Exploratory before Removal

[routern7]

Thanks for you reply and comment on Dr Ramshaw. yeah I am really confused, not sure what to do to be honest, all doctors so far proposed exploratory surgery. Removing the mesh is a big decision but I dont know what else to do at this point.

I am glad you are happy you get the mesh out!! Hope your recoveries goes perfectly.

[Good intentions]

I have read good things about Dr. Ramshaw. There are some posts that mention him on this site. He is certainly worth contacting, I think.

I just got my medical records today, from my mesh removal procedures at the end of 2017. I asked for them just to be sure I understood what had been done. There are some comments in the post-operative reports that might be of interest to you, but probably won’t make things more clear. Dr. Billing reported that both sides of my abdominal wall, where the mesh was, looked “normal” after inserting the tools and taking a look. In other words, there was no obvious sign of a problem. But we already knew that it needed to come out, based on my description of my symptoms, so he removed one side, the worst side, as planned. So, I think that’s why it’s best to find someone who has experience removing mesh or knows of cases where mesh has been removed. They know the symptoms, and, as in my case, sometimes the symptoms are all there is to work with. If just an exploratory look had been planned, nothing significant would have been seen. I don’t have any regrets about having the mesh removed, but my symptoms were obviously tied to the mesh.

Also, one thing that struck me about reading my own correspondence with Dr. Billing, which is included in my records, is that I really did put a lot in to describing my symptoms and the activities that preceded them. I think that that helps everybody involved in making the right decision. The words on the page are all that most of the people involved will have to examine, from the insurance company people who have to approve payment, to the surgeons themselves when studying the case later. Things will also become more clear to you as you try to describe them.

Good luck.

[routern7]

Thanks for your reply, I talked to Dr Brown and he recommended removing the mesh. I am thinking of getting the mesh removed by Dr Ramshaw, what are your thoughts about him?

The pain is constant, I can do any physical activity but when I walk with a cane it goes up. It is ben 6month, I am not sure if this will fix itself.

[Good intentions]

My situation was very different from yours. It was very clear that the mesh was the problem since the pain, soreness, discomfort and side effects covered everywhere the mesh was in contact, and surrounding areas, from the first few weeks after implantation, never ending.

As far as exploratory, the first surgery was for removal of one side’s mesh, it was that bad and we knew it was going to come out, and the look at the other side was just to plan the second surgery. It was one month to the second surgery, but normally they would wait six weeks. I asked to have it moved up to four weeks.

When I was initially planning to have my hernia repaired I searched for surgeons that had experience working with athletic people. It was surprisingly difficult to find any that were close to my location, and known for that type of work. But you might have better luck. With the large number of people that have hernia repair you would think that there must be a surgeon who has seen your type of problem. One who repairs construction workers, for example, maybe.

I found that my whole lower abdomen would swell and be painful like you’re describing, when I had the mesh. I often left my pants unbuttoned and used a belt. Does the pain subside at all over time, if you stop all activities? I could go through a cycle of feeling “okay” by not doing anything but could not go back to being active without starting the whole process of pain and soreness over again.

This thread, linked after, might help you. Dr. William Brown, in CA, has lots of experience. It might be a good starting point for recovery even if it ends in mesh removal. Since you caused some new damage, it might be that you just need help in getting it healed. https://www.herniatalk.com/7643-hern…oid-injections

Dr. Billing in Shoreline, WA is also very good at assessing these types of problems for what they are, he has been removing mesh for over eight years. I mentioned telling people your general location earlier, if you want specific recommendations.

[routern7]

Yes thanks for your reply, you have very good points.
The pain I have is in the mesh area and very intense, sometime feels like pressure, sometimes lot of inflammation. I cant band over or walk or sit especially on solid surface, also I need to unzip my pants every-time I sit.

Do you know what other doctor specialties I should consider?

How long for you beteween exploratory and actual removal?

[Good intentions]

Your problem seems difficult to tie directly to the mesh, since it happened during a specific action. Mesh problems generally seem to build up over time, from what I’ve read, or show up immediately after implantation. You’re saying that you weren’t disabled for about 1 1/2 years, then suddenly, in one action, injured yourself.

Was it one lift of a heavy weight or a period of heavy lifting, like a training session? If it was one lift you might have damaged something else. Of course, since you know what the discomfort felt like originally, you would know if it is more like an amplification of the mesh-based discomfort.

A good surgeon will just do what is appropriate, even if it means closing you back up with no action taken. I think that TAPP is the method that would be recommended. My surgeon looked at the left side while he was removing the right, then used the same entry point to remove the left in a second surgery, so it can be done. I had TEP originally for bilateral implantation. Some surgeons will just go ahead and remove the mesh though, as I understand things. Recovering from mesh removal is a whole new experience, it takes time.

I would make sure that your description of what happened is very accurate and let your surgeon help decide if it might be the mesh. Unless you’re positive. Find a surgeon who knows about the other types of injuries that might have happened.

[routern7]

I already saw 3 of the famous removal doctor and they saw nothing on the CT.
It is inguinal hernia, doctor used Metronic self fixating mesh placed laparoscopically.

I am trying to decide whether I should do exploratory first, wake and doctor tells me what he thinks, or just go for the removal.

I had repair in June 2016, some mild discomfort after surgery. But killer pain started Jan 2018 after heavy lifting, I am currently disabled, cant walk and in chronic pain.

[Good intentions]

There are quite a few comments on the site about how the images need to be read by somebody with specific expertise in hernia repair. If you can get the images and your medical records it will be be very useful for you. Contact the facilities where you had the work done and they will send them to you, probably on a CD.

And your story could use much more detail. Tell the whole story. How long ago? Type of hernia – direct, indirect, inguinal, ???. Type of surgery – TAPP or TEP. Bilateral or one side. Brand of mesh. What was the initial reason that you thought you had a hernia? How was it diagnosed.

Also, more detail about what you mean by pressure and inflammation. I know it’s probably difficult to sit at a computer or your phone to type out the information but it would be helpful. I felt like I had a sponge inside me in the early months after my mesh implantation, which made it difficult to sit in one spot for very long.

If you tell your general location people might have advice on who to see. I know that TAPP can give a good internal view of potential problems but I think that the surgeon would need a good reason to try it. Good luck.