Laparoscopic Herniorraphy
2002.08.10
 
After moving from Brownsville, TX to Memphis, TN in April 2002, I had the pleasure of experiencing a right inguinal hernia. This is a little condition where the intestine bulges through a weakness in the abdominal muscle wall. It's called inguinal because it's just above the inguinal canal -- a space through which a major ligament and the blood and nerve supply for the scrotum travel. My cousin calls this TMI (too much information). Males are blessed with this because during embryonic development, where we all start out as females (so much for the Adam's rib theory), a canal is created for the testicles to descend. This creates a weak spot in the muscle. I find this a major design flaw and have registered complaints with the manufacturer.
 
I did extensive research on the internet to find any way at all to not undergo surgery. There ain't no such beast. So I joined the statistics of 600,000 proud men in the U.S. who have this procedure performed every year. One hopes it's not the same 600,000 each year.
 
I investigate everything to the hilt before I get into it, so I researched surgery texts and current surgical literature on hernia repair before I went shopping for a surgeon. The surgical procedures all require suturing a mesh behind the muscle wall so that the intestine doesn't protrude. It turns out there are basically three procedures used to repair this defect. One is an open incision through the abdomen just above the defect and the other two involve laparoscopic repair where they use tools called trocars (same as those used by undertakers) poked through little holes in your gut. The recovery time is significantly longer for the open incision approach, so that one was "right out." Of the two laparoscopic approaches, one invades the peritoneum (the space between the intestine and the muscle) and the other goes just between the peritoneum and the muscle. I saw "less invasive" and decided this the better route.
 
Well, as it turns out, we have here in Memphis one of the world-renowned laparoscopic surgeons in the persona of Dr. Guy Voeller. His clinic is even called "Center for Minimally Invasive Surgery." Pretty cool, huh? Plus, he was recommended by a friend of mine who had an appendectomy. Since this is who I picked, I thought surely he would not be on my PPO plan, but he was! The phone book and the internet had several downtown offices listed for Dr. Voeller. I kept calling, but no one was home. I called the Germantown office (15 miles away) and at first they told me that the girl in the downtown office was out to lunch. A couple of days and a couple of tries later, another girl in the Germantown office informs me that they don't have a downtown office anymore. So who was covering up for the fictitious office girl downtown?
 
I show up for my appointment in Germantown and I get in right away. Something's wrong with this picture. I'm accustomed to waiting for a couple of hours to see a physician. Since I didn't have to wait, I decided not to raise a fuss about the nonexistent downtown office. A resident comes to examine me first, and after poking around on me for a couple of minutes, says "Mr. Jay. Would you like this hernia repaired?" I said, "You know what? I came to see a surgeon. If you don't want to be cut on, don't see a surgeon. That's what they do for a living." Dr. Voeller came in, poked on me for 20 seconds and said he'd see me the morning of my surgery.
 
Now, first, you have to get a presurgical workup. This was all done at Methodist/LeBonheur Hospital in Germantown and usually consists of lab work. Mine, since I am a smoker over 45, also included a chest x-ray and an EKG. The only bad part of this was the chest x-ray for which I waited an hour. Four or five other people came and went in the x-ray waiting room before I was called. Surely, a plot of some sort, but I let this one slide too.
 
The day of the surgery I show up at 6:00 am along with about 20 other people who are all herded to the "Same Day Surgery" clinic. I was reminded a little of Auschwitz on this march. My wife and I were escorted to my room and I changed into one of those hospital gowns which are open in the back. Then I am told if I want to go the bathroom, now would be a good time. What was wrong with doing this when my ass was covered with clothes? We go through two different interviews with the exact same questions about my medical history with the admitting nurse and an anesthesiology nurse. I am given two pills -- one for gas and one to push everything in my already empty stomach "on down." Then I am wheeled to the presurgical arena which is a beehive of activity full of surgeons, anesthesiologists and nurses starting IV's. Since they already know I'm employed in health care, my IV takes three tries. An anesthesiologist takes another medical history and they give me something to "relax me." I ask what it is and they tell me it's Versed. This is actually a go-o-o-o-od drug. Relax you it does. I don't remember a hell of a lot after that other than being wheeled to the operating room.
 
I wake up in the recovery room , sorry, check that, the Post Anesthesia Care Unit (PACU) at 9:00 am with two whining women on either side of me. The anesthetic makes you a little paranoid and these ladies were obviously under its throes. I try to behave as best I can and they decide to only keep me for half an hour. I'm thinking those two might still be there today. Now it's on to my original room where my lovely wife extends her hand which I notice is missing all her fingernails. It turns out she was more worried about this whole affair than I was. Did someone not tell me something?
 
After about a half an hour a nurse comes to check on me and tells me that when I can pee, I can go home. I tell her that I have to now, to which she replies "Why don't we wait another half an hour until the anesthetic wears off?" Right. I don't know if you've ever had general anesthesia, but let me tell you it takes about a full day for the stuff to "wear off." Finally she and my clawless wife escort my drunken self to the bathroom where I micturate for approximately 5 minutes. When I exit, the nurse tells me that I have now fulfilled all her requirements. Well, ain't that great? Can I go home?

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