Visiting Dr Kang next month, any tips?

[Alan]

Hi all,

I’ve spent many months reading and researching after developing bilateral inguinal hernias earlier this year. I decided on Dr Kang and have booked flights and hotel for next month, as our UK health service is 3+ years waiting and mesh only.

Does anyone that’s been there have any advice or tips? I’m traveling from the UK and not looking forward to the flight or the surgery! Were you able to tour the city after the operation? I’m there for two weeks (Op on day 2) so was hoping to enjoy the city and food.

[Mike M]

Alan – Reach out to Stephen Kwon prior to your trip if you have not already. Stephen is awesome and a great resource for overseas English speaking patients. He will make sure your trip goes smoothly.

I stayed at the CoEx which had everything I needed within walking distance (including a mall below the hotel). Rates were pretty reasonable through an agency or Priceline. The hotel has laundry service, a lot of English speaking staff, and a lot other amenities that made my stay effortless. Coex is close to the hospital but about 30mins drive time due to traffic.

One of the best Korean BBQ places I found was walking distance from Coex. It was a smaller shop but probably the best I had on my trip next to BBQ near the Lotte Tower.

There will be a lot more open sightseeing attractions with your trip. Back in April they were just opening tourist areas back up to the public.

Lotte Tower, Temples and Palaces, JSA, Observatory, White Jade mines in Chuncheon, etc. there is a lot to take in but you should be able to see a lot in 2 weeks. I was pretty conservative the first week but 2nd week I was talked into walking up to the top of the Lotte tower. A lot of stairs but no real issues. Just had to take it slow.

Gangnam-gu is the south side of Seoul where the Coex is located. It was awesome and very amenable to a noobie traveler from the U.S. like me. Load the SHUTTLE food app on your phone too if you like Doordash / Ubereats. It is the best app I found for English speaking travelers. They deliver all over the city.

Dr. Kang is exactly as advertised. You made the right decision imho.

[Alan]

Thanks Mike, I’m taking my partner (who’s a traveler and desperate to see Korea), we are staying at Peyto hotel, which is 400m away from the hospital.

Thanks for the app recommendation – I love Korean food so looking forward to that part of the trip.

[William Bryant]

Good luck Alan, hope all goes well. Would you be able to update us after the operation if and when you feel up to it as it would be a great help to many.

Not just the op but the flying etc..I’m in UK too and apprehensive about such a long flight but have provisionally got a Dr Kang repair in mind.

Salon what do you estimate the cost, all told, flights and hotel etc.

In the meantime hope it all goes well for you. Good luck

[pinto]

I recommend you book a hotel closest to the hospital within your means or requirements. Stephen will give you a list of nearby hotels. My first trip required a long taxi ride that was painful. My second trip, I booked a nearby hotel. As you will be in Korea two weeks, you might think of visiting Pusan, a resort city.

[Alan]

Just had a consultation with Dr Kang after meeting Stephen and going through tests (Blood, chest x-ray, urine and ultrasound). All extremely efficient and quick. Surgery booked early tomorrow, covid test first will be staying overnight.

Hotel is 20 min walk, so the taxi ride back should be quick.

Dr Kang gave me a signed copy of his book so reading this evening before bed.

[William Bryant]

Good luck Alan

[Alan]

Just out of surgery, slept through most of it. The staff are amazing here, very friendly and a few speak English.

[William Bryant]

Was it local anaesthetic you had Alan?

[Alan]

Yes, I was asleep minutes after they injected my IV so didn’t see/feel a thing, woke up towards the end as he was finishing up. Pain is not great at the moment, trying to sleep through it (Will be staying overnight as it as a double hernia).

Dr Kang came round to check up, he said no issues at all during surgery.

I’ve got Acupan 0.9% on an auto doser.

They keep bringing me loads of Korean food which I’d love to eat but feeling sick. I felt dizzy earlier, they checked my blood pressure and said it was low so stuck another saline bag on.

[William Bryant]

Thanks Alan, get some rest and I hope recovery is straightforward.

It’s good to have feed back from another Dr Kang patient. Appreciate it.

[Mike M]

Alan I am glad to to hear your operation was uneventful. Heres to you feeling better soon and a perfect follow up!

[Alan]

I just got back to the hotel, I had to stay over another night as I had bad pain when standing. Had to get a wheelchair to the lobby and borrowed some crutches to get from the taxi to the hotel room (Stephen managed to get some from another department).

I guess I have a low pain threshold as every other patient was fully mobile the day after and out by 10am. I’m in no pain lying down so worse case I’ll spend the rest of the time in bed. I’m going back for a checkup next Wednesday.

