A Perinatal Memoir: How I Unknowingly Lived with a Large Post Cesarian Incisional Hernia for Three Years

By January 23, 2023Uncategorized

Written by an empowered patient of Nuvo Physio

 

How it all started

My health journey as a new mom began in 2018 when I became pregnant with my first son at the age of 31. Up until then, I had always been healthy, did some form of exercise, and ate a balanced vegetarian diet. I pictured myself loving pregnancy and having a small, cute little belly. However, that’s not how it turned out for me. By June 2019, I had endured nine months of nausea, vomiting, heartburn, heart palpitations, dizziness, intense cravings, and swelling. I ended up gaining 75 lbs with that pregnancy, more than half my starting body weight. Admittedly, some people around me were shocked by my appearance, but I didn’t think much of it because I trusted my body to “do what it had to do” to create a new life. My belly was the contrary of what I had envisioned for myself — it was huge. I was also terrified of giving birth, and I think my son knew it, because he was two weeks late. The day before I was scheduled to be induced, I started having contractions and my water broke at home. It was a difficult birth with a lot of complications for both me and the baby, and I ended up getting an emergency C-section after 13 hours of labour. The surgery itself was, in a way, very traumatic for me. I was crying out in pain while they rushed me to the operating room; I told them the epidural I had gotten earlier had very much worn off and I could feel way too much of what was going on. There were so many people huddled around me, and they all kept telling me to breathe and that if it really hurt too much they would put me under. When my husband arrived after changing into scrubs, I told him through loud sobs that I was in severe pain and that they would put me under. He just looked at me with concern and said “they’ve already started”. I was shocked that they would just continue while I was suffering. Although in retrospect they probably were just doing what needed to be done for the baby, whose heartbeat had become irregular, in the moment I felt lied to and in a way, violated. But I couldn’t complain or even talk by this point, and I just cried all the way through. When the baby was born 30 minutes later, I was relieved to hear him cry and they said he was mostly healthy, other than having an infection that would need an antibiotic drip. Soon after they whisked him and my husband away, and I felt a sharp pain. I told them about it and they said “oh, it hurts because we took your uterus out to clean it.” I was, to say the least, stunned, and to this day I still don’t know if you can actually do that, but that’s what they told me.

 

My postpartum recovery and the first hints something was wrong

Two days later, the curiosity of seeing what my new body looked like was really getting to me. I got up from my hospital bed to steal a glance at my belly for the first time after giving birth. I didn’t expect it to be so big as it was, to me it looked just like a big orange with lots of bumps and dimples. Thankfully, I didn’t feel much pain from the C-section and I started taking walks after a couple of weeks. I was really excited to start losing all the weight I had put on and start feeling like my “old self” again. I imagined myself putting on my pre-pregnancy clothes, going out with the baby and feeling great. I worked really hard to achieve this vision, and after one full year of diligent dieting and exercising (strength training and exercise bike), I lost every single pound I had put on during the pregnancy. This is when I started realizing something was wrong with my body. I might have been back to my previous weight, but to my surprise, I didn’t look like my former self in one particular area. The region from my belly button to right under my C-section scar still had what I would describe as a huge round bulge or pooch. It was so big that I got rid of all the clothes I had desperately been trying to fit into. I bought super loose clothing to try to hide it and started feeling like I was losing confidence – in my appearance, but also in my conviction that my body “knew what it was doing”. I felt my body looked odd – like I still had a baby, but only in the bottom half of my belly. When I looked in my area all I could find were sports or injury physiotherapists anyway. When I walked around, I had the weird feeling my organs were “spilling” out of my body, and when I pressed on this area, I even heard what sounded like my stomach rumbling. To counter this, I started wearing only support undergarments or leggings. By then, I felt that every single layer of me had changed, from my external clothes to my undergarments, as well as my skin, my insides, and by body and soul. I simply no longer felt like myself. I really struggled with this, because I told myself I should be thankful for what my body had achieved as a mother, and I also felt superficial for worrying about what I thought was solely an aesthetic concern. I kept telling myself that nobody except myself cared what I looked like, but I couldn’t stop myself from hating this new part of my body. In despair, I started googling “mom pooch” and that’s when I first learned about diastasis recti. Nobody, not even my doctor, had ever told me about this. I figured that’s for sure what I had. I reconsulted my doctor who gave me a printout of a couple exercises and advised that I could find a physiotherapist if desired.

