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Post surgery thoughts
Having gone through the IH pains for over a year and then gone to Dr. Goodyear for surgery two years ago, as you might have read in my earlier posts I am pain free and back to normal life.
For what it is worth I decided to type these post surgery thoughts here. It may apply to you or not but since I am not a medical professional I suggest you exercise caution in applying these to your own case.
1. Surgery IS surgery. It makes your life painful first and THEN IF SURGERY WENT WELL should make you better. There is really no point cribbing about the surgical wound pains and those minor things for 4 to 6 weeks. Just grit the teeth and move on with some pain medication. After 6 weeks if your pain has not gone away, you have something to worry. Really
2. Be sure to do all your research before you fix the surgeon. Skill of surgeon is THE MOST important thing to correct IH. If you chose the wrong surgeon sorry, things can and do go wrong. May be this point needs to be point ZERO but I am typing as they came from top of my head. There are two kinds of surgeons – those with skill and know what they are doing and those with hammer in hand looking for nails to drive. Do ASK every single and silly question you have and discuss with surgeon. He won’t feel silly for asking.
2(a) – Ask this yourself before you open your pants for surgery – Is this the surgeon I can expose my sensitive body parts to be cut and trust? If answer is NO, move on to the next guy.
3. IH to my knowledge is a hole in the pelvic floor and can happen to ANYONE (male or female). It could be genetic too which means if your father, brother has one you are “likely” to get one too (but no necessarily). In my case my father had (never had surgery) and my brother had (Corrected with surgery) The weakness in pelvic floor must be corrected via surgery with a support such as a mesh or another muscle/tissue from another body location. Exercize, eating less, starving yourself to death “PROBABLY” will not work. Believe me I tried those. A hole is a hole is a hole.
4. This point is related to 3 above. If you have IH surgery with mesh you will NOT automatically become a superman after 6 weeks. You cannot kick buildings and lift mountains across the pacific to save sinking Islands somewhere in Europe. You will enjoy pain free life and can assume MOST of the activities but no way you will be superman.
5. Related to 4 again, if you had surgery on one side only and try to behave like a superman, you are LIKELY to get IH on the other side. Why? Because your corrected IH side is stronger and since your pelvic floor had been weak (remember, you had IH on one side for this reason in the first case) it will now break on the other side. Remember the word “likely.”
6. Age is cruel and can kill even supermen. A power lifter at 25 might be a world champion lifting 7500 Kg., but doing the same at 60 can break the back, neck, cause IH and other related problems. Yes sir, we DO ACKNOWLEDGE that you were power lifter ONCE. Ten Hut for it but now you are 60+ and I suggest you give respect to that age and limit your activities. No disrespect for you at all but do you really need such weights at 60+? And if you are a runner do you really need to run 15 miles every day at 60+?
7, If you ask me, I would like to live well till the last moment without any physical or financial dependence on anyone. Physical dependence is much worse you know. So I would rather walk 2 miles daily, lift 10 lbs (yes right TEN pounds) several times, do other things and live diabetes free till late age but would not want to lift 100+ lbs (since I did that at age 22) and break my back and/or spend rest of my life in nursing home being fed through nose.
I apologize this post may hurt someone like Usain Bolt and Arnold Schwarzneggar but having gone through IH surgery this is my personal opinion. I would rather stop lifting heavy stuff even after successful surgery than feel like superman and lift those weights and go back for another surgery.
And also since I went through this surgery, I know the anxiety prior to surgery, the tension to select a good surgeon and the costs involved when going to meet some surgeon away from home etc. I myself went from KY to PA with all family members to get this done with Dr Goodyear. And I spent a good amount of money too. So I know something and how it feels etc. I wish you all the best and pain free life but do remember that you WERE a superman ONCE UPON A TIME and yes sir, those days are past and now accept the reality of time and live with thanks for pain free life.
Who knows what future holds?
