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Appointment next week – Questions?
All,
I have an appointment next week with an experienced General Surgeon in Houston who has very good reviews on the various web sites. What I want to do though is have a list of questions that are specific to my situation which is open mesh repair 2011, now experiencing very likely hernia recurrence. This is what I have so far, can you think of anything else?:
- Experience with repair of Hernia Recurrence with the original mesh still in place?
- How do we evaluate the condition of the present mesh before determining next best steps? ( I have this as high importance)
- Experience in placing a Laparoscopic mesh into a patient that has an open mesh ‘repair’ already in place?
Thanks
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2 Replies
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Thanks GI, what you have written is all good stuff. I’m very nervous about taking the next step forward as it will be nigh on impossible to go back if I make the wrong choice and end up with daily pain as I see on these forums. For my part I’ve never had any issues with the mesh in place since 2011 until November 2018, nothing at all. I need to get more than one opinion I think? I did email my last surgeon whom I know is active, but he hasn’t responded…..yet…..
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The one question that you really want to ask is “how are your patients doing after many years?” with regard to chronic pain and/or discomfort. The “standard of success” is non-recurrence, not the patient’s quality of life. Many surgeons will avoid considering the quality of life of the patient, because it is not part of the overall equation at this time. It can’t be seen physically. They typically lose track of their patients and have no idea how they are doing.
So, if your surgeon avoids talking about quality of life, or makes glib comments like “I haven’t heard any bad news”, or, even worse, discounts chronic pain/discomfort as not a real problem, that is a warning sign. The issue is well-documented and easy to study.
Part of a successful surgeon’s skill-set is getting the patient to accept the procedure. Surgeons are in a box right now with little choice for repair methods. The best you can hope for, probably, is to find somebody that understands the situation and knows which of the mesh products have the lowest odds of chronic pain or discomfort, and how to use the mesh in a way which lowers that probability. There are people out there who had mesh implanted 15-20 years ago who were fine until their second implantation more recently. Something is different, either the mesh or the method. It might be that the latest greatest repair methods for minimizing recurrence are actually the cause of the increase in chronic pain.
So, an old-timer who is using the same method for the last 15 years and can say honestly that his/her first patients are in good shape, recurrence-wise and pain-wise, is what I would look for. Good luck. Take a list of questions with you on paper and use it. Once you get in to the medical setting, it’s easy to lose your train of thought.
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