Hi Russel – Thanks for your comments on hernias and account of your experience. It was a pleasure to see myself described as “young.” I was impressed by the severity of your symptoms and am glad you were able to recover completely in a short time. Although my symptoms are nowhere near as extreme as those you described, my PCP referred me to a surgeon who felt surgery was justified and made a place for me on his schedule. Then I found a barrage of conflicting information online which included the following:

--Studies have found that “watchful waiting” may be an advisable alternative to surgery if hernia symptoms are not advanced.

--Some recipients of hernia surgery, particularly if it involves mesh implants (recommended by my surgeon), describe post-op complications that are painful, debilitating, and difficult to correct. Complication rates cited by studies vary with some as high as 20%. I doubt these unlucky people are singing in choirs. Of course the stories of the vast majority of people like you whose surgeries are successful don't get posted.

--There are accounts of self-healing of hernias without surgery through use of exercise and restrictions on activities and diet.

I've postponed surgery and am waiting watchfully and singing. Of course serious singing creates a certain amount of stress in the abdominal area. Maybe the practice of good breath control while singing could actually help heal a hernia that isn't advanced. On the other hand maybe the effort to nail ff high notes would aggravate the weak spot in the abdominal wall. Russell, thanks for writing; I'm undecided about what to do and will certainly keep your advice in mind. I would appreciate hearing further thoughts you may have or those of others concerning surgery or self-healing of hernias.

Pete

Thanks for your thoughtful reply, Leon. Sorry it's taken so long to respond. Your anatomical tour inspired me to study a bit and figure out that although there is indeed a chance that my direct (as opposed to indirect) hernia could become strangulated, etc., the scenario involving the scrotum doesn't apply to me. I haven't experienced pain from singing or the decreased vital capacity you mentioned, but nevertheless I'm trying to sing at a generally lower volume for the time being and taking more care with breath support. My wife actually commented that my practicing sounds better.

I saw my PCP MD again and we discussed minor hernia pain related to my part-time job in building supply retail that includes lifting. He still supports watchful waiting but is not optimistic about long-term self-healing. He said a referral to a physical therapist or leave of absence from work would have to come from the surgeon. (I've already canceled surgery once. I doubt the surgeon would be interested in self-healing.) I was evaluated by a Pilates instructor who recommended an osteopath who I'm now waiting to see.

I wear the support mentioned by David during most waking hours and do exercises to strengthen the herniated transverse abdominal wall without aggravating the weak area. A key exercise in my routine is bent knee crunches, and singers wanting to avoid hernias might try incorporating this into their workouts. Some versions of this exercise have you raise your feet off the mat, but here's a simple version:

http://www.acefitness.org/exerciselibrary/52/bent-knee-sit-up-crunches

Accounts of self-healing usually include avoidance of strenuous activity for a while, a step I've yet to take and which might include a break from singing with the choir.  The Herniabible website from the UK that David mentioned includes accounts of people in various stages of self-healing (there's a forum). Here are more links for those who might be interested:

http://www.groin-hernia.com/phpBB/viewtopic.php?t=274   accounts of self-healing hernias

http://herniabible.wordpress.com/   - info on the support, accounts of surgery complications, accounts of self-healing

http://www.groin-hernia.com/herniabible/articles.html  - articles and case studies about hernia surgery

Thanks again for writing.