Patient's Query
Hello doctor,
I am about to have an open inguinal hernia operation after 15 days. I have been having terrible anxiety leading up to it. I went to my PCP today and informed him of this. He prescribed 25 mg of Zoloft for me.
I have read that it takes a month for Zoloft to work. Also, I have read that Zoloft can cause bleeding and complications after surgery. I will be under general anesthesia. Is it safer for me to wait and begin taking the Zoloft after the surgery if I need it? Please advise.
Thank you.
Hello,
Welcome to icliniq.com.
I read your query and understand your concern.
I would like to know whether your hernia is the cause of your anxiety. If anxiety is the case, let me assure you that you have nothing to worry about from a surgical aspect as hernia repair is not a complicated or major surgery. So, the blood loss should not be worrying if you were only on Zoloft (Sertraline). But would like to know if you are taking any other medications.
Also, since your BMI (body mass index, a value derived from the mass and height of a person) indicates you are obese, it could be one of the causes of a hernia. I would like to know some other parameters like your blood pressure and sugars, and your cardiac status as indicated by ECG (electrocardiogram) and 2D echo. How is your exercise tolerance? Your coagulation profile, and other basic blood reports like CBC (complete blood count). How about laparoscopic hernia repair? Or why not under regional anesthesia? I would also suggest yoga and meditation to relieve your anxiety and stress.
I hope that you get your answer.
Please let me know if you want some help.
Thank you.
Patient's Query
Hi doctor,
Thank you for your reply.
My BP today was 110/70 mmHg. I do not have any cardiac history. I do work out strength and cardio five days a week on average.
The surgeon is doing open because possible sports hernia with a hernia found on ultrasound. Caused by years of running possibly, but not for sure. Also, have a hip labral tear. They think the pain is coming from the hernia as the Cortisone shot in the hip gave no relief. The surgeon always does general anesthesia.
Other medications, such as multivitamins, fish oil, and Vitamin D. Ibuprofen as needed on rare occasions. It is a direct hernia. A recent EKG a month back was normal. Have a pre-anesthesia appointment after 10 days. They will do EKG blood work and possible chest X-ray, cholesterol was 241 overall not on medication.
So should I start the Zoloft now, or wait until after surgery as I do not think it will do much before surgery for my anxiety? Thinking about the pain after surgery is what is causing my anxiety. I had varicocele surgery and am thinking the pain will be similar. Please advise.
Hi,
Welcome back to icliniq.com.
Regarding Zoloft, peak action may take longer like a month or more, but the drug may start acting after a week. So, it might help your anxiety. I would suggest you continue it.
Regarding your previous surgery for varicocele, I am sorry. Hope this will not end like that. You can ask your anesthesiologist for an epidural if you are pain-sensitive or for a post-operative TAP (transverse abdominis plane) block or ilioinguinal iliohypogastric nerve block (indicated for analgesia following inguinal hernia repair). That should help you. Other than that if your other surgical profile is fine, you are good to go.
I hope that you get your answer.
Please let me know if you want some help.
Thank you.
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Answered byDr. Vamsee Kiran Lakkam
Medically reviewed byiCliniq medical review team
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