Caroline was active at church, her part-time job, with her husband and three kids, and in her neighborhood. She loved to work out with Zumba and run. When she turned forty-five, she started lifting weights once or twice a week to keep active and gain muscle. She was worried about the osteoporosis that her mother suffered from. She joined an excellent group online and started to improve her eating. She found incredible recipes and counted her macros.
For the first six months, she saw minimal improvements. She felt significantly better; drinking water made her mind clearer, and her stomach was less bloated. Occasionally she would have some sharp pains in her stomach, and it would take a few days for her to have a bowel movement. She added fiber to her diet and as a gummy, which improved things.
Ten months after starting this new program, she was lifting at her gym with some of her friends one day. While doing some squats while holding a kettlebell, she felt some tightness in her stomach. She didn’t think much of it and finished her set. She rested and drank some water as the other girls took their turns. When it was her turn again, she bent down for the first squat, but it was clear that she couldn’t continue.
“You’ve stained your abdomen,” said one of her close friends.
It sounded right, and honestly, Caroline could not do any more lifting the rest of the day. The next day, the pain was slightly worse, but she could move around. She avoided any exercise for the next few days. Over the following two weeks, the pain slowly improved. It took her another two weeks before she started lifting again. She did stretches and running, and her pain was minimal.
Two months later, she was back to her usual self, but one day she noticed a small lump in her belly button area. She didn’t think she had seen it before but couldn’t be sure. When she pushed on it, it was really tender. She called her doctor and set up an appointment.
Before the visit, she thought she knew what might be going on. She had several other people tell her their opinions. When Doctor McDaniel came in and performed an exam. She was unsurprised when he said, “I think you have an abdominal hernia, more specifically called an umbilical hernia. We can order an ultrasound to confirm.”
“Should I be worried?” asked Caroline.
“I wouldn’t be. It’s a little tender right now. That could go away.”
“Do I need surgery?”
“Maybe. Not everyone does. We will see how things go in the next few months.”
“Should I be worried?”
“Normally, no. Most of these types of hernias don’t cause huge problems. But you need to let us know if something changes. If you get more pain, or it gets bigger, or you notice any redness.”
“I think I can do that.”
The next six months were relatively normal. There wasn’t a change in the size of the hernia or increased pain. That changed one night during a vacation when she had been outside most of the day. Rick, her husband, and she had escaped to the beach for a few days. She hadn’t felt any pain during the day, but she thought she might have overdone something. She wasn’t too worried but kept an eye on her pain level. The pain didn’t improve at all, and the pain worsened considerably over the next three days. To make matters worse, the hernia doubled in size.
When Caroline returned from her vacation, she called Dr. McDaniel, and he scheduled another ultrasound.
The nurse for Dr. McDaniel called her to come for an appointment to tell her the news. Again, she was unsurprised when she heard Dr. Daniel say, “The hernia is bigger than before. I think it might be best if we get a surgical consult to see if you should get surgery.”
“Okay.”
“I’ll refer you to Dr. Montgomery. She is the best.”
Caroline met with Dr. Montgomery three weeks later, and it was determined that surgery was required. The surgical date was put on the calendar for another three weeks from that day. Dr. Montgomery explained the procedure and the recovery time. It wasn’t horrible, and she was hopeful that she would be back exercising by the first part of the summer. Dr. Montgomery also did a great job answering all of her questions and decreasing her anxiety about the procedure.
Three weeks later, the surgery date arrived. Caroline’s husband drove her to the hospital, and they checked in. Dr. Montgomery came and talked to her for a few minutes after they had checked in and were given a bed. She confirmed that she was ready, hadn’t eaten, and still wanted to proceed with the surgery.
She was told the surgery would require an hour, maybe a little more. She would remain in recovery for a few hours and then go home. She would be restricted in how much she could pick up for the first few weeks. She wouldn’t be able to do strenuous activity until four to six weeks after the procedure.
