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incarecerated right inaurial hernia FOR 86YRS OLD FEMALE
I have a question that i need advice on for a 86yr old woman who has an incarecerated right inaurial hernia,she is not in any pain,maybe a bit of discomfort.
We went to Western H in TO to the ER to check it out as her GP was away and we were released as it was not life threatning and the senior did not want the surgery she freaked out actually,as she went in to check something out and now they wanted to keep her ON and perform surgery and she felt fine so she was not amused,and of course we knew nothing of this surgeon,since then we have been to shouldice H and we have been declined because of her age and light heart condition which is not a big deal apparently so her GP says,just a light condition.
Please help me to make the right choice here.I need advice from people who know,surgeons themselves,or seniors who have been through this.
By letter we were told by Shoudice s IC surgeon to keep a watch and wait attitude as sometimes that is best when one is that old instead of surgery,basically if it aint broke don t fix it,although i think it is a bit broke but should she need surgery then to proceed to a full facility hospital to have surgery. Mind you all this is based on 1 vist and paper work.
This senior is a tad difficult,does not really want to do it because she is afraid and i guess rightly so,surgeons say its nothing a simple procedure then you read about others and their surgories and seems they are none to happy about the surgery,so basically pick a good surgeon,how does one really know., and I think we should get a second surgeons opnion,in case we should do surgery,although it needs to be done local.So not to sure if laproscopy is the way to go.It is starting to sound better than open tension,when I thought SH was doing it i was on board,not so much now.
Here are some names of surgons recommeded to me none to near her home which seems to be a contention as well,so has anyone heard of or had worked performed by them for hernia s by them and what can you tell me about them,or can someone recommend a good surgeon in case hernia surgery is actually the way to go and ---b--any oponion s on this situation and what to do.
For me if it was not incarecerated I would be fine just waiting,can one really adopt this attitude in this situation given her age as well(if any surgeons read this board,thanks in advance).
The names we are given are :
Dr Penner(Western H)
Dr Ing(Markham H)
Dr Hagen(RR by GP)at(Humber H finch)
Dr Moozar (Western H)
Dr Brnneman at Sunnybrook.
Thanks for taking the time.
AMS
We went to Western H in TO to the ER to check it out as her GP was away and we were released as it was not life threatning and the senior did not want the surgery she freaked out actually,as she went in to check something out and now they wanted to keep her ON and perform surgery and she felt fine so she was not amused,and of course we knew nothing of this surgeon,since then we have been to shouldice H and we have been declined because of her age and light heart condition which is not a big deal apparently so her GP says,just a light condition.
Please help me to make the right choice here.I need advice from people who know,surgeons themselves,or seniors who have been through this.
By letter we were told by Shoudice s IC surgeon to keep a watch and wait attitude as sometimes that is best when one is that old instead of surgery,basically if it aint broke don t fix it,although i think it is a bit broke but should she need surgery then to proceed to a full facility hospital to have surgery. Mind you all this is based on 1 vist and paper work.
This senior is a tad difficult,does not really want to do it because she is afraid and i guess rightly so,surgeons say its nothing a simple procedure then you read about others and their surgories and seems they are none to happy about the surgery,so basically pick a good surgeon,how does one really know., and I think we should get a second surgeons opnion,in case we should do surgery,although it needs to be done local.So not to sure if laproscopy is the way to go.It is starting to sound better than open tension,when I thought SH was doing it i was on board,not so much now.
Here are some names of surgons recommeded to me none to near her home which seems to be a contention as well,so has anyone heard of or had worked performed by them for hernia s by them and what can you tell me about them,or can someone recommend a good surgeon in case hernia surgery is actually the way to go and ---b--any oponion s on this situation and what to do.
For me if it was not incarecerated I would be fine just waiting,can one really adopt this attitude in this situation given her age as well(if any surgeons read this board,thanks in advance).
The names we are given are :
Dr Penner(Western H)
Dr Ing(Markham H)
Dr Hagen(RR by GP)at(Humber H finch)
Dr Moozar (Western H)
Dr Brnneman at Sunnybrook.
Thanks for taking the time.
AMS
Replies to This Discussion
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Permalink Reply by Zee on -
This sounds very weird BUT if she is not in pain and it is not incapacitating her at all, WHY DO ANYTHING. At her age being subjected to a general anesthetic is not a piece of cake.
Your posting is quite confusing and you make nothing too clear. I think that this is something her medical provider, her GP or her GPs replacement should deal with.
P.S. I'm not a surgeon, I'm not even a doctor but having spent 30 years as a Health Care Professional, that would be my advice.
Don't put the cart ahead of the horse and I don't think your involvment helps in any supportive way. You can certainly help her arrange appointments and take her to the appropriate places but that would be your only involvement. Certainly get a second or even third opinion but again don't put the cart ahead of the horse.
