How will hernia repair affect backpacking ??? Anyone Know?

[Billy Ray]

Okay… So I have been diagnosed with a hernia. Indirect Inguinal Hernia to be precise.
It hurts to walk and lift things so I don't see how I will be able to backpack without getting it repaired.

Met with a surgeon. It seems they mostly do repairs with mesh made of various types of plastic fabric. But I have been doing some pre-surgery reading on the web (maybe a bad idea?)… and there maybe a 20% chance of having chronic pain after. Also, some complain of reacting to a foreign material left inside. And I'm sitting here imagining that mesh inside and then a backpack waist belt cinched tight over that area and thinking that in itself could feel so bad it would end my backpacking.

Looking for someone who has had a hernia operation that can tell me this is going to be okay… or maybe someone that says: DON'T DO IT!

I'm a bit nervous about this… not so much the inconvenience and trauma of the surgery, but the potential for it ruining backpacking for me.

Please advise.

thanks
Billy

[David Noll]

Billy,
I had a hernia repaired with mesh about 10 years ago and within 3 weeks it was as good as new. It has never bothered me. I am 66 years old, play tennis, backpack and canoe in the BWCA every year. No regrets.

[Larry Swearingen]

Hi Billy,
I've had two Indirect Inguinal Hernia repairs, Right and Left, at separate times
back in the 80's and early 90's. Also a belly button Hernia repaired about 5 years
ago. I'm 69 and hiked about 240 miles on the CDT last year.
Both Inguinal hernias were fixed with mesh overlays. No problems.
The first was done under a local anesthetic on an Out Patient basis. You go home
in the afternoon. Actually both were done on an Out Patient basis except I had the
second done under General Anesthesia. I didn't want to be awake for it that time.
I told the Surgeon "just put me out and I'll wake up in the recovery room.
I didn't like the Local at all. Operating Rooms are Ice Cold and that Operating Table
is like being crucified. Also the Local started wearing off before surgery was done.
Not cool ! So getting put out completely was great for me.
I can't imagine going through the rest of your life with a bulging hernia. It's painful
and the risk of getting a Strangled Hernia isn't worth it. Before the surgery I pushed
the protruding intestine back a few times. shiver here from the thought. They can be dangerous too. Just Google that and see.

What ws Nike's Slogan ?? Just Do It !

Larry

[rOg w]

deleted

[Greg Mihalik]

The first week isn't fun. Once home, at the first hint of pain, take the drugs. If you're not comfortable, take the drugs. Yes, you'll be a little loopy. No big deal. No, you won't become addicted in a week. Don't be a tough guy. Stay comfortable. You'll wake up one day and say "I don't need no stinking drugs". And you're done.

I was out walking withing a week. Let common sense prevail.
10 years out and no issues doing anything physical.

BTW, a strangled a hernia while you're out in the woods… it won't be pretty.

[Jerry Adams]

I had one 10 years ago. I forget, followed their instructions to take it easy for a few weeks? January. Was out backpacking that summer.

I get a bit of pain occasionally. I guess therefore you could call it chronic. Just makes me wonder if there's something I should check out. Not enough to inhibit activity.

I don't think you have much choice. You have to fix it. Just follow instructions about taking it easy, then rehab afterwords.

[Billy Ray]

Thanks for all the good responses and encouragement. Good to hear some positive results from other backpackers as I don't think most of these surgeons have our experience and I often don't think they understand what we put our bodies through when the give advice.

Hopefully all your positive results will serve to mitigate some of the horror stories that can be found on the internet. Believe it or not, a small percentage of hernia repairs end up disabling people for years, if not forever with chronic pain. That would be life changing in a very bad way.

Any others who have a hernia repair experience to share would be appreciated.

Any insights as to 'open' vs. laparoscopic methods? I think I have a choice.

thanks,

billy

[Michael L]

laparoscopic. It isn't even close. minimal recovery time. Much easier on you.

The first was open when I was 2…so I don't remember. I have some pain my doctor thinks is from it now but didn't notice anything for decades. It isn't life ending. But it is a…pain….

I had a laparoscopic repair 4 months ago. I went to my son's soccer game the next day. I was in pain and kind of regretted it, but I did it. I sat around for the weekend (Friday surgery). Then back to work Monday. Pain med for 2-3 days and then only at night for 2 weeks. Sailing along great until I lifted something incorrectly 4 weeks post op. It hurt and hurt for 1.5 weeks. Now the pain is gone again. I haven't tried backpacking again yet, but for the most part I'm fine. I might feel pain once a week with the new one.

My wife had one as well. Hers was open. Much more time to heal. Much bigger hernia. She is usually fine. The area is sensitive. And she will occasionally be in a lot of pain. Like sit down pain. But that isn't often, and it is better than before the repair by far.

[Billy Ray]

Thanks for your report Michael.
4 months… do you feel like you could backpack now?
I would hope to be doing some moderate hiking at about 2 months, strenuous hiking at 3 months, and maybe backpacking again at 4 months. Do you think that is realistic?

