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Hernia possibly getting worse? What to keep an eye on?
Good morning from a new poster. 47 yr old male.
About 4 years ago I got a CT scan for kidney stones. I was told I had a hernia on my right side. I was shocked because I had no pain and there was no bulge to be found. Sometimes when passing gas I would notice a little tug down there but no pain. I went to see a surgeon who did the usual “turn and cough” test and he didn’t really notice anything. He left and checked out my CT scan and came back and confirmed I had it. He said since I had no pain or bathroom issues it was entirely up to me if I wanted to get it fixed. He suggested I just wait and see what happens, so thats what I have been doing.
About 2 weeks ago while on the treadmill I noticed a strange feeling down there. It was like when you shave and the hair starts to grow back and it kinda sticks you. I did a little more checking and actually felt a little bump under the skin. I did my own “turn and cough” test and when I coughed I felt the bump move. Just to verify there was nothing on the left side.
So obviously things have changed. I still have no pain and no bathroom/stomach issues. Though sometimes I feel something tug or move down there.
I have moved to the Austin, Tx area and am thinking of going to see a surgeon again just to see if its time to do something about it. I have been checking on a lot of surgeons and everything I have found shows that Dr. John Abikhaled in Austin is highly recommended. He is also a member of the American Hernia Society.
I have read all the internet horror stories about hernia repairs gone wrong so I am a bit apprehensive since I don’t have any issues.
Any suggestions or comments would be great.
Thanks
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6 Replies
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[USER=”2029″]Good intentions[/USER] somewhat agree. But the data shows that surgeons with more experience, who regularly perform these types of repairs, have a better (lower %) chronic pain/recurrence rate. There is a good video where Dr Ramshaw highlights this fact. It’s common sense of course, but certainly picking a surgeon with decades of experience, who performs 100s of similar surgeries a year is preferable to walking into the local ER and getting it operated on by your run of the mill general surgeon. This is irrespective of the technique or if they use mesh. I do agree with your sentiment that mesh isn’t all that great, and I will certainly be staying away from it!
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You’re following the same thought path that I did. I’m not so sure that people get on-line to give bad reviews of their surgeons, after many months or years. I haven’t because I don’t think that the individual surgeons have the means to know better. I’m also not so sure that it’s the surgeon’s skills that matter so much either. Many of the accounts on this forum are more about general problems with the mesh that they had implanted, not so much who implanted it or how they did it. It can go in exactly as the device makers say it should, but people still have problems. It’s either a problem with certain types of mesh, either the polymer itself or the way the fabric is put together, or individual people respond differently to the material. Or maybe they’re just putting in too much fabric, creating a much too large foreign body response. Like getting stung by 100 bees compared to just 1.
The problem for everyone right now is that the device makers and the medical institutions have all hunkered down to see how things play out. I have heard from people that develop new products and this is their impression, at least for the device makers. That’s why you can’t trust a brand or a clinic or a hospital as an entity. You have to find a person who you trust for their sincerity and, just as importantly, their knowledge. I think that there are many sincere, caring, professionals that do hernia repair but don’t have any way to find out what really works and what does not. They just don’t know and can only do what the device makers tell them to do. Follow the instructions and hope.
As far as protection from the Food and Drug Administration, the FDA, all you have to do is look at how these new materials have been approved for use, the “substantially equivalent” rubber stamp, and some of the weird ideas out there like coating polypropylene mesh with fish oil (it’s been approved and is in use now – Atrium C-QUR), to understand that they have little influence over the device makers. As long as nobody dies from mesh they won’t be involved. Consider how long it’s taken to do anything about transvaginal mesh problems. The same people are behind the development of hernia repair mesh, and the FDA oversight was of little use in stopping the thousands of women from being harmed.
Good luck. Sorry to be so negative. It’s a mine field though. Be careful.