Thanks for reading, and take care
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12 Replies
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Post surgery thoughts
BeenThere
Thanks. One of the things I learned over years is that when you ask the insurance, the hospital or the primary care physician, what they refer you to depends on who they know. Hospital tries to fill up gaps for surgeons and promote them (and vice versa). Insurance does exactly the same. They refer you to anyone on their list (Aka network) and the list is the exact same thing you see on the website. A PCP referring to a surgeon is Scratch-my-back-and-I-will-scratch-yours type stuff. A dentist told me 5 years ago that I had a lesion on tongue that urgently needed to be checked and a referral to so and so oral surgeon was given. I asked if it could be cancer or what? Dentist says yes it could be and that’s why it should be checked.I ignored her since that so called lesion has been in my mouth since age 6 or whatever. In my third of fourth visit the oral surgeon name changed for recommendation and I asked why. No answer. After 5 years I never went to the oral surgeon and she keeps telling me I needed to still go. In one of those cleaning visits in her dental practice I met another dentist this time who said he could not even find any lesion. Huh? So that’s how it goes. After 5 years if I had cancer it should have progressed to stage 5 by now. LOL. It is all about money. Insurance never worries if you are feeling good or bad. Their business is to make money. If you are well, they say “yeah we told you.” and if you feel worse, “yeah sometimes it happens.” You are one in a million. Who cares? It is not their pain to suffer.
There are some grocery shops like Chinese and Mexican stuff sellers. If you go and ask the owner if such and such vegetable is fresh or when it came to shop, he would say “Oh it came right today, take it and it tastes the best.” That alone is a red flag. He is trying to get rid of that stuff.
Talk to people, did you ask for a reference from one of the patients who had surgery with this very doctor who operated on you? General surgeon is different from specialist hernia surgeon.
I often regret spending more money. For example if I spend 55 cents on bananas at Kroger and I find they are 44 cents in Aldi I beat myself for wasting money but when I went to Dr. Goodyear I spent money for plane tickets, hotel and all and NEVER REGRETTED it. Luckily I found that Dr. G is a specialist Hernia surgeon and has the skill. He never needed a Google search or scratch on his head to answer my questions. He has them right off his bat.
Before going to him I met two local guys here and my PCP all of whom confirmed that I had IH. I also knew since I had trouble during bowel movement and a bump was showing up. I did not like the local surgeon; but may be was good. I do not know. When I did not feel confident I decided not to go to him.
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Post surgery thoughts
WasInTN, Thanks for your writing on this subject. I wish Dr Towfigh and the other doctors plus patients put together a written list of questions to present to the surgeon you are interviewing to put in their hands.
Here are the questions I put forth to my first surgeon and hospital staff.
I was not referred and did enough research to ask for a general surgeon that preformed a lot of IH and specialized in hernia surgeries. They referred to a quote expert that did them all of the time. After my surgery I learned that is told to all patients and that the hospital assigns doctors to patient by doctor needing to fill their schedule not which doctor(s) are the best for the type of surgery.
When meeting with the doctor and staff three times before surgery I asked what I thought were the important questions, as follows. Some background on the the hospital. It is known as one of the best in the nation and has a huge budget to have potential patients already believing they are going to be seen and treated by world renowned surgeons. The doctors page listed IH as one of his specialties and he has over 20 years of experience. Found out afterward he was only licensed about 6 years before the 20 years was from when he graduated medical school.
My questions to doctor and staff and answers.
How many IH surgeries has he done. At this hospital all of the time and he stated he had done well over 1,000 of open IH.
Current training. Up on all current practices in IH
Who is going to perform the surgery. The doctor(he also stated that) resident will act as surgeon tech. and only assist. He could only state the mesh was inserted so tight it would never move.
What about surgical team. His person highly trained surgical team. Found out afterward the team was a circulating of medical staff.
What is there is a problem. We have one of the top post surgical hernia surgeons on staff. No one on staff
Recovery. 6-8 weeks fully recovered.
Complications and side effects. Seroma, infection, hematoma. Nothing about pain or loss testicle(2 previous surgeries in area?
Only licensed medical professionals in OR except for one resident. Looks like 2 medical students present.
