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Please recommend hernia surgeon in Houston!
I tried posting this yesterday – but for some reason, the administrators thought it was spam so it did not post. I’ll try to make this brief. I have a rare connective tissue disorder called Tarlov Cyst Disease (it’s where cysts form on your spinal nerve roots from holes in the dura lining and cause the nerve roots to fill with CSF.) I was symptomatic for about four years before surgery and then I had surgery on this in 2012 and it only made my pain much worse. The cysts were on S2/S3 nerve roots, so I have a lot of buttocks, sacral, perineal pain (won’t go into the gory details). Anyway, during my surgery, the surgeon did a sacral laminectomy to access the cysts and used a reabsorbable mesh to close the laminectomy. I have had so many issues since then that other physicians I have seen attribute to the reabsorbable mesh. It basically changes form, turns into a scar tissue and takes about 2 years to “dissolve”. Anyway, bloodwork and reviews by other neurosurgeons seem to indicate that I have had an autoimmune reaction to this mesh and it’s continuing inflammation throughout the area. As a result, I have also developed a very painful inflammatory spinal disease called adhesive arachnoiditis. It’s painful to lie on my back and I can only do so on my temperpedic bed.
So, on to the hernia. I had an inguinal hernia repaired on the left side (open, no mesh) in 1994. Painful, but went well. After initial pain, went on with my life (I was very active before my current condition – weightlifter, runner, etc.). The repaired hernia never interferred with anything I wanted to do. In 1996, I developed another hernia on the right side. Would only bulge slightly if I really pressed down and because of the pain of the first surgery, decided to just leave it alone. And it has been fine.. until recently. I have been seeing a PT to try to strengthen my core to help support my back to see if it will lessen the pain. Unfortunately, one of the exercises he had me do, I did too aggressively and the right side hernia which has been fine has really bulged out. And the left one is also sore (although no bulge – seems intact, but somewhat painful). So – here are my questions.
1. I need to find a good surgeon in Houston that will evaluate me and help me decide whether to leave this alone or to do surgery. (I can’t recall the name of the surgeon that did my first surgery, but he was probably around 60 when he did my surgery in 1994, so I’m quite sure he’s either retired or deceased at this point). I also need a “no mesh” surgery because of my autoimmune reaction to the mesh during my spinal surgery and am fearful that I won’t be able to find one. Can anyone recommend one? Is there a doctor I can call that might know one personally that he/she can recommend?
2. When the bulge increases in size, does that mean more tearing has occurred? So, if the “tear” calms down, will it become more asymptomatic and I can just leave it alone? (I am assuming it is an inguinal hernia – do not know if it’s direct or indirect – it might even be a femoral – really have no clue). Right now, it feels “heavy” and sometimes sore.
3. What are your thoughts on the left previously repaired side having pain? Have I ripped the repair? Wouldn’t there be a bulge? It is just some minor muscle tearing?My life is truly spent on my feet all day walking because it’s ironically my most comfortable position. Of course, now, that extended upright position is aggravating the hernia more. I wish I could see one of the experts that have been mentioned on this site, unfortunately, travel with my current pain condition is very difficult and our finances are a mess after dealing with this and being unable to work for so many years.
Any thoughts? Thanks for taking time to read my saga…Hope it posts this time.
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4 Replies
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quote Chaunce1234:You might try reaching out to:– Dr. John Etlinger in San Antonio Texas, he has been reported to perform non-mesh repairs on select patients.
It’s also possible that he knows colleagues who are able to perform the same procedures.
Finding a non-mesh hernia repair specialist is becoming increasingly difficult and often requires travel or even going out of state, so if you find another surgeon please do share the details.
Good luck and keep us updated on your case and progress.
Thank you! I will look up Dr. Etlinger and see if he knows anyone in Houston he can recommend. I remember looking him up the other day and looking at online reviews – seems pretty positive; however, I didn’t see a review in regards to hernia repair.
I guess I was lucky back in 1994. I did go to several surgeons at that time and chose the one who told me he doesn’t do mesh on women because of their anatomy. It has been a great repair, until lately it has started hurting (after the exercises). I don’t see a lump, but the scar and around it is painful. Hope it’s not damaged. I don’t think I could handle two repairs. Not even sure I’ll get one with my other health issues.
I do have several consults lined up. Unfortunately so many of them have “laproscopic hernia repair” on their website. I don’t believe a non-mesh laproscopic repair is possible, is it? Anyway, I’ve heard back things about laproscopic and robotic surgery. Just saw a news report last night on all the issues with the DaVinci robotic device – actually burning people on the inside!!! Scary.
If I do find a good doctor, I will report back – it may help someone else that is in my boat – can’t travel and broke! I would love to see Dr. Brown in California – I did a search and found some good things about him. I still may e-mail him after my consult here – maybe he knows someone in Houston.
