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Watchful question
Watchful you are about the closest thing to a hernia surgeon we have so can you indulge this question. As you know large hernia on the left. No bulge on the right but pain. 4 surgeons said I had a weakness on the right. My operating surgeon who did the most minimal inspection found a hernia on the right. There was no bulge. Just pain in the inguinal area. An ultrasound pre surgery said likely a hernia on the right. So I let carvajal double mesh me. Op report says he found a direct hernia. The pain on the right resolved. But of course a lot of other issues. Mesh removed. Pain on the right returns worse than before. Two docs say they can’t find a hernia. But no imaging is done. Towfigh says do mri. Wants 600. Wait one to two months. Here is kang s response— Even a small direct hernia can cause pain, but it is not always the case, so currently the possibility of hernia cannot be determined only by pain.
2. MRI or CT seems to be of no help, but “Upright Dynamic Sono” is the best diagnostic method.“Upright Dynamic Sono” is what he does.
If you like, you can ask a US radiologist to do it for you, which is my tip.
Dr. Kang cares for you so that you may come to Korea and get the best benefit.
He doesn’t like at all that you may go back home without much. I really love and respect Dr kang as you know. He seems so sincere. If you were me what would you do? Try to procure an ultrasound? I just wonder if anyone can interpret it like kang. If I have a hernia I suspect he is the best to find it. So it costs 1000 to fly to Korea. I think it’s the best option. If he finds a hernia he fixes it. I can kerr eR p jacking around with US surgeons and dubious imaging tests. Doesn’t it make sense to go to one of the most experienced guys in the world. Who unlike most docs actually appears to have our best interests in mind ? Thx for your thoughts. -
4 Replies
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Let me disabuse you gentlemen of the idea that a surgeon doing their own imaging must be expert at it. Not in my experience. 😀 A couple of surgeons did an ultrasound on me, both non-standard in some way, and one them actually injured me. Also your note about Dr. Kang might be mistaken according to the separate testings I received. He relies on staff he considers highly higly proficient. He’s there at the side of the patient and discusses the findings with both. Given his many operations preformed, he has had many chances to test their proficiency.
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Yes, Dr. Conze should be able to diagnose some other pain causes as well. He has experience with chronic pain cases, and he does revisional surgery.
I still have different types of pain from the surgery. It’s not debilitating and it’s not constant, but it’s fairly disturbing at times. I hope it improves with time. I still have quite a bit of hard tissue in the surgical area – it takes months for the muscles, fascia, and other tissues in the area to heal and soften.
These open surgeries are pretty brutal. Dr. Kang has the right idea with minimizing the scope of the surgery – less tissue damage and faster healing, but I just don’t know how resilient his technique is in bad cases like I had. The good thing for you is that your hernia (if you have it) must be very small.
I haven’t looked into your health board yet.
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Watchful thx so much for this detailed answer. My gut tells me it’s some kind of direct hernia. Painful but too small to detect with physical exam. That’s why the pain resolved with mesh. Direct hernias are known to return. Dr B did a thorough exam but no imaging. He said no hernia. Maybe sports hernia. But my friend Nick from these boards says no way. Very rare. And I didn’t do activities that would cause one. Nick also thinks at 6 months it may still be mesh removal symptoms. It just doesn’t feel like that. It’s a dull ache aggravated by twisting bending etc. I don’t think Dr b is particularly good with diagnosis. He can’t read mri. He missed agm’s rather obvious hernia. I have heard others complain that dr towfig misdiagnosed them with Torn labrum’s etc. plus I don’t think I would use her for tissue repair. Of course there are other things that could cause the pain. Would conze be able to diagnose and treat other types of issues. Thx watchful. How are you doing? Did you request to join my health board. Someone from here did.
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Chuck,
It sounds like this is not minor pain, and it’s at a level where you feel that surgery (with all its risks) is justified.
In that case, I would go to a surgeon who is good at diagnosis. For example, Dr. Kang, Dr. Conze, or Dr. Towfigh. I wouldn’t have the imaging done at some random place. Dr. Kang and Dr. Conze do their own ultrasounds. I don’t know anything about MRI for inguinal hernias, and whether it matters if you go to a specific place recommended by Dr. Towfigh, or you can get it done properly locally, and send her the disc.
Among these three, pick the one(s) you are most comfortable with. If money is tight, then pick just one. I would pick two: Dr. Towfigh and either Dr. Kang or Dr. Conze. Start with Dr. Towfigh, and then go from there. This way, you have two opinions using two different imaging types. I never talked to Dr. Kang, but I had good conversations with Dr. Conze, so I would personally pick Dr. Conze, but Dr. Kang is likely a fine choice as well.
I guess you must have concluded that Dr. B. isn’t particularly good at diagnosing this? He would be the natural choice for you if he had the expertise.
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