How will do the gas. Highly experience licensed Doctor of GA. Found a fellow who had recently been doing nerve block injections.
How do you handle the 3 main nerves. Will locate and preserve. Only one nerve located and could not answer about the other two.
What type of mesh. I requested lightweight and doctor agreed. Only PMII ordered before surgery and was told the doctor had done so few he might not even know which mesh the hospital had on hand.
Will I be catheterized. No
I might have missed a couple but it is close. When I reviewed my medical records none of the questions and agreed treatment are noted or followed. Every question I asked I was not told the truth in order to obtain a consent. The doctor could never answer any of the questions about the surgery, afterward. I did post my first exam notes on this site if anyone wants to see them.
I should have asked why open surgery over lap. Found out he was a lap specialist, so was this for medical student and resident training doing open?
He recommended open and I found out later the best way for open is a local in stead of a general gas, I think Dr G does local. Why general?
Here is a couple scary things that are current with my original surgeon and hospital..
Surgeon. He has moved to another state. He is now promoting himself and as a hernia specialist. From the record I got in a complaint it looks like he had not done one hernia surgery between 2012 and 2015. BE CAREFUL.
The hospital I went to also claims a Hernia specialty clinic that does over 500 per year. They have listed about 10 surgeons basically their GS staff. So that makes about 50 per year per surgeon but in their resident recruitment page a resident exit survey on procedures it shows residents perform almost 90% of the surgeries while only assisting 10%. So if these figures are correct that means each doctor might do as many IH surgeries in a year what Dr. G does in a week or so. Also in this survey, it showed about 50 or types of surgeries. About half the resident never assisted in the type surgery before performing one. There goes what was it read, assist, do one.
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Post surgery thoughts
I went to Dr. G after almost 3 months of see-saw discussions. I originally wanted to go to Dr. Tomas of FL for non-mesh and fixed an appointment with him but after considering all things I thought Dr. G is the right surgeon with right knowledge. My decision was correct and I have been happy with his work/skill/knowledge.
Wise? Me? You do not know anything. I am driven by “F-E-A-R.” Every single thing is fear for my life. I do not know how I became like this but fear drives me. I am also miserly according to whoever knows me. To spend one cent less I go from shop to shop and save money. So to select Dr. G I was on Google for 3 months, emailed and bombarded everyone I knew about surgeries (until they said “STOP”) and decided. I also assumed that once I woke up from surgical table I would be forever in pain – like the Google pages said. So for a fear driven chicken like me it was a gamble. I even wished I died on the table and never came back for reasons I won’t put here. I spoke to both Drs. Tomas and Goodyear over phone before going and talked non-stop to people I know – locally, on internet, on NPHI discussion board and everywhere else including colleagues. I visited the local surgeon and his office twice but did not like to get this IH repaired here. My family said I should do it here locally but I said No. It is not their IH to suffer. Is it? Pain cannot be transferred like a bank account or few dollars unfortunately or fortunately. I might even have very little pain threshold.
I agree everything is connected to Dollars but that’s how life is. Also you said something about surgeon putting everything on table. Think of the time it takes and in general would you be able to do it for every patient? If you do, some patients are alarmed and frightened by the details. Should you frighten them? Medical ethics may have some other things with what Surgeons learn. If a surgeon is trying to make you fear, you should probably seek a second opinion. If you are NOT feeling comfortable to open pants to a surgeon you should never go to him in the first case. Yes, talk, write, email, read and do all possible things and select one.
I am neither wise not foolish but an average Joe. I did what I thought was best and took risk with Dr. G. It turned good for me. Luckily Dr. G has good rating, good name for these surgeries and my insurance has covered him. For going from my place to PA I paid from pocket.
If nerves grow back naturally Chrisopher Reeve would have never been in wheel chair for rest of this life. If the nerve implants work perfect as they claim there would not be a single quadriplegic in the society. Some may work and some may work for some people and some may never work. My rule of life is this – Surgeon is like YOU. He eats Pizza, watches football and even goes to movies and takes kids to swimming classes. If you do salesman work, or auto repair, he does surgery. That’s the only difference. So believe him to the extent he is believable. Anything beyond that, attach a red flag and investigate further.
