Since my hernia made it’s appearance around May 2019, I’ve been battling with the decision on whether to have it corrected with surgery. Back in November I thought I had made a decision not do anything about it only for the thoughts on having it done to come back stronger.

How Does it Affect Me?

Physically the hernia doesn’t cause me any issues at all. It doesn’t cause any pain or discomfort, it doesn’t affect how the bag works but it’s there. When I put my hand in my pocket I’m reminded about it and when wearing t-shirts the bulge reminds me it’s there by protruding out.

The parastomal hernia in all its glory

Mentally it’s been a different story. The battle in my mind on whether to have surgery or not has been raging for the last two months and it’s been affecting me greatly. It dominates my thoughts, it comes up in conversations, it’s a recurring theme in counselling sessions.

I’ve talked to people about it, I’ve talked to my stoma nurses, my surgeon, other surgeons, people who have had the surgery, people who have parastomal hernias and haven’t had surgery. All have provided me with a lot of information that I can use to make a decision but when the decision lands solely on me, I’ve struggled to make a decision. I know the pros and cons of both having the surgery and even when I have an inkling on which way I should go, I flip-flop between the trying to decide what’s best for me physically, what’s best for me mentally and what will improve my quality of life.

The Tough Decision to Make a Decision

I reached a point where I was truly stuck. I didn’t know what to do, what to decide, and nobody was going to make the decision for me. Some may say that I didn’t need to make a decision right now and in a way that’s right, but was not making a decision affecting me?

I needed to research what to do and luckily I found some great articles that instantly resonated with me. As I was reading through them I was finding myself saying to myself, “this is me, this is exactly how I’m feeling”.

Here are some excerpts from one of them:

Human beings are particularly good at rearranging and restructuring our thoughts to create the most positive experience possible in any situation. The psychological immune system protects us, to some extent, from the negative consequences of our choices. Because after all, almost every choice has a downside. The key to happiness is to dwell as little as possible on the that downside.

When you keep you options open, however, your focus is on the downside – because you’re still trying to figure out if you made the right choice. The psychological immune system doesn’t kick in, and you’re left feeling less happy about whatever choice you end up making.

Yes! This is exactly what was happening to me. I was avoiding making a decision and keeping my options open and I was always focusing on the downsides. I was aware of the upsides but the downsides were always a recurring thought.

Reversible decisions don’t just rob you of happiness – they also lead to poorer performance.

And even though the decision is not a reversible one, it was robbing me of my happiness and most definitely contributing to poorer performance in both personal and work life.

Once again, it’s because thoughts related to making the right decision stay active in your mind when you options are open. This places a rather hefty burden on your working memory, and it’s distracting. When you’re still deciding what you should do you don’t have the cognitive resources to devote yourself fully to what you’re actually doing. Your attention wanders. And as a result, your performance suffers.

The decision on which way to go was a thought process that I would revisit constantly throughout the day. Extremely distracting and at times it was a struggle to actually live for now. My mind was constantly wandering and at times I had no control over when it would decide to wonder. I could be mid-conversation and I would suddenly (sometimes prompted by the hernia itself) to start thinking about it.

So keeping your options open leads to less happiness and success, not more. Ironically, people don’t actually change their minds and revise decisions very often. We just prefer having the option to do so, and that preference is costing us.

By not making the decision, I’m just contributing to making me feel unhappy, making me feel depressed, distracting me and affecting my day-to-day life.

But assuming that your choice is carefully considered and you’ve weighed your options, you will be both happier and more successful if you make a decision – and don’t look back.

I Have to Make a Decision to Move On

So the reason for me writing this blog post is to try to come to a decision and to get it out there in the open. To aid in this process, I read researched further.

A simple yet highly effective way to think about a decision is to consider what you recommend to you best friend.

“When we step back and simulate someone else, it’s a clarifying move”

When I ask myself this question, I would recommend that they don’t elect to have the surgery and that look at the downsides to having the surgery and turn those into positives.

For me, if I had the surgery I would risk complications from it, I would risk it returning again, I would risk postponing what I enjoy doing (running) and I would risk higher travel insurance if there are complications (I really miss travelling).

So turning those into positives, I would quite quickly be able to return to running, I would be able to start travelling again with higher, but not astronomically higher, travel insurance and obviously by not having the surgery I wouldn’t be risking further complications.

The downside to not having surgery? A lump. That’s it. A lump. I already don’t think about what people think of the lump so I’ve overcome that hurdle. There’s also a chance there could be a blockage and I have to have the hernia sorted via surgery but that doesn’t factor into the equation as that would be completely out of my control and the decision to have surgery in that instance would be made for me.

Another article suggested to ‘envision the consequences of you actions’.

Look ahead and think about what will happen if you take this course of action you’re considering. See in your mind the consequences of this decision. If what you envision is acceptable, even desirable, this will help solidify your choice. If it’s negative, are you willing to go ahead anyway? Is the likely outcome worth the risk or fallout for the ultimate good?

I know that by having the surgery I would instantly introduce a negative aspect by having another long period of recovery and I know that would affect me mentally. The risk/reward is simply not there.

So, Decision Time

In a way I’ve long known what the right decision is, and that is to not have surgery. But I’ve still not been able to make a decision. Reading these articles has really helped me solidify this decision.

If a friend asked me what to do, I wouldn’t recommend they have it. If I look into the future and that future features me dealing with the consequences that I foresaw then that would make me regretful and unhappy. Therefore I have to make the decision to not have the surgery.

I need to make this decision wholly and completely. The decision can’t have caveats such as I ‘won’t have the surgery right now’ or ‘I may have the surgery in the future’, I need to make the decision and accept that decision. I’m hoping that getting the decision out in the open will help me stick to it and accept it. I’ve tried, without the information I had in the past, to make this decision but I’m hoping that this time it will stick. I think that with the introduction of colostomy irrigation and the Ken Butt wound almost healed, I will back to running and the hernia will become less of a feature of me. At least that’s my hope.

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Diagnosed with IBD in 2002, I have experienced the usual ups and downs of having a chronic disease and tried numerous medications but the time finally came in 2018 to elect to have surgery to improve my life. I had the surgery in 2019 and this is my journey having a 'New Bum'.

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