Looking for recommended hernia experts in Oregon?

[Kelly Winter]

Possible hidden hernia? I have been suffering with nerve pain in my thighs for several years, but in the last year or so have also had pain in groin and hip area. I cannot stand for more than 15 minutes without being in a lot of pain!!! I am overweight,, carrying alot of my weight in my stonach. I have had mri’s of lower back, pelvic. Also have had hip x-ray, abdominal ultrasound and ct scan. All of these tests have come back normal and I do not have a bulge, nor do I have pain when I bend over or cough. Therefore I am told that I do not have hernias and have gone to 2 different hernia doctors. I did have a diagnostic mri guided nerve block done in December of 2015 at Johns Hopkins. I had reached back out to that radiologist asking him to go back and look at my films and tell me if he sees any inguinal hernias and he stated yes that I have bilateral inguinal hernias. Problem is, he is the only one that sees this, both hernia specialists looked at same films and said that I don’t have them. I am at wits end and just cry when I have to explain my pain to doctors for the 50th time out of frustration. Is it possible that I may have them and if so looking for a doctor in Maryland that might actually listen to me.

[Good intentions]

Following up – I did receive the surgical records, and they do have the exact type and lot number of the mesh. It was Bard Soft Mesh. The label accentuates the “Soft” part, in fancy script. Nothing special was noted on my charts. Standard material, standard procedure, standard patient.

He must have had another mesh in mind to start, I’d guess, or he mis-spoke at my followup meeting.

[Good intentions]

quote drtowfigh:

Fair enough.

The mesh and its exact type and lot number should be logged somewhere in each patient’s medical records. Usually it’s in the nursing record of the operation.

Thank you, I’ll see if I can get those records. My surgery was done in an Ambulatory Surgery Center though, and there was just the surgeon, the anesthesiologist and an assistant. Outpatient. For all I know his records are all that exist.

By the way, I’m not trying to compete. I appreciate this site that you’ve put together. I think that all of us, patients and surgeons alike, are hindered by the bureaucracy and fear-of-lawsuits of the medical industry as it exists today, as far as learning about the best way to get things done. I call it an industry because that is how it behaves.

My surgeon has put forth extra effort, sitting through three denials for an MRI and a panel discussion to justify it, to help me figure out what is going on. Even though he has other patients, I’m sure, who are battling much more serious issues. I think that he wants to know also.

We can’t fix things though, by just accepting barriers and the status quo. Please don’t take offense as I dig in to the problem.

[drtowfigh]

Fair enough.

Bard did not carry a lightweight mesh until the past decade or so. It’s called Softmesh.

Ethicon is the only major brand that has ultra lightweight mesh. Its density is about half that of Softmesh. It’s very very lightweight and many of us feel it would be too lightweight for some inguinal hernias, such as a recurrent hernia or a direct hernia.

The mesh and its exact type and lot number should be logged somewhere in each patient’s medical records. Usually it’s in the nursing record of the operation.

[Good intentions]

quote drtowfigh:

Can you clarify? The Bard Softmesh is the lightest weight mesh that Bard carries.

I see that that is the case now. At my followup meeting he told me that he had intended to use a lighter weight mesh, but had changed his mind when he saw the defect. In his post-surgery notes he wrote that he used Bard Soft Mesh. I have a memory of searching Bard’s web site, and finding a lighter weight mesh available, at that time, 2015 (12/2014 was the surgery date). Maybe it is not available now, or maybe he was planning to use another manufacturer’s mesh, of a lighter weight and switched to Bard’s product. Or perhaps he was going to use one of Bard’s other meshes, not specifically intended for laparoscopic inguinal hernia repair. He was proud of being at the forefront of the technology.

I am certain though, that he told me, in person, that he made the decision to use a firmer mesh while he was doing the surgery, because he was worried that the lighter weight mesh would be pressed in to the defect. I did not get the surgery notes until months later, when I started to have problems. It could be that he mis-wrote his notes, or that Bard had a lighter weight mesh available in 2014.

Thank you for bringing that to my attention. Maybe he actually used Bard Mesh, and not Bard Soft Mesh. Bard Soft Mesh is what he wrote in his notes.

To be clear, I think that he did an excellent job. But the job is not working for me. And it’s not clear why. And he is on your list of good surgeons, from a different post.

[drtowfigh]

Can you clarify? The Bard Softmesh is the lightest weight mesh that Bard carries.

[Good intentions]

This thread offers a good example of a surgeon choosing what is, apparently, the wrong mesh for the purpose. A heavy mesh for a thin person with low recurrence possibility. And, apparently, there is a better choice, not a random one, based on the qualities of the patient and the qualities of the mesh. This is what we all need more of – information that can be used to make a decision. There is a way to correlate the choice of mesh with the patient. We need more of this.

Unfortunately, surgeons will change their minds once they’re inside, Based on possibility of recurrence, but not quality of life. My surgeon intended to use the lightest weight Bard mesh, because I’m skinny and healthy, but switched to Bard Soft Mesh when he saw the defect because he was worried about recurrence. So he made the decision on the fly to trade my quality of life for a lower chance of recurrence.

The message needs to get out to the surgeons that there are real people out here suffering a fate worse than a recurring hernia. It’s not all about avoiding recurrence. It seems that the only way to get that message out is to complain loudly, and choose the surgeons who know how to make that choice, through sharing information on sites like this.

[drtowfigh]

Looking for recommended hernia experts in Oregon?

Yes.
I already spoke to Dr Orenstein about you. Give him a try. He is at OHSU.
Dr Chet Hammil and the rest of the surgeons listed are also great. They belong to the same group as Dr Reavis and Hansen.

[HerniasAreNotFun]

Looking for recommended hernia experts in Oregon?

Hi Dr Towfigh,

Thank you for the quick reply and recommendations! I contacted the offices and was told the doctors had either shifted away from hernias for most patients or required a direct referral and were booked months out, so that’s that I guess, but reception offered four other surgeon names who do hernia repair at the same Portland clinic and that are accepting new patients. It sounds like they are all laparoscopic surgeons and the receptionist said they use ‘soft bard mesh’

The surgeons (in Portland Oregon) were:

– Dr Richard Jamison

– Dr Chet Hammill

– Dr John Zelko

– Dr Ron Wolf

Do you happen to know any of them or could recommend by expertise?

I know this is kind of a shot in the dark given that your practice is many miles away in another state, but I’d appreciate any additional leads. I’ve never had to find a surgeon before and I don’t even know where to begin!

[drtowfigh]

Looking for recommended hernia experts in Oregon?

For small inguinal hernia, low BMI (thin patient) and low risk hernia (not recurrent, not smoker, not laborer), then I agree with you: lightweight mesh is definitely preferred.
I suspect most laparoscopic surgeons who are high volume would agree with me.
Consider the following skilled laparoscopic surgeons in Portland:
Dr. Sean Orenstein
Dr. Kevin Reavis
Dr. Paul Hansen

Please let them know you were referred by HerniaTalk.com