Signs You Have a Postpartum Hernia (and What to Do About It) . Sure, it was a sign my baby bump was growing, but the truth of the matter is that it also meant I had a hernia. Breezy Mama turned to OB Dr. Gafori of IGO Medical Group in La Jolla to get the scoop on how moms can tell if they have a postpartum hernia (and since the belly button doesn’t always poke out, many are unaware they even have one!), what to do about it, what can happen if you do nothing, if you can throw in a tummy tuck (ahem) with repair and more. How does pregnancy cause a hernia? First, we should start with a few definitions. Rectus diastasis: This is an acquired condition in which the rectus muscles (the main abdominal muscles that run down the front of your belly) are separated by more than the normal 1 or 2 mm that typically separates them. This very minimal normal separation is made of fascia called the linea alba. Pregnancy and increased abdominal pressure can cause the muscle to separate and cause rectus diastasis. Women may notice a ridge in their central abdomen when they sit up or perform abdominal exercises. Sometimes, you can actually feel the defect. Umbilical hernia: A hernia is the result of weakness or a defect in the fascia that surrounds the muscle. This weakness can result in the contents of the abdomen sometimes protruding out of the cavity through the defect.
In the case of an umbilical hernia, the contents include intestine or omentum (abdominal fatty tissue) that is enclosed by the peritoneum( the membrane that lines the abdominal cavity). Infants can have congenital umbilical hernias which may close on their own as the child grows. However, if these hernias are large or they persist past 2 years of age they may need to be surgically corrected. Adult umbilical hernias, on the other hand, are almost always acquired and do not decrease in size on their own. They often need to be surgically corrected unless they are very small and do not cause any adverse symptoms. Pregnancy is one of the major causes of umbilical hernia in adult women. Other causes include anything that can increase intraabdominal pressure including obesity, chronic cough and ascites (fluid collection in the abdomen which may be caused by liver disease, cancer, etc.). How can a mom tell that she has a hernia? She may have a small soft mass protruding from the area around her umbilicus (belly button). This area may be tender with increases in pressure (coughing, lifting weights, later stages of pregnancy) or with palpation (touching). It may increase in size when she sneezes, coughs, or bares down. What is involved in repairing it? By Marcelle Pick, OB/GYN NP. Over the years, I’ve treated a number of women with unusual weight gain or difficulty losing weight. They often ask me, “Is it my. Hernias are repaired surgically. There are different methods that may or may not include placing mesh over the area in question. The procedure type would be determined by the general surgeon or plastic surgeon doing the repair. Most of these procedures are performed outpatient. How long is the recovery? After having my twins, I noticed that my belly button was still WAY out. After losing all the weight, (thank you twin breast feeding!!!). I have been told by friends that because I had a hysterectomy that I will not be able to obtain a flat stomach as they cut the muscles for this surgical procedure. Up to 75 percent of women develop a uterine fibroid at some. The recovery depends on the severity of the defect and the actual procedure performed to repair the defect. In general, heavy lifting is restricted for the first 6 weeks after surgery. Will moms be able to pick up their children after? Yes, after the allotted recovery time. What can happen if a mom does NOT get it fixed? Many umbilical hernias are small and are difficult to notice and likely to not cause any symptoms. These do not need to be repaired. In the case of severe abdominal pain which may indicate an incarceration (where the bowel gets stuck through the hernia site) or strangulation (when the blood supply to the bowel is cut off) an emergency visit and surgery would be indicated. Will my belly button ever go back in or only if I have surgery? After delivery, the uterus does take time to return to its initial size. Once it does, and once the abdominal muscles are strengthened, you may notice a decrease in the protrusion of your belly button. On the other hand, hernias do not improve with exercise and weight loss. Should I wait to lose the weight before I have surgery? In the case of a rectus diastasis, exercises can be used to help regain some of the strength of the abdominal wall muscles. Rectus muscle plication (bringing the rectus muscles together centrally with surgery) should be performed once weight loss has occurred and typically only if there are no future plans for pregnancy. This is typically an elective procedure but can often help to improve intraabdominal tone so that it is easier to care for and lift your children. It also can help to decrease back pain that is due to poor abdominal wall tone and strength. If you had an innie before giving birth, does a new outie generally mean you have a hernia? Not necessarily. Before having the surgery, is it okay to return to doing sit- ups and other exercises? Yes, though these exercises will not improve the hernia. Abdominal exercises will strengthen the rectus muscles but will not decrease the defect in the fascia. Are some hernias more mild than others or should all be treated? There is no need for repair of a hernia that is small and does not cause any pain. Hernias that are large, that cause pain, or that incarcerate or trap bowel or fat in them should be surgically repaired. If a mom is not done having children, should she wait to have