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Before you submit to surgery. . .

MagazineNovember 1994 (Vol. 5 Issue 8)Before you submit to surgery. . .

Be absolutely sure that you are properly diagnosed as actually having a

Be absolutely sure that you are properly diagnosed as actually having a

If you do decide to have an operation after a decisive diagnosis, opt for the Shouldice technique if you are under 50. Only agree to a mesh repair if you are over 50 or even 60. Don't agree to keyhole surgery until there is more evidence that it can be performed safely.Not all hernias need an operation. Canada performs twice as many hernia operations as the UK, largely because your run-of-the-mill medic can get reimbursed for them, indicating that finances, not need, often are the deciding factor. If a surgeon decides not to operate, he can either do nothing or give the patient a truss, a supportive garment which pushes the hernia back into the abdomen by applying steady pressure. Some patients given a truss (particularly elderly ones) don't understand how to fit it properly and aren't given instructions. If you do get one, make sure it is fitted when you are standing.

Don't be afraid to grill the surgeon on his track record. How senior is he? How many Shouldice operations has he done? What is his recurrence/complications rate? If his answers don't satisfy you, get yourself another doctor. Remember: if your operation needs to be redone, the risks of complications multiply.

Think twice about surgery if you are elderly, frail, you've got a direct hernia or you've had a small groin hernia for many years and not realized it or not had any problems. (For many femoral hernias, which carry a much higher risk of strangulation, an operation may be more justified.)

If you decide against surgery, to combat ulcers or heartburn, eat numerous small meals every day rather than a few large ones. Don't lie down after you've eaten and wait a couple of hours before lifting weights and bending. If you really need to lift, bend at the knees, not from the waist.

Don't eat spicy foods and avoid fried foods which delay digestion and prolong the stomach's emptying time (allergenic foods often magnify the symptoms and prolong the healing process). Avoid coffee, tea, alcohol, colas and smoking. Don't wear tight belts or girdles. Avoid constipation and straining during a bowel movement. Strengthen the stomach muscles by lying on your back, knees bent, lifting your buttocks and lower back off the floor, 10 times a day.


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