Wednesday, August 2, 2017

My Abdominal Wall Reconstruction Experience

When I was told I needed a surgery called an "Abdominal Wall Reconstruction" it was a frightening moment. I spent a lot of time trying to find out everything I could about what that kind of surgery entails. It was more difficult than I'd expected. Some articles or chat forums lump it in with hernia repair surgery, and that made it sound like I could be back to normal in a few weeks. I knew from the discussions with my surgeons that this was a much bigger deal.

One blog I found very helpful was this: http://www.notquitewonderwoman.com/surgery-post-1-ventral-hernia-repair-with-abdominal-wall-reconstruction/

If this is something you're going through, she explains her journey very well, and is much braver than me in that she also supplies photos. She also explains how she found her surgeons which isn't something I can speak to since I have Kaiser for my insurance and they have their own in house Abdominal Wall Reconstruction Team. (Who were wonderful! Thank goodness.) This team included a general surgeon and a plastic surgeon, and a nurse practitioner.

I think part of the problem with trying to find information on complete abdominal wall reconstructions is that not every procedure is the same. When I was researching information about my partial colectomy, it was fairly straightforward to find information on what to expect. While there is a lot of variation in why someone might need a colectomy (cancer, diverticulitis, severe Crohn's, etc.) the actual surgery to get the thing out doesn't seem to vary as much.

However, an abdominal wall reconstruction is going to depend on what's wrong with the abdominal wall in the first place. If there are multiple hernias, or just one massive hernia. Where the hernias are. How much good/normal abdominal wall structures there are to work with, etc.

For example, one of my hernias, the one at the site of the original colectomy was low on the left side of my abdomen, right over my hip bone. The surgeons were concerned that hip bone would make attaching the mesh in that area tricky. They warned that the might need to drill into the bone to attach it, but they couldn't say for sure what they would need to do until they were in there. Thankfully they were able to attach it by wrapping the mesh a little further around my side so no bone drilling happened, but that conversation helped me see how each abdominal wall reconstruction is unique in many ways.

The basic gist of reconstruction though, is separating all the muscles and damaged layers of the abdominal wall and rearranging them so they cover the holes from thee hernias, and reinforcing them with mesh to keep it all together.

I'm at about 5 weeks post-op now, and really happy with how I feel. My doctors have warned me at length that my abdomen will never again be as strong as it used to be and I need to proceed accordingly. At this point in my recovery I still have a lot of restrictions on what I am allowed to do. Lifting, bending, twisting, or using my abdominal muscles in any way isn't allowed. I must be careful to never gain weight. People ask me about that a lot. The mesh is holding my abdomen together now. It will always be there. It can't stretch, so weight gain can cause damage to the tissues attached to the mesh, and possibly tear them. Not good. This will be a major challenge for me, but I have no choice but to rise to the occasion.

Recovery is a long slow process. I will see my surgical team again at 3 months and 6 months post op and learn when I can safely do more. Unless there is a problem, then obviously I will go in sooner.

Anyway, I decided to write more about my experience because of how difficult it was for me to find any information when I needed it, and I was so grateful to find the blog linked above. I hope someone out there finds this useful too. Feel free to ask questions if there is something more you'd like to know.

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