Carv's Thinky Blog I'm an author with a focus on satirical science fiction.


Holiday on Ice, Part 1

Like most men, I've had it drummed into my brain from infancy that pain and fear are emotions any "real man" must labor to suppress. Trouble is, those emotions don't want to be suppressed, especially when there are valid reasons for both. Instead, they just liquefy into a medley of negative emotions with an overriding component of anger. I'm not allowed to be nervous or scared. I don't get to collapse in the corner and cry from physical pain. I'm not sure I'd know how to do it if I tried. Instead, I find myself getting more and more pissed off, because that, at least, is a societally-tolerated element of the male psyche.

Here's why I'm hurting. A few weeks ago, I took a bad step climbing upstairs. This caused days of agony that subsided, thank the stars, in time for performances of the radio drama. Then the pain returned a few days later, except this time it was on the side of my right foot rather than behind my middle toes. I'm guessing it's tendonitis. "How do you get an infection inside your foot?" my wife asks, and I reply it's a good question I don't know how to answer. I just know it flippin' hurts. It's been hurting for days. I have a high pain tolerance, but this is getting ridiculous. Each time my foot leaves the floor, it announces its motion with a riot of exclamation points and lightning bolts.

Here's why I'm nervous. At some as-yet-unannounced time tomorrow, I'm scheduled for inguinal hernia surgery. Inguinal is a fancy medical adjective for "groin stuff," and hernia means a hole in the wall of a body cavity. See, the inside of a human body is divided into several self-contained pockets. Your thoracic cavity, for example, lies inside your ribcage and houses your lungs and heart. Your abdominal cavity contains what we collectively refer to as guts, mostly so we won't have to think about what those guts do. But because of one of the jobs those guts do, namely process infectious bacteria, it's important those organs stay isolated from other bodily systems. Thus, if one were to develop a hole in the wall that surrounds that cavity, it may not be a huge deal immediately, but it can generate problems down the road.

Unfortunately, male abdomens have a built-in structural weakness. When we were embryos, our testicles developed inside our abdominal cavity, then headed south before that cavity began sealing shut. In fact, it never closed completely. There are still two passages called the inguinal canals, through which our spermatic cords descend. When we get cold or scared, our delicate man-parts use those passages to huddle back inside the abdominal cavity. Women have inguinal canals as well, but theirs are strengthened by protective ligaments. Ours are not. So much for intelligent design.

So here's Carv on the ab cruncher a few months ago, grimacing through an ordinary workout. His muscular contractions increase the pressure on his starboard inguinal canal. It gives way, and Carv experiences a sudden stab of lightning from his crotch to the right side of his thorax. He knows immediately something has gone very, very wrong; but for the next month or so, he experiences no symptoms. He thinks he got away scot-free. He is wrong.

What actually happened is he now has a tear in his abdominal wall through which his omentum, the apron of membranous peritoneum that surrounds his abdominal cavity, is free to pop in and out. He can feel it popping, especially in the bathroom. (Activities there cause pressure changes. You figure it out.) And Carv, who apparently feels less nervous talking about his biological difficulties in the third person, begins to lose sleep. About this time, he works on solutions to three anatomy textbooks in a row, and they all tell him the same thing: hernia. He knows how that ends. He remembers his roommate's surgery years ago, which didn't seem a picnic at all. Then he sees a David Spade standup routine about Spade's hernia operation, in which the words agony and catheter make frequent appearances. As the last few months go by, symptoms worsen. It's never terrible, but it's enough to convince Carv to go see a doctor. Sure enough, the doctor recommends surgery. It's not an emergency, the doctor says, but it prevents one. You should do it. Then the doctor indicates with surprising indelicacy how he'll make an incision here, use it to reach up here into Carv's abdomen, insert a mesh that looks like this, blah blah blah. Carv tries to pay attention but hears mostly a ringing in his ears.

Here's why I'm scared. In less than 24 hours, a guy I barely know will knock me out cold, use a sharp instrument to cut a deep hole into my abdomen, and stuff one "bun" of a hamburger-shaped piece of mesh through the hernia. Then, I suspect, he'll inject me full of glorious painkillers and antibiotics. If I'm right about the tendonitis in my foot, the antibiotics should make short work of that condition. My foot pain, unfortunately, will be replaced by at least a few days of horrible groin pain. There'll also be some swelling and discoloration; and hey, if that flipped the switch on your squeam factor, then imagine how it makes me feel.

I'm telling you about this for a reason--not to gross you out, but because no one ever does talk about this stuff. We see it as awful, inappropriate, TMI. But that taboo makes no sense because over the course of our lifetimes, over a quarter of us men will experience hernias. It's a pretty big deal. And maybe it's better I tell you about hernias now, as opposed to you having to look it all up on the Internet while panicking about an impending operation the way I did. Now, given the Whipple procedure my brother just went through, which is essentially having a team of surgeons fire a shotgun at his belly and then patch up whatever remained, my surgery is all but inconsequential. "Real man" that I am--and dear God, am I getting tired of being told what I have to do to qualify as a real anything--I feel a rush of guilt and insufficiency each time I complain about the week of super fun I'm about to have. Does it help to talk or write about it? No, not at all. But maybe it'll help you, am I right? "The More You Know," they keep telling me on NBC.

So what can you do to avoid hernia? Most importantly, try to be born a woman--except, as we're constantly and constructively reminded these days, that comes with its own drawbacks. On the plus side, women are 25 times less likely than men to experience my particular malfunction. Failing that, refrain from smoking and keep your weight in check. Be careful in the gym, in the bathroom, and when coughing. Wait, how do I do all that, you ask? It's an excellent question. I don't know. You probably can't. The fact is, if you're fated to suffer a hernia, that's probably what's gonna happen. It sucks, I know. If it does, you'll have a pretty good idea when it happens. As time goes by, you'll feel discomfort when lifting or straining. You may feel a popping or rippling or gurgling or heavy sensation or actually, you may feel nothing at all after the initial tear. I felt almost nothing till recently, when it turned into occasional burning. In some cases, you'll see visible swelling, and trust me: this is one time you should be grateful I don't include a lot of images on this site. If you're tempted to Google this swelling phenomenon, don't. Luckily, I've managed to avoid that particular symptom.

So. Here's hoping my surgery goes smoothly and I'm up and around after the expected 48 hours of miserable recovery. I'll spend much of that "free" time sitting on an icepack, watching stupid TV, and cursing the male anatomy gods. I'll spend some of it, I hope, snarling through work in my office. I don't expect friends to call or come by, nor do I imagine I'll be in much of a mood for socializing. If your instinct is to say "I'm praying for you," well, try not be surprised or offended when I say it's too late for that. I might add, "You should've asked God last spring not to give me a damn hernia in the first place," but that'll only be the misery talking.

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  1. Good luck with everything tomorrow! I’m sure it’ll go well. Just make sure the cat doesn’t jump on your lap while you’re convalescing. I found that out the hard way after my vasectomy.

  2. Couple of points:

    1. Your foot pain is probably not from an infection. If it was, you would have swelling, redness, and possibly discharge and fever. Tendonitis is response to damage, not infection. Ask your doctor if you would benefit from physical therapy.

    2. Your surgery will go fine. It’s low risk.

    3. I have very few medical fears, but being anesthetized is one of those few. I know they do blood work beforehand, and that it is very safe, but I still don’t want to go there. Don’t take my fear with your, though – I’m just thinking out loud.

  3. Richard, my foot actually is a bit red and swollen. Scott, I’ll remind Sloppy Joe to keep his damn distance.

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