment that the doctor was concerned about some intermittent pain I was having and said that one of the things it could be was an internal hernia.  We talked about when enough was enough, but never really came to agreement on when that point would be. 

Monday I had some achiness in my abdomen most of the day.  It was occassionally enough to make me pause - not enough to deter me in my daily activities - but always there in the background.  So I thought I would call the surgeon's nurse practitioner on Tuesday morning sometime and leave her a message to see what she thought.

So Tuesday morning I was woken up at 5am with excruciating pain in my abdomen.  I immediately  camped out in the Land of Denial - where I am the Queen.  I told my husband that I was a little concerned, but I had too much to do.  I would call the surgeon's office when it opened.  My son had an orthodontist appointment first thing in the moring.  I took him, but as I was driving to the appointment I was thinking "This was not the smartest thing you've ever done, Pam."  I got him through the orthodontist appointment and I left a message with the answering service at the surgeon's office.  As I was leaving the appointment with my son I called my mom to let her know what was going on.  She talked me in to pulling over - that I really shouldn't be driving.  So I pulled over and she and my dad came and met me where I was.  My dad took Caleb to school and my mom took me to the surgeon's office.

After waiting a couple of hours to see the surgeon ( he worked me in to his schedule instead of sending me to the ER which I greatly appreciated) he felt that this was a hernia.  Of course, there is no way to know for sure unless you go in surgically to look, but I was presenting with classic internal hernia symptoms.  He had an opening in his schedule for the next day, but he didn't want me to wait because something like this can go south really quickly.  His partner was already at the hospital and thought he could squeeze me in to his schedule in the afternoon.  So we scheduled things with the scheduling nurse for later in the afternoon and headed home for a couple of hours to set some things straight.

To make a long story short we waited and waited and waited for Dr. Tyner, but he was called into a life threatening emergency surgery situation.  So Dr. Enochs came back to the hospital to perform the surgery himself.  Have I mentioned how much I love that man?  Surgery did not start until after 9pm that night and I did not get back from recovery until after midnight.  Dr. Enochs did find an internal hernia and he was able to repair it quickly.  He also looked for adhesions (or scar tissue) from past surgery that might be catching things and he did an upper endoscopy while he had me under to look for an ulcer, etc...  I had no adhesions and no ulcer, and they caught the hernia before my intestines were damaged. 

So I spent most of the day today hanging out at the hospital waiting to be discharged, etc...  Dr. Enochs was able to perform the operation laproscopically (sp?) so I was pleasantly surprised that I was not in as much pain as I had anticipated.  Of course, I am convinced that they always send you home just as the really good drugs wear off so that they don't have to listen to you when the real pain hits and now that I am home I am a good deal more uncomfortable than I was in the hospital.

So an internal hernia is different than the hernia that most people think of when they hear about hernias.  Most people think of umbilical hernia's (where the intestine pokes out by your belly button), or groin hernias or hiatal hernias (where part of the stomach gets stuck through the diaphragm).  While this type of hernia (internal) is fairly common with gastric bypass patients it is very uncommon otherwise and most doctors won't diagnose it properly.  It won't show up on ultrasound or CT or MRI very well and many "regular" doctors aren't very aware of the increase in icidents with gastric bypass patients, etc...  The more common type of hernias involve the intestines poking through the abdominal wall or through the diaphragm or into the groin area.  Internal hernias are different in that the intestines kind of fold in on themselves.  You loose a lot of fat in the abdominal area and it leaves the intestines kind of loosey-goosey (yes that is a very technical term) and they can end up folding and going into spaces and spots that they shouldn't.  This is what happened with me - and when that happened it got stuck - causing the pain.  It is important to "un-stuck" it quickly so that the intestine isn't damaged or twisted or creates an obstruction or dies.  I was fortunate in that my doctor could just un-tuck things and pin it down and we were good.  Leaving it too long can get dangerous very quickly which is why Dr. Enochs wanted me to have surgery right away.

This is not how I expected my week to go, but I'm hoping that recovery will go well and quickly and I will be back among the land of the living here fairly quickly.  Thanks to all of you who have so graciously sent well wishes and prayed for me.  It is appreciated far more than you know.