Umbilical Hernia - Local Anaesthetic

[ChemistryHunt]

I am having an umbilical hernia repaired a week Saturday. I go to the hospital on Monday to discuss and have a check over.

I absolutely do not want to have general anesthetic. I am not worried about the anesthetic itself (i understand the risks but also understand they are low). I just cannot put myself in a position of being unconscious in a room of people. I can't do it, I cannot even sleep if someone is in the house who I do not know well and trust entirely.

I know the whole point of GA is that you have no awareness, so I wont know during, but I cannot bring myself to go to the hospital to be put under.

It sounds stupid yes, but I cannot do this.

I have been researching and I know you can have local anesthetic to repair an umbilical hernia.

My question really is can I insist on local rather than general anesthetic? I want minimal or no sedation.

I need to be awake and alert.

The hole is apparently quite small and I am fairly slim and OK-ish health wise.

I have had a cesarean done and in all honesty, feeling them moving things around didn't bother me at all, I am not squeamish.

I haven't spoken to the doctors yet as I choose to stick my head in the sand. I need this done as it is causing me pain and getting in the way of me doing things I like.

What do I say? How can I make my case.

I am not comfortable going into the why's and whatnot's about my issue/fear with this with a random stranger (and I don't want to cause offence by saying I don't trust you).

I am having this done as a NHS patient in a private hospital in case that makes a difference.

[Pipistrella]

I'm not sure what the options are now, but anyway I had this conversation with a surgeon a few years ago (didn't have it done then as I was recently pregnant and worried about lifting the baby afterwards, etc)

He was perfectly prepared to do it using a spinal block I think he said, or maybe it was a local.

I didn't want a GA as I'm afraid of feeling sick (personal phobia) so was hoping they could do it differently too. I've never had a general.

He sounded a bit dubious but said they would give it a go, whatever that meant

I am the same build and it's also a small gap apparently. It doesn't cause me pain but I hate being 'broken' and feeling weak in that area.

trouble is now my child is much heavier and I still need to lift him so I wish I'd done it then!

[Pipistrella]

Not dubious, I mean just surprised that I was asking. I suppose most people don't worry - or else they might prefer you to be asleep so you can't move or something. Not sure if I want to be awake, either - I'm reconsidering tbh!

I hope you get what is most un-scary for you.

[ChemistryHunt]

Thank you for sharing Pipistrella. It has given me a lot of hope knowing that they said yes to you!

I certainly think staying awake is the much better option. I am hoping they will agree in my case too.

I have been googling and have found that they actually have another surgeon (not my one) at the same hospital who lists one of his special interests as hernia surgery under local, so they must be able to do it at the hospital.

If my surgeon says no, I think I will go down the route of asking if I can see the other surgeon, or if worst case comes I have seen several private surgeries in London who state they use local so I may just wait and save.

Does anyone know if I have any sort of right to insist on local or spinal rather than GA?

I have had local for other things, such as an excision on my arm a few months ago and obviously had epidural/spinal block type, for my cesarean, and never had any bad reactions.

[Pipistrella]

You are most welcome I wish you all the best with it.

I don't think anyone can give you a GA without your consent, but whether they will still do the surgery is a different question - I doubt you will have problems finding someone who will, though.

[SockQueen]

Umbilical hernia repairs can be done under local anaesthetic or spinal block, but it depends on the hernia and the surgeon. You have the right to refuse a GA, but they have the right to refuse to operate if they don't think it's doable without one - you can't insist they go ahead with local/spinal. Talk to them beforehand and see what they'll say, it's better to get agreement in advance rather than end up getting cancelled on the day.

[Pipistrella]

Sockqueen - thank you on behalf of both of us.

I'm assuming with a LA you don't have to stop eating beforehand, or stay in for hours afterwards?

I think my surgeon told me it would take about half an hour to do the actual repair. I'm not even sure how they do it - I think if you were having keyhole you needed to have a GA, but not if you had open surgery.

I don't know which carries the most risk in terms of successful repair/infection rates/healing well etc.

So much to consider isn't there.

[ChemistryHunt]

Thank you Sockqueen.

I didn't mean insisting that this surgeon used local rather than GA, more that if there is no good clinical reason for me not to have local, can I get transferred to another hospital/surgeon who will be able to do it. Not sure how much choice I get as a patient (NHS) wise.

I have my pre-op this afternoon and am feeling so very sick about it all, haven't slept in a week. Fingers crossed.

[SockQueen]

Pip usually we tell all patients having things like hernias done to fast, even if the plan is to use local, because in the rare event of complications needing a rapid GA, it's far safer to have an empty stomach.

Sorry for the delay, Chemistry I hope you got some answers at your pre-op. You can ask to be referred elsewhere if that particular surgeon won't do it under local. Good luck!