Hernia meant that singing left me in excruciating pain

Musician and singing teacher Peter Evans, 58, moved to France in 2013 with wife Ema. The pair run meditation and singing retreats near Lac de Vassivière.

19 December 2018
By Gillian Harvey

The inside story of readers who have had operations in France – and how they found the health service, by Gillian Harvey

Initial symptoms

In April 2018, I noticed a swelling on the left side of my groin. I recognised it instantly, as I’d had two hernias in the past – the first aged 18, and the second when I was 38. If I lay on my back, it was possible to push the swelling back in, but when I coughed it would pop straight out again. It was a little tender but not painful. I might have over-exerted myself when digging up a rose bush in the garden the day before.

I went to see my local GP, who confirmed the diagnosis. He asked whether I wanted to have the hernia operated on. As they don’t heal themselves and are likely to get worse if left untreated, I said that I did, but wanted to wait until autumn as summer can be busy as I run singing groups and am also a keen cyclist.

However, the next month, whilst running singing classes, which can put strain on the abdominal muscles, I got the first of three episodes of excruciating pain.

A hernia is caused by part of the intestines poking out through a weak section of the abdominal wall; if it gets trapped, it can cause agonising pain and unless you can get it to go back in, it can become “strangulated” and you need emergency surgery.

Luckily, I managed to get it to pop back in by lying down and massaging the area, so hospital was not needed.

However, I made an urgent appointment with my GP, who referred me to the Clinique François Chénieux in Limoges for the following week. Amazingly, I still managed to complete the rest of the singing workshop and also take part in a four-and-a-half-hour cycling event in the intervening week.

At the hospital

The check-up at the hospital was just to confirm the diagnosis and to arrange a date for surgery, which was set for September. I could have had an earlier appointment, but wanted to wait until after the summer. Two weeks prior to the operation, I had an appointment with the anaesthetist to talk about my medication and check my blood pressure.

I was offered the choice between a spinal anaesthesia and general. I opted for the general because I’d never had any problem with them in the past, and didn’t like the idea of being temporarily paralysed.

The operation

I checked in for the operation on the day itself at 7.30am. As I was first on the list for theatre, I was taken to surgery at around 9am. The procedure takes around 45 minutes, and I was fully awake in my room by around lunchtime. 

After a few checks by nurses and the
surgeon, a sandwich and a couple of cups of coffee, my head had cleared sufficiently for me to head home in the ambulance taxi by 7pm. You are allowed to go home the same day if you have a responsible adult waiting for you.

The staff at the hospital were  great and spoke “lentement, clairement et simplement” for me, and both the ambulance taxi drivers were lovely as well – though I did have to ask the guy on the way home to take it a bit easier around the corners of the Lac-side roads!

Aftercare

Once I was home, the local nurses came daily to check the wound and change the dressings for the first week. 

After seven days, with the incision sufficiently healed, they removed the outer stitches (there were two more layers of self-dissolving sutures under the skin).

Around a month after the procedure, I had another appointment with the surgeon so that I could be given the all-clear to gradually resume my usual activities.

Facts on inguinal hernia

How is an inguinal hernia diagnosed?

An inguinal (groin) hernia appears as a swelling in the groin, which corresponds with the passage of the intestines through the inguinal canal. It is usually painless and often disappears when the patient stretches, or presses on the swelling.

A inguinal hernia may remain asymptomatic for years but it will only grow and cannot heal spontaneously. The most serious complication is strangulation: the intestines stuck in the hernia can lose blood supply (necrosis); in this case, emergency surgery is required.

How long does the operation take?

Two types of surgery are possible: by an incision of the groin (which can be done under local anaesthesia) or by laparoscopy (under general anaesthesia). The laparoscopy is minimally invasive and is less painful for the patient.

Could you briefly describe what is done to rectify the hernia?

In almost all cases, a parietal reinforcement (mesh) is put in place to prevent recurrence. Surgery usually lasts about 30 minutes and is carried out on a day-patient basis.

What is the prognosis for patients after the operation?

The risk of complications after surgery are very low (haematomas, after-pain and, in exceptional cases, infection may occur). The use of prosthetics means that the chance of recurrence is less than 2%.

Dr Renaud Chiche, chirurgien digestif at the Clinique Geoffroy Saint-Hilaire

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