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Finding a Dr who understands difficult to find female hernias?
My wife just had a disappointing experience with a surgeon who was confident he’d find and fix her hernia, but ended up just exploring laparoscopically and doing no fix because he coudn’t find it. After that, I read some newspaper articles about the difficulty in finding some hernias in women. So, how do I locate a doctor who truly understands this and can help her without putting her through more trauma?
I’m in Indiana, but willing to travel. I saw the Americas Hernia Society site, but again, I just don’t know how to be sure to pick a doctor who has the understanding and experience?
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7 Replies
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quote koohiisan:[USER=”1916″]Chaunce1234[/USER] , thanks for the detailed info!There were four pictures taken…well…four that were printed and given to me, anyway. The doc said he didn’t see anything.
Regarding her symptoms: in certain positions of sitting, stretching, or at times laughing hard causes a firm bump to protrude out at a location to the left of her navel. I’ve seen it, and felt it, and it’s definitely ‘something’. She has to stretch out flat and force this ‘thing’ back in from whence it came. It is very painful for her.
No MRI or CT was ever taken at all, and I’m thinking that there also was no ultrasound (90% certain of that). The doc simply asked where it was and felt like he could find it based on her symptoms. She’s never been able to make this happen on command so as to demonstrate it, although we circled it once when it was protruding at home so we could show him where it was located. According to his analysis of the photos he showed me, he examined that area with her abdomen inflated but was unable to locate anything.
Just based upon your description of a visible lump, I would try and request an ultrasound (they are fairly cheap and so insurance usually doesn’t fight them), and try her hardest to get the bump/protrusion to be reproduced during the ultrasound with valsava. Sometimes an ultrasound is a preliminary step for insurance to “OK” an MRI/CT as well, depending on how many hoops the insurance makes you and your doctors jump through.
I am not a doctor but I do find it puzzling that an exploratory laparoscopy did not see something if there is actually a protrusion of any sort that becomes visible, since my limited understanding is that a hernia is usually visible upon laparoscopic inspection, but I don’t enough about umbilical anatomy or the abdominal wall in general to help explain any of that.
It’s always possible it’s not a hernia at all, and it could be something else, so try and keep an open mind. In the meantime, reach out to Dr Szotek since he is within your state, he could be a valuable resource.
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[USER=”1916″]Chaunce1234[/USER] , thanks for the detailed info!
There were four pictures taken…well…four that were printed and given to me, anyway. The doc said he didn’t see anything.
Regarding her symptoms: in certain positions of sitting, stretching, or at times laughing hard causes a firm bump to protrude out at a location to the left of her navel. I’ve seen it, and felt it, and it’s definitely ‘something’. She has to stretch out flat and force this ‘thing’ back in from whence it came. It is very painful for her.
No MRI or CT was ever taken at all, and I’m thinking that there also was no ultrasound (90% certain of that). The doc simply asked where it was and felt like he could find it based on her symptoms. She’s never been able to make this happen on command so as to demonstrate it, although we circled it once when it was protruding at home so we could show him where it was located. According to his analysis of the photos he showed me, he examined that area with her abdomen inflated but was unable to locate anything.
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Indeed as other have stated, Dr Szotek is in Indiana and I believe works with Dr Towfigh from time to time.
Are there any pictures taken from the exploratory laparoscopy? I believe you can usually see hernias if they are visible this way, so if it was explored and none found it may suggest another issue.
What are your wifes symptoms? How long have the symptoms existed? Do they ever go away or are they constant? Does anything make them better, or worse? Has she had other testing done to rule in/out other causes? MRI? CT? Ultrasound with valsava?
A handful of surgeon names around the country that may be helpful as a starting point, surely there are others as well:
– Dr Shirin Towfigh, Los Angeles, CA
– Dr David Chen, UCLA CA
– Dr Paul Szotek in Indianapolis, IN
– Dr Bruce Ramshaw in Knoxville, TN
– Dr Jonathan Yunis in Sarasota, FL
– Dr Igor Belyansky in Annapolis MD
– Dr Bruce Ramshaw in TN
– Dr Jonathan Yunis in FL
– Dr Brian Jacobs in NYC
Some of those doctors are quite receptive to patient inquiry, so it may be worth reaching out, perhaps with images, and a brief overview of the case (symptoms, imaging, diagnostics, tests, etc)
Good luck and keep us updated on your case and progress.
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Dr. Paul Szotek is in Indiana at the Indiana Hernia Center. He has contributed to this site in the past. Perhaps you could send him a private message or if you go to the Indiana Hernia Center website you will see how to contact him. I haven’t seen him so I can’t recommend him, but he has offered help and good advice to me here. He is a close colleague of Dr. Towfigh, as well. I think it’s a good place to start! Best wishes to your wife. I know occult hernias can be very difficult to deal with from a pain standpoint!
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quote UhOh!:Isn’t one of the surgeon contributors here in Indy?
Wow, it would be fantastic to have a surgeon who is skilled and so close to home!
I read about [USER=”935″]drtowfigh[/USER] initially, which is what prompted me to dig deeper. Eventually I landed here! Any advice or guidance is greatly appreciated!
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Isn’t one of the surgeon contributors here in Indy?
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Dr. Towfigh probably knows somebody. She is the administrator of the forum. [USER=”935″]drtowfigh[/USER]
http://www.beverlyhillsherniacenter.com/hernia-education/types-of-hernias/
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