Frequently Asked Questions (FAQ)

What is a hernia?
Who gets hernias?
What are the symptoms of a hernia?
What are the different types of hernias?
What is the cost and what could my insurance cover?
Will my hernia go away?
What about complex hernias?
What is the recovery time?
When can I return to work?
When can I return to recreational/athletic activity?
Can I travel after surgery?
Why choose a hernia specialist?
What if I have existing medical problems?
When and how can I schedule surgery?
What about office visits after my surgery?
What if I have other questions?

 

 

What is a hernia?

A hernia is a small sac containing tissue which protrudes through an opening in the muscles of the abdominal wall. This opening can be a result of a congenital flaw or the opening may be an acquired flaw due to sudden or even repeated stress or strain on the abdominal muscles. A hernia develops when the outer layers of the abdominal wall weaken, bulge or actually rip causing internal organs and tissue to push through the tear creating the typical "bulge" found with most hernia patients.

Any part of the abdominal wall can develop a hernia, however, the most common site is the groin area. With an inguinal hernia, the sac protrudes into the groin and sometimes the scrotum. Umbilical hernias occur through the naval, femoral hernias occur below the groin and incisional hernias occur through surgical scars. A hernia is reducible if the sac of the hernia can be pushed back into place inside the abdomen. Non-reducible, incarcerated, or imprisoned hernias cannot be replaced back in the abdomen.

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Who gets hernias?

Approximately five million Americans suffer from hernias every year, according to the National Center for Health Statistics. Most adult hernias result from sudden or repeated strain or stress on the abdominal muscles. Some hernias are congenital. Types of activity typically associated with the appearance of a hernia include:

    • Lifting heavy objects
    • Sudden twists, pulls or muscle strain
    • Chronic straining with urination
    • Chronic constipation
    • Repeated coughing attacks

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What are the symptoms of a hernia?

If you are afflicted by any one or more of the following symptoms, contact a doctor as soon as possible.

    • A noticeable bulge or swelling in the groin area
    • Groin pain
    • Nausea or vomiting
    • Constipation
    • Urinary difficulties

 

What are the different types of hernias?

Inguinal hernias occur in the groin, which is the area between your abdomen and thigh. As the most common type of hernia in adults, inguinal hernias are most common with men although they can also occur in women. With an inguinal hernia, the contents of the abdomen - namely the intestine - protrude through a weakness or tear in the abdominal wall muscle creating a visible bulge and sometimes pain. Pain caused by an inguinal hernia can be a constant, daily pain or may be sporadic, occurring once in a while. Inguinal hernias can also be bilateral, occurring on both sides of the abdomen instead of a single side.

Umbilical hernias occur in or around the naval, or umbilicus. This type of hernia may be due to congenital factors. Umbilical hernias may also result from sudden or repeated strain or stress on the abdominal muscles. In adults, as with any hernia, an umbilical hernia will not heal and go away but rather grows larger with time and often becomes problematic in that incarceration or strangulation can occur. With infants, however, an umbilical hernia may slowly close, delaying surgery until age 3 or 4 unless the hernia causes problems before then.

Incisional hernias can occur in the abdomen in the area of any prior surgical incision or scar. Hernias of this type are often accompanied by a swelling or bulge near the area of the prior incision, typically along straight incisional scars running down from the breastbone to the pubic area. Incisional hernias can be a result of 1) tension placed on the tissue from the prior surgical procedure, 2) disruption in the general area of prior suturing to the abdominal wall or 3) inadequate healing, which can be due to obesity, metabolic diseases, infection or poor nutrition. Since suturing (tension) can be the cause of some incisional hernias, it is highly advised that incisional hernias be repaired with the Tension Free Mesh technique to avoid future recurrence. Pain may be an early warning sign of an incisional hernia, as there may not be any initial presence of a bulge, though this type of hernia can develop soon after the original surgery or at any time thereafter.

Femoral hernias are almost exactly the same as inguinal hernias. The femoral hernia occurs when abdominal contents are forced through the "femoral canal". Typically, this type of hernia forms near the crease of leg in the abdominal region, but in an area relatively lower than the more common inguinal hernia. Females tend to have a slightly larger femoral canal because of the angle and shape of the pelvis, which is why they are more prone to these types of hernias as opposed to men, who tend to have slightly larger inguinal canals making them more susceptible to the inguinal hernia. The two types of hernias are often too difficult to tell apart in diagnosis, which is why a hernia specialist is often required to confirm diagnosis. Femoral hernias are more likely to become incarcerated or strangulated because of their location, which is why repair is strongly advised upon diagnosis of this type of hernia.

