Stinging pain with popping and clicking
11/04/2019 at 5:54 am #12022
Good evening everyone. I joined this forum looking for answers since I can’t find thm other ways, either on other forums or form my own dr. I have spelled this out countless times on other forums that it is now so tired to even rehash it but I am hoping that the good people here will be able to offer some advice and maybe support.
I am a 43-year-old male who is now 11 weeks post-op and in extreme pain. I had a left inguinal hernia that was done laparoscopically here in San Francisco kaiser. I had a synthetic mesh placed in. Mistake i am sure. Ever since the 2nd week I have been in extreme discomfort. I had had a right hernia repair about 6 years ago and it never felt like this. I have tried explaining to my dr countless times about the pain and discomfort and it has taken so much to even be heard that this is for real. It has taken countless emails and visits to try and get my point across. I am now in the midst of seeing another surgeon to address all the pain and movements I feel.I won’t detail every email or correspondence and timeline i have during this time. Since week 4 I have felt odd, I feel pops and clicks that radiate from my groin area all the time. While I work, move or adjust my body posture I feel these extreme bone-cracking pops in my groin. When I bend to tie my shoes Or even raise my left leg and twis I feel the collection of fluid don there. Atop of all this I have extreme pain, like a stinging pain not unlike a needle poking me up through my groin. It swells and burns. Some days I am good and others like today I am very bad. The dr dismisses it as the mesh “settling in” but at 11 weeks to feel this way I don’t think so. I don’t know what is goong on. I have now gone through the upper surgeon channel and speaking to someone who wants to create a pain map for me. They see me next week with much of my aggravation to even be seen. They have prescribed my naproxen but it does not work. they asked me to buy a sports massager to use every day for 5 minutes to help stimulate the nerves and healing but it doesn’t help. Now they wan to shoot me up with steroids in my groin. What barbaric kind of treatment is this? I am in extreme pain and it is starring ot ruin my life. I don’t want to be a statistic of those who have chronic pain forever. I can’t even walk anymore without being in pain. 🙁 Is my body rejecting the mesh? My Dr has seen my and checked me over and nothing physically can be found and no sign of the mesh dislodging. I feel it has come loose that is what I am feeling. Could i have ripped it somehow in the corner?
Does anyone have advice? Does this sound familiar and have others gone through this type of feeling? I am feeling lost and with a medial system not prepared for this and only seem set up for surgery and not after effects.
Hurting is San Francisco.
11/04/2019 at 4:45 pm #20088
Get the details of the method and materials. There might be a clue there. “Laparoscopic mesh” covers so many variations. Your surgeon might have done other things or even made mistakes. That information should be in your surgery notes.
11/05/2019 at 4:14 am #20112
If you have this much pain this quickly after the operation, the cause is usually a problem with the operation itself.
Post the operative report and any photos taken during the operation.
With Kaiser you need to make a lot of noise. If necessary get a second opinion from a surgeon outside of Kaiser.
Bill Brown MD
11/05/2019 at 4:38 am #20126quote DrBrown:
Dr Brown? Yes kaiser you have to make a lot of noise. I was afraid to hear this advice. Am I allowed to ask for those notes and photos? I am getting a second opinion from another kaiser surgeon tomorrow to review. My god I am so worried I will end up being permanent in pain and not treatable or will cost me in the end.
11/05/2019 at 4:48 am #20127
Dr Brown? Yes kaiser you have to make a lot of noise. I was afraid to hear this advice. Am I allowed to ask for those notes and photos? I am getting a second opinion from another kaiser surgeon tomorrow to review. My god I am so worried I will end up being permanent in pain and not treatable or will cost me in the end. And if you are stating in your opionion this may have been operated wrong than what is your opinion on this idea of getting steroid shots?
11/05/2019 at 4:50 am #20128quote SFIrishGuy:
And do you feel if this was do wrong than should I entertain Kaiser’s request to start steroids shots?
11/05/2019 at 4:53 am #20129
would steroid shots be something I should explore?
