top hernia doctors in georgia or tn

[marcello71]

I just saw the author’s username of this post. “Wfadcock”… really?

That’s the first thing that came to your mind? Lol…

“I mean Ohhhhhhh listen ta dis guy ovah here, youse got sum mouth on you”

Lets try to keep it classy from now on maybe.

[Beenthere]

top hernia doctors in georgia or tn

Momof4

It is very hard when you are in pain and suffering, on medications that do very little and find answers very hard to get and conflicting.

Read my post on overlapping surgery. The surgeon that caused my pain and suffering is at VCU and you could get this surgeon without your knowledge. I would never go to a hospital that had my original surgeon on staff.

If you do go to this expert at VCU again ask him

How many total hernia surgeries they have done? Since this is a teaching hospital I would cut that number in half since residents will perform a large number of this surgeons procedures at a teaching facility.

How many done by robot?

How many total surgeries by robot?

How many corrective hernia surgeries total?

How many by robot.

Success rate for each of the above.

Again get the book Unaccountable and read it. This will give you inside knowledge and a road map.

A robot is only as good as the surgeon operating it. Remember it could be a resident who has never used a robot before or done a mesh removal or both before. Many of us have seen and have had surgery by Goodyear, Ramshaw, Chen and Towfigh but I have never heard of anyone mentioning someone at VCU before. The hospital that did mine has 11 surgeons as AHS members but do less that 750 hernia surgeries a year plus they could not even perform a hernia surgery on a well known person and was referred to a real hernia specialist.

Maybe I am lucky but I have been pain free now for four years since my corrective surgery.

[Momof4]

top hernia doctors in georgia or tn

Thanks for the message. I have always said I hate that anyone is in the situation that I am in with all the pain and suffering. It does sound like we are in similar places regarding decisions in treatment, to help eliminate pain. I know I will never be pain free, but I am not giving up on feeling better than I do now! Whether to have robotic mesh removal is a big decision and I am trying to get the right opinions from the experts before I proceed. I have a doctor at VCU, in Richmond, VA , that has offered robotic removal, if possible. Dr. Towfigh has said that he is experienced at abdominal wall mesh removal. I am waiting for Dr. Chen to weigh in on this, since my surgeon sent me to him for a consult. Dr. Chen is the one that suggested I see the doctor at VCU becaise he is closer to home and could coordinate conservative treatments that I have listed in an earlier post. I am still willing to travel from VA to see Dr. Towfigh or, perhaps, Dr. Ramshaw if it will help to come up with the best plan. To answer your question about reactions or systemic symptoms, I have nausea and general sick feeling a lot of the time. I also have some mild swelling in the area and feeling of hot liquid over abdomen (for lack of a better way to describe it). The pain is in new places than before the surgery. I have pulling feeling at my belly button and out to my hips it is very sore. I also have severe groin pain on both sides and burning on the right. It affects my whole life. Daily activities are limited by the pain and inability to sit or stand for long periods of time. Medication management does not seem like a long term solution to me and I would rather fix the problem. I am hoping that is possible. I would love to hear from Dr. Towfigh if Dr. Ramshaw does robotic mesh removal. I am also interested in the adhesion barrier you asked about. I would think it would be a good thing if having A large piece of mesh removed. The expense is trivial if it could improve the outcome and prevent adhesions and chance of later bowel obstruction. I am otherwise healthy, like you, and eat healthy and push myself to walk and do core strengthening PT for exercise. I wish you the best and appreciate that others on this forum understand what we are going through. Sorry for the ramble!

[marcello71]

top hernia doctors in georgia or tn

Hello momof4 I just read your posts in this topic & have to say just how similar our current decision/choices seem to be… Though I’ve only had 1 surgery so far(3 pieces of mesh implanted 23 months ago) I feel that robotic mesh removal would be best for me at this point as well. I pray we both find our way to whomever is best for our individual situations so we both have better pain free days ahead of us.

Do you have reactions or systemic symptoms from the mesh at all?

Was there anyone else that was recommended to you in the Midwest or East that does robotic removal?

Btw Dr Ramshaw is an amazingly nice guy & wonderful surgeon in TN but I don’t believe he does robotic removal at all to my knowledge.
I hope to hear an update of your situation soon & wish you the best of luck.

