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 Post subject: Hernia repair - any experiences?
PostPosted: Tue Dec 13, 2016 6:19 am 
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So few people seem to post these days I'm not sure I'll get a response, but I can't think of anywhere else to put this.

I am due for surgery in a few weeks to repair two hernias; one is the classic inguinal (groin) hernia; the other a small umbilical ("belly-button") one that's not much of a problem. I'm told I will have both done as part of the same procedure.

My recollection of the onset of the first one is that it happened while I was practising standing up, as I have done for years. Since then I've done all my playing sitting down. My concern is how much time I need to take for recovery; the consultant, who clearly had no concept whatsoever of horn-playing, simply said that four weeks is what they tell people who do heavy physical activity. (This is after keyhole surgery, which is what I will get unless something crops up during the procedure requiring open surgery. Recovery times are longer for this.)

I wondered if any of you out there have had experience of hernia repair. My real concern is whether at my age (71) I'm likely to make a full recovery - full in the sense of being able to play as before, preferably standing up, although I know that sounds like a medical question. I realise muscles weaken with age. I'm actually getting pretty depressed about the whole thing, which is not helped by being in some discomfort.

Any comments will be gratefully received.


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 Post subject: Re: Hernia repair - any experiences?
PostPosted: Fri Dec 16, 2016 7:38 pm 
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Location: East Herts
Hi,
Haven't experienced this personally, but my wife is a nurse and her father had exactly the same op last year at age 85. He is back to lifting, hoovering, mowing the lawn etc with no problem. She says:
"4-6 weeks is always a good guide for starting to get back to normal post op. Start playing sitting down and then see how you feel standing up and build up gradually. You may be thinking of how it is feeling now, whilst you have the hernia but the op will repair the hernia by inserting a mesh so should strengthen the muscle to support the abdomen/gut as before. Increasing internal pressure is not a good thing to do, but would have thought this is unlikely during playing as tends to be more of a straining on the loo type pressure. Otherwise breathing and blowing should be fine and just a case of standing for a long period holding a heavy object. Obviously individual cases vary but don't be depressed I am sure with a little patience all will be fine!"

If I remember rightly, I think you may play a triple horn, so perhaps it is time to get something lighter. Perhaps a good excuse to visit Luke's new London workshop to try out a single or two!!

I hope this all helps.

Lastly, does anyone out there know where people now have the great debates that used to occur on this forum?


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 Post subject: Re: Hernia repair - any experiences?
PostPosted: Fri Dec 16, 2016 8:14 pm 
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Very good of you to see this and reply - having consulted your wife; I'm very grateful.

One thing I didn't understand: "Increasing internal pressure is not a good thing to do, but would have thought this is unlikely during playing as tends to be more of a straining on the loo type pressure." Surely playing a wind instrument is all about "increasing internal pressure" - maybe not like straining on the loo, but still pressure. And it was during practice that the hernia started, which is presumably the result of a combination of pressure and a weak spot caused by age.

I must admit I did wonder whether the heavier horn (yes, it's a Paxman triple - very good of you to remember) and the extra resistance (medium bore) had anything to do with it, but I have been playing this instrument since January 2015, standing up until last summer.

I have been warned that it is essential to heed the advice about giving things time to heal; apparently there are many cases of people who feel so much better soon after the op that they assume all is back to what it was and risk causing the repair to fail.

I am feeling a little more positive since I've got the date for the op now (early January) and there is the prospect of an end to the discomfort, which has got quite bad.


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 Post subject: Re: Hernia repair - any experiences?
PostPosted: Wed Dec 21, 2016 8:53 am 
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The advice from Ronan's wife seems eminently sensible, as would be expected from a nurse. A quick internet search of 'brassplaying and hernias' (I'm not suggesting you do it; medical searches always make me think I have every possible ailment as well as a few that are impossible!) produced many players with the same questions you had and the best results always seemed to be from those who heeded the advice on recovery time given by their medical practitioners.

Have a good Christmas and I look forward to hearing of your complete recovery from the op.


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 Post subject: Re: Hernia repair - any experiences?
PostPosted: Fri Dec 30, 2016 11:43 pm 
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Joined: Fri Nov 07, 2008 12:49 am
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Location: Robertsbridge
Having tried to make it as a horn player I recently sold the damn things and joined a local choir. On the day of a recent choir rehearsal I didn't feel well but decided to go anyway.

All seemed fine until we stood up to start singing. I felt faint and then needed to run out fast to be very sick. Although the culprit was our old friend the Norovirus I realised later that the vomiting was encouraged by the process of breathing in and belting out the sound with the help of the abdomen and diaphragm. After two days of feeling near death I got back to daily walks with my dogs building back up to my regime in the gym designed to build my body strength, posture and balance etc.