11/05/2019 at 7:18 pm #20132
Your medical records are legally yours. At you next office visit just ask. I
Medical Records Administration at (770) 220-3870
Bill Brown MD
11/05/2019 at 7:20 pm #20133
The medical records are legally yours. You can check the kaiser website to get the records. Or call:
Medical Records Administration at (770) 220-3870
Bill Brown MD
11/10/2019 at 10:49 pm #20185
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.
I did take some time to talk to the Director at least of the department so let her know how I felt.
Right now I am waiting to schedule a session with the pain injection clinic to start steroid injection in hopes ot help rest my nerves as the Dr had said. I hope this will help. As well I am reaching out to acupuncture groups for help as well. maybe they can do something
I am still in some pain. The poping and cracking sisnt as bad but there seems to be a main nerve that I feel that is painful. I can at times feel it when I wear tighter pants and I breathe in. I feel it move. It even throbs. Could this be a nerve?
11/15/2019 at 2:26 am #20205
When you talked with the director, did she examine you to try to determine what is wrong?
An MRI may help to determine if the nerves or the spermatic cord is adhered to the mesh.
Diagnostic injections can also be helpful.
For example, if the ilioinguinal nerve in blocked with local anesthetic and you feel better for a few hours, that would be strong evidence that the nerve is involved.
In a similar manner the mesh can be injected with local anesthetic and other structures in the area until the one that is giving you trouble is identified.
Bill Brown MD
11/24/2019 at 10:14 pm #20262
Thank you for responding. I had the enitofemoral nerve block done and it did nothing. I am still in pain and discomfort. I will be ok for days then any activoty will bring on this lingering and radiating pain in the mesh area. The Dr who performed it says we should wait 6-8 weeks and maybe try addressing the ilioinguinal nerve next.
IN the meantime Kaiser placed me in contact with the pain management clinic, some specialists for groin pain. Don’t know if this will work.
No, the director had not physically looked me over. I emailed my Dr what you asked about the MRI and the spermatic cord. I am waiting for a response.
11/25/2019 at 3:46 am #20265
You need a very careful physical examination.
Did your skin get numb after the injection, if not then you did not have an adequate nerve block?
If you are skinny the mesh can often be palpated.
If the mesh is injected with a local anesthetic and you feel better for a few hours, that would be strong evidence that the mesh is the source of your pain.
Bill Brown MD
12/01/2019 at 4:22 pm #20323
You need a very careful physical examination.I HAVE AN APPOINTMENT THIS TUESDAY WITH A SPECIALIST IN OAKLAND FOR HERNIA REPAIR. KAISER KEEPS PASSING ME ALONG TO SURGEON TO SURGEON AND IT FEEL NOBODY TAKES ME SERIOUS AND BEEN FEELING SO ALONE IN THIS. THE EMAILS I GET FROM SURGEONS IS THAT OF ANNOUNCE TO ME.
Did your skin get numb after the injection, if not then you did not have an adequate nerve block? I HAD THE GENITOFEMORAL NEVER BLOCK AND FELT NOTING. THERE WAS NUMBNESS THE FORST DAY BIT THAT WAS THE NUMBING AGENT THAT INJECTED ME PRIPR. THE NEXT DAY IT WAS THE SAME. DR RECOMMENDED TO DO THE ILLOINGUINAL NERVE BLOCK IN A FEE WEEKS. DONT KNOW IF THIS WILL WORK OR SOUNDS LIEK IT COULD.
If you are skinny the mesh can often be palpated. I AM A HUSKY MAN, I WORK OUT AND I AM NOT SKINNY NOR FAT
If the mesh is injected with a local anesthetic and you feel better for a few hours, that would be strong evidence that the mesh is the source of your pain.I HAVE BROUGHT UP THIS INFORMATION BUT NOTHING YET FORM DR. 🙁
I HAVE AS WELL MENTIONED THE IDEA OF AN MRI AND IF THE MESH IS CONNECTED TO THE SPERMATIC CORD AS YOU INDICATED BUT SECOND SURGEON JST PASSED ME OF TO SPEAK TO NOW IF THE 3RD DR. IF IT IS WHAT IS THE SOLUTION?
