Staying the Course -- 01/13/2020

[Superbob]

Howdy folks! Football games galore. NFL playoffs have been exciting for the most part. Down to a final four: Kansas City/Tennessee Titans; San Fran/Green Bay.
The Super Bowl I'd like to see is Packers versus Titans. I think it will more likely be Kansas City Chiefs versus the SF Niners. But there have been upsets so...Go Tennessee Titans! What's your choice, if you have one?

College final tonight -- as a Tennessee Vols fan, I usually root for the SEC teams -- go LSU Tigers! But as a South Carolinian immersed in Clemson boosterism, I say -- Go Clemson Tigers. Yeah, I am conflicted and therefore will pull for a great game, and yell "GO TIGERS!"

Latest in my health odyssey: I discovered a soft mass just above the abdomen and close to OHS incision. Fearing possibility of blood clots, I asked my doctor and as a result am scheduled for an ultra sound tomorrow. Meanwhile, a smart cardiac rehab nurse looked at it this morning and immediately said "hernia." After doing online research, I think she might be right. Hiatal hernia. These are pretty common after surgery, and usually they don't cause serious problems (such as acid reflux). If they do, there is a minimally invasive surgery that can quell them, with a very good success rate. Last thing I want is more surgery, but that would sure beat any blood clots. So send good vibes my way tomorrow afternoon if you will.

Meanwhile how is the New Year treating you all so far? Let us hear from you.

Cheers,
Superbob
❤

I just did it for first time -- wrote 2019 -- in headline! Thank goodness our edit function works well. Happy 2020!

 

[rich01]

The real Superbowl was last night.

Geaux Tigers!

 

[Superbob]

The LSU Tigers removed any doubt that they are No. 1 of all college football this season.

The Clemson Tigers are a very good team and battled hard and deserved to be in the playoffs. However...

Geaux Tigers!

 

[Protimenow]

I believe that most hiatal hernia repairs are done laparoscopically. Just a hole or two, through which they put the scope. It may even be an outpatient procedure.

This should be fine. At least, I hope it is.

 

[Superbob]

I believe that most hiatal hernia repairs are done laparoscopically. Just a hole or two, through which they put the scope. It may even be an outpatient procedure.

This should be fine. At least, I hope it is.

Thanks! I saw good bit online about that surgery. Sure not looking for any more surgery, but if this thing becomes a pain, it eases the stress to know there is a minimally invasive surgery with a high success rate and that can be done out-patient or maybe just one overnight in hospital. Had never heard of it before.

 

[Bina]

Bob, hoping that you don't need another surgery, and hoping that you just have a mini-hernia, if any at all.
Last September my hubby came home from work with a serious inguinal hernia, that required a big surgery and lengthy hospital stay.
But he is now rocking a gorgeous 4 inch scar. Remember: Chicks dig scars.

 

[Superbob]

Thanks Bina. That kind your husband suffered seems to be in lower abdomen or groin area (based on a very quick surf I just did). Mine is higher up and occurs fairly often after heart surgery. The cardiac rehab nurse has seen many of these before. (Says she won't bill me for her diagnosis.)

 

[Bina]

Yes, my hubby had the lower hernia, lots of repair work for that one.
Yours, being the upper smaller hernia, should be a breeze to fix up.

 

[Superbob]

Yes, my hubby had the lower hernia, lots of repair work for that one.
Yours, being the upper smaller hernia, should be a breeze to fix up.

Thanks Bina. I'm sorry your hubby had to go through all that but glad that he came out of it well and with a scar that we know chicks love.

Before the hernia possibility popped up, I had read somewhere on the Net (which I'm forever surfing) something about little masses sometimes appearing up high in the OHS incision, months post-surgery, and then often receding on their own. No mention of them being hernias. Got to go back and find that; would be wonderful if it's something like that.

If I'm dealing with a hernia, possibly caused by my lifting too much (at home, not the weight room, 'cause there is no one else in my home to lift things when needed)...then living with that condition seriously compromises my ability to get back to my beloved core fitness class in which we do such weight-bearing things as pushups off a Swiss ball and of course planks. Guess, though, I could just do vastly modified versions of those exercises while mostly flirting with the chicks (hmmm, they do dig the scars, right?)....

 

[epstns]

Bob - I also developed a hernia post-surgery, but mine was a small abdominal hernia just above my umbilicus. At the risk of this being TMI, I will say that it happened shortly after surgery while I was experiencing extreme constipation. . .

It gradually became larger, and eventually painful. Upon exam, the surgeon said it was a "fat hernia" in which a small tear occurred in my abdominal fascia, allowing a small amount of visceral fat to sneak through. He said that there was no need to repair it, as there was literally no risk of any intestines or organs slipping through. I went ahead anyway with surgery to repair it -- a 45-minute outpatient procedure with minimal recovery. Now, some years later, I can't even find the scar. I hope yours is this easy and trouble free, too.

 

[Superbob]

Bob - I also developed a hernia post-surgery, but mine was a small abdominal hernia just above my umbilicus. At the risk of this being TMI, I will say that it happened shortly after surgery while I was experiencing extreme constipation. . .

