Stinging pain with popping and clicking

[SJC]

Holy crap this is exactly what is happening to me! I had hernia repair surgery 6/1/20
Was in extreme left thigh, groin, dick and ball pain due to nerve damage… was prescribed gabapentin, helped a bit, got the nerve block shot 7/15, was weaned off the gaba, on monday pain started returning, but now accompanied by the weird internal clicking and vibration with every step. It’s not painful but extraordinarily unsettling in a way that I cant explain. .. have you ever found out what it is?????

• This reply was modified 3 years, 8 months ago by  SJC.

[SFIrishGuy]

gf1701,

sounds like you are going through similar situation. Would you mind sharing with me if you are having the same issues that I have documented earlier and have you had this done with Kaiser. What methods are using to get by.

quite honestly I don’t know what I’m going to do. I’m kind of stuck right now at Kaiser Permanente until my open a Roman with my company where I might be able to choose another provider I’m kind of stuck right now at Kaiser Permanente until my open enrollment with my company where I might be able to choose another provider. Right now I’m going through the pain modality clinic to Kaiser to work with them on pain management. However with the therapy and the pain injections nothing has worked. Daily I am actually go from better or worse depending on the hour. I still have tingling popping burning sensations I keep hoping this will get better as other people say that it will but it seems like it’s so far off.

[gf1701]

It looks like SFIrishGuy has blazed a trail for me. My situation is similar, also Kaiser, and over 4 months out from surgery. I came here to see if anyone had discussed Kaiser doctors who specialize in mesh removal. In all my research, I have never found any mention of such a being. I don’t know if will come down to my needing mesh removal, but it’s a realistic possibility, and I don’t want anyone but a surgeon very experienced in mesh removal doing it. Any suggestions? In the meantime, I will start the process of obtaining my surgical records; sounds like that’ll be fun.

[SFIrishGuy]

Good intentions,

I wanted to thank you for the information. I never knew any of this and my surgeon never talked about this as well. I’m taking this as an important lesson to do ones research Becker any surgery on method and medical device product options but as well to never think for a second medical providers are educated fully on these implants.

my new surgeon thinks it’s unlikely the breakdown of the grips on the pro grip would affect me on this way.

im in a tricky situation right now honestly an it has been trying on me mentally. I don’t know where to go, I’m still
in pain and discomfort to which I attested previously. And I’m still dealing with numbness in my leg and feet. I don’t know if I nerd to spear ahead and think about having this repaired or wait it out.

[Good intentions]

And, here is a paper written to show the benefits of the PLA. They used 3 months as the “chronic pain” threshold. In other words they don’t know much about the effects after three months. Things might get better.

Good luck. [USER=”3017″]SFIrishGuy[/USER]

https://www.researchgate.net/publication/327877050_Self-gripping_polyester_mesh_with_absorbable_polylactic_acid_microhook_versus_polypropylene_mesh_for_open_inguinal_hernioplasty

[Good intentions]

The data about the PLA degradation is sketchy and undefined. Internal data from animal studies and estimates. Seems like a good idea, close enough to send to market.

Sorry to be cynical. But, doing that things that speed the degradation along might help.

https://www.medtronic.com/covidien/en-us/products/hernia-repair/progrip-laparoscopic-self-fixating-mesh.html

• 9. Estimate derived from the use of information under license from the following IMS Health information service: Hospital Supply Index for the period Sep ’06 – Jun ‘12. IMS expressly reserves all rights, including rights of copying, distribution and republication. Based on typical prices of anatomical mesh and absorbable fixation in the US.

• † Based on pre-clinical animal and/or benchtop studies.

[Good intentions]

Here is the material that you had implanted, linked below. It’s a bit different from the typical mesh, it is a composite mesh, made of synthetic fibers and absorbable fibers. 40% of the mesh dissolves and has to get absorbed by the body. I don’t know the details of how long it takes or if the degradation products cause more inflammation until the body removes them. The fibers of the polylactic acid would slowly break up in to smaller and smaller pieces until they are small enough for the body to absorb. It might be that the small molecules produced along the way cause some pain. If that is the case then waiting might actually be your best option.

If I was in your situation I would do more research on how the resorbable polylactic acid works. You probably want to wait until you know that the mesh has stabilized in its final form.

Another consideration might be that more movement will speed things along. Biking, running, walking, etc. I’ve posted about how some pains that I had were resolved by being more active. Counterintuitive but it fits theories that have been proposed about where nerve pain originates. Acidic and hypoxic environments, bad for nerve health.

https://mms.mckesson.com/product/835600/Covidien-LPG1510AL

[SFIrishGuy]

OK, I was able to received form Kaiser my surgery notes and they are as follows.