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I see a lot of complaints online about botched mesh repairs. And that makes me really think about what method I want. However, from all the reviews I have seen Dr. Abikhaled seems to have a lot of satisfied customers. I have not seen one bad review of him. I also remind myself that most people that have successful surgeries just don’t post about it online. Its usually just people that have had problems. Maybe that makes it seem like something is a lot worse than it actually is. Even after helping cut down an oak tree and haul off big sections and a recent cold with sneezing and coughing, I still don’t have hernia pain or a noticeable bulge. I may be getting hired by the post office and if so will be changing insurance plans. If I can go a few more months without any issues I may consider getting it fixed. Still leaning to Dr. A instead of going out of state. Thanks for your advice.
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Hey I’m in Austin too. Dr abikhaled does a very good physical checking for hernias and I see a lot of positive reviews about him (for hernia repair). Unfortunately he is mesh only. If I were you I’d look for no mesh repair surgeons. If you want mesh dr abikhaled will be good, dr ramshaw out of state likely better. Great no mesh options are dr Brown in California or dr busconi and litwin at UMass. Do lots of research and ask lots of questions, regardless of who you pick!
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Most people who get a hernia repaired will have no problem with it. That’s the good news.
The bad news is there are a substantial number of people who do end up with a problem. Much of what you read online is tilted to the negative because those are the unfortunate people that have the problems, usually chronic pain, or a non-specific sense something is wrong, and then they’re left trying to figure it out on their own.
It’s always a good idea to get an opinion, and maybe even a second opinion or third. Do your own research on repair types, approaches, outcomes. Ask the surgeons what their particular experience is, how many times they have done the same surgery, what their rate encountering chronic pain and recurrence is, or if they track that outcome data, how each is handled, etc. Also consider your own body and your own expectations, if you’re athletic or thin you may have different expectations than someone who is overweight and inactive, and you may have different surgical possibilities as well.
As for your locality, the only surgeons name I have read regarding hernia surgery in Texas is Dr John Etlinger in San Antonio, TX.
Good luck and keep us updated on your decision making and progress.
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It’s been 3 1/2 (Edited – was 4 1/2) years since I got my right side direct hernia. Since then I’ve had Bard Soft Mesh implanted, then removed, and am now recovering, trying to get back what I can. I often wish that I had just lived with the hernia. I thought that I was choosing between staying at 85% of my former capabilities or paying the time, surgery pain and risk, and money, to get back to 95%. Nobody described the potential complications, or the probability of having them. It all seems hidden, and purposely ignored. The surgeons I talked to before-hand implied that it was an easy, outpatient procedure. All I needed was a ride home afterward.
It’s very surprising how many surgeons, and doctor’s just don’t acknowledge the problems with the current methods of mesh implantation, despite all of the lawsuits, and new forums like this one cropping up, and their own patients coming back with problems. I think that they might just realize that people won’t have the surgery if they tell the truth about what they know. It creates a whole undesirable atmosphere of distrust; of the medical profession, the insurance companies, and the various clinics and hospitals. It’s more than just a few patients that have their lives screwed up.
But there are honest, open, forthright individuals out there. I recommend staying away from the large clinics, because they have incentive to stay with the mainstream methods, right or wrong. They are large for the purpose of negotiating contracts, and subsequently have large outside influences pushing them to avoid acknowledging problems. Many surgeons in the big clinics don’t really have a choice of materials, their purchasing departments choose for them based on cost, assuming that the meshes are all the same, and they are probably also limited in methods of repair.
If your surgeon can’t describe a few stories like you’ve read on this forum, and discuss why they might be happening, then they’re either in denial or dissembling, avoiding the issue. Choose a surgeon who will acknowledge and confront the issue directly. One who keeps track of their patients progress and doesn’t assume that “no news means success”. Then you’ll have a better chance of a successful repair. The individual surgeons shouldn’t be avoiding responsibility for the work that they do. If yours denies there’s a problem, I would move on to another.
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