Epigastric hernias occur between the lower part of the breastbone and the naval and is caused by a weakness or opening in the fibrous tissue of the abdomen. This type of hernia usually consists of fatty tissue and rarely contains intestinal tissue. Although generally small in size (no bigger than a golf ball), epigastric hernias can easily become pinched in their small area, sometimes causing a great deal of pain.

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What is the cost & what could my Insurance cover?

Most health insurance plans cover the costs of hernia surgery at the Hernia Center of Southern California including many PPO plans. Patients, however, are still responsible for any co-pays or deductibles that fall within their insurance plans. The Hernia Center of Southern California has additional options, including financing, available for those who are not covered by health insurance, or those with special needs. For more information on these and other options, please contact our main office at 877-2-HERNIA from 9am- 5 pm Pacific Standard Time.

 

Will my hernia go away?

Although a hernia may not worsen for months or even years, an untreated hernia WILL NOT get better on its own. Hernias which are reducible, are not generally an urgent danger to your health, though they can be painful. A non-reducible hernia can become life-threatening if any part of the intestine becomes trapped or strangulated in the opening or weakness and then requires emergency surgery.

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What about complex hernias?

Our state-of-the-art Tension Free Mesh technique is successful at repairing large, recurrent and complex hernias, although some of these types of hernias may require general anesthesia in order to be repaired effectively. However, even if the hernia is large or complex, most inguinal, umbilical and many incisional hernias can be repaired with local anesthesia with sedation.

 

What is the recovery time?

Rapid recovery after surgery is dependent on the location of the hernia, the type of hernia, the repair technique used as well as your individual, physical health. With the advanced surgical techniques used at the Hernia Center of Southern California, our patients experience considerably less post-operative pain, have fewer restrictions after surgery and recover rapidly. We typically see our patients return to everyday activities within DAYS of surgery and can return to work and back to recreational and sport activities within two weeks.
NOTE: Recovery following incisional and/or more complex hernias may be slightly longer to some extent depending on the involvedness and type of the hernia and the general heath of the patient.

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When can I return to work?

After hernia repair surgery at the Hernia Center of Southern California you will be able to rapidly return to normal, daily activities as well as work and athletic activities. We use a "tension free" repair that results in minimal post operative pain.

This is a guide to assist you in determining when you can be expected to return to work after hernia surgery. At the Hernia Center of Southern California you will be examined by your surgeon after surgery to determine your individual guideline for returning to work.

Sedentary Work

This work includes secretarial work, computer work in the office or home. Work involving sitting, standing and walking with lifting less than 20 pounds.

Patients may return to unrestricted work 3 to 5 days after surgery. They will experience minimal pain which can be managed with over-the-counter pain medications such as Advil®, Motrin® or Tylenol®.

Minimal to Moderately Physical Work

This work includes electricians, plumbers, factory workers, mechanics, and workers in retail stores and laborers who lift 20 to 80 pounds. This does not include stockers who lift repetitively.

Patients can return to unrestricted work two weeks after surgery. They may return to work in one week with a light duty restriction of no lifting over 20 pounds. When you return to work you will experience minimal pain which can be managed with over-the-counter pain medications such as Advil®, Motrin® or Tylenol®.

Heavy Physical Strenuous Work

This work includes construction workers, road workers, heavy duty mechanics, and retail or wholesale stockers or order pullers who stock orders and load and unload pallet jacks throughout their work day.

Patients can return to unrestricted work four weeks after surgery. They may return to work in one week with a light duty restriction of no lifting over 20 pounds. They may return to work in two weeks with a work restriction of no lifting over 80 pounds and no repetitive lifting. When you return to work you will experience minimal pain which can be managed with over-the-counter pain medications such as Advil®, Motrin® or Tylenol®.

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When can I return to recreational or athletic activities?

