Tag Archives: surgery

Hernia Repair in Corrections: Now? Later? Never?

For most medical conditions, incarcerated inmates receive care that is equal to, if not better, than what is available to the average American. I think so, anyway. Often, in fact, inmates have easier access to medical services and receive even more attention and more care than their un-incarcerated counterparts.

For some reason, though, one exception to this general rule is hernia repairs. Some correctional facilities seem to have a policy, whether official or unofficial, that they will not approve hernia repair unless they absolutely have to.

Instead, I will argue that repairing hernias early in their course is both good medical practice and also cost-effective medical policy. Bonus!

hernia alert

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Tips for Diagnosing Appendicitis

Paramedic Rob's appendix ruptured. Six months later, he had surgery. Now that's tough!

One of the last remnants of my previous life as an Emergency Physician is that I am still to this day the Medical Director of the local fire department and paramedics.  I also do the fire fighters’ yearly wellness physical exams.

(As an aside, my wife helps me by drawing blood, doing EKGs, getting patients’ prepped, etc.  She tells everyone who will listen: “I have the best job in the world.  I tell fire fighters to get naked—and they do!  Every woman wants my job.”)

Anyway, recently, a paramedic came to me with this nagging abdominal pain that he had had for over six months.  It was never so bad as to make him quit working, but it never went away either.  After I looked him over, I thought he might have appendicitis—but for six months?  I sent him for a CT and sure enough he went straight to surgery.  It turns out that he had actually ruptured his appendix six months ago and he had been walking around ever since with a walled-off intra-abdominal abscess. Continue reading