 

 

My second pregnancy

I started looking for a physiotherapist in my area, but when I looked online all I seemed to find were sports or injury physiotherapists. That’s when I got pregnant with my second son. I naively figured my body would be changing anyway, so I didn’t bother continuing my search. I did, however, start seeing lots of different doctors because my pregnancy was labeled as high risk due to some complications. Each time I would meet a new doctor, I would mention that something was wrong with my belly, and indeed in the first six months it looked more like a big capital letter “B” instead of a standard pregnancy belly. But nobody thought anything of it, with the exception of one doctor, who said “that’s your uterus, it’s bulging forward. You’ll need surgery to get it fixed after giving birth.” I was very concerned by what I had heard, but she also didn’t have any additional information, so I figured I would keep asking more doctors. Only one month before the birth, one of my doctors told me that my uterus had ripped open during my first birth, that they had sewed it up in a T-shape, and that I was not a candidate for a VBAC. Again, I was simply shocked!  What little trust I had left for the healthcare system by this point had completely left me. I felt deeply angry, but I felt I had no choice but to move on. As a mother, I instinctively put my children first and just chose to focus on them instead of what was going on with me. In preparation for my second C-section, I was asked to meet the surgeon who would be performing my operation. I felt hope coming back to me, because I would finally get to ask questions to someone who I thought was knowledgeable about the issue I was facing. But I faced another big disappointment that day. The at-risk pregnancy clinic had lost my file, so the surgeon just asked me to tell her what I knew about my condition. After explaining why my pregnancy was high risk, I added that I thought that maybe something had gone wrong with my first birth, that my belly looked really weird, that I wanted her to examine me, and that I wondered if she could sew my abs back together after the upcoming C-section. This did not go as expected. Unfortunately, I wasn’t examined and eventually told she wouldn’t be the one doing the surgery; it would be the surgeon on-call during my appointment. I left that clinic angry, hopeless, and confused as to why they even wanted me to meet her in the first place. When I finally got to the operating room, I remember the two surgeons gasping after cutting me open. I overheard them talking about something being wrong and needing surgery, but I tried to focus on the baby arriving. The next day, one of the surgeons came to my room and told me my abs had completely moved to each side of my body. She put her hands on each side of her torso right above her hips to demonstrate this. She said the more experienced surgeon who was working with her the day before had never seen as bad a case of abdominal separation, and that I would need surgery to correct it. She didn’t have more information. To me, that only solidified my self-diagnosis, that I had diastasis recti. Do I have diastasis recti after all? I started on my second weight loss journey because I had again gained another 75 lbs and started doing every diastasis recti program I could find online. I desperately wanted to prove them wrong, that I could fix this myself without surgery. At my six-week postpartum appointment, I told my doctor about what had happened. I insisted she examine me again. This time she did and she said that while I did have diastasis recti, that my abdominal wall was “strong”, so that I may have misperceived the sensation of my organs “right under my skin”. She gave me the same sheet of paper with 2-3 exercises and told me to go see a physiotherapist. I said “but the surgeon said I needed surgery” and she disagreed at first, but then said “okay, I’ll refer you to a surgeon at the hospital.” I felt excitement again, because I would be able to talk to someone who understood my condition and would help me fix it. I wasn’t ready yet to get surgery and I still wanted to explore exercises, but what I wanted most was information about what I couldn’t see was going on right inside of me. This one bulge had completely transformed me into a new person. I dressed differently, I sometimes had pains in that area that were so bad that I’d need to go lie down, and I avoided any regular exercise because I was afraid of making my diastasis worse. To be honest, I also resented my husband because my body had changed so much to create our family, and he had stayed the same. Two weeks later, I was so excited and relieved when my doctor called to say the surgeon at the hospital would meet me. But then, only two days later, she called again to say the hospital didn’t do that kind of surgery and that I had to go to the private sector. She did say she would give me a prescription so I probably wouldn’t have to pay out-of-pocket. I started looking for surgeons, but while doing research, I read that after having abdominal repair surgery, women are not to have other children. My husband and I had hoped to have a third one, so I was anxious and hesitant and went back to Plan B – the exercises. I started back up with my search for a physiotherapist, and expanded my radius. That’s when I found Nuvo Physio. I read through their website and then all their social media content. Although their office was more than one hour away from my house, I knew I needed to see them because I could tell they were passionate and knowledgeable about prenatal and postpartum health. Nuvo Physio was indeed exactly what I was looking for. I met with Jennifer, and she took extra time, listened, examined me, gave me exercises, recommended support garments, placed physio tape on me, and checked my progress. I never felt judged or hopeless, I felt cared for. It was in fact Jennifer who told me my bulge wasn’t just diastasis recti, it was also a hernia. She was as surprised as I was that after meeting so many doctors, not one had properly diagnosed me.