The surgery was easier than I thought, arms and waist strapped down, area shaved and iodine applied. Then a hello from Dr Kang before the sedative was injected, that’s the last thing I remember until waking up just as Dr Kang was finishing up, I didn’t feel a thing.

Food was good, it’s rice, soup and a mix of pickles/kimchi. I ate the first meal shortly after surgery but once the local wore off I was in a lot of pain so skipped the next meal.

Dr Kang and Stephen were amazing as well as the nurses.

[William Bryant]

Hello Alan, appreciate the updates and I hope the pain subsides for you.

I seem to remember that some of Dr Kang’s other patients applied ice (like a pack of frozen peas) to area, that might help BUT check with Dr Kang first to see if it’s a good idea.

[pinto]

@Alan
“I guess I have a low pain threshold…”
Not true. I have a high pain–high–threshold but needed a crutch over there for my first operation. My only pain came from trying to raise myself out of bed and of course needed a crutch to walk. Don’t despair because by the end of the week you won’t need the crutch. Going home in the airport I used a chair because I wouldn’t be able to handle my baggage. I had rapid recovery after that. Good luck.

[Alan]

They gave me a load of ice packs shortly after surgery which helped a lot.

I’ll ask for a wheelchair at the airport, did you have any issues on the plane with pain? I might ask if I can have a isle seat so I can get up frequently. (My ankles were like balloons after arriving!)

Dr Kang said a direct hernia needs quite a lot more repair than indirect and would be more painful, especially bilateral. It’s very swollen but not red so he was happy to discharge me.

[pinto]

Kang nixed use of ice! He was surprised that I thought ice would help healing. In fact I never needed ice but before that I had read stories on the internet about people using ice post-op. I got the idea ice would be needed. Also I thought I would need aspirin, etc. but never had to use it.

My understanding is direct IH is more painful than an indirect one. I had indirect but as I said I needed a crutch to go from my bed to the restroom in the hospital and anytime thereafter walking. My only pain was getting up from the bed. Walking wasn’t painful if I took measured steps.

I had no pain on the plane. By that time I didn’t need a crutch but avoided any strenuous movements. Driving home from the airport though was tough on me. But not after my 2nd operation (for recurrence). The two were very different about pain–the 2nd time around, no crutch needed and I was more confident moving around after the first week, incl. my drive home from the airport. (Note: for my 2nd one I am unsure I would have been able to leave the hospital unassisted. I purposely stayed there several days for security. The result was that my condition was immensely better, immensely, than at the same time period for my first op.)

Alan: (My ankles were like balloons after arriving!)
You may already know we need to flex our ankles and calves during the flight to forestall such swelling. Sometimes walking around is big help but don’t push it if you don’t feel fully confident. Get an aisle seat as close to the john as you can.

[sensei_305]

Does Kang remove mesh as well? Where do I find his contact info?

[William Bryant]

Dr Kang does remove mesh, Chuck will know a bit more about whether Dr Kang can remove mesh no matter how it was put in or not as I think Dr Kang replied to Chuck on here about it.

Google Dr Kang Gibbeum hospital. That should get the contact details you need.

[sensei_305]

Thank you William for the input.

[Alan]

That’s interesting about the ice, the nurses gave me two packs, one for each side and then a pair under each arm (my temp shot up on the first night). I found it did help with the pain but obviously only while applied.

I was stuck in the middle seat on the plane and didn’t want to disturb the chap sleeping in the isle seat 😂, will be changing to an isle seat for the return so I can move about (I’m 6’3″ so not much room to stretch)

I had my 1 week checkup with Dr Kang today which involved an ultrasound and chat. Everything looks good he said. Interestingly he said I had a small double indirect hernia forming on the right side which he fixed during surgery. He also said the right side has minimal chance of an indirect hernia so I’m hoping I won’t have to come back again for future repairs.

Pain is significantly better today, I’m a bit gutted I haven’t been able to tour Korea but as long as the repair is good and I can make it home I’m happy.

I asked Dr Kang about mesh removal and repair just now, he said he just completed one this morning, laparoscopic is not easy as he will have to remove the mesh via open surgery (Maybe best seeing a laparoscopic specialist?) but open mesh is not a problem.

• This reply was modified 10 months ago by Alan.

[William Bryant]

Thanks for update Alan. Hope pain continues to ease

[sensei_305]

I wonder if hernia mesh is removed laparoscopically, and tissue repair is to be done, will the tissue repair be done laparoscopically or do you have to have an open surgery during same time?

[roger555]

Did Dr Kang use absorbable or non-absorbable sutures? As far as I know he uses non-absorbable in some cases.

