shovel snow 375Take care during winter activities to prevent developing a hernia or reinjuring a repaired one, warns St. Luke’s general surgeon Emanuel F. Nogueira,MD.“A hernia occurs when an internal organ or other body part protrudes through the wall of a muscle or other tissue that normally contains it. A strenuous activity, such as lifting and throwing heavy snow, or yanking the starter cord of a snow blower, can put extra strain on the abdominal muscles. This could cause a hernia or reinjure one that had been repaired previously,” says Dr. Nogueira, chief of surgery and director of the Hernia Center of Excellence at St. Luke’s Upper Bucks Campus. Dr. Nogueira has earned the Surgeon of Excellence in Hernia Surgery™ (SOEHS) designation by Surgical Review Corporation.

If you’re shoveling, Dr. Nogueira suggests scooping up smaller amounts of snow, especially since you are also twisting and turning to empty the shovel. Also, be cautious when snowboarding, skiing, ice skating or even just walking on icy walkways, he advises. A slip or fall could cause you to move in an awkward way, causing a tear in the muscle where a hernia could develop.

The most common types of hernias, inguinal and femoral hernias, may be present at birth or can be the result of muscles weakened over time due to age and repeated strain on the abdominal and groin areas. Besides strenuous activities, obesity, pregnancy, frequent coughing and straining on the toilet due to constipation can cause hernias to become larger. This can result in symptoms.

Pain, accompanied by swelling or a bulge that can be pushed backed in, is the most common symptom of a hernia. Other symptoms may include a dull aching sensation, a feeling of fullness, constipation and vomiting. Heartburn is a common sign of a hiatal hernia, which is a type caused when the stomach bulges into the chest through the diaphragm. While most hernias are not life threatening, it is best to see your doctor at the first sign of symptoms, he says.

“Nothing will ever fix a hernia on its own. It’s like punching a hole in the wall. It never gets better. Rather, over time it will get bigger,” he says.

Because smaller hernias are easier to repair, with fewer risks and quicker recovery, Dr. Nogueira usually encourages his patients with painful, bulging hernias to consider surgery. Most early hernia repairs are performed using minimally invasive laparoscopic surgery. With this procedure, the surgeon makes a few small incisions near the hernia and inserts a thin tube with a tiny camera call a laparoscope. Using images from the laparoscope, the surgeon then uses mesh to repair the hernia.

Dr. Nogueira also suggests that anyone considering hernia surgery seek out a surgeon experienced in hernia repair. In 2016, the St. Luke’s University Health Network’s Quakertown Campus was designated as a Center of Excellence in Hernia Surgery™ (COEHS) by Surgical Review Corporation. At that time, both it and Dr. Nogueira, were the first and only Center of Excellence in Hernia Surgery designees in Pennsylvania. The center is now located at the St. Luke’s Upper Bucks Campus in Quakertown. To schedule an appointment with Dr. Nogueira, call 215-538-4852.

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