Warning: Spoilers ahead for ‘Girlboss’
Netflix‘s newest series Girlboss offers a loose—”real loose,” according to the show’s opening credits—account of Nasty Gal founder Sophia Amoruso’s rise to “girl boss” fame. While parts of the series are fictionalized for your binge-watching pleasure, many plot lines do come straight from Amoruso’s bestselling 2014 memoir, #GIRLBOSS. One thing that really did happen to Amoruso: That whole inguinal hernia situation.
In her memoir, Amoruso explains that she got a hernia in 2006—and she actually credits it with the founding of Nasty Gal. “If I’m being totally honest here—and that’s what I’m being here, totally honest—Nasty Gal started because I had a hernia,” she writes in her book. She explains that after discovering the not-so-subtle hernia in her groin—”the hernia was visible even when I had clothes on, with a little bump sticking out like ‘boop'”—she got a job so she could have health insurance to cover the cost of surgery to repair her hernia. She worked at an art school checking IDs, and that’s where she had downtime to start her eBay shop, Nasty Gal Vintage. The rest is Nasty Gal history (and by that I mean she went from flipping vintage clothes to founding her own Nasty Gal clothing brand, which she left in 2014).
Netflix’s Girlboss series shows Sophia discovering and treating her inguinal hernia. In the medical world, inguinal hernias and hernia repair surgery aren’t rare. “It’s one of the most common surgical procedures we perform,” Dana Telem, M.D., M.P.H., director of the Michigan Comprehensive Hernia Program at Michigan Medicine and an associate professor at the University of Michigan Medical School, tells SELF. “There are probably 400,000 to 500,000 inguinal hernia repairs performed in the country each year, but they’re much more common in men than they are in women.”
An inguinal hernia occurs when tissue—either fatty tissue or part of the intestines—pushes through a weak spot in the abdominal muscles. Some people can be born with a split in the muscle fibers of their abdomen, causing an inguinal hernia at infancy. Other people can acquire an inguinal hernia over time, due to an inherent or increased weakness in the abdominal muscles. Kathleen LaVorgna, M.D., chair of surgery at Norwalk Hospital, likes to compare an acquired inguinal hernia to an old pair of jeans. “The knee starts to wear out because the fabric takes a lot of pressure because you bend at the knee,” she tells SELF. “And once the fabric gets weak enough, you get a split.”
That “split” can happen due to a number of triggers, including strenuous activity—such as weight lifting in the gym—pregnancy, or even straining during a bowel movement or urination. A doctor can diagnose an inguinal hernia by the physical signs (oftentimes a bulge on either side of the pubic bone) and symptoms, and then decide the best course of treatment. If the hernia isn’t causing symptoms beyond a visible bulge, it might just require a watchful eye to make sure it doesn’t cause complications. “The annoying hernias that bulge through are usually just the fatty layer coming through,” LaVorgna says. But if it’s already causing mild symptoms—like a tugging sensation—surgery is the best option to fully repair the hernia before it becomes more severe.
In Girlboss, Sophia doesn’t treat her hernia and it leads to painful complications. She starts feeling a sharp pain, begins vomiting, and in the next scene she’s in the emergency room. She claims her hernia “exploded,” but that’s not the case. When someone with an inguinal hernia exhibits these severe symptoms, it typically means a loop of intestine got caught in the hernia and obstructed the contents that move through the intestines (think digested food, stool, and liquids). “Then people bloat up and get nausea and vomiting,” LaVorgna says. “It’s a very strong pain that makes people rush to the emergency room and we operate on them as an emergency case.”
Hernia repair surgery is low-risk and usually requires pushing the tissue back to its proper place and patching up or sewing the weakened area to reinforce the abdominal muscles, LaVorgna says. Telem adds that only about two percent of hernias reoccur after the procedure. “The surgery is pretty safe,” she says.
If you find a bulge in your groin—as Sophia did—or feel an abnormal discomfort in the area, Telem says you should get it checked out. “Even if you don’t want to fix it, no one died from information,” she says. “And if you have a hernia you have to know the warning signs of when to seek emergency attention.”
Also: 7 Signs of Colorectal Cancer You Should Know