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Permalink Reply by ams on -
Well first off thank you for the reply.
I am assuming you were a nurse,so you will understand this .
I was told having your bladder dislodged and hanging out there with food and fat being lodged in the fat will bring on possibly an infection which will be painful and piosoness or the intestine can become stranulated because it is incarecerated at this point and cannot be lodged back in without surgery which she would have 6 hrs to get to ER to save her bladder and and worse her life.
On the other hand nothing may happen thus the wait and watch recommendation meaning do not do anything,is that to confusing,sorry if that was unclear,my post was about oponions on if surgery was a good idea from hopefully people that have gone through this or in the health business such as yourself and if she requires surgery then I would like a very good surgeon to do it with the best follow up care,thus me asking for an oponion.
Thirdly I cannot see how someone wanting to help to do the right thing by a senior who is not able to help herself is not not helping her.
So thanks for your reply,I am leaning in the direction of no surgery but should something have to be done I would like a good surgeon,and BTW it would be done under local if it could be tolerated,I certainly do not want to put her in a ER situation and you can bet I have contacted 7 practioners already and well no one really has the answer and most surgeons have not replyed,although her GP did lean towards doing the surgery,I just want to get a second and posiibly third oponion and have a good surgeon to rely on should the need arise.
If anyone else has any oponions or recommendations I am taken all into advisement and would like you all to know that I only want to do the best by her and want to be ready should the need arise
Thanks
AMS
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Permalink Reply by Zee on
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hi again. No I was not a nurse. I would think that if strangulation was potential then there is the likelyhood that surgery should correct the issue. If a local anesthetic can be done, that's a positive.
There shouldn't or couldn't be food or fat in the bladder. A hernia is a bulge, not a perforation.
As for finding a good surgeon or for that matter any doctor. There are excellent ones, there are goods ones and then there are the not good and then the very bad ones. Yes they do exist.
Best bet is to talk to people, especially in your area or if you can go to the local hospital and ask some questions of say , surgical ward nurses to get their impressions. They might not be too open tho.
The best in the field can be found at local hospitals, it need not be one of the very big "political" hospitals. Can her GP not give her another consultation ie send her to another surgeon for an evaluation? Someone who may have lots of experience with bladder hernias. To get good quality medical care you have to ask questions and listen to the answers and especially the way the answers are given.
You can't prebook a surgeon unless you've known him/her for years. If something suddenly happens your best bet is your local hospital, going to a bigger hospital will not automatically ensure anyone surgeon, depends who is on call unless you have a pre-existing relationship.
The information you give is confusing because you are involving the bladder and the intestine and the two are not really related. I think that you can rest easy if none of the medical input you have received to date says it is not an accute condition that 'could be' dangerous. I'm wondering if you have been reading things off the internet and don't really understand what you are reading. I feel your worrying and it may be for not.
Best to turn all your worry over to her GP. He/she will know what to do.
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Permalink Reply by ams on
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gtadaizee said:hi again. No I was not a nurse. I would think that if strangulation was potential then there is the likelyhood that surgery should correct the issue. If a local anesthetic can be done, that's a positive.
There shouldn't or couldn't be food or fat in the bladder. A hernia is a bulge, not a perforation.
As for finding a good surgeon or for that matter any doctor. There are excellent ones, there are goods ones and then there are the not good and then the very bad ones. Yes they do exist.
Best bet is to talk to people, especially in your area or if you can go to the local hospital and ask some questions of say , surgical ward nurses to get their impressions. They might not be too open tho.
The best in the field can be found at local hospitals, it need not be one of the very big "political" hospitals. Can her GP not give her another consultation ie send her to another surgeon for an evaluation? Someone who may have lots of experience with bladder hernias. To get good quality medical care you have to ask questions and listen to the answers and especially the way the answers are given.
You can't prebook a surgeon unless you've known him/her for years. If something suddenly happens your best bet is your local hospital, going to a bigger hospital will not automatically ensure anyone surgeon, depends who is on call unless you have a pre-existing relationship.
The information you give is confusing because you are involving the bladder and the intestine and the two are not really related. I think that you can rest easy if none of the medical input you have received to date says it is not an accute condition that 'could be' dangerous. I'm wondering if you have been reading things off the internet and don't really understand what you are reading. I feel your worrying and it may be for not.
Best to turn all your worry over to her GP. He/she will know what to do.
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Permalink Reply by ams on
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Hi again.May I ask what you did in the health profession.
Sorry for the confusion,yes some info was off the internet.Some her GP and 2 surgeons but very brief.
I am not confused I just sound confused sorry my head races faster than my writing and I am not clarifying my thought patterns,I have made diagrams and read all kinds of info on different hernia s
She has a right inginal incarcerated hernia and it is not blocked by the bladder,but as you say it has the potential to become strangulated.
