Understanding and measuring parastomal hernias can be a bit confusing, especially when you're trying to make sense of medical reports and advice. A parastomal hernia is a type of hernia that occurs around a stoma, which is an opening created during surgery to allow waste to leave the body. Here's some helpful information and advice on this topic:

- The poster recently had a CT scan that mentioned a "parastomal hernia" but didn't provide any size details. They are curious about how doctors determine the size of a hernia.

- The poster has a medical history that includes severe diverticulitis and a vaginal fistula, which led to emergency surgery in August 2023. During this surgery, part of the sigmoid colon and rectum were removed, and a colostomy was created.

- They are currently dealing with some challenges: their original gastroenterologist was dismissive of their abdominal pain, and while a new GI ordered a CT scan, they won't discuss the hernia size without another in-office visit, which is a 5-hour round trip.

- Their colorectal surgeon doesn't perform hernia repairs, so they have scheduled an appointment with a hernia surgeon, which is also a 5-hour trip, on July 8.

- They are frustrated with the fragmented care and unclear imaging information and are asking what "IMH experience" means.

Here are some insights and advice that might help:

1. Imaging for size assessment:
- Some people have had their hernia size documented on CT scans, but sometimes surgeons don't include exact measurements.
- An MRI can provide more detailed information about the size, position, and behavior of the hernia compared to a CT scan. It's a good idea to ask the doctor to specify the views needed.
- If the current scan doesn't have measurements, you can request copies of the images and report for another surgeon to review, or the new surgeon might order repeat imaging.

2. Clinical evaluation and urgency:
- A hernia that flattens when lying down is often called "reducible." If a bulge remains or bowel function is affected, surgery might be needed.
- Early evaluation is important to prevent future complications, especially if there have been multiple abdominal surgeries that could cause dense adhesions.

3. Selecting the right surgeon:
- Parastomal hernia repair is usually done by a general or hernia specialist surgeon. Consider going to a teaching hospital where all clinicians can access shared imaging and notes.

4. Self-management and support:
- Wearing an ostomy or hernia support belt can help flatten a mild hernia and provide protection during physical activities.

5. Navigating the healthcare system:
- Keep asking for full explanations and copies of all imaging. Don't hesitate to seek second opinions if clinicians are dismissive.
- "IMHO/E" stands for "In My Humble Opinion/Experience," indicating that the advice is from personal experience, not professional expertise.