At a mere 71 there should be no reason that I can think of to stop you playing the horn. I couldn't see the point in owning two horns which never left their cases so sold them and used the money to upgrade the engine, suspension, brakes etc to make my road going Subaru Impreza ready for use on the race tracks where it belongs.

I recommend driving on a race track as fast as possible as an alternative to playing the horn. You need to concentrate hard, be aware of what is going on around you and then see how fast you are able to corner without hitting the bank. The element of risk is very similar to the risks we take playing the horn and can be scary (another familiar feeling).

I am sure that you will regain the strength to play the horn standing, sitting or even on the march. (See Sarah Willis). ;)

Tony C (74 and counting)


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 Post subject: Re: Hernia repair - any experiences?
PostPosted: Mon Jan 02, 2017 12:09 am 
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Thanks, Ian and Tony.

At 71 I don't want to let myself believe I'm getting old, but I must admit that I have found the idea that my body is letting me down quite depressing, not helped when I was told I had not one, but two hernias. And all of this comes at a point when I felt, as an amateur, that I was making some real progress in my playing - most frustrating.

However, I have now been for my pre-op appointment, which was reassuring, as the various tests (ECG etc.) showed my health is basically OK.

In just over a week's time the repair will be done and, although I'm not looking forward to it, I am fed up with the discomfort and the palaver of wearing supports etc. In spite of everything I have managed to keep playing, however, and am looking forward to doing third in the Rosenkavalier Suite and all the other stuff in tomorrow's concert. I've told my orchestras I will be not re-appear for six weeks or so and will be easing myself back into playing gradually.

The time I gain from practising and rehearsals will be put to good use in my other passion - composing.

I'll update this thread in due course, just in case anyone is still reading it!


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 Post subject: Re: Hernia repair - any experiences?
PostPosted: Mon Jan 09, 2017 9:57 pm 
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Briefly - I was operated on today.

On examining me, the surgeon recommended a repair on yet another site - the left groin - because there was a weakness similar to the first hernia I experienced in my right groin. I hope that this means I don't get any more problems when I eventually resume playing, and in the long term.

So I have had THREE repairs done. It sounds worse than it really is; there is some discomfort at the moment, as is to be expected. The care I received from the surgeon, anaesthetist and the many nurses who assisted was first-class. I cannot fault them. (I was an NHS patient in Luton & Dunstable University Hospital.)

I'll make one further update when I start playing again.

Apologies for inflicting my woes on you, but it may provide reassurance to anyone in a similar situation.

Happy New Year!


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 Post subject: Re: Hernia repair - any experiences?
PostPosted: Tue Mar 28, 2017 7:40 am 
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I've been playing again for several weeks now. I held back for a long while - seven weeks after the surgery, as I could get no reliable info on when it was likely to be safe to resume. After eight weeks apparently you can do heavy lifting.

I started gradually just doing a few scales with nothing above the stave and limiting myself to twenty minutes of gentle blowing. I attended no rehearsals for a couple of weeks.

When I cranked up the playing to include higher notes and started rehearsals I found I was getting quite a lot of discomfort, first at one of the three surgery sites, then that subsided and another one started. It was bad enough to make me wonder if the repairs had failed. Rehearsals were very tiring. However, the discomfort is now on the way out and, eleven weeks after the op, I'm feeling reasonably optimistic.


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 Post subject: Re: Hernia repair - any experiences?
PostPosted: Wed Aug 16, 2017 11:14 pm 
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My guarded optimism was not justified.

I did a couple of concerts without mishap, but occasional discomfort persisted, then eventually something seemed to be moving in my right groin when I was playing loud and/or high.

I have well-placed contacts in the hospital where I was treated and on 19th July, before my GP was able to arrange an appointment, I was summoned directly to the General Surgery clinic, where I was examined by the surgeon who treated me before.

He confirmed a recurrence of the right inguinal hernia. He said the mesh to do the original repair had been correctly placed, but had not stopped another hernia forming ("which should not have happened" - whatever that means.) I asked him if the horn-playing had anything to do with the recurrence; he agreed it had. I had more or less decided that I was going to need more surgery and so it proved. I was fast-tracked and operated on last Saturday, 12th August by the same surgeon.

This time it was "open" (i.e. not keyhole) surgery and I have a pretty large incision above and parallel to my right groin. The discomfort isn't severe as long as I'm on medication, but I do need quite a lot of painkillers and it seems to be taking longer to settle down than last time.

Speaking to me after the operation, the surgeon firmly told me not to resume playing for six weeks - very different advice from (the admittedly vague advice) last time.

I'm left to speculate as to whether the initial repair should have been done better, and whether the surgeon then understood the considerable abdominal pressure created during horn-playing. Are these two details not confirmed by the very large area now repaired? - a mesh 13 cm by 8 cm has been inserted.

Pissed off? You bet. But at least the repair was done quickly (less than four weeks from the initial consultation) and hopefully it has been done properly this time. I know these things happen.


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