[Momof4]

top hernia doctors in georgia or tn

Thanks for asking! I haven’t read the book yet and am not sure it would make a difference in the questions that I ask the doctors. I have already done my homework and I trust Dr. Belyansky, Dr. Bittner and Dr. Chen, and of course Dr. Towfigh, even though I haven’t seen her. We spent lots of time at my appointment talking and discussing options. Besides medication management, which I am already trying now and don’t see it as a long term solution, there is mesh removal. Dr. Bittner is going to talk to the others, including Dr. Towfigh, and we will talk in 2 weeks. I am also going to consult with Dr. Belyansky since he did he surgeries and I respect his opinion. I don’t blame my problems on anyone and think that, unfortunately, I am just one of those patients that is a statistic. I am so thankful for the help I have received so far. Now I am trying to make it through the holidays and enjoy the company of my wonderful family. Happy Thanksgiving!!

[Beenthere]

top hernia doctors in georgia or tn

Did you get the book and read Unaccountable?

How did the visit go?

[Momof4]

top hernia doctors in georgia or tn

Happy to have this forum that provides help from fellow patients, as well as hernia experts. Thank you for the well thought out reply with lots of good question recommendations. My husband usually goes to appointments with me and we write out a brief history and questions to ask the doctor. It also helps to have two sets of ears! Dr. Bittner and Dr. Belyansky have always patiently answered our questions. I’ve never really asked about who is actually doing all of the surgery. So far, we have completely put our trust in Dr. Belyansky and feel he will make decisions that are best for me. Not sure if this is naive! When I went to Dr. Chen, no surgery plan was made because he said we have to try 3 months of conservative treatments, which I am at the end of after 6 months (lots of down time between coordinating appts-very frustrating). He said we would talk afterwards, which I haven’t followed up with yet. I guess I’m waiting to see what is recommended on Wednesday. The doctors have been in contact with one another and I am very appreciative of their time. I still haven’t ruled out more travel, maybe back to Dr. Chen or, perhaps, to see Dr. Towfigh for her expert opinion. I know she is one of the best at reading imaging and diagnosing problems and also experienced with robotic mesh removal. I know she has said ,more than once, that no one should be living (if you can call it that) with this type of pain for a year or more. To me it’s unacceptable!! Once again, thank you for taking time to offer help to others who are suffering. I will keep you updated in hopes that it will help someone else.

[Beenthere]

top hernia doctors in georgia or tn

Hi Momof4,

This might be a little long. Sorry

If you can get and read Unaccountable by Martin Makary before your next appointment. This might help you with some questions and what to look for. I think it took me about 4 to 8 hours to read. https://www.amazon.com/Unaccountable-Hospitals-Transparency-Revolutionize-Health/dp/1608198383

I hope I have given some good advice and have been clear and concise. I am the worst writer and it is very hard for me to put my thoughts into a written message. This is about the hardest thing I can do.

Your story and what you have gone through is way above what I had to deal with and I know exactly how and what you are going through. I hope wherever and whoever you decide on gets you back to your presurgery condition.

I am a lay person and I am giving you my personal thoughts. You need to go by what you feel is best and which Dr. you trust the most. Out of all of the General surgeons here in the US, I am guessing that their might be 50 to 200 that specialize in hernia surgery. Remember it is just a hernia, just a simply surgery! The number of the true expert/specialist might be around 20 or so with only 1-10 that have knowledge, experience and skills to truly know when they start a surgery like what you need and to understand what is presented to them and how to fix what is or has been broken. You already saw Dr Chen supposedly one of the best. What was his surgical plan?

I have never been to your state or have any knowledge of VCU or any information on the Dr. I think you are seeing but I have personal experience with member of the GS staff at VCU I could never recommend that surgeon and I would be very leery of a hospital that has this surgeon on its staff. VCU and the Dr. you are seeing could be the best in the world but go slowly.

On robotic surgery. It is fairly new to hernia but has been used in other area’s but it is only as good as the surgeon and their skill using it. My parents have a very good friend who had a bad robotic surgery by quote one of the best in the nation. The person who had to surgery was a research Dr. working on a cure for one major disease, graduated from the same school that did the surgery and had complete trust in them. He is one of the most interesting person and nice guys you would meet that know about every issue you could think of. After the surgery the Dr. dropped him like a hot potato and would not speak with him. Shortly afterword he got an infection that almost killed him. Last time I spoke to him he was a broken man a shadow of himself. Very sad. I also saw this same Dr. and wanted to do a different type of surgery but roboticly. Interesting he recommended this surgery with no imaging and when pressed about if he was going to do the entire cutting edge surgery it was like deer in headlights, he froze and could not answer the question. He finally did state that he would be present in the OR with a resident doing the surgery. Goodbye. I would rather have the best/skilled hernia surgeon in the world with 30 to 50 year old technology without mesh than an average general surgeon with a robot with mesh doing my surgery.

