Yesterday I had a redo of inguinal hernia surgery, which I originally had in August of 2019. When there was a swelling at the site later, I assumed it was a seroma (an accumulation of fluid at the site), and since seromas often take a while to go away, I wasn’t worried. But it didn’t go away, so I had an ultrasound, revealing that the damn hernia had recurred. My surgeon, who’s top notch, was really peeved at this, as he said that in his entire career he’d never had such a recurrence, and had no idea why. (He added that yesterday’s operation would reveal the cause.) Inguinal hernias are the maladaptive result of our having evolved as quadrupeds and then become bipedal, but their status as “vestigial pathologies” doesn’t hearten me much.
I scheduled surgery at the U of C hospital as soon as possible, as I don’t want the damn thing there (it could get strangulated, which can kill you), and there’s always the possibility that they’d stop elective surgeries if the pandemic recurs big time.
So I went under the knife (actually three of them) yesterday. Because my surgeon had a complicated procedure before taking me, I waited 3.5 hours in the lobby, and then, after I was moved into pre-op, where they put their initials on the hernia (to ensure they operate on the correct side), connect you to IVs, give you a slight tranquilizer, a blood thinner, and IV fluids, and make you take off all your clothes except for that damn gown that opens in the rear—I waited another two hours. Everyone was very nice, but I was bored to tears.
Finally came the moment of truth, when they wheeled the gurney into the operating room. That always gives me a perverse kind of thrill, as it reminds me of Ben Casey and Dr. Kildare, and I’m always curious to have a look at the operating room, which contained the giant laparoscopic robot, before they put me to sleep. It was crowded with people, and the big robot with its three giant cutting and manipulating arms loomed in the theater:
The surgeon sits at the console on the other side of the room as in the photo, manipulating the arms, which made three holes in my belly (they always do the middle as well as the non-hernia side to see if there’s any issues there). Robotic surgery is one of the more amazing and salubrious medical innovations of our time.
My original surgery was done by the robot, and the surgeon told me that the chances were very high that the redo would also involve minimally invasive cutting. But, he added, there was about a 15% chance that I’d have to have the “old” procedure, which involves a big incision and a much longer healing process. Fortunately, the robot did the trick this time.
Just before they wheeled me into the OR, they gave me an injection that, said the anesthesiologist, would make me forget stuff. I asked him why, and he said that many people don’t like to have memories of going into surgery. But I didn’t forget stuff: I remember every word said to me while they filled my lungs with oxygen and were preparing to knock me out. There were two men in the room and four women, including a female medical student (I had to give permission for the student, which I did), but I realized that they were going to see me naked. This was brought home to me when I woke up almost completely shaved in the nether parts. Oy!.
I was particularly interested to experience the loss of consciousness. Would it be nearly instantaneous, like last time when everything went black at once? It was even faster this time! I remember the anesthesiologist approach me on the left side, and I asked him “Is this going to knock me out?” He replied “Get ready for the happy juice!” (What a card!). And that’s the last thing I remember; I don’t even remember losing consciousness. (By the way, the fact that consciousness is completely removed, even without dreams, with propofal—the “Michael Jackson drug”— and then restored within ten minutes after surgery, is strong evidence that consciousness is a purely physical phenomenon.)
I woke up almost instantly; the operation, I was told, took about two hours. I was groggy for a while, but just wanted to get my tuchas home. Within an hour a friend picked me up and I got back to my crib, lying in bed for a short while and then making some soup. When I felt more restored, I took this selfie of my shaved belly (trigger warning: shaved belly!) The curious thing is that I did forget things during post-op: I called several friends today to tell them I was all right, and a few informed me that I’d already called them last night.
Note that they shaved me bald (the depilation went much lower), and that there are three punchholes, all closed with a superglue-like material. That’s the only scarring, and when the hair grows back they’ll be invisible.
I had some slight pain during the night, but regular Tylenol took care of that. I had no prescriptions for antibiotics or other pain meds, as they also gave me an IV antibiotic in pre-op.
So, Ceiling Cat willing, that is the end of this procedure. I didn’t get to talk to the surgeon yet, though I’m just as curious as he was about why the damn thing recurred.