 

 

Deciding to get the surgery

With the knowledge that I had a hernia, I knew that my only option at fixing this permanently was surgery. After many conversations and anxiety about ending my chances to be a biological mother again, I decided to consult a surgeon. I still didn’t know what to do, but I felt I didn’t want to keep living with mystery pains and a distorted body, I wanted to at least hear what the surgeon had to say. Jennifer recommended a particular surgeon’s clinic for my surgery, and it turned out this surgeon was also the surgeon I had found online who I had picked for myself. After meeting the surgeon, she immediately diagnosed me with a very large incisional hernia on my C-section scar, along with mild diastasis recti. Thankfully, the hernia was so large that it wasn’t an immediate health risk, but with time, it would get worse. Here I really struggled: Did I do something wrong that inadvertently brought on this condition? Was this somehow my fault? Was I being superficial? Was I being fair to my husband? Was I somehow robbing the life of the unborn baby I wanted? Did I really want that third baby, at the risk of worsening my hernia and continuing to live with the condition for a few more years, or fix it? Was I selfish? I had so many questions and it was hard. A lot of people told me to put myself first, but it felt wrong and weird. In the end, what really settled it for me was that I just wasn’t ready at that very moment to have a third baby, and I also wasn’t ready to keep living as an “altered” version of myself for an unknown number of years. I had already had this hernia for three years and was 35. How much longer was I willing to live as someone else? I ended up deciding on hernia repair with mesh, abdominal repair, abdominoplasty, and light liposuction. I probably didn’t need all the “extras”, which in the end would require a team of three surgeons to undertake, but I wanted to come out of this journey with as few regrets as possible. Before the surgery, I was sent to do blood work and an MRI to see which organs were in my hernial sac. The results showed that I had a very large hernia (8 by 8 cms) and that the bulge was filled with my intestines. I thought back on all the times I told my doctors I felt as though I was touching my organs right under my skin. I had instinctively known what was wrong with me, but maybe didn’t get the diagnosis I needed because I didn’t know to ask about incisional hernias. I had never heard of them and when I had searched for hernia and diastasis recti in the past, all I had found were umbilical hernias. I didn’t even know incisional hernias even existed before finding out I had one. My surgery ended up costing me a little over $26,000, so it definitely was a big investment for my family. Again, I felt a lot of guilt. I was not only spending a lot of money on something I felt was superficial (because I could live with the pain), but I was also in a way “not loving myself as I was” for wanting to change my appearance. I found it hard to focus on the medical aspect of it. I also felt guilt about not being able to have any more biological children. Maybe I could have gone back to my family doctor and just have the hernia fixed at the hospital, but I knew they wouldn’t repair the diastasis or loose skin, and honestly I had lost faith in my doctor. I didn’t know how long it would take to have the operation scheduled or how I would look coming out of it. With a private sector operation, I had more information and I felt more in control. I was nervous about the operation because I’d need time off work (2.5 weeks since I work from home) and a full eight weeks of recovery without lifting my sons. I knew it would be difficult for my husband to take complete responsibility for the children during this time.

 

The surgery and recovery

The day of the operation, Jennifer from Nuvo Physio came to witness the procedure. I was so happy to have a friendly face there with me. The operation went well and when I woke up after a few hours, I felt nauseous and dizzy, but the pain was under control. The first few days, I was only awake for 20-30 minutes at a time and I mostly slept. I also didn’t eat much. It was painful getting in and out of bed and I slept on an incline cushion I had gotten during my pregnancies. I had two surgical drains installed and I thought those were the most uncomfortable part. Normally the drains are removed after one week, but mine were producing too much liquid and I had one taken out after 10 days and the other 14 days. Honestly, I was surprised by the level of pain I felt after the surgery, it was worse than I had imagined. I wouldn’t even compare it to the C-sections. I only started feeling an improvement after the last drain was taken out and I could start standing up straighter (it’s recommended to stay hunched over after an abdominoplasty and I couldn’t have straightened up even if I had wanted to). The skin on my stomach felt really tight, like it might tear if I stretched too much. I also often had back aches from hunching over and my digestion was completely off. My skin felt like it was just one big blister. For the first five and a half weeks, I felt so much pain and was exhausted. One day as I got into bed and felt another stab of pain, I started wondering if maybe the pain wouldn’t get better and I had made a mistake. Miraculously, the next day I woke up and felt the pain had really alleviated. From that point forward, I started gradually feeling better and more like myself. By seven weeks, I felt stronger, and at the eight-week mark I felt much like I did before my pregnancies. I had a big feeling of relief from not feeling strange pains in my abdomen.

 

What’s next for me

Now that I’m recovered, I can lift my children without issue again and it’s great. I bought some new clothes. I re-started physiotherapy with Nuvo Physio to regain some of the strength I lost in my core. I have a positive outlook about feeling in control of my own health journey again. Overall, I just feel more like myself and I’m thankful I’m not constantly worrying about my body anymore. Of course, sometimes I do feel sad about not being able to have other children, but my husband and I have decided we’ll adopt if we come to a point where we feel ready to have another child, which is a big source of relief.

My takeaway: If you feel something is wrong with your body, trust your instincts and don’t give up on finding a health professional until you get the help you need.

 

Sincerely,

An Empowered Woman

Nuvo Physio

Author Nuvo Physio

At Nuvo Physio, you’re our #1 priority. We can’t stress this enough! Our goal is to help educate you while guiding you on your journey. We’re always thinking of new ways to improve our services in order to bring a positive change to your experience. We’re passionate about what we do. Let’s work together!

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