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| Umbilical Hernia |
These notes give an overall guide to your stay in hospital. You may see some differences in the details of your treatment, since it is tailored to suit your own condition.
WHAT IS AN UMBILICAL HERNIA? This is a weakness or swelling of the navel (belly button). It will get bigger and become unsightly. Sometimes fat or bowel gets stuck in the hernia causing severe pain and illness.  A cut is made around the navel. Any fat or bowel in the hernia is pushed back or removed. The weakness is mended with strong stitches. The skin is then closed up. Reception When registering at reception your medical aid details will be required. Your medical aid may require that you obtain an authority number from them for the hospital. Please check this. If you are not on a member of a medical aid you will be required to pay a deposit or to sign an indemnity form. As far as possible we will try to advise you about hospital costs before your admission. Welcome to the ward You will be welcomed to the ward by the nurses or the receptionist and will have your details checked. Some basic tests will be done such as pulse, temperature, blood pressure and urine examination. You will be asked to hand in any medicines or drugs you may be taking, so that your drug treatment in hospital will be correct. Please tell the nurses of any allergies to drugs or dressings. The surgeon will have explained the operation and you will be asked to sign your consent for the operation. If you are not clear about any part of the operation, then read this again and then ask for more details from the surgeon or from the nurses. Visit by the anaesthetist If you are having a general anaesthetic, the anaesthetist who will be giving your anaesthetic will interview and examine you. He will be especially interested in chest troubles, dental treatment and any previous anaesthetics you have had. Diet. You will have your usual diet until 6-12 hours before the operation when you will be asked to take nothing by mouth. This will let your stomach empty to prevent vomiting during the operation. Shaving The operation area will be shaved to remove excess hair. Timing of the operation The timing of your operation is pre-arranged so that the nurses will tell you when to expect to go to the operating theatre. Do not be surprised, however, if there are changes to the exact timing. Premedication You may be given a sedative injection or tablets about 1 hour before the operation. Transfer to theatre You will be taken on a trolley to the operating suite by the staff. You will be wearing a cotton gown, wedding rings will be fastened with tape and removable dentures will be left on the ward. There will be several checks on your details on the way to the operating theatre where your anaesthetic will begin. The operation is then performed. Coming round after the anaesthetic. Although you will be conscious a minute or two after the operation ends, you are unlikely to remember anything until you are back in your bed on the ward. Some patients feel a bit sick for up to 24 hours after operation, but this passes off. You will be given some treatment for sickness if necessary. Will it hurt? There is some discomfort on moving rather than severe pain. You will be given injections or tablets to control this as required. Ask for more if the pain is still unpleasant. You will be expected to get out of bed the day after operation despite the discomfort. You will not do the wound any harm, and the exercise is very helpful for you. The second day after operation you should be able to spend most of your time out of bed and in reasonable comfort. By the end of one week the wound should be virtually painfree. Drinking and eating You will be able to drink within an hour or two of the operation provided you are not feeling sick. The next day you should be able to manage small helpings of normal food. Opening bowels It is quite normal for the bowels not to open for a day or so after operation. A laxative is sometimes required. Passing urine It is important that you pass urine and empty your bladder within 6-12 hours of the operation. If you find using a bed pan difficult, the nurses will assist you to a commode or the toilet. Sleeping. You will be offered painkillers rather than sleeping pills to help you to sleep. If you cannot sleep despite the painkillers please let the nurses know. The wound The wound has a dressing which may show some staining with blood in the first 24 hours. The wound is held together by fine stitches. They are usually removed after 7-10 days. The dressing, which is usually waterproof to allow showering, will be kept on until the stitches are removed. Sometimes a plastic suction drain is used to suck out excessive secretions from the wound. This will be attached to a plastic portable suction bottle. It is pain free and is removed after a day or two. There may be some purple bruising around the wound which spreads downward by gravity and fades to a yellow colour after 2 to 3 days. It is not important. There may be some swelling of the surrounding skin which also improves in 2 to 3 days. After 7 to 10 days, slight crusts on the wound will fall off. Occasionally minor matchhead sized blebs form on the wound line, but these settle down after discharging a blob of yellow fluid for a day or so. Washing You can wash the wound area as soon as the dressing has been removed. Soap and tap water are entirely adequate. Salted water is not necessary. How long in hospital? Depending on the size of the hernia and your general health you may be able to leave hospital on the same day. Usually, however, you will feel fit enough to leave hospital after 1 or 2 days. You will be given an appointment for a check up about a 7 to 10 days after your operation. Sick notes Please ask your surgeon for any sick notes or certificates that you may require. After you leave hospital You are likely to feel a bit tired and need rests 2 or 3 times a day for a week or more. You will gradually improve so that after a month you will be able to return to your normal level of activity. Lifting At first discomfort in the wound will prevent you from harming yourself by too heavy lifting. After one month you can lift whatever you like. There is no value in attempting to speed the recovery of the wound by special exercises before the month is out. Driving You can drive as soon as you can make an emergency stop without discomfort in the wound, i.e. after about 10 days. What about sex? You can restart sexual activities within a week or two, when the wound is comfortable enough. Work You should be able to return to light work within 2 weeks and a heavy job within 4 weeks. Complications Complications are rare and seldom serious. If you think that all is not well, please ask the nurses or doctors. Bruising and swelling may be troublesome, particularly if the hernia was large. The swelling may take 4 to 6 weeks to settle down. Infection is a rare problem and will be treated appropriately by the surgeon. Aches and twinges may be felt in the wound for up to 6 months. Occasionally there are numb patches in the skin around the wound which get better after 2 to 3 months. The risk of a recurrence of the hernia is about 1 in 30.
The operation should not be underestimated, but practically all patients are back at their normal activities within a month. If you have any problems or queries, please ask the nurses or doctors. |
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