Her GP has given me someone who she says is good and I called his office to get some info and they said he is very good esp with lyproscopy that is what he has been doing as of late,this would entail going under gerneral which I do not think is a good idea,so I am looking for someone who could do both kinds of hernia operation s very well.
I have to say that privately I do not like the hospital he works out of and it makes me a tad nervous and it is far for her,so going with what everyone is saying it is a bout a good surgeon,but she would like to go to a H close by,so I found a surgeon close by by making phone calls to surgeons offices on my own and her GP says she has heard he is good as well but why would she just not offered that up in the first place since it is close by,problem is he has a 6 mos wait,and for some reason her GP will not send off to more than 1 surgeon I do not see why,so I am stuck trying to fit every need to make a good choice,..
Thus this board is another way of me asking around.
I have to tell you we went as I posted to the ER for a full day was seen by a surgeon who really does not have a lot of experience as he just graduated a few years back,and he wanted to operate that night,plus i asked the nurse about him and she had never heard of him and he is the one that told me that fat becasue of a cat scan is lodged in there actually quite a bit of fat and it could get infected so I do not think we can argue with the cat scan thus me doing my research , anyway since then shouldice said the same thing as yourself to wait and watch approach.
Sometimes putting it out there like on this site maybe someone has info and exp they can highlu RR or not RR.
An e.g. is a person on another board recommeded a surgeon who at one time worked with shouldice and has his own practice and was given a high RR by a nurse but I went online and got quite a few bad reviews on well mostly his staff and a few on him,and the odd one was good,so that stopped me dead in my tracks and it is far for her.
So thanks for taking the time to get back to me it is helping me to choose wisely and ultimately its her choice and I think she has had this hernia about well I would say over 2 years we just do not know,its just this xmas I really noticed the bulge and got worried.Friends and family say its unhealthy to just leave it like that which makes me feel that I am not doing a good job of taking care of her and that we should do something about it.
So hoping for the best and the hand of god steering us in the right direction.
Thanks for your ear and taking the time to reply and to listen it helps me.
AMS
Happy Family Day
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Permalink Reply by Zee on
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Well the waters just get muddier and muddier and because of your vasilations, I will make no more comments.
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Permalink Reply by ams on
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Well thanks for your advice and sorry for affending you.
Take care
AMS
gtadaizee said:Well the waters just get muddier and muddier and because of your vasilations, I will make no more comments.
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Permalink Reply by Zee on
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No you did not offend me. I just can't help you. Even the best person needs to have some understanding of what is at issue. Good luck in your search but I think you may be making this far more difficult than it needs to be. What one person thinks of as good, might be someone elses' bad.
There are over 50 kinds of hernia's. A physician is who should see the patient. You can not make any decisions unless she has signed a Power of Attorney. I suggest you let her medical practitioners handle this.
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Permalink Reply by Zee on
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Slept on this and thought some more. I stand by my previous reply BUT if someone has diagnosed (thru xrays, CScan, etc....) a strangulated hernia then she needs medical care as 'distal' to the strangulation can die/rot/gangrene. Let the professionals take care of this person.
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Permalink Reply by ams on
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Just to put you at peace ,it is currently incarcerated at his point,can lead to strangulation,as practioners say they do not have a crystal ball so it is a matter of doing the right thing and making the right choice through the practioners ,and i am leaning with you on this one to watch and wait,but good surgeons will show us the right way and take age into consideration.
Just thought i would clarify after all your posts and time ,thank you for your thoughts.
Have a nice day,all should go well.
AMS
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Permalink Reply by Zee on
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I don't understand the casual attitude of people re an incarcerated hernia. but then I don't see much difference in the end result of strangulated or incarcerated other than one is a twist. I'd tend to think that at 86 this person wouldn't tolerate any bowel blockage for any period of time.
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Permalink Reply by ams on
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Neither do I.
W abd W was what we were told by the best Shouldice.
She has no pain at all in fact if it was not for the bulge we would not have even known,except for the cat scan.
Sometimes older folk are just so afraid of surgery they perfer to take chances until the day of reckoning comes,and sometimes they are correct to wait,its just one of those worrisome things.Now she is ready at this age to do what is right which is a step in the right direction.
Thus me asking around for advice and other surgeons with the emphasis on their experience,some reply s make me nervous some calm me downwill ,in the end it is ours to cure and find the right answer and hopefully the right surgeon with the right atitude. Ask Gp to put 1st one through today for our app.Funny though on this board no one speaks,so thanks for this much.
Thanks my dear and take care
AMS
aizee said:I don't understand the casual attitude of people re an incarcerated hernia. but then I don't see much difference in the end result of strangulated or incarcerated other than one is a twist. I'd tend to think that at 86 this person wouldn't tolerate any bowel blockage for any period of time.
Dilbert
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