Thanks so much to all the kind people who took care of me, from pre-op through recovery. Special thanks to Dr. Vivek Prachand for his compassion, his willingness to answer questions, and his and steady hand at the robot. Like Dan Dennett, I say, “Thank goodness!”
I’m so glad you made it through the surgery with minimal pain and scarring. The holes look much like the ones for my husband’s gall bladder removal — although I think that produces a couple of more slits. Surgery for ordinary problems is quit extraordinary now. They certainly don’t slice you from stem to stern like they used to. May you remain healthy, wealthy and wise.
Your belly looks like a 3-eyed character from a bar in Star Wars! Copyright the image, and sell it to Disney (who now own Star Wars)!
But seriously, get well soon!
GCM
I wonder if they found any fossils in there?
https://phys.org/news/2020-11-million-year-old-five-eyed-fossil-reveals-arthropod.html
“Hmmm. That never happened before.”
I suppose there are worse things one can hear from a doctor. Glad things turned out well.
My last procedure was in June when they replaced my pacemaker/defibrillator (it was 10.5 years old). The procedure was at 8 am and I was home for lunch.
Hope you are good now for the next decade 👍
Seems to be good. Other parts are wearing out though.
When I had surgery almost 6 years ago I was happy that it was going to happen after lunch because I thought my surgeon would be well rested. But then a couple of emergencies came in & I ended up waiting several hours & when I saw my surgeon he looked totally exhausted. The nurses told me that’s normal for surgeons. What sucks for me is they make you take off your glasses/remove your contact lenses. I have don’t want to if I have to get surgery next time (just don’t tell them I’m wearing contact lenses) because I can’t see anything in the surgery room and I even had to tell everyone that I’m extremely myopic so I can’t see their facial expressions therefore all emotion they are going to have to express verbally.
Oh and I think the thing that you forget is being intubated and having the tube removed. I think I was awake for a while but don’t remember any of that.
if i wanted to argue about your consciousness statement, i would suggest that the rapid loss and recovery of consciousness suggests a physical mediator of consciousness as much as it does a physical consciousness, but is silent on any spiritual/magical aspect of consciousness.
dreaming is common after propofol sedation; the relationship of opium smoking and dreams was described long ago. coleridge’s’kubla kahn’ emerged from opioid dreams, tragically interrupted.
i was taught that amnestics are used during induction of anesthesia to blunt the powerful suggestive state which anesthesia facilitates.
I was gonna say something to a similar effect.
“By the way, the fact that consciousness is completely removed, even without dreams, with propofal—the “Michael Jackson drug”— and then restored within ten minutes after surgery, is strong evidence that consciousness is a purely physical phenomenon.”
Yes, it could be evidence of that, or simply evidence that you just forgot what you were conscious of during sedation.
It’s impossible to tell if you were really unconscious or if you just have no memory of it.
Well, consciousness includes pain, a “quale”, and if you had extreme pain during anesthesia you would surely react to it. You don’t. And surely part of “consciousness” is remembering things that you heard, felt or saw. Patients do not remember any part of an operation, ever.
Also, as a friend told me, “we don’t have reliable measures of whether you are conscious, but when you are under you show reliable EEG responses that are consistent across subjects (as is sleep) suggesting that you are in another state that is not conscious. Unless it goes horribly wrong, you are not aware when under, and we have no evidence of such awareness.”
In addition to an anesthetic (inducing loss of consciousness), patients are almost certainly also administered one or more analgesics (for pain relief) before and during surgery: for my hernia op, there was a large bolus of IV acetaminophen (for pain and inflammation) pre-op and ketorolac (for pain) during the op.
Oh yeah. That cocktail is the sweat stuff.
Double hernia mesh insertion under questionably effective local anaesthetic. Korean Doctor in top notch central Tokyo private surgery. 9am op home in the afternoon.
Far-Eastern reverence for learning through suffering massively overrated. But like I said, excellent work!
And I was told that the amnestic is given to allow them to give you less anesthesia (because anesthesia is dangerous) such that, for some people, they might actually be partially conscious and suffering, but because of the amnestic they won’t remember it.
