Asymptomatic 9 cm Aortic Aneurysm
In the summer of 1995 I retired from a NW Alberta College where I had been instructing Business Courses. In the latter part of that summer I reacquainted myself with my former hometown of Calgary and resettled in my new home in November. Two of my grown children live here so the "transition" to retired life was fairly easy. In my spare time I travel, play bridge, read and putter about my "castle".
15 March, 1997
In May of last year, following a "routine and periodical" medical exam, my Physician decided that "further tests" were warranted for what he found to be "disturbing sounds" being detected in his stethoscope. Sound imagery and other tests detected a 9 cm. Aortic Aneurysm. To this point I had always enjoyed good health. Further, there were no physical signs of pain or any physical discomfort. In very short order I was in the hands of a very capable cardiovascular surgeon who completed the necessary repairs. My recovery was very quick and I was walking by the third day and home by the fifth day.
For the next five months I slowly built up my stamina and regained most of my previous physical condition. However, during a periodical check last October my Doctor commented on a rather large "bulge" on the belt line on the incision line. My hernia has now developed to the point that I must do something to correct it. Through this facility I was informed that two side effects ,which are not uncommon to aortic aneurysm operations, are incisional hernia's (5-10%) and a cessation of the ejaculatory process, with some recovery occurring 8 to 12 months after the operation. As one person stated it, "it does not affect your sex life but is a free vasectomy."
So now I have returned to the "Net" to learn what is best for repairing "incisional hernias". To date I have had a fair divergence of professional opinions as to what to do. Everything from a complete reopening and re-stitching with mesh of the original incision to key hole (laporoscopic) surgery. The cure (it would appear) is worse than the original ailment.
All of which leads me in hindsight to express the view that anyone going through Aortic Aneurysm Surgery should inquire of their doctors what process they use in completing incisions of the abdomen.
As to what I will end up doing for the Hernia will depend to a large extent on the medical advice I receive. If any reader has had similar experiences I would like to hear of their outcomes. Anyway I hope my experience is an assist to others!
Update 25 Jun 97
Since my AA (May 23,1996) I have experienced a slow ,but steady, return to normal living. As I indicated,I found a 'friend'(hernia) had developed on my belt (incision) line in November of 1996. This began to grow in prominence for the next three months and then stabilize at the size of a small apple. My incision,above and below the lump,appeared unaffected. I had no particular physical discomfort or pain. True,I had to revert to larger size loose fitting shirts and I had to mothball some pants because my girth could not accommodate them. I suffered this "indignity" until April at which point I was referred to a surgeon.
I was informed that I had an Incisional Hernia (which affects 10-15% of most persons who have had AA's) and that the entire incision would have to reopened and re-closed using Mesh. I was further informed that the recurrence rate usually ran 25-30%. I could expect 7-10 day stay in a hospital. I found this news appalling. So I sought out a second opinion from another surgeon,and received the same opinion.
During this period I explored the Internet in the hopes of finding other sources of information, etc. in much the same way that I discovered your URL. I found a wealth of data and references on the subject matter of Incisional Hernias. I found,among other things,that this is a medical specialty with several proven treatment techniques (The Shouldice Method,Laparascopic Surgery,etc..)
After my MD submitted my medical records I opted for Surgery at the Grace Hospital in Toronto. By the time the surgery was undertaken on June 10, by a Laparoscopic Surgeon Specialist (Dr. A.Voitk), it was determined that there remained a 10-15% required conversion to conventional surgery. The operation was performed under General Anaesthetic in an outpatient ward and done laporascopically. I remained in Toronto for three days,had a final checkup and came home on the Saturday.
Apparantly my Hernia was much larger than anticipated and required more that the average "Tension Free" Mesh. For the past week and a half I have been undergoing a similar adjustment to "normalcy" that I encountered with my AA.
Was it a wise move? Only time can tell. In light of the choice of general surgery and with a far lower recurrence rate my initial response would be yes. I have had some unpleasant adjustments with stomach and nausea and I am still a little on the weak side. There are some physical adjustments that I wish I had more information on (when does one know the mesh is there to stay?).What is a normal recover period? And so on.
In any event,if you have undergone an operation for an Incisional Hernia I would really like to hear of your experience and any advice you may be able to pass on. If I can offer any observations please be my guest.
Discussion, comments, or questions: Robert Dixon
© Copyright 1997 Robert Dixon
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