DR BROWN, THANK YOU FO TAKING THE TIME TO ADVISE ME ON THIS. THIS HAS BEEN A PAINFUL JOURNEY AND I FEEL IT IS NOT BEING ADDRESSED LIEK IT SHOULD. I AM ALMOST 3.5 MONTHS POST OP AND BEEN TRYING TO ADDRESS THIS WITH KAISER SINCE THR 4TH WEEK. CAN YOU ADVICE HOW YOU WOULD APPROACH THIS IF YOU WERE IN MY SHOES? DO I MAKE A GRIEVANCE? I HAVE SPOKEN TO SO MANY PEOPLE EVEN GOING SO FAR AS TO SPEAK WITH THE UNIT DIRECTOR OF SURGERY BUT EVEN NOW I FEEL I AM NOT BEING TAKEN CARE OF LIKE I SHOULD.
12/06/2019 at 5:04 am #20340
If you did not develop numbness after the nerve injection, that means that they missed the nerve.
Thus I believe that there is a strong possibility that nerves are the source of your pain.
I am in Fremont if you want me to examine you.
Bill Brown MD
12/07/2019 at 1:00 am #20353drtowfighKeymaster
The Kaiser system in Northern California has a new surgeon who is their go-to for post inguinal hernia repair chronic pain. His name is dr a David Nguyen and he works at KP Oakland.
I would start with an MRI to check the mesh placement. Ultrasound is not helpful once mesh has been placed laparoscopically.
12/09/2019 at 4:55 pm #20367
Dr Bill Brown,
Good morning sir. Thank you again for taking the time to speak with me on this forum. From your reply I am going in next month to do a second round pain injection block on the ILLOINGUINAL nerve. Nervous and tired of the pain all the time but I will try.
last week I traveled to kaiser in Oakland and had intake from dr David Kang Nguyen who is a specialist and we talked about the options. He was familiar with this forum and I believe he may know you as well. He decided after a complete review of my hernia area to send me in for an MRI which was fine last Friday. I am awaiting the results with much anticipation and nervousness.
im still in pain. I have tingling sensation throughout my left body in my feet and arms which they can’t seem to understand why. But pain resonating in my base of my parts I’m getting more nervous. I am hoping this is all nerves and not damage to my sperm cord or anything.
Your advice had been helpful. I will keep the thread going here and if you are available than I may need to speak with you at your office.
12/12/2019 at 3:47 pm #20404
I hope that you are making progress.
Bill Brown MD
12/12/2019 at 5:43 pm #20407
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.
12/13/2019 at 4:28 pm #20414
Was Dr. Nguyen able to offer any suggestions?
Bill Brown MD
12/13/2019 at 8:33 pm #20420
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.
have pain, throbbing and burning type of pain in my groin. Scared a bit and just wish to feel better.
12/14/2019 at 5:33 pm #20425drtowfighKeymaster
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.
12/16/2019 at 11:46 pm #20446
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
12/17/2019 at 12:02 am #20447quote SFIrishGuy:
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.
12/17/2019 at 1:37 am #20449
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
12/17/2019 at 2:57 am #20450
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.
12/17/2019 at 4:21 am #20451
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?
12/17/2019 at 8:56 pm #20453JnomeshParticipant
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
12/19/2019 at 2:18 am #20476
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
12/19/2019 at 2:45 am #20477
[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.
12/19/2019 at 6:36 pm #20490
OK, I was able to received form Kaiser my surgery notes and they are as follows.
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:
Crystalloid: 500 ml
(1) No – Per Anesthesia Provider Comments: none
(2) No – Per Surgeon/Proceduralist Comments: none
* No specimens in log *
Generated on 12/17/19 7:35 AM
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 –
Inventory Item: MESH SURG
PROGRIP 15X10CM INGUINAL
LT ANATOMIC SELF FIXATING
Serial no.: Model/Cat no.: LPG1510AL / Covidien
12/19/2019 at 7:10 pm #20491
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.
12/19/2019 at 7:18 pm #20492
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.
- 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.
12/19/2019 at 7:23 pm #20493
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]
12/29/2019 at 1:40 am #20557
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.
01/07/2020 at 11:46 pm #20725gf1701Participant
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.
01/10/2020 at 3:19 am #20799
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.
08/06/2020 at 2:33 pm #27755SJCParticipant
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 1 month, 2 weeks ago by SJC.
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