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


Holiday on Ice, Part 2

Tomorrow marks the two-week anniversary of my hernia repair surgery. (Please, no gifts. A themed cake would be horrifying.) My surgeon prefers to slice his hernia patients and reach inside rather than any newfangled laparoscopic method. This turned out to be a blessing in disguise, as he found an additional, smaller hernia near the first and repaired that as well. Nothing hurt as bad as the bill, but yes, there have been days of significant discomfort. I hesitate to call it pain because, while there have been a few yelp! moments, they're few and far between. So far I've taken only two of the Percocets prescribed by my doctor, forgoing even the Ibuprofen after my swelling went down. Yes, there was swelling. It wasn't as gross as you might think, but it did get my attention. Same goes for the discoloration, which tended toward a light-purple hue Wikipedia characterizes as "thistle." That only lasted a day or two, about the time I spent intermittently draping my midsection in bags of camp ice. Strangely, yesterday was one of my worst Oh Em Jeebus! days, partly because I made the foolish mistake of sneezing while in a seated position. Apparently, hernia repairs hate it when that happens.

It's embarrassing to talk about this, but only because my brother and stepfather are going through much worse so what the hell am I even going on about. I feel no shame in telling you the travails of my junk. You may think it's TMI. I accept there are cultural taboos, but the fact is men's health deserves to be publicized and generally understood more than it is. Societally, we've come to a place where we can talk about breast cancer and other female or mostly-female health concerns, and that's great--so why not hernias? I guess the main reason is it makes men wince to read it, and yes, IT REALLY DOES. Listen, I've read a lot more about the subject than you probably have now, so I get it. But honestly, isn't this something all men should know? If 27% of us are likely to suffer a hernia, shouldn't we know what to do about it?

I'll spare you the photos--you're welcome--but I now have a four-inch scar an inch northwest of Action Central. That's a serious scar. I'm also losing weight, partly on purpose and partly because I've been down in the dumps. It sucks being under the weather. It sucks having to take today off because I sneezed 24 hours ago. It sucks that I'm still getting bills from people who conspired to stab me near the sanctum sanctorum. It sucks that my wife has to take on greater responsibility. I think that's the part I hate most--but she's been a champ, and I suppose somewhere down the line I'll have the chance to make it up to her. I hope not, but life throws us lemons and we make Limoncello.

The main thing you should know about hernia repair is that for all the words I've thrown at it, and for all my discomforts and indignities over the past 13 days, it's still better to know my intestines aren't likely to burst through my abdominal wall like the "snakes" in one of those prank peanut butter jars. If you're a man with weird dragging or rippling or throbbing sensations down there in your equatorial region, then maybe you should head over to WebMD's inguinal hernia section and compare your situation. If your symptoms match, talk to your GP and have her set up an appointment with your urologist. Try to think of the resulting consultation as a truly exciting first date. The surgery's a drag but nothing you can't handle. In fact, I'd vote for the last two weeks over a flu every time. And if you happen to get your repair done through South Sound Surgical Associates in Olympia, WA, hey, please tell 'em Carv sent you. Maybe they'll knock a few bucks off my bill.

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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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