[ajm222]

Just a quick update: finally made a decision (at least for now) after a 20 minute phone call with Dr. B. today. He was kind enough to call because all of my questions via their portal lead him to believe I had enough uncertainty that some time on the phone was warranted. I had basically made up my mind before the call but he helped me feel better about the decision. Decided to cancel. I got freaked out about the actual surgery the uncertainty of the results and the lengthy recovery, and potentially having another hernia immediately after. My symptoms are a tad unusual, and while they may indeed be caused by the mesh, I think I had too rosy a picture of removal. I was hopeful all these issues would resolve and that I would have no hernia after removal and I would heal and be totally back to normal. While that might be the case, the risks seem too great at the moment for the level of discomfort I have. And the fact that in the last 6 months or so the pain and soreness has almost totally gone away, and the tightness and discomfort are just a tad better (and there are times I don’t even think about it), it didn’t seem like the time to have the surgery. That could change, and we may talk again in 6 months, but for now the pros and cons weighed just a bit more in favor of the cons. I want to see if things continue to change for the better, or if this is the new baseline. If the latter, I’ll just have to see if I can live with that or not. I have to keep in mind the mesh is doing it’s job and I’m not really hurting, and no functional issues at the moment, and there is that chance that things could be worse after surgery. It’s been exactly two years now. He said he doesn’t really do any repair robotically so it’s likely there would be a thin layer of scar issue holding things in but not guaranteed.

Anyway, still can’t speak highly enough of Dr. Belyansky and his staff. Truly first rate.

[ajm222]

Just a quick update – I have still be vacillating daily about what to do. I’ve been sending questions to Dr. Belyansky through the app portal, the latest of which asked what the likelihood is that there will in fact be enough scar tissue to hold things in after removal. I had thought this was highly likely, but realize now it may have been too optimistic after doing a little more research. And when I consider I am not in constant pain, and faced with the possibility that there is a very real chance I may need yet another surgery after this one, I’m just not sure I handle all of that. He’s set to call me on Monday and so I should know after that conversation if I am going to cancel the removal surgery. If he says it’s very likely I won’t need another surgery for many years if ever after removal, then I may proceed. If he says it’s more like 50/50, then I’ll probably cancel and give myself another year or so and reassess later. Dr. Procter suggested the outcome is more variable and unpredictable.

There’s also still the nagging thought that some of my complaints are psychosomatic. Anxiety about my predicament definitely makes things worse. Might be stuff I can adjust to over time. Especially if a removal surgery could potentially just complicate everything and lead to even more surgery down the road.

[ajm222]

this is old but a thread i re-read constantly as i prepare to potentially have my removed soon.

maybe @drtowfigh can comment, but i was told that i’d likely no longer have a hernia even after removal because the robotically-placed mesh would normally create a ‘scar plate’ that would remain after removal and hold things in. sounds like @vtjbrent had a tissue repair after his was removed, suggesting maybe that wasn’t the case here. just curious as to why. not sure how his original mesh was placed but have to assume it was laparoscopic.

by the way, my current reasons for having my mesh removed are primarily foreign body sensation. also get the ‘pulling/tugging’ described above. not having pain much anymore. still weighing the risks/benefits give those facts.

thanks

[ajm222]

any updates to your recovery?

[ajm222]

I’ve spoken to two surgeons in my area that do mesh repairs, and Dr. Belyansky does them as well. And of course Dr. Towfigh. I think there are a fair number of surgeons who do them, they just don’t do enough for it really to be their thing. And I guess if you get a tissue repair you want someone who does them all the time. Dr. Brown of course also does them.

[ajm222]

i had also seen studies and anecdotal evidence suggesting progrip actually, generally-speaking, had better outcomes than other types of mesh. and perhaps that’s on average true. but maybe it just has more potential to cause problems in those whose bodies tend to overreact to an implant.