I don’t think the fact that you can remember getting knocked out means it didn’t work.
I have read that general anesthesia is positively correlated with dementia. I refused general anesthesia for colonoscopy and I recommend that others refuse it also when refusal is a viable option, as it is for colonoscopy.
Dementia is “correlated” with plenty of other things too, like subscriptions to AARP magazine. Unless there’s some specific point to make about “general anesthesia”, what is the point of offering personal medical recommendations about “general anesthesia”?
There can be meaningless correlations and at the same time be a relevant correlation. For example, the correlation between sleep medications and cognitive problems compellingly suggests a causal relationship, there are plausible biochemical explanations, I would avoid those sleep medications and it is good practice to take such medications only for a short time. We do not know if there is a causal relationship with anesthesia and dementia risk but I am inclined to think it is causal.
“the correlation between sleep medications and cognitive problems compellingly suggests a causal relationship, there are plausible biochemical explanations”
Right – so we are waiting to hear how some of the “biochemical explanations” are to be ruled out as the cause of dementia – as the medical advice given above to decline “general anesthesia” is not inconsequential. Is it because the anesthetic molecules interact with the blood-brain barrier in a particular way that other molecules don’t? If so, how long does this process take to lead to “dementia”? What, specifically, is meant by “dementia”? Which organism is this observed in? Which proteins are key players?
General anesthesia is not always optional. But when it is optional, such as for colonoscopy, I think we should avoid it. There is no such concern with local anesthesia.
I had some lighter “put you to sleep” stuff. in one session, I woke up when they were cauterizing. The surgeon was super nice to me though.
Things are looking good! Excellent!
Glad things went well!
I’m glad your recovery is doing well!
Yeay! 🤗😺
I have to ask the silly question – Did the Doctor give any kind of discount since the first time did not do the job?
I had my big time operation several years ago, open heart surgery due to an Aortic Aneurysm. Have to do lots of special tests prior and then you go in real early in the a.m. because this thing can take all day. They seem to shave you from one end to the other. Did about 4/5 days in the hospital for that one. A few years ago I had what they call a TAVR, transcatheter aortic valve replacement. I had this one wide awake for the whole thing. Hard to believe you get to experience a heart valve job while wide awake. Also just one night in the hospital.
No discount, but I’m told that at the University of Oklahoma, where payment is cash on the barrelhead, and quite cheap, a redo costs nothing.
I was expecting your belly would show scars from the previous intervention. Did they heal so well they left no trace?
BTW, yes thank goodness. I say that every time I visit the dentist or MD.
Yes, I can’t see the scars from the previous one. Part of it might be the hair regrowing, but I really can’t see any marks.
Is it possible they made the new cuts at the same location as the scars from the earlier operation? After all, “recurrence” implies the new hernia is at the same location as the first one.
Well, it wasn’t at exactly at the same location: a tad to the right. And yes, I suppose they could have cut at the same place.
Pardon the pun, but…that’s quite remarkable.
If they operate on your face, they wrap it in scarves to start the healing, a skilled job, hence the term scarf ace.
Learn something every day!
I thought scarf ace is someone who is very good at eating something quickly.
Just before they put me under I would have asked to say a few words:
Klaatu barada nikto!
Had my gallbladder removed two years ago but I didn’t get to see the operating room. I was in a pre/post-op room The anesthesiologist said someone would stop by in a minute to ask me how I’m feeling.
That was it, no counting backwards, no wheeling around, just talking to the anesthesiologist and then the nurse asking how I feel.
Congratulations on your safe return home.
I had similar robotic inguinal hernia surgery a couple of years back. No shaving (I was told that it could cut/abrade the skin, which they didn’t want because of risk of infection), just a close clip to 2-3″ below the umbilicus pre-op, with clipped hair vacuumed and dabbed off with a slightly sticky tape. I guess each surgeon has his own preferences. And the operating table had a sticky covering in the waist-to-hips area, apparently so I couldn’t slip during surgery.
Crikey, I didn’t realize the methodology varied that much!
