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Need some direction to find answers
I would really appreciate some advice and or direction. It’s been a bit more than 6 months since I had inguinal hernia surgery. May 5,2017. Laparoscopic using Bard 3D max light mesh. Healing went well, pain disappeared rather quickly. I did great for 6 weeks post surgery, no pain once the initial post op pain subsided. I felt normal and physician ok’d me to go back to my usual life. So I tried some golf, doctor knew from first visit pre-surgery I played so we discussed when I could play again. I had some discomfort after the second round, but the next day I awoke to severe stabbing pains with every step. I went back to my doctor and he felt golf had stressed the surgical tacks and the pain would stop in time as they dissolved. Over time the severe pain did cease and I am improved, however pain still creeps in daily and can increase by just walking about or standing after awhile. Sitting upright at a table for a few hours can cause some discomfort as well. I awake some mornings just fine and only have random pains after I am moving about, other days I awake with a stiffness in my pelvis bone area that tends to linger. I experience random dull stabs or tightness at the former hernia site and what feels like numbness or possible warmth down to my inner thigh area. I rest by reclining once it begins to reappear and the discomfort decreases in a reasonable amount. I was a fairly active person, including regular exercise, no pain issues prior to surgery, now I’m not active at all. I now confine my activities to just basic functions at home and necessary errands. Just for FYI my age is 61, 6’3” and 200 pounds. Other than this issue I am in good health.
I visited my surgeon again in August and he did have an ultrasound performed on me, with valsalva, and it showed nothing of concern to him. He isn’t interested in having an MRI or CT scan performed. I look normal, no bulges or discoloration. Bodily functions are normal. My surgeon isn’t offering me anything now except trying pain management shots.
With the goal of getting my old life back I would prefer to better understand what is causing the issue and finding a solution if possible. I believe my options at this point is to rest more and see if things improve further over the next few months. Find another surgeon and get a second opinion? Which I guess could end up in a revision of the first surgery work. So I would prefer suggestions to include for that possibility. From where I live parts of Virginia and Maryland are within reasonable distance. So I would be open to any recommendations. Or some other possible option I would appreciate being made aware of. Thoughts please. Thank You.
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4 Replies
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Pain that is gone after surgery but comes back that is similar as before makes me concerned about hernia recurrence (can happen even with no bulge, etc).
You need an evaluation by a surgeon that deals with recurrent hernias.
They will need your op notes, any imaging you have on CD w/reports.
They will get a history, physical and do an exam.
If they feel it’s nerve related they can do dermatome map testing in the office in a few minutes. -
I am not a doctor but my 2 cents is that if you can manage or resolve a problem without another surgery, then you might want to try that first. A pain shot might help and it could also be diagnostic and informative, if a numbing shot in one particular nerve pathway completely resolves the pain, then that may help a doctor to help narrow down the cause. But discuss this all with a knowledgable doctor, maybe even get a second opinion, let them help you come up with a plan. Some doctors also may prescribe a 30-45 day course of powerful NSAID (meloxicam, naproxen, etc) assuming it is compatible with you.
Does anything in particular help the pain go away, or make it notably worse? Does heat or ice help or hurt? Does applied pressure make it better or worse? Is the pain generalized, or focused in a specific area? If you are able to take NSAIDs, does ibuprofen or aleve help, or make no difference at all?
This following list may or not be helpful to you, it’s various doctors in the eastern half of the USA which have a specific interest in hernias and/or groin pain.
– Dr Brian Jacobs in New York, NY
– Dr William Meyers in Philadelphia, PA
– Dr Alexander Poor in Philadelphia, PA
– Dr Jarrod P Kaufman MD in Brick, NJ
– Dr Igor Belyansky in Annapolis, MD
– Dr David Grischkan in Cleveland, Ohio
– Dr Paul Szotek in Indianapolis, IN
– Dr Bruce Ramshaw in Knoxville, TN
– Dr Jonathan Yunis in Sarasota, FL
Obviously there are going to be many other great docs out there too, so by no means is this thorough or inclusive. If you are inquiring yourself with doctors, you might want to ask if they have experience with the particular issue you are dealing with, and if they have been able to treat it successfully, and how. As others here have echoed, re-do surgeries are complex and if you ever go that route then you would definitely want someone with notable experience in that regard, particular with laparoscopic experience since your initial surgery was laparosopic. Dr Towfigh and the other helpful physicians on this forum undoubtedly have some recommendations as well.
Good luck, stay positive, and keep us updated on your progress.
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I agree with “Good Intentions” that you should look into this problem now and not accept the diminished lifestyle caused by your pain. You should definitely get a second opinion from a “hernia expert”, who deals with problems and pain from hernia repairs. In Annapolis, MD there is Dr. Igor Belyansky. He is a highly skilled surgeon in hernia repair and mesh complications. I’ve seen him myself. In Fairfax, VA there is Dr. Sharon Bachman, she comes highly recommended from Dr. Towfigh, who runs this forum. I live in VA and have travelled to MD for Dr. Belyansky and ultimately ended up traveling to CA to see Dr. Towfigh and have mesh removal. She is the best! She really listens to her patients and uses the information and imaging,which she reads herself, to come up with the best treatment plan. You may not need mesh removal but Dr. Towfigh says not to accept pain from hernia repair as your new normal. That is not normal!! Best wishes for a speedy resolution to your pain from someone who has been there.
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quote mulligan22:I visited my surgeon again in August and he did have an ultrasound performed on me, with valsalva, and it showed nothing of concern to him. He isn’t interested in having an MRI or CT scan performed. I look normal, no bulges or discoloration. Bodily functions are normal. My surgeon isn’t offering me anything now except trying pain management shots.
Find a surgeon who removes mesh and also repairs hernias. Your surgeon did what most hernia repair surgeon’s typically do – confirmed that his repair had not failed (recurrence is the main official failure mode, pain and discomfort don’t count), and offered medication to cover up the symptoms. Only a surgeon who has accepted that the mesh repairs can fail or have problems, and that some people’s bodies will not accept certain types of mesh will be able to give you good informed advice. Many surgeons who use mesh are in what looks like some form of mass denial about the flaws of such a very widespread, and growing, hernia repair method. It’s a difficult subject to deal with, but they’ll have to come around eventually.
Chaunce1234 has put a list together which you can find on this site. A few doctors that remove mesh and also repair hernias are Dr. Towfigh, who often posts on the site and is a moderator, I believe, Dr. Peter S. Billing of Edmonds WA, Dr. Brian Jacob, in NY, (he actually lists mesh removal as one of his procedures on his internet profile), and Dr. Igor Belyansky, in MD. There are several others. They have seen the signs of bad mesh and also the results of removal so they should have the best perspective. Doctors who only do mesh implantation, like your surgeon, generally don’t want to, and don’t know how to, deal with mesh-related problems. It’s just the state of the industry at this time.
I’m not saying that you will need or want mesh removal. But getting an early evaluation and gaining knowledge now will help you in the long run. If your body is not dealing with the mesh in the right way, time will not help much besides getting used to a diminished life, and it might make the mesh more difficult to remove.
Your situation is very similar to mine, in all aspects. It started about started about three years ago, with Bard Soft Mesh and a direct inguinal hernia. Good luck.
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