Wednesday, September 4, 2013

This is for the Ladies...with Hernias

I feel like it's important for me to share my journey to diagnosis, treatment, and recovery from an inguinal hernia.  Why talk about something that's a common medical problem and really not that interesting?  Because it's not a common medical problem for women, therefore, many women who suffer from hernias go a long time without being understood, diagnosed, and ultimately fixed.  This post is for the ladies who, like me, end up turning to Google for answers because the medical world isn't providing them.

This time last year, a sharp, but not an incapacitating, pain began to originate from my lower right abdomen.  My husband and I had just moved, and I packed up a whole house and did hours of yard work every day.  I thought maybe I pulled a muscle so I waited a couple months to see if it got better but instead the pain became more consistent and slowly worse.  Despite me describing all of this to several doctors, the consideration of a hernia never came up (even though I asked about it).  Nothing was protruding from my abdomen or groin--"We would see it," they all told me while I lay on the examining table.  I was ordered a CT scan to check for kidney stones but the report came back with no specific findings.  A gastrointestinal specialist told me I couldn't have a hernia because it would have appeared on the CT scan.  They were all wrong.

What ensued for nearly a whole year was an emotionally and physically draining process of seeing three different physicians, two gynecologists, a gastrointestinal specialist, an endocrinologist, having a CT scan, three ultrasounds, numerous lab work, and a procedure performed with still no answers.  The last doctor I saw ultimately thought I was imagining the pain and recommended anxiety pills and trigger point injections even though they didn't know what they would be "shooting" at.  I'm so glad I didn't follow her advice.

Finally, when I had given up hope, an OB/GYN referred me to a pelvic pain clinic with the thought that I could have endometriosis.  The clinic, which specializes in obstetrics and gynecology, spent 45 minutes asking me in-depth questions, performed an extensive pelvic examination, then the doctor had me stand up to feel each side of my abdomen with both hands.  In the end, the hernia was diagnosed because he was able to feel the fullness I described on my right side and noticed an asymmetry between my left and right side.  No actual tests were needed.

Hernias are obviously much more common in men and easy to diagnose, but they should never be ruled out as a possibility for women—even if it cannot be seen or does not appear on a scan.  The best way is to feel for it by performing a basic exam with the patient standing up, not lying down.

Perhaps the most upsetting part to me is that I came across this article from the NY Times in September 2012 and it prompted me to ask each doctor with whom I met about the possibility that I was suffering from a hernia.  It seems I'm not the only one to go through such a frustrating ordeal.

I guess my advice for anyone suffering from an unexplained pain is to be vigilant and strong.  I'm a strong person, but doctors are my kryptonite.  I am not going to lie...having to see a new doctor every week and never getting taken seriously made me depressed.  It was so hard to stay strong and advocate for myself when I was knocked down over and over again, but it's true that you have to be your best advocate.  Doctors are just people--flawed, imperfect, and not always helpful, or caring for that matter.  You have to take care of yourself and keep searching.  Eventually, someone will come into your life to help put the nightmare behind you.  

When I actually got diagnosed it only took a couple months to have the whole thing straightened out.  I was referred to a gastrointestinal surgeon who performed outpatient laparoscopic surgery with mesh to repair my right side (a full blown hernia), as well as to patch up a node of fat poking out on my left side which could lead to a hernia down the road.  

The surgery was not as bad as I thought it would be (at least not laparoscopic).  It felt like someone made me do 3,000 sit ups for the first few days, but within two weeks I was just about back to full mobility.  The greatest change, however, is in my mood.  The uncertainty and pain from before was like a dark cloud hovering over me. 
I'm a writer so you better believe I shared my thoughts and discoveries with every single doctor with whom I had met--not to rub it in their face (okay, maybe a little), but more importantly, to spread the word about the medical mistake of overlooking hernias in women.  After what I went through, I really don't want this to keep happening.  If you are a woman out there going through this, good luck and stay strong.