• This reply was modified 10 months ago by roger555.

[Alan]

Some people do not need any repairs after the mesh removal. If required then a meshless repair can be done after removal.

He uses both, depending on patient preference.

[MarkT]

“…have yet to find anyone with a tissue repair who is back 100 to normal”

Really?

[Watchful]

Other than your case, I also haven’t seen any “100% back to normal like the hernia and surgery never happened” cases. There always seem to be at least some minor issues. My dad is a good example. Successful tissue repair, but with some minor discomfort that never went away completely. Unfortunately, the hernia recurred eventually, possibly because he’s overweight.

• This reply was modified 11 months ago by Watchful.

[Mike M]

@Chuck

The only thing I couldn’t do after a few weeks of recovery was run (not because of pain though). I run just fine now. Lifting, coughing, etc. I couldn’t feel it after the recovery period. I did a little exertion after the recovery period but my goal was to take it easy until after 6 months, which is when the tissue has fully healed from what I understand? Walking and some light lifting at most. 6 months was early Oct so I’ve been lifting more weight now and being a lot more active.

My BMI was at the upper limit of what most doctors would consider for open Tissue no Mesh repair. The upper limit for most places is around 30% not 25%. I’m a bigger dude all around 6’3″. Ideally I need to lose around 40lbs. My hernia was larger than typical, not insane? but it was the size of a hen egg per Dr. Kang.

The pros were – I have no pre-existing medical conditions. Normal Blood pressure, no diabetes, no previous surgery, healthy, and still fairly young? in my late 40s.

No issues but it was a little scary before surgery to consider the points Dr. Kang made regarding weight in the US vs. weight in South Korea. Most individuals in South Korea are in better shape weight wise than in the US (even older patients). You start to doubt if open tissue no mesh could ever work on X patient but it does work. I am definitely not the hardest patient he worked on but I wasn’t a walk in the park either. It goes back to really doing the research and selecting the best doctor with the highest level of surgical skill you can find and access. I can totally see now how a surgery like this could end in a nightmare if you are in the wrong hands.

Funny – I actually lost weight in South Korea (10lbs) in the two week period and I ate rice and Korean BBQ non-stop. I also had pizza a few nights. I should have stayed there a month. I walked around a lot after surgery but nothing crazy.

I have friends who have had mesh and others who have had no mesh repairs. I also read many cases including those on these forums. The consistency in the stories are interesting. Open tissue no mesh – More challenging early on ( even up to the 1st year ) then issues fade to nothing. Mesh – No issues early on then varying degrees of issues ( including debilitating ) after the 1st year.

I will double down on Dr. Kang. He doesn’t cherry pick patients to generate skewed numbers that don’t reflect the results of the population. He is well respected by former patients and other specialized doctors in his field like Dr. Yunis. He has successful completed no mesh repairs in probably the widest variety of patients not seen since the introduction of mesh.

[Mike M]

@Chuck Also in regards to the structure being back to 100%.

Scar tissue is unidirectional vs. bidirectional.

My understanding is because of this the tissue is about 70-80% of what it was previously. However when you add in structure like permanent sutures and the fact the procedure attaches to other parts of the body in that area to provide additional strength? who knows? Optimistically I would hope it was better than prior to the damage occurring.

[MarkT]

So I’m an outlier, a rare problem-free, back-to-normal case after two separate surgeries, and the ‘at least minor issues’ rate is hovering somewhere close to 100%?

I think perceptions of reality are being badly skewed by non-representational sources like this forum, doctor review sites, anecdote, etc.

I would suggest that the reason you haven’t heard of more cases like mine is because people with unremarkable experiences tend not to seek out opportunities to share those unremarkable experiences.

Also, the bad cases, however rare, tend to be what stand out and remains salient in our mind.

[Watchful]

None of us know the real statistics. There is certainly reason for concern. The observation that the incidence of chronic pain is higher than expected came directly from the chief surgeon at Shouldice in his interview with Dr. Towfigh. They’ve been doing a major study of this as a result of noticing this problem. Let’s wait for the results of this study before concluding anything – hopefully they’ll be published.

• This reply was modified 11 months ago by Watchful.

[MarkT]

That is quite the false equivalency to respond with “none of us know the real statistics”.

I know that you are smarter than that.

[Watchful]

Without knowing the statistics based on a good study, how can you say that the chronic pain or discomfort cases are rare? That’s my point – we don’t really know how rare or not rare these are.

I’d like to see another statistic which never seems to be studied which is what percentage recover to 100% normal – zero pain, discomfort, numbness, twinges, tightness, etc. How rare or common is that?

[Author]

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