Umbilical Hernia Repair Surgery (Oh, and a wandering IUD)

Hey there. Just recovering from the surgery I had yesterday. Yep, surgery. SURPRISE!

I'm not sure where to begin. I guess I'll start at the beginning...

After I had our second child, I noticed that my belly button was an "outie" but not in a cute, 6-pack-abs kind of way. It didn't hurt, it just looked ugly (and kind of pudgy). Fast-forward about 11 months later and I was about 12 weeks pregnant with baby #3. My mom and I went to lunch one day and I ate too much and was VERY full afterwards and noticed that my belly button had become REALLY tender. My mother is a nurse so I showed it to her and she said, "Oh, that's a hernia." Being a nurse, things like that just roll off of her tongue with no cause for concern. But I remember thinking that if it hurt this bad now and I was only 12 weeks pregnant, how much more was it going to hurt as my belly grew?

However, I soon found that as my belly got bigger, my belly button didn't necessarily hurt any worse. It was still a little sensitive (especially when I'd eat too much) but no big deal. And my OBGYN even kind of blew it off and said that "umbilical hernias" are somewhat common for pregnant women and it may fix itself after the baby was born.

Well, fast forward another 10 months or so (baby #3 about 2-3 months) and my belly button was still herniated. As the months went by, I would notice that it would hurt when I ate too much but nothing too crazy. I also could push the hernia completely back in. It would always immediately come back out, but it was able to go in and out with ease and I found myself playing with it often. I was told that the fact that I could push it back in was a "good" thing because that meant my intestines weren't strangulating. Ah-nice, thank you. Earlier this summer, I had an annual appointment with a general practitioner and I mentioned the hernia to her in our discussions. She actually even questioned if it was in fact a hernia but suggested I see a gastroenterologist to see how much and what exactly was sticking through. I said, "Well, it doesn't really bother me, should I be concerned?" You see, I had read a few horror stories about hernia repair surgeries. Damn Google. But her response was that it may not bother me now, but when things start slowing down when I'm 65, ahem, meaning my digestion, it could become a serious problem. Yes ma'am. Got it. No need for a dying small intestine. So I made an appointment with the gastroenterologist that my mom sees that she's known for many years.

Now, wouldn't you know that for the past few weeks, I've REALLY been trying to focus on my health and losing weight. I've been eating better and I've been exercising.  I just finally got to that point where I was DONE with being blah and I was focused on losing weight. I have learned that I have to be careful with what kinds of abdominal exercises I do because I also have diastisis recti--a separation of my abdominal muscles that is common among women who have had multiple pregnancies. This diastisis is not something that a surgery will fix. And certain exercises like sit-ups, burpees, & planks can make the separation worse. It's frustrating because I'm working on losing my "mummy tummy" but I can't do so with traditional exercises. But you can also imagine that the fact that there is a separation at all could likely be what assisted the hernia in "popping out." I'm not sure if I exercised "too hard" (4 days a week was likely "too hard" for my body) but last weekend, my belly button started bothering me.

We were off on Monday for Labor day so we did a bunch of family things, including a trip to the zoo, lunch at our brother-in-law's restaurant, a trip to the grocery store followed by dinner at the restaurant that is attached to the grocery. When I went to order my dinner at the restaurant, I remember feeling strange. It was as if I was hungry, but I felt like nothing else could fit in my stomach and my belly button was REALLY SORE all day. When we got home I laid down on the bed and tried to push my belly button back in--to no avail. It was SO tender and so sore and not just the belly button but a good 2-3 inches all around it was tender. Great. Just great. Well, the good news was that the gastroenterology appointment I had made months prior was the next day--good timing!!!!

I went to the appointment and sure enough, the doctor agreed that I had a hernia, said I would have to have surgery relatively soon to fix it and ordered a full gastroenterology work-up on me. Colonoscopy, Endoscopy and all! I wasn't thrilled at the idea, but I do have some digestive issues that I've always wondered about so I guess you could say I was "reluctantly excited" about all of that. But he told me he didn't think my intestines were "strangulated" or that the hernia was any cause for immediate concern. First step was to schedule a CT-Scan so that they could see how much (and what) was "caught" in the hernia. Luckily, I was able to make that appointment 2 days later (on Thursday). I got some bloodwork done at his office and then was on my way.

