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Thank you for your comments. My purpose is to raise my understanding about these things. We’ve got the latest authoritative scope on hernia, so how does it fit with what we already know. Can we sharpen our focus a bit. A big issue is chronic pain. Probably it’s been around that prior pain raises the chance for post-op complications.
William points out that some findings show it’s less clear: absence of prior pain is no guarantee. I would want to know if prior pain was truly absent before doubting the role of prior pain in surgery outcomes. Would you classify patient condition of “didn’t trouble them much” as an absence of pain? Perhaps it were enough to derail successful outcomes.
Why important? The more relevant prior pain is the more the patient condition factors into assessment of surgery. What’s more relevant, patient condition or surgeon skill? Various patients over the years here at HT describe how they have gotten the run around post-op by their surgeons. Isn’t it a matter of responsibility? How much is failure attributable to the surgeon? Some surgeons seem to avoid the question.
To be reasonable, the subject of pain is ill-understood scientifically/medically and unfortunately some patients with criminal intent will try to milk the system for whatever they can get. It’s fascinating that train wrecks typically invite onlookers who later jump onto the train posing as actual passengers for the victim benefits! I’m not a doctor but I must imagine that they must be on the lookout for scammers. This is maybe why only belatedly has chronic pain arrested the attention of hernia surgeons.
My commentary reminds of discussion at HT of methods, Kang Repair vs. Shouldice. Isn’t it interesting that Dr. Kang treats all comers whereas Shouldice has strict requirements as to who they will treat? Could this difference be ultimately that of responsibility? One is more willing than the other to assume responsibility? Or put another way, one is more fearful of responsibility than the other. How is it that Kang’s incision for IH repair is less than an inch and half but Shouldice’s, two to
three times bigger? Could this difference also be one of responsibility? The bigger the incision, the less responsible the surgeon needs to be? Just some random thoughts for pondering.