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Nerve damaga after hernia repair

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Had laparoscopic surgery 2 weeks ago, everything seems to be healing well but immediately after waking from the GA I had no feeling in my right thigh. This numbness has now progressed to extreme sensitivity and sharp pains. My surgeon referred me to a neurologist and he has said it's probably damage to my lateral cutaneous nerve which is the sensory nerve for that area. He has put me on lyrica, Celebrex and Neuro-b but I'm not a big fan of meds.

What I'd like help with is;
Is e fact I now have pain instead of numbness a good thing? Ie is it healing?
Can it heal?
Is there a possibility it is caught in the repair? The neurologist said its so small it's unlikely and also that it runs near the hip bone so isn't close enough, this part I'm skeptical of.

Any other advice appreciated, the pain seems to be getting worse not better.
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First Helper User Profile Gaelic
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replied June 12th, 2012
Especially eHealthy
sKiBa,

If the pain (feeling of not wanting to touch the skin) is in the same area as the numbness was in, then that may be a sign of the nerve waking up. unfortunately, it may stop at that stage, all you can do is wait and see if the nerve continues to wake up.

Neuropraxia of the nerve (stretched, injured, but not cut) can take up to six months to resolve, by definition. If the nerve wakes up between six months and a year, it is called axontomesis. It the nerve is permanently damaged, it is called neurotomesis.

But, most lateral femoral cutaneous nerve injuries are neuropraxia and wake up on their own. This nerve can be injured during hernia surgery (especially in the open procedures), but it has also been seen to be compressed in football players, persons who wear hip-hugger pants with a tight belt, and in people who wear heavy belts (like military or construction workers).

It is unlikely that it is entrapped in the scar. That usually shows up many weeks after the surgery, not right at the beginning. As to it being actually in the repair, that is also very unlikely, as it is very superficial, very small, and not exactly in the location of the repair. It is much more likely that it was stretched during the manipulation for the surgery, or it was pressed upon by some of the instrumentation during the surgery.


Again, the fact that the sensation has changed is a sign of improvement. Just keep your fingers crosses that it continues to wake up.


Good luck.
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replied June 12th, 2012
Thanks for the detailed and helpful response, this definitely gives me some talking points for my next meeting with my neurologist.

Do you know if there is anything that can be done to facilitate the recovery of the nerve? Diet/vitamins etc.?

Also, are you familiar with the drugs I have been prescribed? The Lyrica appears to be pretty heavy duty and i'd rather not take it unless absolutely necessary.

Thanks again.
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replied June 14th, 2012
Especially eHealthy
KiBa,

Lyrica (pregabalin) and Neurontin (gabapentin) are often prescribed to patients for "nerve" pain, pain caused by injury or illness to the peripheral nerves. This can be from a direct injury, compression of a nerve root in the spine, or a neuropathy from a systemic illness (like diabetes).

Both these medicines work on a specific reception center within the central nervous system. They work very well for some patients, not so much for others. The only way to tell, is to try one and see if it works. If it does, it can provide a significant amount of relief in some patients.

But, the medicine is not really a "cure" for the nerve injury. They are basically there to help with the symptoms. Nerves are very finicky little things. They do not take an insult very well. But, as long as they are not cut, and the injury was due to compression or stretching, they usually do wake up, it just takes time.


The medicines (Lyrica and Neurontin) are not narcotic pain medicines. In the US, Lyrica is a controlled medicine (Schedule V - very low on the scale), as some patients do get a little buzz or drowsiness from it. Some patients also develop some dependence on it, if taken for a very long time, and as such, may have withdrawal symptoms if stopped abruptly. Again, most patients have no problems with Lyrica, but these things do occur in a small percentage of patients.

You should probably not stop the medicine abruptly, but if you have concerns about it, do speak with your neurologist about it. Again, it helps a lot of people's nerve pain, but if it is not doing anything for you, you might want to ask your neurologist if you can discontinue it. But, you should give it at least 2 or 3 months before giving up on it.


Again, lateral femoral cutaneous nerve problems are not uncommon after hernia surgery. If the sensations in the area are changing, that is usually a good sign that the nerve is waking up. (Just like when you sit on your foot and it goes to sleep. Contrary to what your mother told you, that you were cutting off the circulation, you are actually not doing that, but compressing the nerve(s). Once the pressure on the nerve is relieved, the nerve will start to wake up. It then goes through the predictable stages of being completely numb, to painful (not wanting to touch it), to tingling, and finally fully awake.)

So, again, hopefully, your nerve will continue to wake up.


Wishing you the best. Good luck.
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replied February 8th, 2013
shouldice open inguinal hernia surgery
32 yo male. My lfcn was damaged or compressed in my open inguinal hernia surgery at shouldice hospital. The surgeon, Ram Singal, disagrees, but I had all the symptoms appear right after the surgery so there's not much to debate. anyway, it was very painful for the first few days especially when i walked. now it is less painful and i can kinda walk normal for a short period of time (9 days since surgery). I was extremely worried it would not heal because I got poor information from the hospital and it took awhile to learn what was wrong and calm myself down to wait it out and see how much better it gets. anyways, the numbness hasn't changed, I wonder if i will ever get full feeling back on the whole side of my leg. i have high hopes that i will be back to work within a month or two. i haven't been technically diagnosed with anything yet, think i should see a dr soon though. even tho it is getting better. i went to emerg to pick a dr's brain there, maybe get a diagnosis (before i knew) and he basically said 'what do you want me to do? do you want painkillers?', yea thanks for the help bud. There is stretches that can help release the compression apparently, which I am going to start doing in a week or so once my hernia is good and healed up, I think i have a few minor pulled muscles in the leg too from my attempts to move around and avoid the painful positions at the same time.
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replied February 8th, 2013
problems with the lfcn can be called Meralgia Paresthetica by the way. that's what I think I have.
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replied April 27th, 2013
Hernia Solution.
I am a 40 some odd year old living in Australia. Generally healthy. Don't smoke. Drink occasionally. Exercise regularly (MTB). I had numbness in and around my hernia repair for a number of months. My research told me that the nerves was more than likely injured/damaged since I had an invasive repair. During my 6 week followup My surgeon told me that numbness and pain around the surgery area was normal as well--and that it would clear up on it's own after time (as to how well--time would tell). He also said that normally, nerves would be injured and it was part of the process. From what he said, none of my nerves were seriously damaged (though I suspect he may have been hiding the truth to stop me from freaking out). I explained to him the numbness I had alarmed me, because I didn't realize how large an area around my stomach would be effected.

He was satisfied with my healing and gave me the green light to exercise during that followup though. I didn't wait around! I joined a gym. A strict regimen of 3 workouts a week, heavy (and I do mean HEAVY) ab workouts coupled with cardio work. I started working out with TOTAL numbness around 8-10 inches in diameter from the surgery site (the numbness spilled into my left groin area). In 11 months it's down to the size of a penny. I would credit the surgeons' skills--AND my intense ab workouts. I mean I would work out my abs to the point of getting sick. I knew that if I stimulated the area enough, I could cause it to heal better.

It seems to have worked. So I recommend trying this course of action to anyone interested!
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