News Feed Discussions Long-term pain: bounced between sports hernia and complications from hernia repair

  • Long-term pain: bounced between sports hernia and complications from hernia repair

    Posted by dmpain on January 2, 2020 at 2:31 pm

    Hello All,

    First time poster. I found this forum a couple weeks back. I am finding some encouragement from those of you who have recovered. Thank you for your stories. Also a big thank you to the Drs. who post information and thoughts here.

    I am 49 and in good shape. Historically very active. Swim, bike, occasional run, family hiking, etc. I had laparoscopic bilateral inguinal hernia repair with mesh in 2016. Small but painful hernia on the left, some pain on the right but no obvious hernia. My surgeon sold me on bilateral mesh based on the argument that one surgery would fix and prevent the potential for all future hernias (sigh). I had intermittent pain – mostly on the left side – for the first year after the surgery. My surgeon said some pain was normal in the first year. The second year was mostly good but I would have a bit of pain here and there. The pain was similar to what I have now but not as intense or as consistent. In the autumn of 2018 I started to have more pain but I was having other health issues (migraines, ulcer symptoms from over use of NSAIDs) and the groin pain was the least of my problems. All of the NSAIDs I was taking for the migraines in the first half of 2018 may have been masking the groin pain. Early in 2019 the pain increased and has become nearly constant since then.

    The pain was generally greatest on the left but sometimes greater on the right. I get a pinching sensation when I am sitting. It intensified when I am leaning forward. The pain is lower along the inguinal canal on the left – near the original hernia – and a bit higher on the right. It was also most painful in the morning when I would wake up. Walking sometimes helps with the pain. Now and then I had more generalized pain along the inguinal canal – itchy or burning. One odd dynamics is the entire region feels inflamed and painful when I am getting a cold. It has been constantly painful the past few weeks. Extreme pain at times. The itchy/burning generalized pain is nearly constant now.

    Primary care physician checked for recurrence of hernia, had me tested for urinary tract infection (twice) and talked about kidney stones (I had them before but the pain was different). Ordered a CT with contrast that showed the mesh and clips all in place in 2018. I went back to my surgeon spring 2019. No new hernia. He looked at the CT and said it was not the mesh and sounded more muscular or perhaps a sports hernia. He referred to a specialist. Ordered MRI. MRI showed no obvious sports hernia. Xrays showed no hip issues. Orthopedic and sports rehab surgeon (but not a sports hernia specialist) was good – listened to me more than the hernia surgeon – but did not see an obvious diagnosis of sports hernia but also could not rule it out. She suggested sports medicine PT to help with diagnosis and perhaps reduce pain. PT could reproduce pain by pushing on and around locations of pain along inguinal canal. Soft tissue work and some of the exercises caused a considerable increase in generalized pain that would decrease back to baseline over 2-3 days. PT increased my core strength but did not reduce overall pain.

    I got a second opinion with another in network hernia surgeon in early Dec. 2019. Not a great meeting – it felt superficial – but we talked through options. Put me on 300mg/day gabapentin and recommended NSAIDs (even after I said I was sensitive to them). No change in pain. The same surgeon and he said he was sorry the gabapentin has not helped and suggested I taper down. I am now nearly done. He said there were limited treatment options – including mesh removal which is not guaranteed to resolve the pain. He suggested that if the pain was focal and can be pinpointed that another option is injections of a long acting local anesthetic or steroids into the area.

    I feel like I’ve been kicked around between discussions of sports hernia vs. hernia surgery complications. I feel like each new appointment leads to another month or two of conservative treatment or tests or a month or two wait to see someone else. So now I am here looking for any thoughts and information I can get to educate myself the best I can so I can push for better care. The pain is becoming debilitating.

    Any thoughts on my symptoms from Drs. and members? How reasonable are the next steps suggested by my local surgeon? Should I go back to considering sports hernia? Should I be reaching out to someone with more experience with complications from hernia surgery like Dr. David Earle (located a couple hours away) for what would now be a third (or fourth) opinion? Other questions I should be asking?

    Happy New Year to all and thank you in advance.

    Jnomesh replied 4 years, 9 months ago 3 Members · 6 Replies
  • 6 Replies
  • Jnomesh

    Member
    January 6, 2020 at 3:58 pm

    There is dr. Jacobs in nyc. He is private but will put in the time and prudently examine yourself case. I would put him slightly behind the surgeons mentioned above
    from the feedback I heard from other people you might want to skip Novitsky. He is a talented surgeon but he only seems to acknowledge that plug and patch meshes are bad. Otherwise he rarely seems to think other mesh can be the root cause and seems to instead go down the pathway of a muscle tear or something else.

  • dmpain

    Member
    January 5, 2020 at 4:21 pm

    Thank you Jnomesh and Good intentions.

    Yes, frustrating to have such little clear guidance on the pain I am having. The progression of specialists sounds familiar. I guess I also want to rule out other possibilities before undergoing what would be a major surgery.