Anesthesia Type:
General Anesthesia
Findings:
Direct inguinal hernia. No cord lipoma. Left anatomic progrip mesh. No tacks
Procedure in detail:
The patient was taken to the operating room and placed supine on the operating table. All pressure
points were padded. A time out was performed, pre-operative antibiotics were given, and sequential
compression devices were applies. After a general anesthetic was induced, the patient’s arms were
secured out on the arm boards, and the abdomen was prepped and draped in the standard surgical
fashion with ChloraPrep and sterile drapes.
An infraumbilical incision was made and the anterior fascia was incised. The rectus muscle was
pulled to the side and the dissecting balloon was placed in the preperitoneal space and inflated under
direct visual inspection. The dissection balloon was now removed and the structural balloon port was
placed and inflated. The pre-peritoneal space was insufflated with CO2 and the patient was placed in
Trendelenburg which he tolerated physiologically. Two 5 mm ports were placed in the low midline
under direct visualization after injection of local anesthetic.
We inspected the left side. There was a moderate direct hernia but there was no indirect
hernia present. Using blunt dissection and minimal electrocautery, Copper’s ligament was exposed.
The pseudosac was freed from its attachments and reduced. The lateral space was then opened in a
similar way, making space for where the mesh would lie. The peritoneum was then dissected off the
lateral structures, and swept clear of the cord structures. The cord was reinspected to ensure there
was no additional indirect component or cord lipoma to remove which there was not. Once the
peritoneum had been completely cleared off the area, a piece of Pro-Grip anatomic inguinal hernia
mesh was introduced into the pre-peritoneal space and laid such that it was 2/3 above and 1/3 below
Cooper’s ligament. This was then pressed into place with the mesh hooks.
Once the mesh was in place, the remainder of the local anesthetic was instilled into the pre-peritoneal
space. The mesh was held in place and the peritoneum held away while the space was deflated
under direct visual inspection to prevent any clamshelling. Ports were removed, and the abdomen
was deflated. The umbilical site was closed at the fascial level with 0.0 Polysorb. Port sites were
closed at the skin level with 4.0 Biosyn subcuticular sutures. The wounds were then washed and
dried, and sterile skin glue dressing applied. The patient was awakened from the anesthetic and
transferred to the Post-Anesthesia Care Unit in satisfactory condition.
Sponge, needle and instrument count was correct at the end of the case. The attending surgeon was
scrubbed and present throughout the case.
Estimated Blood Loss:
3 ml
Fluids:
Crystalloid: 500 ml
Drains:
Complications:
(1) No – Per Anesthesia Provider Comments: none
(2) No – Per Surgeon/Proceduralist Comments: none
Specimens:
* No specimens in log *
Implants/Explants
Generated on 12/17/19 7:35 AM
Implants
Implant name: MESH SURG
PROGRIP 15X10CM INGUINAL
LT ANATOMIC SELF FIXATING
Laterality: Left Area: Inguinal
MESH SURG PROGRIP 15X10CM INGUINAL LT ANATOMIC SELF FIXATING LAPAROSCOPIC –
LOG668844
Inventory Item: MESH SURG
PROGRIP 15X10CM INGUINAL
LT ANATOMIC SELF FIXATING
LAPAROSCOPIC
Serial no.: Model/Cat no.: LPG1510AL / Covidien

[Good intentions]

[USER=”2580″]DrBrown[/USER] is in the area – https://www.sportshernia.com/

and Dr. Towfigh is in the LA area [USER=”935″]drtowfigh[/USER] https://twitter.com/Herniadoc?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7 Ctwgr%5Eauthor

​​​​​​Dr. Billing is in the Seattle area. https://www.transformweightloss.com/

The internet is great for searching for information and informal discussion. But contacting doctors directly is the best way to go deeper. A clearly written letter is a good way to start. Get all of the details down and in order so that they can consider them, with time, before speaking to you. Good luck.

[SFIrishGuy]

Update.

I have spent the entire day on phone and email with kaiser, getting the runaround and hitting brick walls on who can help.

I’m currently at the ER from advice from a new doctor who says there is no other advice they can give but to come here.

my surgeon is unavailable and didn’t respond to requests for help only to find out he is out of office but didn’t set up auto responder or for anyone to monitor their inbox.

my general refused to speak with me or give advice what I should do even when i spoke with a member of his office. He couldn’t be bothered to help and lectured me in email.

please , if the are any specialist in the Bay Area is California whom can help or would be willing to see me please message me. I’m in dire need and I’m not getting the help or care from kaiser Permanente

[Jnomesh]

It’s important to know that very highly regarded hernia surgeons does not mean that they are very good surgeons when it comes to possible hernia mesh issues.
most surgeons don’t recognize issues with mesh unless they find a recurrence or classic nerve pain symptoms.
i love in NYC and saw some of the most highly regarded surgeons as well as multiprocessor scans and MRI’s and all said nothing was wrong with the mesh.
One snipped me off to pain management
the other told me to get a back massage and a third told me there was now way to remove the mesh-that it would be like takeoff a pair of player and trying to remove tar off of cement.
After 6 months of wasting my tome and energy I finally made my way to 2 hernia surgeons that have experience with mesh issues:
one some something fishy on the MRI all others ask was fine and he made a educated guess that my mesh had shifted
Tue second surgeon definitively saw on my cat scan (the same one others said was fine )that the mesh had folded and shifted
I ends up having my mesh removed by the second surgeon dr. Igor Belyanski. After removal he told me it was way worse then the scan has shown and that the makeshifts was completely balled up and rock hard.
i tell you this because I have come across tome and time again people staying in their network or state or city and dealing with local doctors or specialists.
You need to goto someone or reach out to someone who has experience with both mesh issues and mesh removal otherwise you will just be spinning you wheels in mud.
There are surgeons mentioned on this forum although few in number who have the expertise.
Belyanski, Towfigh, Billings and Kprata.
i has to revel from NY to MD for my consultation and most people have to do this to see the best.
id highly rx seeking a second and even a third opinion with some of these surgeons so you can get a fair and competent answers to your issues

