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Left inguinal hernia repair -- It was great for a year
I had a left inguinal hernia repaired via the open mesh procedure in December, 2009. I had post-operative pain that was significant starting in the recovery room. Doc had implanted a disposable pain pump device that was supposed to continuously infuse lidocaine via a catheter for a few days to relieve any discomfort. Was sent home from the hospital with a some lortab tablets for pain as well. That night, the lidocaine infuser failed and I was in terrible agony. The lortab pills did nothing. The next morning, called doc and he wanted to see me. My wife drove me over to his office (30 min away). Every pothole felt like I was getting kicked in the groin, hard. Doc confirmed that the infuser malfunctioned (that rarely happens, right?). He sent me home with two days of percocet (2 every 4 hours). That was not enough and had to get a refill script written for two more days worth. That did it for the worst pain. I followed by taking a couple more days with the left over lortabs. Then I was ok pain-wise (advil was enough for the most part). This is all not too relevant to the reason for my post....but I wanted you to have the background. If you are doing this for the first time, forget the lidocaine infuser if offered... its expensive and it can fail.
It took about 2+ months to heal completely to where I did not have some abdominal discomfort when straining working or otherwise (and yes I did have a swollen left testicle for weeks). After that - I was better than great - a new man for about a year. I mean things that had hurt me for years and years disappeared (e.g. unexplained pain on my left abdominal wall and even running up to my diaphragm area as well as low back and buttock pain). Like I said, a new man. I was so happy after enduring the surgery and felt the results to be excellent, exceeded all expectations.
THEN ... in early February, 2011, at about 2am one night while away on a business trip staying in a hotel, it was like something slipped in my groin area and I was in terrible pain for about 4 or 5 hours. It was bad enough that I was considering going to the ER but decided to tough it out until I could go to a "doc in the box" walk in clinic in the early morning to save some money. The pain was so bad for these hours that I could not sit still and often had to rock lying in the fetal position. Just as I was about to get up and go to find medical attention, the severe pain abated ---- but I immediately felt that familiar hernia type pain (pain in my side radiating down to my left testicle). Just as when I first sought treatment for the hernia, most pain would relieve over night after laying down....then gradually return during the day starting with pressure by mid-morning then worsening to be pain by the evening. Even my low back ache returned.
When I returned from my business trip, thinking the hernia had recurred, I called my surgeon and made an appointment. Upon examination, he said that he could not feel a hernia... and very rarely, one could exist but most can be detected. Then for the following months, I was subjected to the following "non-invasive" attempts to deal with this:
1) To rule out diverticulitis or similar as well as kidney stones, I had an abdominal CT scan. This was negative on the diverticulitis but I did have a kidney stone (but it was on the wrong side from the pain - guess I have something to look forward to some day).
2) Then, I was treated with two different antibiotics sequentially /Cipro was the second one to rule out epididymitis. Negative, symptoms persisted.
3) With each doc visit, no sign of a hernia by digital examination. After the "easy" steps, doc suspected nerve issues with scar tissue terms like meshoma, neuroma, etc were used. The next treatment was a series of injections of Maricane (long acting lidocaine) mixed with Betamethasone (steroid). Basically, 10ml of this mixture was injected into where it hurts most (groin area at first and later there and along/beneath the incision scar).
4) The injections were repeated 5 times (for a total of 6) approximately every 6 weeks. The shots are very painful but I was "comfortably numb" by the time I left the office each time - this not hurting feeling lasts 12 hour or so, then it wears off. None the less, the injections make me feel nauseous and sick for a few hours so after the first time, I had my wife drive me for the injections. For the next few days, there is significant injection site pain and hernia type pain. Steriods affect me poorly and I can not sleep (at all) for the first couple/three days and I am super hungry/eat everything in sight (and then go out for doughnuts at 2am). Then gradually, starting on the 7th day or so, the hernia pain becomes less and less on a daily basis and becomes more like pressure only (by the end of the day, when untreated, it would worst - the injections help). This lasts for about 3 weeks. Then, by day, I quickly return to "normal" i.e. no pain the early am, pressure by mid-morning giving way to pain by evening. Activity (like working in the yard), speeds up the process.
5) After the 4th injection, I was started on 25mg of Elavil per day, reported to alleviate nerve pain in some cases. I will say that it is a good sleeping pill but has had little tangible affect on the pain.
6) This week, I had the 6th (and final -- not doing this any more) injection. Doc also gave me Lyrica (50mg 3x/day to start) to try for a couple weeks acknowledging that this is grasping as straws. He said it will work within a couple weeks, or not at all. If not, there is nothing else non-surgical to try other than continuing injections. I am staying on the Elavil for the time being, as well.
At his recommendation, I have now scheduled a second hernia surgery for mid-December. Besides, I 'm sick of this and really can't bear any more groin injections. That is just almost inhumane. Find where it hurts worst, then stick a 3" need in it. Right. The plan is to:
1) go in through my belly button with a laparoscopic surgical camera and look at my lower abdominal cavity to see if there has been any hernia recurrence or other abdominal reason for this pain.
2) if a recurrence or something else is found, surgically fix it (not laparoscopically, that is just to look, but using the open surgical method).
3) Use the open procedure (re-open me up) to view the mesh repair and identify any issues from that end.
4) if nothing else is identified, find the nerves (he mentioned 3 of them as possibilities) that are likely entwined in scar tissue and cut out 1" segments.
Has anyone had similar experiences? It will be interesting to see what the real solution is --- it could be a mesh problem as many on here have had. But I had a really good year after the initial repair; have been told that mesh problems tend to present early-on. My money is on a hernia recurrence that can't be detected by feeling for it because of the mesh repair. But, my doc says the nerve entrapment is statistically more likely the issue but a recurrence is entirely possible. The sudden onset of all this is one reason for such suspicion on my part. I would have thought if it was nerve entrapment that it would have come on more gradually (not like turning on a light switch).
I hope this information helps someone... I'll plan on posting an update after my exploratory surgery. In the meantime, if anyone has similar experiences or thoughts on what is going on with me please share them. Thanks.
Hopefully I won't have to go through that, I'm only 18 and I have inguinal hernia on my right testicle. Not much pain right now but the right testicle seems to be filled with fluid and I can feel the hernia behind it and see the bulge. Going in for surgery very soon. Scared about it after reading so much about people's bad recoverys. Hope your doing better with yours. - Dylan
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