Here are some of the questions I would ask the Dr and every person on his staff that you meet. Go in with your eyes wide open and your radar on.

How many years have you been licensed. Also check with the state for any complaints.

How many hernia surgeries have you done the entire surgery. What types hernia surgery and open or lap.
This is a teaching hospital at the one that I have my surgery I found out up to 90% are done by a resident.

Are you going to perform the entire surgery. If not why, who is and what is their experience.

How many have you done in the last year. Success rate. What were the problems.

How many corrective surgeries. How many cases like mine. Results.

Do you have your own surgical team.

Do you have any research grants or financial connections to any of the products to be used in the surgery.

How many robotic surgeries have you done. How many hernia with robotic. How many corrective hernia robotic. Outcomes. There are many Dr.s who are getting money to use robotic surgery to expand the types of surgeries done and prove the concept.

Can I get a copy of the video of the procedure.

Are you a state employee and do you have extra legal protection against law suits. My state there is such a small amount that a state Dr can be sued for, that no lawyer will even talk to you about a lawsuit. The hospital keeps this very close to the vest and does not disclose this fact.

What is your surgical plan and outcome you expect.

recovery time for this complex surgery.

Who will be performing the Gas. Their years of experience. How many surgeries have you done with them.

Get and read the informed consent before signing and surgery

Who is going to be in the OR. Mine was only to be one resident to assist him. But it was One resident, one fellow, two medical students plus his personal surgical team was listed as floaters and the surgeon could not answer any questions afterword on any part of my surgery. It might have been a ghost surgery.

I am sure there are more questions to ask. Some surgeons are put off by questions, since they think whatever they tell you you should just say yes and agree with them.

Trust your sixth sense. Get a copy of all of your medical records and before going ahead with the surgery get a copy of this upcoming appointment. I found out after my surgery that the surgeon did not have any history or progress notes and any of the agreed treatment plan in my medical history

I hope this makes some sense. I wish you the best and if you have any other questions just ask. Again sorry for being so long.

Get the book Unaccountable.

This took me the last day to think this out and over an hour to write this.

Good Luck

[Momof4]

top hernia doctors in georgia or tn

Beenthere,
Thanks for the interest and question. I know you have offered lots of good advice to many on this forum. The last surgery I had was September of last year and was abdominal wall reconstruction. It was my fifth surgery since my hernia problems started. Since the AWR, I have developed severe groin pain and pain that has spread across my abdomen and pulling at my belly button. I traveled to CA from VA to see Dr. Chen and he wanted me to try various conservative treatments – lidocaine patches, muscle relaxers, epidural injection, nerve blocks (tried three different ones), PT, medications. I haven’t gotten relief from these treatments and live in pain everyday. I have an appt next at VCU to discuss next options. Robotic mesh removal was mentioned at my last appt but I’m not sure that is what will be recommended next. I cannot live like I am and am looking for relief. I had a smaller piece of mesh, from a femoral hernia, removed earlier and had a subsequent tissue repair, which failed. The operative report from AWR said I had direct and indirect inguinal hernias on one side and femoral, direct and indirect inguinal hernias on the other. I also had muscle atrophy from previous lap triple neurectomy . I know you have done lots of research and any advice you can offer about my complicated case is appreciated!

[Beenthere]

top hernia doctors in georgia or tn

Momof4

Did you have your surgery yet?

[drtowfigh]

top hernia doctors in georgia or tn

Both are excellent surgeons for mesh removal for the abdominal wall, if necessary. Dr. Belyansky is also highly skilled and experienced in mesh removal for the groin region.

I am unclear as to exactly what type of hernia you had repaired and where the mesh was placed for your abdominal wall reconstruction. That said, both Drs. Bittner and Belyansky would be skilled to handle the issue and I would highly recommend them and trust their recommendation.