Consciousness has to be a physical phenomenon because otherwise what’s the alternative? That it’s a supernatural phenomenon?
Hope you’re fixed now.
It can be a epiphenomenon that arises from complex brains.
Yes, but that’s still completely dependent on physical structures.
Yes but the distinction is there is no one place in the brain where you can say “a ha there it is the consciousness module”.
But the fact that it disappears during anesthesia seems irrelevant to the distinction.
It’s always relevant. To think there is a central place of consciousness is erroneous. And people tend to grab into that when they hear the word “physical”.
That it disappears is completely consistent with naturalism, and at most 50% consistent with supernaturalism on the grounds that there are no constraints given constraints, so this does count as evidence favoring naturalism.
… given supernaturalism.
I’ve had pilonidal cysts (@ tailbone/top of the cleft of the buttocks) removed twice, once in HS and once in grad school. Second surgeon looked at the remnants of the first op and said, “What butcher did this?”
He also said that their evolutionary origin had something to do with “pin feathers of a duck,” which is the only reason for mentioning this. No idea if that’s an accepted factoid.
Otherwise, re. gluing the holes shut, I can imagine the origin of that as from the stoner brother of a med student, on hearing details of suturing technique, saying something like, “Dude, why don’t you like try something like superglue??”
Are they called sutures because if they are dome well someone says, “they suit yer”?
My father once broke his coxis when som nincompoop pulled a chair away when he was sitting down… very painful!
Insert Carry On joke here… [ “Ooh! My coxis!” / “I thought he landed on his back…” ]
Coccyx… it’s a tricky one.
Especially If you and a friend both break them because then they ate coccyges.
Are
Oops! Jez will tell me off for that spelling error!
Re. nincompoop, I always assumed that it originated in the ’20s, but did you know that the etymology is from Latin?
I learned that a little less than 4yrs ago. You can guess why I can be so specific about the time.
Used in Vietnam for stopping wounded soldiers from bleeding out, I was told. Apparently that was a spray.
We use both in the operating theatre; little tubes and opsite spray. Most surgeons use the tubes, while the spray is used for cuts on staff’s hands, such as paper cuts, so that we can still scrub for cases. It stings very painfully for about twenty seconds.
Reminds me of an intriguing fact : peat moss was used to save lives of wounded English soldiers in World War I — peat moss!
I had a double inguinal surgery done in the old fashioned way, which I hope to never repeat.
Yes, I hear that can be painful and the recovery prolonged.
Memory loss from anesthesia: I’ve experienced, and seen others experience a loss of memory for events or conversations that took place before the surgery. It feels like a little chunk of memory is excised.
Coming out of anesthesia I have experienced some pretty good hallucinations. And those I remember, very unpleasant.
So glad it went well! It’s astonishing that you were home making soup the next day.
No, the SAME day. Operation at 3 pm, soup at about 7:30 pm.
I had the “Michael Jackson” drug before external cardioversion with 250 joules. What a strange drug. I could taste it, then I woke up, back in sinus rhythm. I felt like I was out for hours, it had only been 5 minutes. I asked the cardiologist what cardioversion was like w/o the drug. Answer: “you wouldn’t be sending me a Christmas card.”
Thanks for letting us know that the operation was successful and you’re on the mend. Great news…I wish the great news would have been bolstered by an early Biden victory.
…and on to the latest remake of the sci-fi classic:
The Three Stigmata of Jerry Coyne
Welcome back.
“I was bored to tears” well that’s good, they call you a ‘patient’ and you complied… but that may be a little too enthusiastic… 🤪
Hope that was the last time for this procedure, recuperate with enthusiasm Prof(E)!
My first surgery – on my knee – ended with me waking up in a chair only for a female nurse to come in a few minutes later and say, with a cutesy voice and maybe a wink “Heeeeeere’s your underwear!”
I don’t think they really needed to remove them. My underwear weren’t near the incision site. They didn’t even shave my leg except right around the knee. Even if they did need to remove them, why not place them with the rest of my clothes instead of having them delivered separately with a ceremony.