Thursday arrived and I went to my CT-Scan. While filling out the paperwork, they have you complete and sign this acknowledgment page that you are not or could not possibly be pregnant. I hesitated a little. If you read my first (ever) blog post here, you'll recall that I had a strange little "scare" recently, even though I have an IUD. Basically just had some cramping that was VERY unusual. AND 10 days after that blog post, I had some spotting which was also VERY strange since I haven't had any spotting or periods at all during the year that I've had this IUD. So I mentioned the recent scare to the tech but assured her that I was 99.9% sure I wasn't pregnant, blah, blah, blah. We agreed that it was obviously a fluke thing and to proceed with the radiation, I mean CT-Scan (because after about 5 negative tests, it's pretty clear you're NOT pregnant. WHAT? Don't judge, I had my reasons!). Thirty minutes later and I was done and on my way. As I left, I asked the lady at the front desk to please send my results over to the gastroenterologist ASAP b/c I had an appointment in the morning (Friday) and he could review them with me then. The appointment was just for a lactose intolerance test, but I wanted those results because my belly button was getting more tender, a little more pink, and harder each day. OH--and I've failed to mention that I hadn't pooped since Sunday (even though I was taking Miralax and a stool softener). Sorry--TMI? Oh well, read another blog.

I stopped to get a salad to bring back to work (fiber) and was headed on my way when my phone rang and it was the gastroenterologist's office. My doctor got on the phone and said that I needed to go ahead and head over to the general surgeon's office TODAY. In the 30 minutes since I had left the imaging clinic had already sent over my scans. Sure enough, my hernia appeared to be "incarcerated" meaning something was stuck--might be intestines, might just be a bulge of fat/tissue--and I had to have surgery sooner rather than later. OK, I thought. I had been saying all week that my belly button "wasn't right" so I was sort of prepared for this news. Then as we were about to hang up, my doctor said, "Oh and also, your IUD is NOT in place." Me: "OH REALLY????" Things are beginning to make sense.

Got to the general surgeon's office and my mom met me there. He was a very nice, funny doctor and made me feel very at ease. He looked at my stomach, said that more than likely it was "fat" poking through (lovely) and that he does surgeries like this all the time, he'd push the hernia back in, put some mesh in there and it would be fixed. We talked about stitching the hole up versus the mesh. He said that there is more likely a recurrence when you simply stitch up the hole. While we were talking, he still had not received my actual scans but just then his nurse popped in and said, "Her scans are in." He asked to be excused and I said, "Oh, do you mind if we come with you, I'd like to see them." So my mom and I followed him into his office.

Looking at the scans, you could clearly see my belly button poking out and he showed me a spot where maybe my intestines looked swollen but it might just be the angle, blah, blah, blah. As he started to get up, I said, "Do you mind...the doctor mentioned that my IUD wasn't in place. Can you see it?" He sat back down and started scrolling through the scans..."Hmmmmm." His head tilted sideways. "Hmmmmm....ok....mmmmm." I could see what he was "hmmmm-ing" about. I could see my uterus and then off to the side and a bit "north" of my uterus, I could see my IUD. He rubbed his bald head and took a few deep breaths. We headed back to the consult room. He told me the hernia surgery--no big deal, easy-peasy. The IUD part--a little more tricky b/c he wasn't sure if it was even in my uterus anymore. He mentioned things like it could poke my bowels, or cause my uterus to bleed. All I could think was--GET that thing out!!!! I've never been a huge fan of my IUD. From the moment of pure, agonizing pain when my OBGYN put it in place (and then had to essentially put it in place again b/c she didn't get it right the first time) I just wasn't sure how I felt about it. NOT having a period...that's great and all...but isn't that what our female bodies are SUPPOSED to do? It just seemed so unnatural to me. I mean, sure it was nice to not have a period or any cramps or PMS. But lately, I've just kind of been over that thing. ESPECIALLY when I had those recent cramps and thought perhaps I had gotten pregnant. Ever since then, I've REALLY wanted it out. But NOW it all makes sense. My guess is the cramps may have been when it was escaping from my uterus by poking a hole through it and then the spotting was a result of that.

