Morgagni Hernia

Morgagni hernia is one type of Congenital Diaphragmatic Hernias (CDH); it's the rarest type only occurring in 2% of CDH cases [1].  I was diagnosed with this hernia on June 27, 2017.  Not only is it rare to have a CDH, and then rarer still for it to be Morgagni, but it's rarest for it to exist and be discovered in adulthood.  So, finding people's stories about surgery and recovery was difficult, which is why I'm making this page.

It started at a work leadership meeting.  We were served a lunch and I thought the bad food was giving me bad gas.  When I got up to use the restroom during the meeting, it hurt to stand up straight.  When I got back to my table, I chewed a couple gas tablets and cursed the caterers.  I drove back to the office feeling even worse and complained to my employees there that the food was making me sick.  I even wondered aloud if I should ask my boss if I could go home early.

Driving home from work was difficult.  The pain in my abdomen was getting worse.  My husband was off work so when I got home, I helped him nap with my daughter, Violet.  Lying in bed was excruciating and I wasn't sure I'd be able to get back up.  I made it downstairs and chewed some more gas tablets all the while Googling my symptoms.  The pain had started to move to my shoulder so one thought I had was it could be my gallbladder.

I eventually texted my mom and told her I was in a lot of pain and asked if she could drive me to Med Express.  (I didn't want to go to the ER and then be diagnosed with "really bad gas" and look like an idiot.)  She drove me there and on the way, I realized it was hard for me to take deep breaths.  By the time we got to Med Express, I could not stand up straight at all.  It hurt too much.  I paid the $40 copay and was called back only to have the PA tell me to go to the ER.  (I'm still pissed off about that.)

At the ER, they did the usual: pee test to be sure I wasn't pregnant, blood tests, hooked up an IV (because I wasn't allowed anything to eat or drink since it was my abdomen), and gave me a shot of morphine.  For anyone who hasn't had a shot of morphine, the nurse who gave it to me that night described it perfectly—"It's like someone's pulling your soul out through the back of your head."  After a while, they sent me for a CT scan with contrast (for anyone who hasn't had IV contrast, it makes you feel like you're peeing yourself).  I think it was 10 or 11 at night before the doctor came in and said, "Well, you have a hernia.  It's internal, so it's not in a place where I can push it back in with my hands."  Uh, ew.  He left saying he had to consult the surgeon.

This is when I freaked out.  I'm a squeamish person normally and have never been under anesthesia.  So as soon as he said "surgeon", my anxiety went through the roof.  It didn't help that the doctor came back in and said he had to send me to Pittsburgh for the surgery; they couldn't do it in Altoona.  I called Chris, bawling, demanding someone come be with me.  He gathered up a bag for me with clothes and my laptop and my dad came to the hospital to be with me.

It was probably 2 or 3 in the morning when my transport was finally able to come.  Dad got directions from the nurse for how to get to Presby in Pittsburgh and the Med Van guys wheeled me outside.  It was a very bumpy ride, but the guys were nice.

By the time we got to Pittsburgh, I was in crying-pain.  The surgeon came up to see me and showed me the CT scan of my colon going up into my diaphragm.  He said they would pull my colon down and fix the hole.  Depending on how bad circulation was to my intestines, he said they may have to remove some.  I thought, "Oh, God, I'm going to wake up with a colostomy bag."

Dad stayed with me while they got ready for surgery.  The anesthesiologist explained that they would put a breathing tube down my throat and probably more IVs.  Super!  Thankfully, she said she'd wait to do all that until I was asleep.  I think they gave me something in my IV to help calm me down and the last thing I remember is being asked to wiggle my toes.

Dad was waiting for me when the surgery was done.  I don't remember much after waking up except hearing them tell my dad I was going to ICU, then I wasn't, then I was, and finally, they decided to send me back up to my original room.

I woke up with an NG tube (nasogastric tube), an IV in my left hand (in addition to the one in my right arm), catheter, a sore wrist (where they had some kind of IV measuring my arterial blood gases), a nasal oxygen cannula, and a chest tube under my right arm pit.  From garbled Facebook messages I sent my mom during this time, I was apparently in a lot of pain.  Dad went home after I was settled in my room.

My mouth was SO DRY.  I still wasn't allowed to eat or drink anything and by the time I was lucid enough to know what was going on, it was probably 48 hours since I had eaten last.  They gave me some mouth swab sponge things, but that was worse than the dry mouth.

I had a "pain button" I could push every so often and I pushed that sucker as much as I could, considering they took my catheter out shortly after surgery and made me get up to go to the bathroom.  I couldn't go the first time; the chest tube hurt too much, I couldn't get into a good position, so they straight cath'd me.  After that, I was able to pee, so every time I had to go to the bathroom, I had to call the nurse because they had to carry my chest tube container, along with unplug my IV pump and leg massager things.

One by one the tubes came out.  The catheter was first, followed by the NG tube (NOT fun having that pulled out.)  The chest tube was the last to go; they had to keep doing chest x-rays.  No one really told me why, but from what I could gather is part of my right lung was collapsed.  (During surgery, they filled my abdominal cavity with carbon dioxide so they could see what they were doing.  I'm not sure if the gas or my colon pushing on my lung made it collapse, but something happened.)

They took my pain pump away when I was allowed clear liquids because then I could take liquid oxy (which barely touched the pain I was in.)  It felt like I had a permanent stitch in my side from running too fast...which I guess I did kind of have a permanent stitch in my diaphragm.  One night, I was left alone all night with a new pulse ox hooked up so they could monitor my oxygen saturation levels.  Apparently, when I was sleeping my sats went down.  I guess I passed because they didn't send me home with oxygen.

Since they had to monitor my digestion and how I was handling my diet, I was in the hospital for 7 days.  I was finally discharged on July 3 and Dad, Chris, and Damian came to drive me home.  It was a rough drive.  Like I said, I was still in pain and at one point I started choking on my spit.  But, I couldn't cough hard enough to help clear my throat.  I thought I was going to die.

I wasn't allowed to work or lift anything more than 5 pounds until my follow up in two weeks.  I made Chris and Violet sleep on a mattress downstairs because I was in so much pain, I couldn't even think about Violet kicking and rolling into my stomach in bed.

Here's the point of the page—I could not for the life of me find anyone's story of recovery.  So here's mine: it sucked.  The pain did not go away until about 4 weeks after surgery.  I was sitting on the floor messing around with my laptop and something sort of "popped" or shifted around my diaphragm area.  It didn't feel good, but it didn't feel bad either.  After that, the pain wasn't nearly as bad.  I think there may have been a stitch or gas bubble or something caught in there.

As I write this, it's about 5 or so weeks after the surgery.  I still get sore from time to time, but it's way better than it was.  The weird dent in my stomach from the incisions is going away and the incisions themselves are healing nicely.  I'm technically not supposed to lift anything more than 25 pounds for the rest of my life, but we'll see how that goes.




1. https://en.wikipedia.org/wiki/Congenital_diaphragmatic_hernia

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