Q: I am haemophiliac with factor VIII deficiency. Recently I got pain on the right lower side of the stomach and the doctors at Nizam Institute of Medical Science said that it is a hernia which needs operation. It will be expensive as I have to take factor VIII continuously till it is healed. At present I have no pain but have noticed a swelling. What will be my fate if I don't go for surgery?

A:You require surgical management of the hernia. It is advisable that you undergo surgery as an elective procedure and not as an emergency surgery of strangulation. This way the proper precautions are taken, complications of emergency surgery avoided. I understand the monetary factor which should be addressed in a planned surgery. Temporary truss is not accepted. He should avoid actions which increase the abdominal pressure like weight lifting, certain exercises.