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Recurrent hernias prevented Dan Allen, 62, from doing the things he loved— working on his farm, tinkering with cars and hitting the ski slopes with friends. With each hernia, the retired firefighter says he gained weight, adding to his already large frame. “I couldn’t bend at the waist without discomfort,” says Dan, whose highest weight was 260. “I had to get down on one knee to tie my shoe.”
Dan’s first hernia appeared in 2009 as a bulge on his stomach. His primary care physician referred him to surgeon Bryan Ellis, DO, who found that Dan had an umbilical hernia—a weakness in the abdominal muscles in and around the belly button. Umbilical hernias are most common in women during and after pregnancy, but also affect people who are overweight. If left untreated, they can cause serious illness.
“The hernia had become big and was incarcerated—trapped by fat in the belly button,” says Dr. Ellis, who repaired the hernia surgically and added mesh reinforcement. A second hernia appeared in 2013, requiring another surgery. In 2016, the hernia was back, and Dan returned to Dr. Ellis, now with the TriHealth Comprehensive Hernia Center.
Dan’s obesity and lack of conditioning, coupled with his pre-diabetes, contributed to the hernia recurrences. “Excess weight increases the pressure on the abdominal muscles and makes them weaker and more prone to developing hernias,” explains Dr. Ellis. In addition, Dan, a former smoker, had been diagnosed in the past with chronic obstructive pulmonary disease, another risk factor for hernia repair failure.
Dan was forced to retire early after 30 years as an industrial firefighter for General Electric. “I was in a lot of pain,” he explains. “Putting the hazmat suit and fire gear on and off and climbing up and down ladders was taking its toll.” During his consult with Dr. Ellis about a third surgery, the conversation took a life-changing turn. “Dr. Ellis sat me down and said, ‘If you lose weight, your health will improve. The next surgery will be more successful and your recovery easier,’” Dan recalls. “I told him I wanted to ski Snow Shoe Mountain in West Virginia and he promised I’d get there.”
Dan was referred to Nina Gray MD, a bariatrician at TriHealth's Weight Management Center specializing in non-surgical weight loss. The two discussed the reasons behind Dan’s weight gain and reviewed his diet and lifestyle. They decided a low- carbohydrate/high-protein diet was the best approach. “Though the goal was to lose weight for surgery, we wanted to create a program that Dan liked for life—so the weight would stay off. His diet is now leaner, filled with fruits and vegetables and low on unhealthy processed foods,” explains Dr. Gray. Dan says he learned to make better food choices. He still can have red meat, though it’s a leaner cut now. And he has switched his occasional beer to one lower in carbohydrates and calories.
Dr. Gray approaches weight loss as she would a chronic medical condition, individualizing prevention and management strategies and meeting regularly with patients. The key is to balance exercise and nutrition. At the TriHealth Fitness & Health Pavilion, where Dan received his weight-loss consultations, patients have access to medically based exercise, rehabilitation and education programs.
For Dan, manual chores on his farm in Fayetteville were his workouts of choice. He also followed a series of abdominal strengthening exercises. When he returned to TriHealth’s Comprehensive Hernia Center one year later, Dr. Ellis did a double take. “He showed up in my office 70 pounds lighter,” says Dr. Ellis.
In December 2017, Dan underwent hernia surgery at TriHealth’s Bethesda North Hospital. Dr. Ellis performed a standard open surgical procedure called Rives-Stoppa repair with retrorectus mesh. “There were challenges due to scar tissue and weakened tissue from previous hernias,” he says. Two months after surgery, Dan was on the ski slopes. “The weight loss and hernia repair made a phenomenal difference in my maneuverability,” recalls Dan, now also free of blood-pressure medication. He calls his energy level “tremendous” and says his wife has benefited from his lifestyle changes as well. “She’s lost 45 pounds.”
Dan is grateful for the care he received at TriHealth and approaches each day with renewed zeal. “My doctors opened doors for me—I can do everything I want now,” says Dan, excited to ride his horse again.
“Nothing holds me back.”