[SFIrishGuy]

Good intentions,

I took the advice from you and dr brown and decided to order a electronic copy of my records. The surgery notes is the ONLY record they won’t allow you to view online at the kaiser portal.

once I receive I will have to look through and paste here some info for answers.

what is your experience with mesh? You seem to have what or done. Did you have it removed? Have you benefited from it? What alternatives to mesh did you find?

[Good intentions]

People supply many details about their procedures. You can copy a portion of the report and paste it as an image or upload the documents, or cut and paste text. Some of the surgeons on the site will look at your report if you send it to them. It’s good to have it in hand, you’ll probably understand it better as you learn and might see something meaningful in the future.

Plus it’s good to see which combination of procedure and material cause problems. The internet is the only place, apparently, that this type of data is shared. Everyone else is working in a silo, and I think that many involved like it that way. If there was clear evidence that all mesh products are the same, no difference by knit pattern, material, or implantation method, and that 15% of mesh implantations have problems that would be terrible for business. Better not to know. My cynical side, again.

[SFIrishGuy]

To good intentions ,

do people post their ops report on this forum for review? Is this typically of members here.

I don’t have the report. I have to still submit application

[Good intentions]

quote SFIrishGuy:

I reviewed the medical records with a head surgeon and nothing out of the ordinary was documented. It was routine. I went in for an ultrasound to see if the mesh was intake and indeed it was or they said they cannot see any evidence of reoccurrence.

If you can, post or transcribe the actual surgical notes to the forum. All that has been discussed so far is “laparoscopic mesh implantation”. The actual notes will/should have the details of your actual experience. Any errors, or oddities about your situation, should be recorded there. One surgeon’s “normal” is another surgeon’s “never should have done that”. There is no real “ordinary”.

And you might think that the people you have talked to have actually examined your records but I found that often the doctors are too busy to dig deep. They will read a few words then assume the rest, and think that they can do a diagnosis in 15 minutes or less.

I don’t know Dr. Nguyen but I saw a well-respected surgeon about my mesh problems and he did not even read my history before the visit. He just assumed that I had had a recurrence. The visit was a complete waste of everyone’s time, and my money. since he only had 15 minutes to learn everything from scratch, in a conversation.

[SFIrishGuy]

dr towfie,

thank you for getting back to me. Dr Nguyen thinks the numbness isn’t related to the mesh despite me thinking otherwise. So he wants to get rechecked with neurology. as we speak my leg leg is tingling and numb. I still feel the mesh as I breathe in and out. So I continue to be scared and have no clear path to what I shouldn’t do

no discussion of mesh removal or even alternatives to mesh. I’m not aware of them or options.

im at a point where I don’t even know if I wish to continue with my health care provider since they have snot adddessed my case in the right or timely way. why would I trust them now to operate.

any advice is helpful

[drtowfigh]

Mesh can cause reactions which can include burning or tingling in the feet and hands. That’s very rare but I have seen it. So, if there is a plan for mesh removal, then you must have a non-mesh alternative plan to repair those hernias. Dr Nguyen is a good resource for you.

before doing any removal surgery, it’s important all other causes for your symptoms are thoroughly examined.

[SFIrishGuy]

Dr brown,

I spoke with dr Nguyen yesterday Ans results ftom
MRI were not indicative of a wrong placed mesh. There was no evidence of a fold or tear but as Dr Nguyen stated I was still for the scan so it might not show anything.

not to many options. I can either move forward with having it removed and redone but there is no guarantee I would not feel the same thing as before or worse. The full risks have yet to be discussed. But regardless as he explained I can’t move forward until more time has passed and I have gone through the pain management and modality clinic at kaiser and gone through some therapy before he can make that recommendation. Recommended that maybe with time something may change. But as he stated if I’m having this much pain and discomfort it should come out.

in the interim he asked me to still
move forward with injections and a neurological exam again to deal with the numbness in legs.

i still
have pain, throbbing and burning type of pain in my groin. Scared a bit and just wish to feel better.

[DrBrown]

[USER=”3017″]SFIrishGuy[/USER]
Was Dr. Nguyen able to offer any suggestions?
Regards.
Bill Brown MD

[SFIrishGuy]

Dr brown ,

I am not making to much progress. It has been frustrating since you have to raise so much noise with kaiser to be heard or seen. It’s disheartening

I have telephone. Appointment with dr Nguyen this afternoon to go over results of the MRI. My numbness and tingling has gotten worse. My left food and now right stay tingling all day. So I’m very scared.