Anyway--surgeon said he'd do my surgery the next morning (which was Friday) at 11:00 am. He planned to do it as outpatient (in and out in one day) but because of the IUD issue, he couldn't make any promises until he got in my abdomen. He also wanted to do the surgery at the actual hospital instead of his outpatient clinic that way there would be OBGYNs on staff in case he needed one. I thought that was a good idea.

So home I went to "Google" my night away...umbilical hernia repair, hernia surgery recovery, IUD migration, embedded IUD, etc.

Friday morning we drove to the hospital. Got admitted, registered, changed, in my holding bed...and then the waiting game. Surgeon was running late. By the way--my chart said my surgery was for "Incarcerated Umbilical Hernia and Removal of 'foreign body'." Doctor finally got there around 12:30 and they gave me what they called my "margarita" in my IV at about 12:45. They wheeled me to the operating room and I remember talking to the nurse and laughing and thinking I was going to remember what we were talking about...NOPE.

I guess I woke up after I was brought to the recovery room. I was drinking water and eating crackers (both of which would come RIGHT back up in a few short minutes) when my husband and mom came in. Surgery was over and all was good. Hernia--just fat poking through (I'm glad it was just fat--but ew. I mean EW!). IUD--FOUND with one of the "arms" poking out of my uterus. He said he was able to get that out by pulling gently on the string. Guess he said the "hole" was small enough that it would fix itself. I think I slept a little more b/c it was Friday around 4:30 and we knew traffic would be bad. I had to go to the bathroom as a prerequisite to leave. Had a little bit of bleeding so I got to request some of my favorite mesh underwear! I think I'm the only crazy person who likes those things. Anyway, like I said earlier, I vomited after I got up and walked around--nurse said that was VERY normal. They even had little plastic barf bags in a dispenser in the wall (of course I grabbed three to put in my car thinking only of the boys...and then I grabbed a couple extra for me). We finally left and headed home. I was nauseous the entire ride home. Got out of the car, walked inside and vomited three more times. I felt MUCH better afterwards!

They gave me Hydrocodone/Acetaminophen ("Norco") for the pain. And told me to keep up my Miralax, GasX, Dulcolax and probiotics. I've had three c-sections...I KNOW about keeping things "moving" after surgery when you are on pain killers. I don't even TRY to mess with that. Scary thing is that I was already having issues prior to surgery...so I'm REALLY backed up now (where IS my water by the way?).

I came home with a square piece of gauze over my belly button kept in place by the thinnest piece of clear tape I've ever seen. The tape is about 6" x 6" and is stretched right over my belly button in the center of my stomach. I don't even know how I'm going to get this tape off b/c it is SO thin and feels like a part of my skin. I think they told me to take a shower and take it off the day after surgery but I haven't yet. My mom (the nurse) said I could wait until tomorrow--best to keep that wound clean b/c you don't want to get an infection--even the doctor told me that is just awful.

I also have two small incisions on each side of my belly button, about 4 inches or so from my belly button. These were for cameras and "tools" I believe so that he could see the hernia better and fine the IUD. They are covered by 2 vertical steri-strips (one strip on each side). They told me to leave those strips on until they fall off or until my follow-up appointment.

I was in a lot of pain the first day after surgery but it was totally manageable with the Norco. Our boys even came home that afternoon--although I didn't play or interact much with them. I mostly slept. Problem was, I had this POUNDING headache and I personally think it was from the codeine in the Norco. My mom said that it could also just be from all the anesthesia drugs. I took the Norco until day 2 post op, and then I switched to rotating between regular Tylenol (1,000 mg) and Ibuprofen (800mg). My mom told me to wait and not take Ibuprofen the first day in case I had some additional bleeding from the IUD removal. But being that today is Sunday (it's taken me two days to write this post), she said it was OK to take. I also had coffee this morning. So I'm not sure if getting off of the codeine helped in getting rid of my headache or if drinking some coffee helped (my caffeine headaches are usually torturous). But I'm glad to have that gone. I'm VERY bloated with lots of gas--however, that gas doesn't seem to be going anywhere. Strange. The pain from my surgery is mostly only felt when I get up from laying or sitting down. Rolling over in bed yesterday was pretty painful, but today is a little better. I've been sleeping with a pillow under my belly when I'm on my side. It feels better to sleep on back though. When I get up from laying down, it basically feels like my insides take some time to adjust themselves and they just sort of burn. Well, not sort of--they burn. It also feels like I did about 1,463 sit ups.

