Monday, November 9, 2015

Umbilical Hernia Surgery After Twins

December 2012

I will never forget my 6-week checkup after the c-section.  I'd answered "yes" to all of the appropriate questions, my c-section scar was healing nicely, I wasn't having any feelings of depression, and I was  comfortable with breastfeeding.  Check, check, check, check.  My doctor asked if I had any questions and I casually said, "So when will my belly button look normal again?"

And then I felt it.  The long, dramatic pause.  She'd been waiting to tell me the bad news and I had no idea.  I just thought I had a delayed belly button.

"You have an umbilical hernia - as long as you have it, you'll never have an innie."

In all of my research, I'd never come across an umbilical hernia in adults.  I had no idea what she was talking about.  Turns out, they're quite common with pregnancies, especially twin pregnancies.  I carried 14-pounds of babies to 38 weeks, so it was no shock to my doctor. 

An umbilical hernia is a sac formed from the inner lining of your belly/abdominal cavity that pushes through a hole in the abdominal wall at the belly button.

My doctor let me know it would require surgery and I would need to have it repaired.  She gave me the names of two doctors of general surgery and told me to set up a consultation.  

I made an appointment and met my doctor.  He was very kind and asked me all sorts of questions about my twins.   He then asked me to lift my shirt and before I'd even finished he said,"Ohhh yeah, that's a hernia."  My face:
He talked to me about options.  There are two different ways to correct an umbilical hernia. 

1.  A less invasive procedure called laparoscopic surgery can be performed, in which the surgeon makes several smaller incisions around the hernia site. A thin, flexible tube with a light on the end is inserted into one of the holes.  Your surgeon inserts surgical instruments into the other keyhole-size holes in your abdomen to repair the hernia. Performed under general anesthesia and is outpatient.  

2.  During a conventional open surgery, the surgeon makes an incision below your belly button to access the hernia.  Your surgeon will find your hernia and separate it from the tissues around it. Then your surgeon will gently push the contents of the intestine back into the abdomen, and lay a piece of mesh over the weak area (usually not in children) to make it stronger.  Performed under general anesthesia and is outpatient.  
With my situation, he preferred option two.  He also let me know it was too early to perform the surgery (my kids were eight weeks).  I'd lost the baby weight but my body was still adjusting to all of the changes and he was afraid if I did it too soon I would need to have it again.  

There were three huge takeaways from this consultation:

1.  When you have umbilical hernia surgery, you shouldn't lift anything more than 10 pounds for 4-6 weeks.  That is exactly what a mom of young twins wants to hear.

2.  No more pregnancies after the surgery.  While the baby would be completely safe, it would completely negate the surgery and another would be necessary.  He told me to come back when I knew we were done having kids.

3.  You are strongly advised not to work out your core when you have an umbilical hernia.  It can cause "strangulation," which means a general surgery can turn into an emergency surgery.  Very dangerous.

I knew we were done having kids and exercise was the last thing on my mind, but I wasn't about to go a month without lifting my babies.  And so we waited.  

Thanksgiving 2012 

I haven't shared this with many, but there were exactly two months in the spring of 2015 that my husband and I thought we wanted a third child.   Once we realized we were absolutely done, my daughter ended up in the ER for breathing issues.  Thanks to the ER bill and ambulance ride, we hit our deductible and that made my umbilical hernia surgery practical.   I wanted to wait until after their third birthday because birthdays are a huge deal to me and the thought of not being able to hold my babies that day wasn't an option.  I also hoped they would be old enough to understand "Mama can't lift you."  Their birthday is October 30 so the surgery was scheduled for November 4.

As the months crept by, I looked at November 4 as the day I would stop saying, "I think we're done having kids" and start saying, "Our family is 100% complete."  And if you've been in that spot before, you know how hard it is to say.  Even for two people who've always thought they only wanted two.

The Surgery

Check-in was at 6 am and I was told I couldn't eat/drink anything after midnight.  That morning I took a long shower and put on my comfiest clothes.  My husband just accepted a new job and this was one of his last days at his current position so my mom took me to the hospital.

Everything leading up to surgery felt so similar to the c-section.  They asked me 100 times what surgery I was having, checked my vitals, and hooked me up to an IV.  I met with the doctor and anesthesiologist and then shivered under two blankets while I waited my turn.  They wheeled me to the OR and I swear I fell asleep before I even arrived.

Surgery lasted 30 minutes and went well!  I was in recovery for about an hour before they released me to head home.  

My doctor used glue to hold my incision together (rather than staples) so I was told I could shower when I felt like it and would need to come back in two weeks for a follow-up.  

