Pinto / Dr Kang

[drkang]

Hello Pinto,

As a surgeon who operated on you, I was very sorry to hear that you had a recurrent hernia a week ago. I will do my best to fix your problem.
Unfortunately, Kang repair is not without recurrence. Through continuous improvement over the past nine years, I am now evaluating that Kang repair has almost reached the stage of completion, but it is still not perfect. The relapsed patients, including you, are my teachers and contributors to the completion of Kang repair. We have improved Kang repair through these failures. In that sense, I will take to heart your assertion that early ambulation might be the cause of relapse. Just like putting different kinds of materials in a furnace and melting them to make new steel, I will try to make better surgical methods by melting these many pieces of advice in the furnace of my thoughts.

Whenever I come to Herniatalk, I am very impressed that you, non-professionals, study harder and have more heated discussions than the expert doctors. Many of you already appear to be far beyond the professional level. I believe that your efforts will never be in vain. As a member, I will do my best to contribute to your discussion by occasionally presenting my opinion.
Thank you!

[pinto]

In my case nothing was needed other than the med given me by the hospital, which took me through the time I was there. I had only one pain complaint, which I have described. Because I had no pain otherwise I felt I didn’t need meds. Probably the med removed any pain but I never felt pain between takings of it. In summary the only time I felt pain: getting out of bed, riding a taxi, and walking within the first week. The taxi ride and getting out of bed were killers! I had no throbbing pain–in bed if motionless, no pain. After I got home I don’t think I took anything. In Seoul I bought some OTC in case but never used it.

[William Bryant]

Maybe prudent if an overseas patient stayed a few extra days. To minimise pain and aid recovery.
Is any pain relief prescribed?

[pinto]

>>What is the usual stay duration at the Gibbeum post op?
The promise, not an unusual one, is you will be able to walk out the same day. However, they provide you a one-night hospital stay as part of their package. For prudence sake, I pre-arranged the one-night stay. You are a foreigner unable to speak the language and you pass up the chance??? What happens in the dead of night in your hotel room if something goes wrong (and most hotel staff if not all cannot speak English)??? 😀 Gibbeum gave me the impression that most people opt out of the chance. Crazy if you ask me. My “roommate” there, a Korean, was in much pain after the op but his wife came and took him home. Me, I had no pain at all. Painless except for getting out of bed and the taxi rides. That was good because my body was telling me, “Don’t move.” If not, then maybe there could be a tragic end.

[William Bryant]

Thanks Pinto.
What is the usual stay duration at the Gibbeum post op?
Brilliant that Dr Kang is sorting things out. Hope it goes well for you.

As far as UK is concerned I think you you’re right that the nhs does do watchful waiting as cost cutting… I’ll find out soon as I had my ultrasound last week and I expect I’ll see my doctor again in a week or two’s time. He will probably sat then what the next stage is: whether to wait or have op.

I’ll post update once I’ve seen him.

[pinto]

Just got back from a time out from all-things-hernia. As an update imaging tests came in showing presence of a hernia, something that was of no surprise—-left side IG, medium size as was the original. Dr. Kang apologized on behalf of his hospital and has been superlative in giving me full attention in answering my questions. He is also confident he can and will repair the recurrence.

What could have happened? Dr. Kang brought up the suturing. I think the original suturing was compromised because of my early hospital discharge. After one night in the hospital I returned to my hotel but experienced the most intense pain ever in my life–whenever the taxi cab rear tire hit a bump. The lateral vibration seemed to tear right through my loins. This by the way happened even a week later. Generally I only had pain by the taxi ride and when I had to get up from my bed. Just to raise myself on all fours required methodical movement millimeters at time; every move was in slow motion so as to forestall the pain. Did this happen in the hospital? NOT! Because I had a motorized bed which at a push of a button automatically raised me to a sitting position so I could leave the bed. During my week stay in Korea I had to use crutches because I had to! Dr. Kang and staff said, “no, this does not happen.” But it did to me. On my return home, I had to use a wheelchair in the airport; otherwise I could not have left. I could walk short distances but not long ones especially carrying a flight bag.

Dr. Kang does not agree with my assertion that these difficulties compromised the suturing. However, I humbly disagree based on the following: He recognizes that the Shouldice method has high medical standing, which by the way can require patients to stay in the hospital for as many as five days. Further Dr. Kang instructs his own patients when discharged from his hospital to cradle their groin for protection from car ride jolts, etc. Although he doesn’t agree with Shouldice’s five days, nevertheless he cannot throw my assertion out of hand. Suturing clearly must be protected after surgery. The issue is for how long. In my case, I needed a motorized bed and avoidance of car rides for at least some days. If I had those, recurrence would have been less likely.

William, I wish you to report about how UK doctors handle watchful waiting. That is, what criteria do they use for determining when a patient can have surgery. It is my understanding that for financial reasons the national health service requires doctors to push watchful waiting. Given that the UK health system pushes watchful waiting, then they must be pretty up on the matter. I would appreciate hearing about it if you become informed about it.