[ajm222]

it’s fascinating (and scary) that i learn something new every day. hadn’t really considered the fact the progrip would be the source of more pain given all the little velcro-like prongs used to keep it in place, but it makes sense. with the advice of my surgeon we chose that type specifically because tacks wouldn’t need to be used, and i had read so many horror stories about different types of permanent fixation causing nerve pain.

i also wonder if perhaps that’s why my pain is less now after 22 months or so. the PLA prongs supposedly dissolve after about a year. i imagine in some cases it can take quite a bit longer. i did continue to have pain up until about 18 months or so. but not nearly as much now. but it feels like there’s a lot of scar tissue present which along with the mesh itself may be the reason for so much foreign body sensation and tugging/pulling.

hoping that if i do get this surgery they can remove some of this scar tissue (which i think they do a little bit of just in the process of removing the mesh).

[ajm222]

dr. towfigh has responded to a similar thread saying she’s really one of the only people who does lap or robotic pure tissue repair i believe. she said dr. belyanksy and dr. jacob and maybe another are interested in learning this from her. otherwise, i think most tissue repairs need to be done via open method. so if you have lap or robotic removal, you’d probably need a separate surgery for repair (if needed) unless you went to her.

there may be some situations where perhaps a weakness or very small hernia or defect might be able to be touched up somehow robotically if the surgeon was in there doing a removal. but i’m just speculating.

[ajm222]

thanks.

also, i did just manage to change my password. stuff is there, just a little tricky to find.

[ajm222]

thanks. yeah, and Dr. Towfigh also seems to have gone quiet after an initial big push to get this up and running (understandable when your day job is being a very busy surgeon). Hopefully they are in fact working on improvements. Probably no money in it, but the import and amount of activity related to this site would probably make it worthwhile to have a dedicated professional involved for just a month or two to get everything set up properly and running smoothly. maybe they’ve already done that. but then perhaps a couple of regular volunteer moderators could keep an eye on things daily just to deal with spam and things of that nature, and refer major issues when they arise to a contractor or something. not really sure how this works elsewhere. anyway, not any real abuse or spam that i can see going on here anyway so no real need to do any heavy moderating or admin activity.

To Alephy – same or worse? well, different. but not better. i mean, no lump sticking or popping out. different kind of pain. plus a bunch of other new symptoms. so probably worth giving removal a shot and letting a gifted expert like Dr. Belyansky have a look inside there. whenever i get really freaked out about mesh removal, i remember all my friends who have had multiple surgeries in the groin region already. and they are ok. sometimes it takes a couple of efforts to get things right. and i trust my local dr. and dr. belyanksy, and even drs. brown and towfigh who have also both said removal sounds like a reasonable plan at this point. i never really truly ‘recovered’ from the first one, and i should really accept that that’s not acceptable. and hope for the best when it comes to surgery next month. i’ve certainly done about as much research as I can hope to do at this point.

my primary worries are testicle loss (as this is the main thing all the surgeons have warned about) and loss of sexual function, and having nerve pain start that i don’t have now. but Dr. Belyansky has never had anyone lose a testicle under his watch, and Dr. Procter said there are several sources of blood supply to the testicle so it shouldn’t be a major concern. i think dr. towfigh also said it would be unusual. and i have two of them anyway. and the nerves and things that manage sexual function are not involved in this surgery. and the fact that i don’t currently have nerve pain should be an excellent indicator that i shouldn’t have any after removal.

i just know if i pull the trigger i’m going to be completely freaking out the night before and the day of surgery and second guessing myself. i even did that a little bit before the first surgery. this will be much worse psychologically speaking. and the days afterwards are going to be hairy as i deal with pain and the fear that i’ve made a mistake. unless of course i immediately feel the relief that some people feel regarding the absence of that foreign body sensation. if so, maybe i will even welcome some of the pain, as the foreign body sensation and tightness really has been the thing that’s been driving me nuts most of this time.

[ajm222]

Dr. Belyansky has estimated that the likelihood of recurrence for most of his patients in this situation is somewhere between 5% and 10%. not bad. not as good as the sub-5% for mesh repairs, but as we all know even those can fail. he also told me he doesn’t place any restrictions on his patients after removing mesh and not doing any other repairs when no hernia is present.