After Surgery

The incision is quite small and directly under the belly button so you would expect recovery to be a piece of cake.   LIES.  Day one was extremely painful.  Every time I got up to go to the bathroom I thought I was going to pass out or throw up.  The incision is located in such a place that no matter what you do, you're using the surrounding muscles.   And keep in mind, I had not worked out my core for THREE YEARS (let's be honest, it was more like six) so what little muscles I had were very weak.

Other than bathroom breaks, I stayed in bed the entire day.  One of the huge blessings of having a previous c-section: I remembered how to appropriately roll out of bed to cause the least amount of pain.  

Day two recovery wasn't much better.  I still felt sick every time I went to the bathroom and even called the doctor because I didn't think the pain pills were working.  That afternoon, however, was a turning point.  My mom ran a quick errand while the kids napped and Sloane woke up crying.  Once I realized I was the only adult home, I rolled out of bed and walked across the house to check on her.  My mom came home five minutes later and found me in bed with my crying daughter.  Mom was horrified.  I was grinning.  It was the longest I'd walked without feeling sick.

Day three was magical.  I stopped taking the pain pills and was able to move with ease.  The only issue I had was weakness - I really couldn't do much without feeling exhausted.  However, I made a point to get up every hour and walk around.  Sometimes I would just stand in the doorway and watch my kids play.  The second they noticed me I had to leave because I have two very active, very heavy babies that like to jump in my arms.  But those stolen moments made the day much easier for me.  

Final Thoughts

I know a lot of you are in a similar situation and are wondering if/when the surgery is right for you.  I know every person is different, but I'm really pleased with the timing and how it's worked out thus far.  My mom has been able to stay with us (that is HUGE) and the main reason it's been a success.  If you choose to have the surgery, you will need someone to watch your kids for a good five days (more if possible).  I'm now five days out and while I feel great, I still need to take breaks and I flinch anytime my kids get near me due to the incision (similar to moms who've had a second c-section, I'm sure).

I would love to answer any questions you might have and if you're in the DFW area, I'm happy to recommend my doctor!
I'm already looking forward to holding these two again!!

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  1. So I had an umbilical hernia when I was in college. I have no idea how the heck I did it, but I did! Mine was above my belly button, so I had to say goodbye to my belly button ring. I wonder why they say no more children, since clearly (or not so clearly) I was not making babies in college and I now have 2 without any complications. I guess times have changed or it's a completely different entity if it's below?? I'm glad you're healing well!

    1. I went to see a general surgeon for a consultation regarding mine about 3 months after my twins were born. He too told me that I need to be completely done having babies if I want to get the surgery. That is because they sew together the connective tissue underneath your abdominal muscles (that's what tore when I was pregnant and thus created the hernia). If they sew it together and then I get pregnant again, it will most definitely tear again and defeat the purpose of ever having gotten the surgery in the first place! So it's not that you CAN'T have children again (it's not a hysterectomy), it's just not recommended.

  2. Congratulations on making it through surgery so successfully. What a relief to get past it! I had the same thing, as well as separated abdominal muscles, and had this all repaired a year ago. Following the no-lifting advice is not a joke, I thought I was being very careful... But my hernia returned. Ugh. I had it relaired again 6 months ago and so far, so good. Good luck to you! Rest!!!!! :)

    1. Ok, your comment has me so nervous! How soon did it return? Did you know (did it hurt?) or did you just go in for a routine checkup and they discovered it??

    2. My belly button started popping out gradually over about 4 months. At the 6 month follow up, which is standard for my surgeon, he confirmed it was back but much smaller. He offered to fix it again for free (free for him! More recovery for me and our family though, ugh!!!). In hindsight, I wish I would not have resumed to normal activity after getting the green light from the surgeon. I think my body took a longer time to heal, and may never really be the same as before. Take it easy and you will do just great!!

  3. Excellent post!!! I would have thought it would be a piece of cake compared to C-section so thank you for your honesty! Glad you are on the mend.

    1. Definitely a piece of cake compared to a c-section! The biggest difference is you go home the same day after this surgery so those glorious hospital-only meds don't come with you. But how I felt on day 5 was 1000 times better than day 5 with a c-section!

  4. Such a good post!! So happy you're on the mend!

  5. I'm surprised you posted so soon after the surgery, but glad to hear it was successful! Curious, does your belly button look "normal" now?

  6. I had this surgery in late June. My girls were over 6 months old and I am still not too happy with the results. My doctor was great. He did my breast abscess surgery too. That scar has healed nicely and they were done 3 months apart. I am 4 months post opp and my scar is still red and my belly button has popped half way back out again. I am hoping it goes back further. My doctor did say that after a year if it hasn't, he will fix it (for free). But it does look better than before, just not as happy with my results as I expected. I had the second option too.