surgery? Unless the hernia is causing bothersome symptoms, repair should be delayed until childbearing is completed. In rare cases, hernias can cause problems during pregnancy that may necessitate surgery during the pregnancy. A person that has a symptomatic hernia prior to pregnancy may have worsening symptoms during pregnancy and should probably consider repair before they get pregnant. Can doctors do a tummy tuck while repairing the hernia? Yes, the medical term is abdominoplasty and this can be performed at the same time as a hernia repair. In most cases the abdominoplasty procedure includes plication (reattachment) of the abdominal muscles centrally so that the rectus diastasis is repaired. If a hernia is indeed present, the general surgeon or plastic surgeon can repair it at the same time. Want to stay up to date on all the latest? All subscribers are automatically entered to win a Summer Infant Baby. Touch! Hurry and enter your email address here: About Dr. Gafori: Valerie Gafori MD, FACOG is a board certified obstetrician/gynecologist. She completed her undergraduate degree in Physics at MIT, her masters degree in Biology at Stanford University, and medical degree at UMDNJ: New Jersey Medical School. She completed her residency in OB/GYN at George Washington University and joined a private practice in Washington DC for one year before she moved to La Jolla. She is now in private practice in La Jolla, California with IGO Medical Group. She has special interests in minimally invasive surgery and gynecology. Testimonials. We are proud to present some of the testimonials that have come from women who have been helped by Female Alternative Surgery. They are sharing their experiences, in part, to show other women that there is an alternative to hysterectomy. If you are a former FAS patient, please send us your testimonial so other women can be guided by your success in overcoming the various medical conditions which in the past, were treatable only by hysterectomy. Featured Stories. More Testimonial Stories. Resides Salem, WII had Female Alternative Surgery (FAS) with Dr. Hysterectomy is permanent, there is no going back after making that choice. FAS patients get extra TLC! The doctor has an excellent surgical team and they don’t operate unless the whole team is available, Dr. Del Junco hand- picked each person for their expertise and really they were wonderful. Del Junco jokingly said I wouldn’t like him post- op because he would be making sure I was walking enough and get after me if I wasn’t! Del Junco, Patricia, and the entire rest of the office staff and hospital team. I had no hope, no life, and no joy but you gave me the reason to believe that God is able and is always there if we can only believe in his capability. He will never fail us, because he created people like you Dr Del Junco for a time like this. I was rejected by doctors but you told me don’t worry it can be done. Yes it was done and I have my life back. May The Almighty God continue to guide you and use you for so many more people out there with hope. May God direct more people to you so that they will have a new life after they get in contact with you. I am so happy to say I have my life back after over 1. MTResides: Texas. I’m on my way to the gym and I just had to take sometime out to thank you and the Dr. I’m working out 5 days a week and even attending a title boxing class. I feel so bless to be able to do as much physical activity as I want. With the long periods gone now I’m able to do so much. After I leave the gym this morning I’m going to play softball with my daughter. Thanks so much keep up the great work. CWResides: California. My wife had surgery Nov 2. Dr. He did an outstanding job along with . I am writing this to convey what a pleasure is was to work with them and your post- operative staff at Mission Community Hospital. First, you are fortunate to have Dr. Del Junco on your team. He is a consummate professional and truly cares about doing the best job possible for his patients. My wife has been suffering for over 2. Del Junco performs is a beacon of hope for those who are routinely told that there are no options other than to perform a full hysterectomy. This operation should alleviate 9. Del Junco did not rush through surgery but was meticulous in his approach and during our initial consultation helped to provide a big picture as to what was involved and options prior to surgery. He is very good for MCH. Overall, you should know that we would recommend MCH to anyone who is looking for a very positive experience in health care. DRResides: California. I just wanted to Thank Dr Del Junco and his staff for the Outstanding service. I would highly recommend women who are suffering to please see Dr Del Junco, he is different from other Dr’s; he actually cares. When I arrived at the Hospital I was treated like a Celebrity the entire 4 days. Dr Del Junco and his team had excellent bedside manners. Nursing staff - no one can beat the love and attention that I received. I watched my Surgery the day after my procedure, I was blown away by the detail and the patience of Dr Del Junco’s work. He took his time to make sure he took care of all my issues. It looked like he was doing surgery on a member of his family. His work was neat and clean. The surgery was done bloodlessly which was very important to me. He respected my beliefs. I cant thank him enough. I’ve been suffering for over 2. I’m looking forward to having a normal menstrual cycle. Thank you Thank You. Del Junco please encourage them to go ahead and improve their quality of life. You are a medical maverick! A true explorer and pioneer! You are a master surgeon and I will be forever appreciative of your skills, of what you have strived to offer as an alternative