How long ago was your wife's repair?
(wondering how long after she is still having significant pain)

thanks,
billy

[Bob Gross]

How fast you recover is hard to predict.

I had one back in the 1970s and recovered quickly. I had another one in the 1990s and recovered quickly. I was hiking three days later. It probably slowed me down a little for one trip, and then I was good after that.

A lot of it has to do with how lean or how fat you are. Fat doesn't heal much. Lean muscle and tissue will heal.

–B.G.–

[Billy Ray]

Thanks Bob… you are always a font of good information.

Billy

[Nico .]

I've nothing to add to the discussion, but I've been reading along with interest as I've had a (small) hernia for roughly the last year. It's subtly visible but otherwise hasn't really bothered me yet. My doc didn't seem particularly concerned about it if it wasn't bothering me, but I assume if it worsens or becomes larger I'll need to do something about it. It's reassuring to know the recovery for most is quick and lasting… it'll be a struggle to sit still for too long waiting for it to heal should I ever opt to get it fixed.

[Michael L]

Billy,

My wife's was years ago. I don't remember how long. The pain isn't constant, but it does happen. Seems to come in spurts. Like a few months ago she got up and went to go to the kitchen and kind of dropped to a crouch/fell down in pain. After 15-30 seconds she got up and was past it. I think the nerves and scar tissue/mesh get caught sometimes. She has been rollerblading, hiking, had a kid, plays volleyball, etc.. after the surgery.

I'm sure I could backpack now. Not that it's the same, but I carried a lot more weight on a recent family trip in my backpack then I ever do hiking. I had no issues. I went hunting over Christmas with no signs of pain.

I think with standard healing you will be good to go. Just follow the doctors orders. And then even after that, lift correctly. In a few months if you are like I was, you will be fine. I know I could do a few miles within the month no problem on rolling hills.

[John Vance]

I had a double hernia repaired with mesh two summers ago via traditional surgery. I left the next day for Yellowstone with my family and pretty much layed around the first few days. By day 5 I felt pretty good and walked 5-6 miles on the trails and boardwalks which was a bit much. 30 days after the surgery, I left for a 12 day backpacking trip in the Winds, mostly off trail and had no problems. I slept comfortably, had no problems with the waist belt on my pack, and experienced no real pain. I did however, take a shelter with a side entrance which helped a great deal.

It has only been in the past month or two that I have not felt anything "weird" going on down there and I am not certain whether things finally healed or I just got used to it. No real pain, just felt like there was a pair of socks in my pocket or something. I think I resumed normal workouts a bit too early lifting weights just a week after the repair. My doctor told me I was pushing it but also said as long as I felt ok and didn't strain I should be fine. Besides, he said, "I love doing hernia repairs – it's the bread and butter of my practice. Go ahead and do what ever you like, I am more than happy to charge you again."

I do think the activity increased the amount of scar tissue as the mesh pulled from newly grown tissue over and over again. I would say that I am 95% back and that may be it. Once I got past 50 it seems each physical "event" never completely heals 100%, you just start accumulating a host of little aches and pains that gives you character or just makes you cranky.

[Billy Ray]

"I've nothing to add to the discussion, but I've been reading along with interest as I've had a (small) hernia for roughly the last year. It's subtly visible but otherwise hasn't really bothered me yet. My doc didn't seem particularly concerned about it if it wasn't bothering me, but I assume if it worsens or becomes larger I'll need to do something about it. It's reassuring to know the recovery for most is quick and lasting… it'll be a struggle to sit still for too long waiting for it to heal should I ever opt to get it fixed."

Nico… you are wise to wait. From my readings this potential 20% chronic pain for years maybe due to the nature of synthetic mesh. There is apparently a small but growing use of bio-mesh made from things such as pig intestines that shows great promise of having fewer problems than synthetic mesh. In my case, I can't wait as it is painful for me just to stand some days… and certainly extensive walking and lifting makes it hurt.
Believe me I am struggling with the sitting still issue… worse than you might think as I had foot surgery early November and was out of action until I returned to the gym and treadmill mid December… that's when I first noticed groin pain… bad enough I had to back off… but thought it would subside with rest… did not… two docs later I am scheduled for surgery Feb 20… If it takes two months after that to get to do significant exercise I will have been out of action for Nov thru April = 6 months !!!!!!!!!!!!!!!!! Back in November pre-surgery I was upset about taking what the doc said would be a month off to heal from foot surgery… I be a happy camper… NOT !!! So I am a bit panic stricken at the thought that I could be one of the 20% that end up with chronic pain and a potentially MUCH longer time until back on the trail…

thanks for listening everybody…

Billy

[Billy Ray]

Thanks for the report John… very encouraging.. I'll take the socks in my pocket so long as it is not pain that keeps me from doing what I love…

Billy

[Nathan Avery]

Surgeon and backpacker here. I just wanted to reassure you that while the chronic pain rate after hernia repair is certainly higher than was previously thought, and might be as high as 20%, most of the people in that group had relatively minor pains which completely resolved after a few months to a few years. Only about 3% of patients in large studies had pain severe enough to require visits to pain clinics. There is also the possibility of removing the nerves in a second operation if chronic pain persists.