I remember feeling disappointed, thinking that if the nurses wanted to have some fun they should have done it when I was conscious…
Maybe they took it off by mistake and forced the nurse to take it to you after the mistake so she felt all awkward. 😀
Yeah it makes no sense why your underwear wouldn’t be in with your other clothes. Whenever I go anywhere for anything that requires putting on the humiliating robes, they further humiliating you buy giving you a CLEAR plastic bag to put your clothes in and have you carry that clear plastic bag with you wherever you go. I now bring my own bag that can contain my clothes & when they tell me to put on a rob I disobey them & double robe. When you are getting mammograms you can tell the saavy women who do this regularly – they have their own bag & they are defiantly wearing two robes.
Hm when I had surgery on my ankle recently I had to remove all my clothes and put on one of those gowns – I had stupidly assumed I could keep my underpants on.
I think it’s the protocols of the clinic/surgeon preference. I’ve heard of some that make you gown and remove all clothes for cataract surgery which seems nuts to me.
How serendipitous! I just posted pretty much the same comment regarding my own eye surgery.
Haha weird.
They also gave me something that removed all feeling from the waist down, which I thought was overkill, but maybe it’s easier to do it there than at the knee.
It was an odd experience for the next few hours touching my legs and nether regions as if they belonged to someone else …
Strange. They do worry about blood clots with knee operations especially.
I also had to do that for my first cataract surgery a few years ago but, for my second one a couple of months ago, I was allowed to wear my street clothes covered by a gown. It was a different doctor and surgery center but perhaps the difference was due to COVID worries. It seems reasonable that one’s clothes have nasty bacteria but removing them seems more likely to spread them than covering them. I’m guessing it’s probably not a real problem anyway for eye surgery.
Thanks for posting this! Amazing science, technology, and problem solving! And of course as they say, get well soon!
Glad you came through safely PCC.
Welcome to the club. I have a triple navel as well, having had the same surgery some years ago.
Glad to hear all went well! The anesthesiologist at my recent operation told me she was going to give me some “gin and tonic”.
I’m always amazed at the complete lack of consciousness and dreams under anesthetic. The first time I had it, 20 years ago when I had all my wisdom teeth removed, made me think that if death is like that, then it’s not to be feared.
So glad to hear you came through ok.
Looks like inguinal hernia is yet another instance of unintelligent design.
I believe also that the trouble a lot of us have with our sinuses is also a result of our upright stance and therefore even more unintelligent design.
Jerry, I wonder if it recurred because of those huge bags of duck feed you’ve been lugging to Botany Pond everyday. Or could you have been injured that time you slipped in the pond?
Thank you for the details. I have never gone under the knife, but I am considering doing so while pre-existing conditions are still covered by insurance. I was worried about pain afterward, so knowing that tylenol could be enough is a relief.
…Not that I’m a wuss about pain — I’ve had gall bladder attacks several times per year for 20 years, which is the surgery I’m considering. That pain is seriously unendurable, but I’ve endured it rather than allow someone to cut me up!
I hope the rest of your recovery is uneventful.
Like a shaved porn star! hahaha
Seriously though, thx for the description. I’ve “nursed” an inguinal hernia for a few years now (mine is lower and not likely to kill me) and I’ve been very curious about the procedure.
Love the robotics. Like a Japanese car factory!
And ain’t anesthesia grand?
Propofol is one of my favorite juices. Not kidding – that liminal state of consciousness is incredible and beautiful in its own way. And I speak from experience of altered states of consciousness (I write about psychedelic’s for various publications).
D.A., J.D., NYC
https://whyevolutionistrue.com/2020/06/10/photos-of-readers-93/
Jerry, I’m glad you’ve made it through and Les Girls send you eyeless cat- niece hugs for a speedy recovery x
We do lots of laparoscopic hernia operations in the OR where I work, but don’t have a robot yet, which is a relief, given that I’m a scrub nurse who hands instruments to the surgeon.
I wonder about the economics of it; the cost of the robot unit must be immense, so the savings must be too, in terms both of not needing a scrub nurse and shorter surgical and recovery times.
I’m glad everything went OK!