We typically recommend and promote patients returning to recreational or athletic activity in stages, as soon as possible, depending on the type of hernia and surgery performed. Since each patient is a unique individual with their own needs and abilities, we specifically tailor each patient's progressive return to recreational and athletic activity to your needs and abilities. We tend to follow a four week rule for most athletes. Week one consists of light or easy activities to maintain flexibility. Week two consists of minimal to moderate activities. Week three consists of moderate activities and week four consists of strenuous activities. Activities are performed four times weekly, gradually increasing in intensity.
Disclaimer: These activities are recommended by Dr. Albin for his patients who he personally examines after surgery and individually initiates an exercise program depending on the patients healing and skill level.

 

RUNNERS
One day after surgery we recommend walking for one hour per day. After two to three days of this, it is increased to two hours per day. Once patients are comfortable walking then running is initiated.

Running activities are performed in five minute intervals. Patients can run for 20 to 40 minutes, or four to eight intervals of five minutes each, depending on their comfort or skill level.

A typical week will be as follows for the first week:

WEEK 1 - Light jogging

Day one: First week of jogging consists of five minute intervals, in which a light jogging interval is done for only one minute followed by four minutes of walking.
Day two: No jogging.
Day three: Light jogging interval for two minutes followed by three minutes of walking.
Day four: No jogging.
Day five: Light jogging interval for three minutes followed by two minutes of walking.
Day six: No jogging.
Day seven: Light jogging interval for four minutes followed by one minute of walking.

WEEK 2 - Moderate jogging.

WEEK 3 - Slow run.

WEEK 4 - Normal running pace.

WEEK 5 - No restrictions. Speed work or hills can be added without restriction.

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SWIMMERS
One day after surgery we recommend walking for one hour per day. After two to three days of this is increased to two hours per day. Never swim alone.

Day three: Begin swimming. Slow swimming with exaggerated strokes that mimic stretches.
Day five: (to day 14 depending on your comfort level) You may begin slow or recovery type swimming gradually increasing up to one hour. Salt water swimming may also begin day five.

WEEK 2 - You may begin aerobic swimming and drill work, all at a moderate pace.

WEEK 5 - You may initiate speed work and swim without restriction.

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CYCLISTS
One day after surgery we recommend walking for one hour per day. After two to three days of this is increased to two hours per day.

Day three: You may begin cycling on a stationary bike. Start at a slow low intensity or pace for the first week day. Begin with no more than 30 minutes the first day. Cycle every day to begin with. Gradually you may increase the time, up to one hour. We prefer use of the stationary bike the first week to avoid falls.

WEEK 2: You make bike on a non stationary bike. For this week we recommend flat terrain. Your first outdoor bike ride should be a small loop, such as around the block, in the event you are not quite ready. Gradually, as your comfort level improves, you may add more time on the bike.

WEEK 3: You may add some hill work.

WEEK 4: You may add speed work and cycle without restriction.

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WEIGHT LIFTERS
One day after surgery we recommend walking for one hour per day. After two to three days of this is increased to two hours per day.

Day five: You may make your first trip to the gym. You may use light free weights or machines at minimal tension. This is done to maintain your flexibility. You should not lift over forty pounds the first month. We use you personal toning weight as a guide.

WEEK 4: You may lift 25% of your toning weight.

WEEK 5: You may lift 50% of your toning weight.

WEEK 6: You may lift 75% of your toning weight.

WEEK 7: You may lift your toning weight.

WEEK 8: You may lift without restriction.

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GOLF
One day after surgery we recommend walking for one hour per day. After two to three days of this is increased to two hours per day.

Day three: You may begin putting and chipping.
Day five: You may be ready for a pitch and put or a par 3 course. Restrict yourself to irons greater than number seven. If you like the driving range you may do so, but stick to your short game. Favor the higher number irons.

WEEK 2: You may start hitting a few of the heavier irons. By weeks end you can increase your use of the lower numbered irons.

WEEK 3: You may add the woods. You may be ready for a 9-hole or executive golf course game.

WEEK 4: You may play a full 18-hole game without restriction.

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HIKING
One day after surgery we recommend walking for one hour per day. After two to three days of this is increased to two hours per day.

Hike sensibly. Always let someone know where you are going. Bring an ample amount of water. Stay on the trail.

Day three: You may begin hiking on flat terrain. Start with a short, easy hike. You may gradually increase the distance depending on your comfort level.

WEEK 2: You may begin with short, moderate hikes or long, easy hikes.

WEEK3: You may begin long, moderate hikes.

WEEK 4: You may begin strenuous hikes.

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BASKETBALL
One day after surgery we recommend walking for one hour per day. After two to three days of this is increased to two hours per day.

