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Auto immune disease and mesh rejection
I was wondering if there is a connection or higher risk for someone with a known auto immune disease and mesh rejection? :S Thanks!
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14 Replies
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Auto immune disease and mesh rejection
Very interesting! And good to know there are choices!
Even though the Graves disease is in remission now from what I know it could flare anytime from something my body doesnt like or even stress so its great for me to know about this.
Very helpful information! Thanks!
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Auto immune disease and mesh rejection
BIOLOGICS mesh are derived from Cadaveric tissue from humans or animals. It is decellularized so there is no immunologic rejection. The basis is mostly collagen and other fibers. Depending on the manufacturing, they can be very inert with little to no inflammation associated with it, unlike synthetic mesh b
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Auto immune disease and mesh rejection
Thanks Dr Towfigh!
What is biologic tissue/is it animal derived?
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Auto immune disease and mesh rejection
Sandiego,
My inclination to your question is: YES!
We have no proof that patients with autoimmune disorders have a different reaction to mesh than others. However, in my experience, I have anecdotally noticed that patients with lupus, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome have had a prolonged and abnormally high inflammatory response (aka pain) to mesh implantation. Removal of the mesh has resolved their flare up.
I systematically do not place mesh in such patients. If they need mesh, I choose a Biologics tissue with low inflammatory potential (but higher risk for recurrence). There are also hybrid meshes coming to the market that have very little synthetic mesh.
I wish to have an opportunity to study this patient population. To date, no blood tests are abnormal among them to help predict this mesh reaction.
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Auto immune disease and mesh rejection
I am so sorry that has happened to you. 🙁
Ive had to live with pain the last 4 years and find Reiki to be pain relieving . It doesnt take the pain away completely but helps.
Its a very simple technique to learn yourself and as simple as just laying your hands on the pain area . Do a google search for your area if your interested. Its usually a one day class and not horrible expensive and a skill you will have for life.
Ive also seen hernia surgeons repair others mistakes so have you tried getting a second opinion? Ive seen troubles with defective mesh also,could that be your problem?
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Auto immune disease and mesh rejection
Thanks DE
That is good to know!
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Auto immune disease and mesh rejection
goundfaller – You’re insights are important, and more should listen! I especially like you statement that if the operation didn’t work, then just say so. While it’s uncommon, I have to tell patients that sometimes, and I readily do – it is what it is. Having said that, the majority of experienced surgeons that I know do not think their job is the surgery only. Unfortunately, that perspective comes with experience, and the experienced perspective comes with a lot of time. But even experienced surgeons can have problems. Nothing is 100%. If you think you’re having trouble with your previous hernia repair, you should seek another opinion from a surgeon interested in hernia repair. One can be found at the Americas Hernia Society website. You only need to input your location to find a member near you. You can then determine if they meet your needs or not. Hope this helps! DE
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Auto immune disease and mesh rejection
sandiego – Having the suture material extrude from the skin is annoying, but temporary. You’re body isn’t “rejecting” this in the sense it is an immunological response. It is having a normal foreign body reaction, and that, coupled with the technique (including tissue handling in the OR), along with a minor, subclinical infection (maybe) may have cause this response to be more intense at the skin level. This doesn;t mean it will happen with a future operation, nor does it mean there will be a problem with the mesh. Those things of course could happen, but the skin suture issue can definitely happen without a mesh issue. Hope this helps!
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Auto immune disease and mesh rejection
It’s irresponsible and unethical. I understand that any number of problems can happen and one can’t always definitively say that it is an inherent problem of the mesh or that it was the doctor’s mistake (or some other thing), but if it doesn’t work then it doesn’t work. Say so. I felt dismissed and pushed out of the office when I went back a year later with trouble. I have suffered from serious depression in the meantime and my relationships with family and friends and coworkers have suffered. If I could take the pain back I had before the surgery, I would. It was manageable.
Please doctors, let the data be accurate instead of trying to protect your reputation or the future of the procedure or the usage of the prosthetic. I wouldn’t even dare to speculate how many other people feel the way I do and believe, and probably rightfully so, that the complications are sorely under reported.
It’s funny how when I explained my situation to my current physical therapist he just dropped his head and remarked how typical it is and that their job is to simply do the surgery and then wash their hands of the situation and move on. The sad part is that better comprehensive care with professionals that know how to talk to patients beforehand coupled with doctors that can perform the surgery and a concerted after care protocal would help so many people either make the right decision to not have the surgery or to find adequate follow up care when things dont work out. Instead, we leave everything up to the patient to make a less than informed decision and then flap in the wind afterwards. Surgeons only know their part which is the surgery but they and their team should know where to send people next, especially in the face of complications.
I challenge anyone to find detailed information about adequate written follow up care in addition to the “dont lift more than 10 lbs for 4-6 weeks and then go about life as usual.” Your abdomen was just cut open! If I broke my arm I would get more advice and help and my arm isnt at the center of all my movement. If the research to support the follow up care isn’t available yet the surgery is still performed, someone needs to fast track that into happening.
Futhermore, if you do find detailed follow up care instructions on recovery and resuming life and/or coping with complications…POST IT! HERE! People need information. I know, I know everyone is different and the follow up can’t be standardized. Well I would rather know what I could possibly be doing instead of sitting here with my thumb up…which was my original surgeons suggestion. “This is just going to be the new you” is what I was told.
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Auto immune disease and mesh rejection
Groundfaller
Sorry to hear of your troubles. Im hoping it gets better in time or there is a way to resolve what ever complications youve had.
Ive had the same thought about people or Doctors not reporting the troubles they have had.
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Auto immune disease and mesh rejection
Thanks DE
Do you have a percentage rate of people that have problems with mesh? My last surgery I had dissolvable stiches and within one week my body “spit” them out of my skin. Dr said my body didnt like the stiches! i hope that is not a bad sign that i would reject mesh also!
Thanks!
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Auto immune disease and mesh rejection
Those are excellent points groundfaller. I try to teach this to our residents often. Just because the surgeon doesn’t find a hernia recurrence, doesn’t mean the operation was a success. It’s only a success if the patient thinks so. That is why the informed consent process is so important. Not to rattle off a long list of possible complications, but to find out what it is the patient is trying to solve and what their expectations are. It is then our job to listen, and give our opinion on how likely we can solve their problem. The go over the downsides of the options in plain language. I’m very sorry to hear you had a bad outcome from mesh, even it was from a hernia repair. Having said that, there are many other factors involved, and there are many large studies demonstrating the low risk of mesh related complications. I’ve attached one such study. Hope this helps!
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Auto immune disease and mesh rejection
From personal experience, I have to wonder about the accuracy of reports when I hear about the “success” of mesh. I have had life changing complications as a result of mine. I saw the surgeon who performed the operation multiple times in the year following the surgery and I have even seen other surgeons and medical professionals for other opinions. What I wonder, is who, and more importantly how, information is reported. I feel like my surgery is considered a success in their eyes. I wonder how many other people feel like the surgery did not go well and the surgeons aren’t hearing the feedback.
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Auto immune disease and mesh rejection
No known increased risk. Unfortunately, it is completely unpredictable how any individual will react to mesh. Fortunately, it is very uncommon for someone to have a bad “reaction”. You will hear about bad outcomes with mesh, but given the fact that it is used over a million times a year in the US, the number of problems is relatively small. Hope this helps!
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