program, and for your continued willingness to work outside of “conventional” thinking in order to preserve the quality of life for the women that are lucky enough and blessed enough to find you. Thank you from the bottom of my heart! I just wanted to send you a little update. I just came back from my well woman exam, and all is great! This is my first visit since the surgery and all is well. Thank you so much Dr. We will keep sending patients your way. DDOResides: Montana. Hello Dear Women and the Men who love them: All I can say is that . When I called their office . RN. The patriarchal medical system in our country would have had me “take out the uterus and the cervix through your vagina” and they would have had me believe that my uterus was “just a muscle.” I knew better. And when the tears flowed at the words of a young gynecological surgeon telling me that I didn’t need my uterus anymore because I didnt want any more children (I am 5. I knew all was lost for the standard medical community. They could only offer me what their skill level was – take it out! Thanks to my accupuncturist and a brave woman in Jackson, WY who shared her story with me I found Dr. By that time I was bleeding 2. I had an emergent bleeding situation my “uterus was coming out without question.” That was in late January 2. Del Junco Jr.’s office within the week and luckily there was a cancellation in March 2. I flew down with my husband to have the surgery in the first part of March. He is compassionate, full of joy about what he does and listens deeply to his patients concerns and desires. My husband was able to stay with me in the hospital night and day for the four days I was there. The staff at Temple were an incredible group of caring women. My night nurse had also had the surgery so she knew exactly what I was going through. The day after the surgery I was walking around no problem and within a day of being released I was walking three miles a day and by the ten day check up visit I was walking five miles a day. Walking is imperative to the success of this surgery. Do not be afraid to walk. And do take six weeks off of work as you will need the rest. I did not know how sick I was until now – six months later – as I reflect on how tired and difficult life was with all of the bleeding. I had 3. 0 tumors removed and Dr. It took five months but I am cycling again and feel great. My bladder function is as good as it was before I my two children. I have good energy and do not have any of the hot flashes or other symptoms of menopause I was having so severely before. While this is a journey both psychologically and physically it was a journey well worth it to me. No ne of the doctors here could believe it. Since having the surgery I have told many women about my experience. Many do not know they have any other options other than hysterectomy. Because of the large size of them and my desire not to have blood during the procedure, I was told by my physician I would require a hysterectomy because a myomectomy would be too risky. Although I have no desire to have children, I thought this was a bit extreme considering my age. Del Junco doing an Internet search for alternative treatments. Choosing to have treatment with him turned out to be the best decision. His entire philosophy not only on the surgery but the aftercare is so different from anything else out there (completely bloodless surgery and no waivers for hysterectomy to name just a couple). As a comparison, I had a friend who had a C- section the same time I had my surgery and my recovery time was a fraction of hers. My entire family was amazed at how quickly I was mobile and moving on my own. I also want to add that the nursing care at Temple Community Hospital was AMAZING and Patricia in Dr. Del Junco’s office is wonderful! I am now 4 months post op and everything is back to normal. I feel great and am so glad I found Dr. Thank you, thank you, thank you! AEResides: Hawaii. Dear Dr. I have not been able to do this in years. THANKS Dr. Del Junco for really truly giving me my life back! I no longer need to use my husband for support at night in order to change positions nor in the morning to help me get out of bed. I can sneeze and cough without dropping to my knees in excruciating pain. I can get in and out of a car without feeling horrific pelvic pain. I can go to the mall with my girls and not have to sit every 1. My husband, my girls and I THANK YOU for caring! What you do every day is truly a gift and I will never forget this gift you have given me and my family! SBD*****************Follow Up (5 months later from same patient)*******************Dr del Junco. I need you to know that I am still doing very well and have absolutely no regrets with my decision. I am able to walk forever and not have a care in the world. My energy level is so great now and I still remain pain free. I am scheduled to see my GYN . A bit alarming as they have not questioned one bit of how I am doing given the fact I have not called them for pain meds or birth control pills or just to vent re: the severe pain! THANK YOU SO MUCH! You have given me the greatest gift I could have ever asked for! My 2. 01. 3 is looking very healthy and bright. The surgery was so effective it has contributed to the good health I enjoy today. Del Junco,A special note of gratitude sent your way. It is a rare thing to find a man who is so dedicated to his profession as to step outside the box, swim up stream and fight ridicule from his peers and colleagues. I commend you in your diligence and will forever be indebted. LJResides: Southern California. I found out about my fibroid tumor while undergoing a pregnancy ultrasound. Del Junco Jr. JSResides: North Carolina.
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