What to ask surgeon tmw re: hernia repair

[ampt]

Hi all,

I am finally seeing the surgeon tmw about my umbilical hernia. Can you give me suggestions of what to ask about repair/surgery? I'm hoping for the "golden ticket" to an abdominoplasty!!

Thanks in advance!
Angie

 

[hilary1617]

Hi Angie,

I'd recommend asking whether s/he intends to use mesh and if so what type/brand.

Kind regards,
Hilary

 

[ampt]

Would the mesh be required if I am able to get an abdominoplasty?

 

[Munchkin]

Would the mesh be required if I am able to get an abdominoplasty?

Tricky question. Hernia repair itself is tricky because every surgery increases your chances of adhesions and recurrence of that, or another, hernia. If you have a simple, small hernia the doc may just close it up and you are done. If the hernia is larger, the surgeon may decide to use mesh to make sure it doesn't herniate again. Sometimes the mesh causes more problems than the hernia. Sigh. Hernia repair sounds simple but it not always that easy.

Talk to your doc and know what you want. Do you want muscle repair? Read about it! If your doc says no abdomioplasty, are you willing to pay for a PS to do that part of the procedure at the same time? And is that OK with your doc? I guess you could call that option the bronze ticket!

 

[DianaCox]

I would suggest that IF you also have an umbilical hernia, and/or any reason to NEED mesh, that you get the surgeon to state that because of this, and the desire to avoid mesh which can cause problems later, s/he is recommending also doing an abdominoplasty with diastasis repair to decrease the chance of recurrent hernia and to avoid the mesh. I got my husband's umbilical hernia repair turned into a full "mommy makeover" with diastasis repair and even some skin removal, all covered by insurance (and our plan is NOT regulated under Knox-Keene. (And some day, I plan on doing the same for myself, if I magically or otherwise lose another 20 lbs, in order to repair my incisional hernia - in conjunction with removing a lipoma on my waist, and re-fixing the umbilical hernia I had repaired with my DS 12 years ago.)

See the attached.

 

[ampt]

Thank you for the document, Diana. I feel better having this in my hand/mind.

It is my understanding that I will meet with this surgeon, she will poke/prod me, order a CT to confirm the diagnosis, and since she is a general surgeon, I believe I would need to be referred to a plastic surgeon for reconstruction.

With that said, does anyone know of a sympathetic Kaiser plastic surgeon? I'm in the SF Bay Area. I'm willing to travel.

 

[DianaCox]

Your timing is good - read this thread: http://bariatricfacts.org/threads/insurance-coverage-for-plastics-victory-in-ca.3216/#post-47656

Having said that, I have heard horror stories from Kaiser patients who have gotten reconstructive surgery from Kaiser when they were forced to provide it - sloppy work, cosmetically unacceptable. I would ask for PIX of the surgeon's work before allowing myself to be touched by one of them, as well as trying to find any patients of theirs you can speak to.

Moreover, I would go OUTSIDE Kaiser for at least one consult, as well as to get the letter of necessity that will put Kaiser in the position of having someone ELSE say you should be getting reconstructive surgery - otherwise, their OWN surgeons will be motivated to find you don't qualify even under Knox-Keene.

 

[ampt]

Diana, luckily, Dr. Rabkin does such consultations! I am sure I will be making an appointment with him soon!

 

[ampt]

Welp, it's a 5 cm INCISIONAL hernia, right by my belly button incision. My surgeon is going to confer with her colleague to see if he would recommend a CT for diastasis diagnosis, and POSSIBLE abdominoplasty. Otherwise, just a mesh hernia repair...