    I mentioned Dr. David Earle mostly because his name came up in a list on this forum. I am between Boston and NY so I am already looking regionally. and Dr. Yuri Novitsky in NY was another name I saw on this forum. I will look into the other Drs. suggested.

    The two in network hernia surgeons have now said they don’t know anyone who deals with complications of hernia surgery so I have leverage to push for an out of network referral to someone with this specific expertise.

    Any of the Drs. that post on this forum have thoughts on my symptoms? I know this is just a message board but it would be helpful – particularly as I push for more specific treatment guidance. Questions I should be asking?

    Thank you all.

  • Jnomesh

    Member
    January 3, 2020 at 5:28 pm

    Sorry two times I tried to reply only to have it not go thorough
    I have a very similar situation and had my mesh removed. You can PM if you would like more information

  • Jnomesh

    Member
    January 3, 2020 at 5:25 pm

    I wrote a very long response and it did not go through and forgot to save it
    so here is a very condensed version and feel free to private message me.
    I had my mesh removed and went through a very similar experience before that of being passers of to different doctors and surgeons all said it went the mesh all tests showed nothing “wrong with the mesh or repair”. Back doctor hip doctor GI doctor
    etc.
    had to go out of my hometown of NY to find dr. Belyankski In MD. He saw in the same scan that all the others said was fine that my mesh was folded and had shifted. The mesh was removed and was much worse when he actually went in-completely balled up and rock hard and on all sorts of structures it shouldn’t be on.

    i agree with Good Intentions. Skip dr. Earl . Don’t settle for someone just bc he is in your state as hard as that may be. He may be a great surgeon and capable of removal but from what I read from others and seen from his responses you will probably go through the same hoops with him too unless he clearly sees proof of something wrong with the mesh or classic symptoms (ie infection that warrants removal )

    bc your mesh was implanted laparoscopically you will want to seek out a surgeon who specializes in lapro removal: dr. Igor Belyanski, Dr. sherwin Towfigh, Dr. Billings. The mesh should be removed the same way it was implanted so I’d remove dr. Brown form the list bc he specializes in open removal.

    seek two or 3 consults. Be prepared that even with these mentioned surgeons who specialize in mesh removal and issues-you may have to make the final decision whether to get your mesh removed. Very rarely is there “proof” that the mean is the cause but you know your body. The stuff i was feeling and experience was nothing like I had ever experienced-it was so unnatural and so debilitating. I don’t think any of these surgeons can empathize with what people are going through with mesh issues unless they feel it for themselves.
    if your issues started after mesh was implanted that should he the biggest evidence.
    wjek I was going through my experience a co worker whose husband had mesh issues told me flat out “ if you’ve gone to everyone and had every test done and they say everything is normal then it’s the mesh”
    the sports hernia is a joke. That usually only happens with extreme athletes and even then they feel better when they lay off and rest from their sport. Yours is 24-7 pain even when resting. This is not a sports hernia.

  • Good intentions

    Member
    January 3, 2020 at 3:47 pm

    Testing.

    Could you get the details of the type of mesh that was used? They might not all be the same.

  • Good intentions

    Member
    January 3, 2020 at 12:18 am
    quote dmpain:

    H
    I am 49 and in good shape. Historically very active. Swim, bike, occasional run, family hiking, etc. I had laparoscopic bilateral inguinal hernia repair with mesh in 2016. Small but painful hernia on the left, some pain on the right but no obvious hernia. My surgeon sold me on bilateral mesh based on the argument that one surgery would fix and prevent the potential for all future hernias (sigh).

    Any thoughts on my symptoms from Drs. and members? How reasonable are the next steps suggested by my local surgeon? Should I go back to considering sports hernia? Should I be reaching out to someone with more experience with complications from hernia surgery like Dr. David Earle (located a couple hours away) for what would now be a third (or fourth) opinion? Other questions I should be asking?

    Happy New Year to all and thank you in advance.

    Your “sigh” indicates that you’ve learned about how the industry works. You should reach out to the doctors that understand mesh problems AND have removed mesh. Dr. Earle has commented in the past in support of mesh. I think that he would probably sound very much like your current surgeon. You can search for his last few comments on the site. His comments on Atrium’s mesh product are also used in their marketing literature.

    Dr. Belyansky, Dr. Brown, Dr. Billing and others have much experience in removing mesh and have probably met many patient s like yourself. Your situation, from start to now, sounds very much like mine, and others. The source of the problem can not be seen by imaging or any other technique, especially if it is a broad pain/discomfort, not localized to a nerve area. It’s probably just the mesh itself.

    @drbrown

    Here is what I think is the last contribution by Dr. Earle on the site. Good luck.

    https://www.herniatalk.com/9814-american-senator-rand-paul-to-have-shouldice-surgery-in-canada

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