Day three: You may start shooting hoops by yourself.

WEEK 1: Try a one-on-one game with an easy opponent.

WEEK 2: You may play full court, but be prepared to sit out most of the game.

WEEK 3: You can play a good portion of the game.

WEEK 4: You may play full court without restriction.

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TENNIS
One day after surgery we recommend walking for one hour per day. After two to three days of this is increased to two hours per day.

Day five: You may start hitting some balls. Play with an opponent that will hit the ball to you. It is not advised that you run after the ball at this time.

WEEK 2: Play a game with minimal running.

WEEK 3: You may play without restriction.

FOUR WEEKS after surgery - Return to any and all recreational and athletic activity (except weight lifting), including contact sports, is recommended by four weeks after surgery. By this time in the recovery process you should be back to all original activity as you were before surgery. If you are still experiencing some discomfort, this is normal. However, if you experience pain at this point in the recovery process, please contact your doctor as soon as possible.

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Can I travel after surgery?

A number of our patients travel to the Hernia Center of Southern California from in and out of state. Since our surgical techniques are minimally evasive and allow patients to return home the SAME DAY of surgery, traveling for anywhere from 1-4 hours after surgery is permitted, as long as the patient is not operating a vehicle on his/her own. Patients visiting from further distances are advised to take up local lodging and after a follow-up visit the day after surgery, patients are then allowed to travel home by any way of travel. For assistance with local lodging, please contact our office at 877-2-HERNIA from 9am - 5pm PST, Monday through Friday.
NOTE: Patients diagnosed with complex or incisional hernias may require a stay of two or more days in the area. Please consult your surgeon about potential travel restrictions prior to making your final travel arrangements.

 

Why choose a 'hernia specialist'?

We at the Hernia Center of Southern California understand each of you that come into our office is a unique individual with needs and circumstances unique to only you, which is why we customize each surgery and recovery to you. Sure, most general surgeons will perform hernia surgery within their practice, completing an average of roughly 25 hernias each year. However when compared to the HUNDREDS of hernia specific surgeries performed here at the Hernia Center of Southern California annually with the care and techniques we have perfected, is there really any question to who should perform your surgery? When given the choice, many rest assured with their choice of a specialist, knowing they are receiving safer and more effective hernia repair.

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What if I have existing medical problems?

Many patients with controlled, preexisting medical conditions (Diabetes, High Blood Pressure, etc.) tolerate our surgical techniques exceptionally well, as these techniques are performed under a local anesthesia with sedation and not the riskier general anesthesia. In some cases, however, it may be necessary to obtain medical clearance from your primary care physician, but this can be discussed with you over the phone prior to your visit.

 

When and how can I schedule surgery?

Scheduling surgery at the Hernia Center of Southern California is simple, quick and convenient. In most cases, surgery can be scheduled within 1-2 weeks or less and can be scheduled on a date that works best for you and your schedule. If you wish to arrange surgery by phone, or have other specific scheduling questions, please contact our office at 877-2-HERNIA from 9am - 5pm PST, Monday through Friday. For your convenience, we have all the appropriate forms available HERE, so you may print, complete and either fax or mail ahead of time to speed up scheduling for you. You will need to get Adobe Reader to view these forms. Get it FREE here:

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What about office visits after my surgery?

We offer FREE postoperative care, even past the global period, for all of our patients. After you have undergone surgery with the Hernia Center of Southern California, we will immediately schedule a follow-up appointment for you, as close to one week after your surgery as possible. We pride ourselves on attentive patient care and want to do the most we can to make sure you are back to your regular, everyday activities as soon and as safely and comfortably as possible. Any and all postoperative care will be carefully discussed and reviewed with you immediately following surgery, however, please feel free to contact our office at 877-2 HERNIA, 9am - 5pm PST, Monday through Friday, with any questions regarding your surgery and we will be happy to assist you.

 

What if I have other questions?

Please do not hesitate to contact our office at 877-2-HERNIA from
9am - 5pm PST, Monday through Friday if you have any additional questions about hernias or hernia surgery that were not answered in your visit to our web site. If one of our staff is unable to answer your question, we can have one of our surgeons contact you at a convenient time as well. We can also be reached via fax (626) 584-7886, email or CONTACT US as well, whatever is most convenient for you and we will get back to you as soon as we possibly can.

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