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Hi Pinto,
I’m not sure I understand your question. At no point did I ever have a hernia. I had thinning and partial tearing of the inguinal floor which is common in sports hernias/athletes. At no point did I have a traditional hernia with intestinal contents bulging anywhere inside of me. I was still doing 8 hour rehearsals regularly just with a lot of pain. Dr. Brown did extensive palpation when I first consulted and there was no hernia to be found anywhere.
2. I have no idea if the steps are considered standard. It should not be the patient’s responsibility to become a doctor and study whether or not the doctor is doing standard/appropriate steps. I was a pro dancer which he knew, he was a doctor advertising that his main practice was to work with pro athletes for sports hernias/overuse injuries in the groin. After I asked all the important questions like will it affect how my body looks, how my muscles activate or are able to function and he reassured me of everything without any doubt – I trusted him and went on with the surgery. To be frank I did not care at that moment what the exact steps were I trusted that he knew what he was doing the same way people trust me when I judge a competition or teach a class. I explicitly said I am very holistic with my body and for him to do the absolute minimum possible that I would rather have surgery again than to have something done to me that is too extreme and causes irreversible damage/weakness. From my understanding he was going to repair the floor in a way that would not cause weakness and the only risk was some tightness and that it could tear again as I go back to work which I was okay with. I also had the understanding that he would close the external oblique whole and that the spermatic cord would be in the canal after the surgery. At no point did he mention that he would close the external oblique in 2 different overlapping sections and leave the spermatic cord under the skin. I read from another sports doctor a few years back that he regularly just tightens the inguinal floor of athletes that have this surgery and then just closes everything normally and they go back to sport. This is what I thought was going to happen to be frank. He also said that the outline on his website was a general one but that if he found less damage once operating he would adjust the surgery to my needs and only do what is necessary. When he first assessed me he palpated my entire groin and said I did not have conjoint tendon damage nor inguinal ligament damage/injury and gave off a very confident feeling that it was not a big deal and that it was nothing that he couldn’t fix. Hope this gives you a better explanation of my mindset going into it.
When I consulted afterwards the main points that doctors stumbled on were;
1. Why did he slice open the floor in its entirety from the conjoint tendon all the way to the epigastric artery if only a small part was thinning/tearing. One doctor was particularly concerned about the amount of damage he did here he said “you’re so young..you have so much life ahead of you why would he do that”. Again I don’t have a way to gauge if this is normal or not I didn’t realize it wasn’t normal until this doctor pointed it out to me.
2. Why did he not just close the external oblique back whole once the floor was repaired instead of developing it superiorly and inferiorly to then overlap the parts he just created. They said they can’t understand why he wouldn’t just close it whole.
3. Nobody has been able to tell me how its possible to have the spermatic cord just under the skin and no longer in the canal or why it was done – I’m guessing without causing unnecessary structural damage.
4. Because I have structural weakness that spans across my entire core and is affecting multiple systems, they don’t know if he did any additional cutting. One surgeon said it could be nerve related but I highly doubt it the one saving grace I have is that I made him write in the consent form that he would absolutely not cut any nerve under any circumstance. I’ve had a few other patients of his send me operative reports where in the middle of surgery he started cutting their nerves even though they had not approved or discussed any of this prior to their surgery. He was regularly making decisions on the go like this even if the patients were not diagnosed with a nerve issue apparently. My operative report mentions that he identified all the nerves and that they were all fine/he did not touch them and the pictures of the surgeries match the report here all the nerves seem healthy.
I know he lied at one part in at least one part of the operative report. When I first consulted him, my left side (the less injured one) did not have any inguinal floor damage/pain. My scans showed that it only had external oblique tearing near the external ring and Dr. Brown agreed with this on palpation. He said that side was an easy fix (you just close the tear) and it would only be a 6 weeks recovery. When I woke up from surgery he had done the same procedure as he did on the right where he sliced open the inguinal floor in its entirety and wrote in the op report that the floor had “destruction” but nothing suggested that not even his own pictures of the surgery. One doctor said his pictures do not confirm it at all and that they would not hold in court if I chose to go that route. That’s the only part of the report where I know he actively lied. For my right side where the floor was actually thinning/torn he had pictures to show the damage before slicing it open and the wording was specific in the report. But for the left side he does not show any damage and the only picture is the one of the floor sliced open after he cut it open despite no diagnostic of any damage on that side.
All I know is I woke up from surgery and it seemed like all the strength/tension from my groin was completely gone. This is too much information but I actually pooped myself a bit in the hotel the first two days. I could not control my butt? sphincter?. I thought it was from the surgery maybe my body was just reacting to it but to this day I can’t fully control it, it never went back to normal. It shoots out out of me I can feel my sphincter not being under normal tension. For the week following surgery I felt and watched my core spasm throughout the days and slowly release all the tension I had built across my core for my entire adult life. The entire side of my body released – my lats – all the way up and my back – everything released. My back got so tight/so painful from not having any core tension/strength I could not bend forward or lift anything and I still can’t to this day properly lift anything heavy or bend without back discomfort. Something about protagonist/antagonist muscle groups. I’ve never had this happen in any previous surgery. I have friends with severe abdominal surgeries with unbelievably big scars/trauma and their cores aren’t deformed/weak there’s just a big (or multiple in some cases) scar(s) there. For this type of release to happen something had to be structurally released from its origin or altered. The main thing I noticed after surgery is how it felt like I did not have a groin anymore. It feels like everything below the start of the scar on each side is gone. Absolutely zero tissue tension or activation. I thought this would come back as I try to rehab but it hasn’t. Its incredible uncomfortable to walk and as I have specified many times before my gait is incredibly unstable. My knees are completely destroyed since the surgery as there is nothing stabilizing my hips when I walk and my knees are taking the hit from every single step being different I’m assuming. I don’t have normal pelvic stability and no amount of pelvic tilts or rehab is changing anything. When I sneeze instead of the different layers of my abdominal wall tensing up as one big unit to resist the pressure from sneezing, I see my different core muscles bend in different directions trying to disperse the tension/pressure created from the sneeze.
Hope that answers your questions and sorry for the wall of text its hard for me to organize all the information in a concise manner.