Luckily after Internet we have much more information at hands now than a few decades ago.
I have been happy so far. If tomorrow the mesh goes awry and causes me trouble, I will be the first one to come here and complain non-stop (until Dr. Towfigh throws me out) 🙂 God bless.
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Post surgery thoughts
So you’re telling me you like Dr Goodyear? 🙂
I managed to find the 1% of surgeons.Not everyone is as wise as you, I feel a surgeon should lay it all out on the table. Not sit back quietly hoping the patient asks the right questions. They may not be as educated as you and not know what to ask don’t you think? You don’t think surgeons try and sell their procedure to others maybe down playing a neurectomy as “they’re only sensory nerves , they’ll grow back.”? Statements like those to ease or convince a patient it’s going to be ok let me cut you open, it’s my favorite procedure or let me put 3 pieces of mesh in you when you don’t have hernias at all.
99 percent is a generous number sir. It’s driven by dollars. Once you inquire about a possible issue I would say most want to fear you into some kind of treatment. -
Post surgery thoughts
Two quick things about this – in response to the above post by “Mesh” handle.
1. Nobody on the face of earth can force you to have surgery – not your dad, mom, kids or your surgeon or the POTUS or even the SCOTUS. It is COMPLETELY your own choice. Against your wishes even a barber cannot cut your hair. At least that is what the rules are in the USA. It is illegal to commit suicide but VERY LEGAL to eat fat and full of Cholesterol foods and die of heart attack. Agree? So to have surgery or not, to have mesh or not is completely your choice.
Having said the above here is the second one
2. Can you hold and wait? 99% of the good doctors and surgeons NEVER want to cut you up for ANYTHING. A good surgeon wants to FIX your stuff; so your life will be better. But if you go to a surgeon and ask him to cut you up since YOU FEEL something inside, he will not agree until HE IS CONVINCED that cutting up is GOOD for you. Many years ago I went to a surgeon for another problem and he refused to cut and told me “Remember, anything that comes to you naturally is gone for good once it is gone and can never regain the same condition but we may be able to fix something.” It is like wearing eye glasses. Remember your vision at age 10 without glasses? You can wear glasses and restore your vision to 99.9% after myopia but you will never have that 100% natural vision that you had once.
Again having said that, my dad waited all his life and died with the hernia. He was told that he was to be careful; and he never really had to lift anything heavy in life. So he was fine till his death at 66. My brother waited 20+ years and had hernia both sides and finally had surgery one year ago. Was he lucky to live without surgery and no entrapment? May be but a few months before surgery he refused even to lift a small backpack since he felt those pains heavily. After surgery he lamented how he lost his 20 years with this stupid IH and could have gone for surgery much earlier. I waited from my first diagnosis by my PCP in 2007 to 2014 when the bump developed and was giving me trouble.
Should YOU WAIT? read the first point again. Your body, your health and your choice. My PCP actually said “watchful waiting” and not lift anything heavy. In his words “be careful.” But I ignored his advice assuming I was a superman. Growth of IH proved that I am a STUPID IDIOTIC mortal after all.
If you wait, can the IH be trapped and may force you to go to ER? The answer is “Nobody knows.” It is so because every case is different. If you know what the word “chaos” is, you know what I mean. If not, may I suggest you watch Jurrasic Park movie where Malcom the mathematician explains what chaos is? How strong is your pelvic floor? How good are your genes and many other factors come in. Even the surgeon who puts mesh in your body can only hope (depending on the historic facts that whenever the surgeon did it earlier, it went OK) that things go well. It is like driving a car on highway. Most people go fine but isn’t it dangerous on highway and can one die? Yes sir it is dangerous if you or the other driver is drunk or doze off. And yes every day people die on highways.