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quote Good intentions:I can’t speak to the details of your problems but two things do come to mind.
One is that if you are unemployed you’re probably paying for your own insurance. If so, you might find that your insurance provider will only reimburse for work done by “in-network” care providers. This is a very recent development, for 2019, that seems to be almost industry-wide for individuals paying for their own insurance. This might narrow your choices if you want insurance to pay for any procedures, since 2019 is just days away. Check your coverage. One the other hand, you might find that paying full price outside of your insurance network is actually less expensive, after calculating for deductibles and the percentage that you’ll pay.
The second is on finding somebody who will do a non-mesh repair, let alone consider doing one. Mesh repairs are rapidly becoming the “standard of care”, I believe because it simplifies the whole healthcare process. Healthcare is trending towards more of a triage type system, designed to get large volumes of people in and out and as quickly as possible, and to use the cheapest methods, because controlling costs is so important. Healthcare is not really for the patient anymore, so much as it is a business for taxpayers and shareholders. It is highly likely that you will find many surgeons willing to “try” a mesh repair on you, even though the result of a mesh reaction for you would probably be a disaster.
This might sound discouraging but I think that it is true. Don’t be persuaded to do what you know won’t be right for you.
On your bulge, I think that hernias get larger because more material is pressing through the defect, and also because the defect gets larger. You will want to avoid letting the defect get too large because that is one of the original reasons to use mesh. It can cover a large area, making a difficult job easy.
Since you were and might still be very athletic, consider consulting with physicians who treat professional athletes. They will be the ones most likely to know who does non-mesh repairs, since most athletes avoid mesh. Contact the trainers at teams like the Dynamo, Astros, Texans, or Rockets. You never know, somebody might have advice.
Good luck.
Thanks for your response. I am actually on disability, so I have Medicare which I know even further limits my options. I can’t afford to pay out of pocket. I am so familiar with the “triage” system of medicine. I have been to so many doctors that I could scream for my current condition. I am no longer athletic at all – my sacral nerves are permanently damaged and my lumbar spine at times feels like hot acid is flowing through it. I will not do a mesh repair after my experience with the other surgery.
I am wondering – what is considered large? It is large because it is a bulge that never goes down unless you lie down? But I’m also very thin (I’m only around 93 pounds – lack of exercise and pain has caused muscle wasting), so my hernia may stick out more than it would on others.
Very good suggestion on researching a physician that treats athletes. I have a friend who is a massage therapist for one of the major teams in Houston – I have reached out to her to see if she can find out anything for me.
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You might try reaching out to:
– Dr. John Etlinger in San Antonio Texas, he has been reported to perform non-mesh repairs on select patients.
It’s also possible that he knows colleagues who are able to perform the same procedures.
Finding a non-mesh hernia repair specialist is becoming increasingly difficult and often requires travel or even going out of state, so if you find another surgeon please do share the details.
Good luck and keep us updated on your case and progress.
-
I can’t speak to the details of your problems but two things do come to mind.
One is that if you are unemployed you’re probably paying for your own insurance. If so, you might find that your insurance provider will only reimburse for work done by “in-network” care providers. This is a very recent development, for 2019, that seems to be almost industry-wide for individuals paying for their own insurance. This might narrow your choices if you want insurance to pay for any procedures, since 2019 is just days away. Check your coverage. One the other hand, you might find that paying full price outside of your insurance network is actually less expensive, after calculating for deductibles and the percentage that you’ll pay.
The second is on finding somebody who will do a non-mesh repair, let alone consider doing one. Mesh repairs are rapidly becoming the “standard of care”, I believe because it simplifies the whole healthcare process. Healthcare is trending towards more of a triage type system, designed to get large volumes of people in and out and as quickly as possible, and to use the cheapest methods, because controlling costs is so important. Healthcare is not really for the patient anymore, so much as it is a business for taxpayers and shareholders. It is highly likely that you will find many surgeons willing to “try” a mesh repair on you, even though the result of a mesh reaction for you would probably be a disaster.
This might sound discouraging but I think that it is true. Don’t be persuaded to do what you know won’t be right for you.
On your bulge, I think that hernias get larger because more material is pressing through the defect, and also because the defect gets larger. You will want to avoid letting the defect get too large because that is one of the original reasons to use mesh. It can cover a large area, making a difficult job easy.
Since you were and might still be very athletic, consider consulting with physicians who treat professional athletes. They will be the ones most likely to know who does non-mesh repairs, since most athletes avoid mesh. Contact the trainers at teams like the Dynamo, Astros, Texans, or Rockets. You never know, somebody might have advice.
Good luck.
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