“Let’s roll,” said Caroline.
After surgery, when Caroline awoke, she found herself in recovery. Her husband was close by talking with Dr. Montgomery. She barely remembered coming out of surgery but had fallen back to sleep quickly. Now, her mind felt clearer. She asked, “How did it go?”
Dr. Montgomery turned and said, “I was just telling your husband, Rick, that things were more difficult than anticipated.”
“What does that mean?”
“The surgery took over two hours. We had planned on doing everything arthroscopically, but when we got inside, it looked like there was some additional tissue involved. Despite our initial attempts, we were forced to open up the abdomen with a bigger incision to repair the hernia.”
“Were you successful?”
“Yes,” replied Dr. Montgomery, but she glanced at Rick. “There was a lot of bleeding, more than usual, and the added tissue made things a little more difficult. The recovery time we talked about before will be a little longer. You have a larger incision site than we planned.”
“How large are we talking?” asked Caroline.
“About five inches.”
“Will it leave a scar?”
“Yes, it will. I’m sorry.”
“It’s fine.”
Rick added, “I’m sure everything will look great.”
“One last thing,” noted Dr. Montgomery. “We sent some of the extra tissue to a pathologist to take a look. I’m sure it is nothing, but I’ve never seen that much extra tissue in a hernia before. That will take about a week to get back.”
Caroline remained in recovery for the next few hours. Her pain became surprisingly strong before she left, but she was able to have a bowel movement that was a little runny. It took some effort to get into the wheelchair as she was not able to walk on her own.
The next few weeks were brutal. The healing process was slow and cumbersome. It became frustrating for Caroline that she was not able to do things on her own. The incision site was healing okay, but it was painful every time she laughed, moved, or went to the bathroom. She was surprised that the bloating got worse, but she assumed that it was from the pain medications.
Dr. McDaniel’s office called a few times to check up on Caroline. Two weeks after surgery, Dr. McDaniel called and asked for Caroline and Rick to come to his office for a check-up. The call was early in the morning and they arrived at the office around eleven a.m.
They were brought back to an exam room almost immediately, and soon Dr. McDaniel and Dr. Montgomery stepped into the room. Caroline was surprised to see both at the same time.
Dr. Montgomery asked, “How is the healing process?”
Caroline explained what she was able and not able to do. She described the pain in her stomach, abdomen, and sometimes when she went to the bathroom. Soon, Dr. Montgomery performed an exam on the incision site and pushed her stomach in different places.
Once finished, Dr. McDaniel asked, “How is your energy level? How are you eating? How are your bowel movements?”
Caroline gave a detailed account of each question. She talked about her fatigue, on-and-off desire to eat , and her weird bowel movements.
Once she was finished, Dr. Montgomery said, “We got the results back from the tissue biopsy.”
“Is that why both of her doctors are here?” asked Rick.
“Yes,” said Dr. Montgomery. “Unfortunately. There is no better way to say this than, to be honest. The findings show an aggressive form of cancer. We’ve never seen it before in a hernia, and it is important to understand that the hernia certainly didn’t cause this. In fact, without the hernia, by the time it was discovered, it would be far too late.”
The results blindsided Caroline. Never in her life had she expected this diagnosis. They talked a lot about her subtle symptoms of feeling fatigued, sharp pains, bloating, bowel movement changes, and more.
“What’s the plan?” asked Rick. “How do we make her better?”
“The chances that she’ll recover completely are very low. We can try some chemotherapy, and that could shrink the cancer. Maybe another surgery, but chances are that this will get the best of her in the end.”
“So, the surgery made her worse?” demanded Rick.
“No. She would not have lived for another three months had she not had the surgery. Now, we can push back her life expectance for maybe two years.”
Caroline went with treatment, and for the most part, she did exceptionally well. She had some poor days and some good days, but she lived two years, six months past the date of diagnosis, and tried to enjoy every moment.