So should you stop driving? Same analogy works here too. I had a mesh and my life looks better than before. I spent money and beleived Dr. Goodyear to do nice work. He did great work. Whatever worked for me – watchful waiting, mesh may or may not work for you. What to do? Believe your gut or instincts and if you are a believer of God, do believe in Him too.
Final straw or nail in the coffin is this – everyone dies. Some die of accidents, some of heart attack, some of anxiety and some of surgeon’s faults and some of simple hernias. So do not worry. If one is dying today, those living need not be happy that they are alive because the living people now will die later. Too blunt; huh? Sorry about that.
Best of luck
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Post surgery thoughts
Would pain be the only reason to fix a hernia?
I mean if the if the odds of serious complications like strangulation are so rare like .5%
why fix it at all? Why take the 20-30 percent chance of having chronic issues with mesh?Good post btw….most of it.
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Post surgery thoughts
Thanks, WasInTN:
I am moving this post to the top. What a great list! -
Post surgery thoughts
quote :WasInTN“If in future something goes really wrong”…… It’s the Mesh!!
JG
With this kind of mental block I cannot argue anything. If you so wish it is *THE MESH* so be it. Are you a medical professional? Have you seen this kind of mesh problems over your career for dozens and hundreds of times? How do you conclude that everything that goes inside your body is ONLY because of mesh? Is there a sure shot way to find out? If you do have such a thing, please do all of us a favor. Send your details to FDA and they will take some action.
Au Revoir
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Post surgery thoughts
WasInTN
“If in future something goes really wrong”…… It’s the Mesh!!
JG
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Post surgery thoughts
quote :WasInTNNicely written and I agree with everything you mentioned but for me, and others the question of utmost importance is should one have a petroleum based foreign material implanted into their body (Mesh) that may cause more of in issue than they had with their original issue, a hernia? Outside of complications arising from physicality that disrupts one’s hernia repair, (recurrence), most major issues that result from a mesh based repair is do to the mesh.
To have mesh or not to have mesh that is the question?
A surgeons skill and common sense on behalf of the patient is certainly essential for a good outcome.
JG
I do *not* agree that most issues occur due to mesh in mesh based repair. There are a dozen things that can go wrong. Among them are
1. Skill of surgeon (I put this as 1 since it matters THE MOST). If you chose a wrong surgeon (aka hammer in hand in my example) it could be troubling. Once the surgeon opens the IH area, ASK FIRST if (s)he knows how to fix unexpected things that can go wrong. Suppose the surgeon cuts up and finds that the hernia is large, extending to some nerve blah blah which was not expected, would he still fix or would he close up and say sorry I could not fix it? You know surgery is not like taking a MRI test where you find the test very claustrophobic and walk out without doing it and without losing anything (I did this once). So I chose Dr. Goodyear since I read reviews, talked to people emailed and bombarded a gazillion questions to each email I could find and asked one local surgeon in KY and another Urologist in KY about these things.
2. Do you have any allergy to certain things like latex, plastic etc? Better find those before you go for surgery. It is hard but better late than never and suffer later. No question is too small or too silly to ask. If you do not ask it is NOT THE DUTY OF surgeon to let you know ahead. Surgeon would even assume you have no allergies.
3. If surgery went wrong and you ended up in pain, how would you prove it is due to mesh? No surgeon will admit it. Unless another surgeon opens the wound and tells you that the original surgeon royally screwed up you won’t know. Even if at all the second surgeon tells you, would you be willing to sue the first surgeon and will the second surgeon come to court and give testimony? It is a VERY long shot and would not work. Even if he does that, lawyer can screw this up by asking, how would you prove that the first surgeon really did not put sutures correctly and what makes you think that the mesh did not move blah blah and you know how an attorney can twist and turn everything in a court room (and why so many doctors – particularly in NV state – give up their practice due to lawyers). LOL. I have heard that an obgyn was sued 22 years after delivering a baby since baby (now a man) developed some problem which was connected remotely to how the baby was delivered. How does that sound? Would the obgyn even remember what tools she used 22 years ago? This is like suing McDonald for selling food cheap (and arguing that’s why I became obese.)