My husband is a godsend. I'm so very lucky to have him. He's taking care of our boys, cleaned the entire house (mopping as I type), allowing me to rest AND this week--the real challenge--he'll take the boys each morning to daycare and also pick them up, bring them home, feed them, bathe them and put them to bed. Or I suppose that I could put them to bed...except actually lifting middle and little into their cribs. But I could read to them. The nighttime routine is usually ALL me b/c hubs works long hours. He's going to be exhausted I know. I'm hoping that I can rest for about a week. I think after that I should be good. Maybe a week and a half. My in-laws are also life savers! They watched the boys for us Thursday & Friday night (after watching the youngest all week bc he had fever). They never hesitate to help if they are available and they are wonderful with the boys! All of our parents have offered to help and I know they would jump if we asked. We are so grateful and so lucky!

All in all, I'm very glad that things happened the way they did. I'm glad to have the hernia fixed. AND I think we are SO lucky to have found the "free-agent" IUD. In a way, I can't help but wonder if this is a "sign" that I shouldn't have an IUD :) But I'm not really one to believe in things like that. I would just like to remind everyone to TRUST their bodies. I knew that my hernia had gone from being "OK" to being something that needed to be fixed in just a matter of days. Once I wasn't able to push it in anymore, I knew things had changed and I knew I'd better get that CT-Scan sooner rather than later. So when she asked me, I told her I wanted the appointment ASAP. And I KNEW something was going on internally when I had those cramps and that spotting that I now know are from my IUD migration. I wish I would have gone to my OBGYN when it first happened but I guess I figured it was normal. But I shouldn't have thought that--if I hadn't had any cramps or bleeding in the past year, to suddenly have them isn't "normal." Luckily, that was only a few weeks ago. So I guess that brings me to the fact that I'm GLAD that I mentioned that little "change" to all of the doctors and even to the technician at the CT-Scan.

A friend asked me if I was upset with my OBGYN regarding the IUD. Of course not. I certainly don't think that she would have INTENTIONALLY put it in incorrectly. I think somehow, it just moved. How could that be her fault? It has been a year since she put it in. I do know that I won't be getting another IUD. :) I'm not certain at this point what our birth control choice will be. I think I'll just watch my cycles until my annual appointment in November and discuss with my doctor then.

I wanted to type this up and put it "out there" because I've recently been doing a lot of research on postpartum umbilical hernias and found it helpful when I read other's accounts. I also did about 24 hours of IUD migration research online. HA! My follow-up appointment is in 11 days so I'll be able to talk to the surgeon sans the "foggy" brain and find out a bit more about the surgery. I'll post an update at that time. I took some before and after pictures. My surgeon also gave me a couple of pictures of my innards of what I think is the lone arm of the Mirena sticking out of my uterus (picture taken from lower abdomen I assume). I'll post those at the very bottom so be warned that they are down there. I'll also confirm with my doctor at the follow up appointment exactly what we are looking at in those images.

The first three images are from the night before the surgery (when I was VERY bloated, mind you). Is it bad that now that I see these pictures I just want to draw a face on there with my belly button as the nose? HA!

Here is one picture from day one post-op:

Here are a few pics from about 2.5 days post-op and after my first shower in which I removed the center tape and gauze that covered my belly button. The incision is so small and I know soon you'll never even KNOW it's there! yay! You can see in the second picture there is still the vertical tape on the left side (my right side):

And lastly--the "innards" picture!! Again, I'm not 100% sure what this picture is showing but will find out in a few days--but obviously you can see the "wandering" Mirena with it's one arm sticking through something...