It gradually became larger, and eventually painful. Upon exam, the surgeon said it was a "fat hernia" in which a small tear occurred in my abdominal fascia, allowing a small amount of visceral fat to sneak through. He said that there was no need to repair it, as there was literally no risk of any intestines or organs slipping through. I went ahead anyway with surgery to repair it -- a 45-minute outpatient procedure with minimal recovery. Now, some years later, I can't even find the scar. I hope yours is this easy and trouble free, too.

Steve -- Thanks for passing along your experience with post-op hernias. Much appreciated. I read online that various sorts of these are pretty common after heart surgery, and sometimes don't require surgery. Then comes the question, though, of whether you want to wait for serious complications or go ahead and have it taken care of.

By pure coincidence, a mailer addressed to "postal customer" arrived Friday announcing a demonstration of robotic-assisted technology followed by free screenings for hernias next Tuesday. I signed up for it. It will be at a respected local hospital (which is affiliated with Duke in a number of specialities including heart). Checking online I find the lead presenter will be a local surgeon who has excellent reviews with Health Grades. Not necessarily saying yet I would select him, but I could use an informed screening. Right now I just have the cardiac rehab nurse who immediately said "hernia" when viewing this soft incisional mass at the top of my abdomen. In a class, she gave us a detailed breakdown of how the heart works that was more informative than anything I've ever seen. I haven't yet contacted my September OHS team at UNC/Chapel Hill, but I will do so after the screening. May well need to take a road trip for them to take a look and advise.

BTW, the idea of "robotic-assisted surgery" makes my skin crawl. Brings out my Luddite biases, I suppose. Sounds like they will be touting that for hernia operations. Anybody have thoughts on robotic surgery, or experience with it?

The toughest thing will be telling my wife, who gets nervous about aging maladies as they occur in each of us. However, she's been asking to have lunch at a nice new restaurant over near the hospital, so I could begin by saying we will do that Tuesday...ah, uh, but first we can go to an informative medical presentation nearby. (Yes then I will have to explain why -- and tell her, truthfully, that I am having no painful symptoms, and that this is not an uncommon problem in recovering from heart surgery.)

So again, thanks for shared experiences and perspectives.

 

[Johan]

Robotic assisted surgery is marvelous. Had my prostate removed two years ago with the aid of the Da Vinci surgical robotic system. Surgeon sits at his console couple meters away and robot does its thing over the patient.

Definitely the way to go for patient recovery etc. 6 tiny holes for robotic arms with all their different functions to get in. Largest incision of about 3cm was where the robot had to pull my enlarged prostate gland out. One night in hospital.

Conventional prostate surgery would have involved a major incision through abdominal muscle, with everything that goes with that.

Seems as if the robot and surgeon did a good job to cleanly remove the prostate gland with all the malignancy still in the capsule. No subsequent radiation, no chemotherapy. Two years later still clear.

Bob, if they offer you robotic assisted surgery, go for it!!

 

[Protimenow]

Robotic doesn't mean that the surgeon programs the 'robot' and walks away, leaving it up to the robot to do the work.

Robots handle the fine cutting and other things, through one or more holes near the surgical site, and take directions from the surgeon. The cuts and movements can be much finer than a surgeon can perform. Plus, if you're a really good patient, they may even implant a GPS tracking chip, so Big Brother knows exactly where you are every second of the day (maybe no chip implantation).

If I was to have a robotic surgery, I'd think twice about it - then probably go for it.

 

[epstns]

The one critical factor in choosing robotic surgery is the question of how many of this type procedure has the doc done? In some procedures (like prostatectomy, Johan) they say that the learning curve doesn't begin to flatten out until the doc has done that procedure 300 or more times.

Of course, experience is one of the top selection criteria for most surgeries. . .

 

[Johan]

Robotic doesn't mean that the surgeon programs the 'robot' and walks away, leaving it up to the robot to do the work.

Robots handle the fine cutting and other things, through one or more holes near the surgical site, and take directions from the surgeon. The cuts and movements can be much finer than a surgeon can perform. Plus, if you're a really good patient, they may even implant a GPS tracking chip, so Big Brother knows exactly where you are every second of the day (maybe no chip implantation).

If I was to have a robotic surgery, I'd think twice about it - then probably go for it.

Steve, now I know why every time I go onto the internet I get bombarded by adverts pushing products I just vaguely thought of getting, or casually discussed with wife, like "maybe we should look into getting a new decoder for satellite TV". It's that secret chip the robot implanted during my prostatectomy to communicate with its pals at Google Artificial Intelligence headquarters.

 

[Johan]

The one critical factor in choosing robotic surgery is the question of how many of this type procedure has the doc done? In some procedures (like prostatectomy, Johan) they say that the learning curve doesn't begin to flatten out until the doc has done that procedure 300 or more times.

Of course, experience is one of the top selection criteria for most surgeries. . .

Very, very true. In prostatectomy "nerve sparing" are the magic words. Robots can do the fine cutting very well provided the operator/surgeon is adept at steering it. At the time there were only two machines in the country and I was definitely part of the learning curve! As far as the surgery and recovery were concerned all went extremely well, no pain, no infections, quick recovery etc. As far as nerve sparing was concerned however, only 50% spared. Now more than 2 years later beginning to overcome the side effect of that.

 

[rich01]

It's like your surgeon is playing a video game.

 

[Protimenow]

It's like your surgeon is playing a video game.

Maybe they should train some really smart fourteen year olds to do it. They'll probably have much better control of the joystick.