[Momof4]

top hernia doctors in georgia or tn

Thank you for the reply. I agree that Drs. Belyansky and Bittner are very talented with hernia repair. I am still wondering about robotic mesh removal, as they may not have as much experience as the three of you. Also, in your opinion is robotic mesh removal an option for AWR mesh that was put in open utilizing flaps or does it have to be removed open? Sorry for so many questions! Just trying to understand options available.

[drtowfigh]

top hernia doctors in georgia or tn

Drs Bittner and Belyansky are also super gifted and talented surgeons for hernias. I was referring to inguinal hernias, not abdominal wall, and would add Dr Belyansky to the list for inguinals.

[Momof4]

top hernia doctors in georgia or tn

I had an epidural injection and got no relief, not even the first ten minutes which the doctor said would be an indication of whether it may help long term. I followed all instructions and waited a week to see if it helped. Unfortunately, no relief. So I am at the end of the “conservative treatments” list given to me by Dr. Chen. At my last appt, Dr. Bittner mentioned robotic mesh removal as an option to explore. I know you use the robot in difficult mesh removal surgery. Is it an option for mesh that was put in during open AWR with flaps? In a recent post you recommended yourself, Dr. Chen or Dr. Ramshaw for robotic mesh removal. Do theses doctors on the East coast, Dr. Bittner and Dr. Belyansky, have the same experience and skills, or just the three of you? Thank you for your help. Your opinion is respected and appreciated!

[drtowfigh]

top hernia doctors in georgia or tn

Epidural can help if nerve blocks didn’t and it’s a nerve issue.

Otherwise, it’s not a nerve issue.

[Momof4]

top hernia doctors in georgia or tn

It has been 3 months since my appointment with Dr. Chen and I have been working with Dr. Bittner at VCU, as suggested by Dr. Chen, to help coordinate some interventional radiology injections. I have had ilioinguinal nerve block, TAP block and CT guided suprapubic block (I got the feeling this isn’t done very often!) I havent gotten any relief except a little relief from burning on the right side with ilioinguinal block. If nothing else, I guess these blocks will prove to be diagnostic. Still in lots of pain. I am going to go back to Dr. Bittner to find out next step, but I believe I am supposed to try epidural blocks next. Do any of the doctors here think that epidural blocks would help if none of the nerve blocks in the groin and abdomen helped? Is there a way to find out if there is a problem with the mesh and it isn’t a nerve problem? I have pain from my belly button to my pubis and out to both hip bones and Severe bilateral groin pain. Thank you for your help and any advice is appreciated.

[drtowfigh]

top hernia doctors in georgia or tn

Injections in the back help for:
– diagnostic purposes, to help determine if it’s a nerve issue at all
– sympathetic blocks can help with certain types of chronic pain
– predictive benefits for nerve stimulators in advanced cases of chronic pain

I tend to like to narrow the focus of the pain regimen so I don’t rely on epidural injections unless I think I need it to help narrow the diagnosis after that.

Botox may work in cases of tight repairs. Not for nerve pain.

[Momof4]

top hernia doctors in georgia or tn

Dr. Towfigh, I would like to hear if you have had any patients that have had success with epidural injection treatments. I know you see lots of chronic pain hernia patients, like Dr. Chen, and also recommend conservative treatments first. So far, the lidocaine patches and muscle relaxers haven’t given any relief. I recall that you have mentioned Botox injections on this forum as well. Is that something I should mention to the interventional pain Doctor? I appreciate your feedback!

[pszotek]

top hernia doctors in georgia or tn

In my opinion Dr. Chen is correct on this one. Since all nerves originate in the back and wrap around to the front the idea is to block/numb the nerve at the base and theoretically pain should not be conducted from the distal area to the spinal cord and thus the pain is alleviated. This is my view and likely Dr. Chen’s. Sorry if I am misinterpreting your post and this helps understand what Dr. Chen is likely thinking. Take care. Dr. Szotek

[Momof4]

top hernia doctors in georgia or tn

One of the things tha Dr. Chen recommended I try is epidural spine injections from an interventional pain specialist. I went to see Dr. Ben Foo in Annapolis, MD. He has given epidural injections for groin pain that is radiating from the spine. My pain is from hernia repairs and mesh implantation, so he isn’t convinced the injections will work for my type of pain, which originates from my groin, not by back. Have any of you had patients benefit from this type of treatment? Dr. Foo is willing to try but doesn’t want to give me false hope. Thanks for your input.