Either open or laparoscopic approaches are totally reasonable. One large study did suggest that the chronic pain rate might be lower with the laparoscopic approach. Also, patients who undergo the laparoscopic operation are able to get back to full activity faster than patients who undergo the open operation. Although, the laparoscopic approach does tend to be more costly than the open operation, but probably moreso for your insurance company than for you. Let me know if you have any more questions about it.

[Billy Ray]

Nathan,
thanks… your response is helpful.
I think the scariest part of surgery is deciding and committing to doing it (that and actually going there the morning of the surgery)… that's where I am at right now… trying to get comfortable with a commitment to it.
From what I have read on the web and here I think I am leaning heavily toward the laparoscopic method.

I have Kaiser so the cost is the same for me either way. They gave me the choice.

thanks again,
Billy

[Eric Blumensaadt]

Just three days before a Grand Canyon trip my inguinal hernia totally popped out.

I had it surgically fixed with a "one stitch" method and a month after that I was fine for backpacking.

Since then (8 years ago) I've been fine.

[Billy Ray]

"one stitch" method ???????????

Can you elaborate on that Eric?
what is the 'one stitch' method? haven't heard of that…
was there mesh used?
open surgery or laparoscopic?

thanks,
billy

[Anonymous]

"Looking for someone who has had a hernia operation that can tell me this is going to be okay… or maybe someone that says: DON'T DO IT!"

Billy- I had inguinal hernias occur within 2 months of each other on opposite sides of my abdomen. The surgeon gave me 2 options for repair, incisional or laparoscopic. The tradeoff, as he explained it, is between less pain and quicker recovery for laparoscopic, due to the smaller incisions, and a stronger repair job with the incisional due to better access to the tissue being repaired. I chose the incisional, WITH MESH, and was up and walking the same day, walking half a mile the next day, a mile the day after, and up to 5 miles within a week. The second time around I got cocky and walked 8 miles the day after in less than 3 hours. That was a little overboard, and I had some extra soreness, but in both cases, I was back to my normal hiking routine of 8-10 miles in the Cascades within 2-3 weeks. If you go with incisional, you will have considerable soreness, especially when trying to get out of bed or off a couch, but it will not endanger the incision or the repair. If you can tolerate pain, you'll have pretty smooth sailing and a stronger repair with the incisional approach. If not, go laparoscopic, but the repair is not likely to be as strong. At least that is what my surgeon said. either way, hernia repair is a very low risk operation, and will not limit your backpacking. I am living proof of that. Go for it, because the possibility of complications such as incarceration of the small intestine is not something you want to have happen back in the mountains if you do not have the hernia repaired. Like you, I was scared $hitless going in, but it was all in my head. I have never regretted the decision.

Edited: My hernias were repaired with mesh, and I have experienced no residual pain.

[Billy Ray]

Thanks Tom…
I appreciate you sharing your experience. Helps.

billy

[Anonymous]

"Once home, at the first hint of pain, take the drugs. If you're not comfortable, take the drugs."

+1 with the proviso that it will constipate you, and when you finally get around to doing your business, it ain't gonna be fun.

"BTW, a strangled a hernia while you're out in the woods… it won't be pretty."

Again +1. My surgeon warned me about the consequences, to include gangrenous small intestine if it became incarcerated and was not treated within 24 hours at the most.
That was a major consideration in my decision to have it done before it became absolutely necessary.

[Nathan Avery]

Just to clarify a few things that have been said by others…there is no "one stitch" method of repairing adult hernias that does not use mesh. In teenagers you can argue for high ligation of the hernia sac and not use any extra mesh or sutures, but most surgeons would not recommend that method in adults due to high recurrence rates.

Also, the strength of the repair should not be significantly different between the open and laparoscopic approaches. The other surgeon was probably referring to early studies which suggested that recurrence rates were higher with laparoscopic hernia repair, but larger studies have since shown that open and laparoscopic operations have essentially the same recurrence rate as long as you have an experienced surgeon.

[Valerie E]

Had my inguinal hernia repair in 2012. My experience was similar to Tom's (only I chose the laparoscopic method). I ended up with some small complications during surgery because of scar tissue build-up from a prior (major) abdominal surgery, but it was no big deal.

I had a quick recovery, virtually no pain (all I took was a couple of Tramadol for the first day or two, then nothing), and back to walking/hiking within a few weeks, with NO residual effects.

It's really a very small surgery that can prevent some big problems later on. As always, look for a "high-volume" surgeon, who will already have encountered most of the possible complications that might arise.

Good luck, and I'm sure you'll be fine! :^)

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