This post is about having botox injections for abdominal reconstruction due to hernias. I would like to start this by saying that I have no medical training and this post is just a patient’s view of going through this procedure. If you have any questions, then you should speak to your doctor.

Botox injections

After having my large intestine removed in 2013 due to Ulcerative Colitis and having an ileostomy formed, I developed hernias. I also had other major open surgeries including a jpouch formation and subsequent removal. I have had multiple hernias as a result of these surgeries, both parastomal hernias, incisional and currently a large problematic hernia in my abdominal wall.

I’m due to have surgery tomorrow to fix these issues with an abdominal wall reconstruction and as part of the preparation for this, I have had botox injections into the abdominal muscles.

When I was told I was having this done, there was very little information and when I have spoke to other doctors and nurses, they have had no idea about it! So I turned to Dr Google (which generally is a bad idea but can be useful!!) I found a talk by a doctor called Talar Tejirian at the International Hernia Collaboration Symposium held during the 2017 SAGES Annual Meeting in Houston, TX on Thursday, March 23, 2017 on why she uses botox for abdominal reconstructions. Just a warning that this link includes a video and images of open surgery so please don’t click on it if you could find this upsetting. The video was ok but aimed at surgeons. I couldn’t find anything patient friendly by the NHS or other people who have been through this. Hence my reason for this post.

I can only describe my own experience of this, and I have no idea if this is typical or not, so please do chat with your doctor if you have questions and let me remind you again that I am not a medical professional. Also I will be honest with how it felt and talk about the size of needles. I do this because I wish I could have read a patient’s experience beforehand. But if you are nervous and don’t like this sort of thing, then you probably should skip the rest of this post.

The procedure

The appointment was for 4 weeks before my surgery date, the doctors told me this is because the Botox is at it’s most effective 4-6 weeks before the surgery. They use the botox to paralyse the abdominal muscles. They do this because when muscles are working, they contract, by paralysing them, it makes them long and loose. And so when they do the surgery, they are easier to manipulate and stretch to cover the hole where the hernia was.

I went into hospital after being told not to eat after midnight and just drink water till 6.30am. We went to the day surgery unit in the hospital and saw the surgical team and then I went down to theatre. It was a weird feeling being in the surgical theatre awake! I have had 8 surgeries for my illness and so been in a few theatres but always knocked out!

I was in a hospital gown and had to remove all my clothes and laid on a bed. Then the surgeon used an ultrasound to find the muscles. There wasn’t local anaesthetic either, so I was a little scared. He injected into the muscle with possible the largest needle I have ever seen!! It kind of looked like a joke needle!

I will be honest, it did hurt. It was a very odd feeling as I felt the needle break the skin and then push through into the muscle. It was a long needle, but also quite thick. I could feel an odd burning sensation as he pushed the botox into the muscle and then removed the needle.

I really had my fists clenched and was trying not to swear as he then repeated this three more times on my left side, before moving onto four injections on my right side. The injections were on the front of my abdomen. If you rest your hand on your stomach with your thumb by your belly button, then the injections were about in line with the little finger.

It took probably 15 minutes in total and once it was done, I walked back to the ward. I felt the effects almost immediately. The muscles relaxed and my hernias extended pretty quickly. Back on the ward, I had a cup of tea and a slice of toast and then was able to return home.

After the procedure

It’s now been four weeks since the injections. My surgeon told me to expect for it to significantly worsen the hernias. He said “you will be cursing my name for the next month!” and he is right! Every day it feels looser. My hernias are sticking right out and I can feel so much movement inside my abdomen. I have spent most of the last three weeks resting, either sitting or laying down as it is incredible painful to be stood up.

I am using the hernia vests and support garments that I already had, but have found I need to wear two or three to feel secure. But when I do this, it squashed my ileostomy bag and I have leaks. So it is a difficult balance.

I am taking strong painkillers every day and struggling to sleep through the night. It is very uncomfortable even when I am laid down in bed. I feel like I can feel every movement inside my belly. When I lay on my side, it feels like my insides fall to that side! Very weird feelings!

It worsened every day, it isn’t the most painful experience ever, but it is very very uncomfortable even when sitting or laying, and when I am up and about walking or standing, it does feel like all my insides are going to fall out.

I just hope that the benefits during surgery will make all this discomfort and inability to do anything for the past month all worth it.

My next surgery is tomorrow and I am just hoping that it will resolve all my issues and this is the last time I will need to be dealing with hernias and the complications around them. Fingers crossed and I will update after the op.

I would love to hear from anyone who has also had the botox injections for an abdominal reconstruction so do get in touch!

Sam xx