4. Not all foreign material will cause trouble in body. There are people who live with bone implants (rod inside leg or elsewhere) and there are people who live with heart valves. These materials do come in contact with blood flow and need anti clot drugs rest of their lives or most of their lives. Compared to that this mesh is NOT directly in contact with the blood flow. So mesh is not everything that is a problem. But it is possible and the misconception of mesh is really somewhat exaggerated IMO.
5.We tend to blame mesh because we know it is a foreign body but if the surgeon is good, how are the other people doing OK? Well mesh may have some problems in some people who are allergic but did they test all these before surgery? I have heard that there were some cases of putting plastic mosquito net as mesh in India and the patient was fine.
6. Dasarda worked for some people and they are happy too and even I wanted to get that done but after talking to people I decided not to go for it. The reason is that the Dasarda technique borrows tissue from another location and attaches it for IH as repair tissue. Since my IH is in family occurring to my dad, brother uncle etc, a friend asked me to consider this – it appears I am genetic to this disorder, so if I get this Dasarda done, the pelvic floor is likely to break elsewhere due to the genetic weakness. I agreed since it looked good point to me.
7. Before going to Dr. G in PA I spoke to him on phone and my biggest worry was this – would there be blocked bladder and would I be NOT able to go to bathroom? My worry came because I read on Internet that in some cases the guys could not pee due to blocked tissue or whatever. Dr. G asked me on phone if I had ever any issues with bladder. I had none. So his question was “why would you worry?” Immediately after surgery within 10 min (they gave me cookies and soda to drink after my morning fast) I went to bathroom and while coming back it hit me how silly I felt about the bladder problem. I never had any problems.
8. I wrote all my silly questions or whatever (sometimes repeatedly) and asked Dr. G all those. He was more than happy to answer every single question and that too with authority. I felt comfortable to put my sensitive parts in his hands since he does these surgeries every single day – at least 2 or 3 per day. He is not a “general surgeon,” mind you but a hernia specialist.
Remember one thing. IH is because of HOLE IN PELVIC FLOOR. If a surgeon can fix it with medication, he will be more than happy to do it. It is simply not possible to fix that way. And Surgeon is NOT FORCING You to have surgery to make money. It is YOUR CHOICE. Surgery should IMPROVE YOUR qualify of life not surgeon’s bank balance. If you think you believe all these will happen, opt for surgery. but if you think that you can live with pain and never want to have surgery, so be it. My father never had surgery and never lifted heavy stuff after he was told of the IH. He died with it and never complained since his IH never progressed badly. My brother suffered for it over 25 years and could not even lift a milk can (refused to lift). I was told to be careful (watchful waiting in 2008) and waited till 2014 and had surgery. Once I had surgery (only on the right side) and recovered my brother had surgery (both sides) and lamented later “How I screwed my 25 years and suffered!!). He is fine now and has no complaints. I am OK doing well.
And to quote Indiana Jones in his movie series, “Choose Wisely” from which cup you want to drink to eternal life. the guy there with long sword will tell you if you have “chosen wisely” or “chosen poorly.” 🙂
Finally Internet is a great thing to get information but overloading that info into your brain can sometimes be dangerous. I did overload all this info and then decided to close everything and went to Dr. G. I am very happy I went to him. So far no worries. If in future something goes really wrong, so be it, I will take it up as God throws it to me.
Thanks
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Post surgery thoughts
These are great stories to share and I wish more patients did the same. Thank you for taking the time to share your experience, surgeon, before / after, etc.
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Post surgery thoughts
WasInTN
Nicely written and I agree with everything you mentioned but for me, and others the question of utmost importance is should one have a petroleum based foreign material implanted into their body (Mesh) that may cause more of in issue than they had with their original issue, a hernia? Outside of complications arising from physicality that disrupts one’s hernia repair, (recurrence), most major issues that result from a mesh based repair is do to the mesh.
To have mesh or not to have mesh that is the question?
A surgeons skill and common sense on behalf of the patient is certainly essential for a good outcome.
JG
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