[ajm222]

I spent a lot of time on forums where hernias aren’t the primary topic of conversation but where they are discussed (weight lifting forums, running forums, etc.) doing some of my own research, and there were many people there that described getting mesh hernia repairs about that long ago and didn’t have any issues. of course, you won’t likely see many people like that here unless they’ve gotten another hernia and are doing some new research for themselves because it’s been so long.

[ajm222]

he means the mesh causes scarring and fibrosis and there was enough scar tissue left after the removal of the actual mesh that there was technically no longer any hernia present. everything was held in by the scar tissue (‘scar plate’) and the growth that occurred after the mesh was inserted. Dr. Belyansky can peel away the mesh and there is usually enough scar tissue left over from the healing process that an additional repair is no longer necessary.

[ajm222]

hey [USER=”1176″]Momof4[/USER] – sadly your messages to me didn’t come through. i can see you sent something but no text was present. i will try and send you my email address via message and you can use that, but not hopeful that will come through. thanks for your messages regardless!

[ajm222]

quote deeoeraclea:

[USER=”2051″]ajm222[/USER] We are in very similar boats. I had a progrip mesh inserted in me in August and constantly have a feel of tightness and also a decent amount of pain at my pubic and hip bones. The situation is livable, but not pleasant. And, it does not seem to be getting better with time — if anything, it is getting worse. I am scheduled for surgery in mid-February (also a lap mesh removal with the robot) and am hoping I do not end up in worse shape. From what I have gathered from others is that, the risk of having more pain post-mesh-removal is not a huge risk (as no nerves are involved). The main risk is a higher probability of a recurrent hernia. Though, if there are any Doctors on the forum that disagree with my understanding of the risks, I would be glad to hear from them. I am also quite concerned that I am making the right decision to have another operation.

forgot to mention that in the case of dr. belyansky, he’s been quoted as telling patients anywhere between a 4% and 10% chance of recurrence after removal with no additional repairs or anything. that’s actually quite good i think.

[ajm222]

quote deeoeraclea:

In my case, 4+ months after surgery, I am still in a fair bit of pain and am not seeing any improvement. If I had seen SOME reduction in pain, I would have waited things out. But, given the lack of progress, I see no reason to be in pain an additional 4 or 5 months before I have the mesh removed

yeah, that’s tough. it all depends on the degree of pain i think, but constant and moderate or greater pain of any kind at that point isn’t usually a ‘good’ sign. i think people have seen significant improvement along longer timelines (like 6-18 months), though. but it’s a lot of anecdotal stuff.

[ajm222]

quote pmv:

[USER=”2051″]ajm222[/USER] I also have suffered with a herniated disc in my lumbar spine at the L3-L4 level that caused excruciating pain down the front (not back) of my left leg. After approximately 12 weeks that pain subsided. And during that 12 week period. I didn’t notice any tightness/pulling in my inguinal area from the hernia surgery that was performed prior to the herniated disc.

That supports your “distraction” theory. When your mind is occupied with other issues (be them orher pain like my herniated disc or more pleasant experiences like going on vacation and forgetting about the demands of work) the bothersome symptoms seem to disappear, albeit temporarily. The mind-body connection is amazing and still not fully understood.

Along those lines, have you consulted with a pain medicine doctor to see if there is anything that can be done to alleviate your symptoms short of mesh-removal surgery? Also, have you considered alternative modalities like acupuncture? It may be worthwhile exploring these treatments before surgery? But only you know your body, your threshold for pain and not feeling normal, and your emotional/psychological makeup.

You sound like a very logical person. I am sure you will make the right choice. But, like me, try not to overthink your situation. It isn’t life-threatening. And is an elective procedure.

Again, I wish you (and others in the same position as you and I) the best.

thanks again! all excellent points. given that pain is no longer really the concern, i am not currently considering speaking with a pain specialist or acupuncturist. i did consider anxiety meds to see if that would help me move past this psychologically but never started the ones i was prescribed (i’ve been on them in the past – long story). and i did take up a new hobby – guitar – as a distraction. but aside from that one short respite over vacation, the tightness has always been there. i think at this point consulting Dr. Procter and deciding whether to delay the surgery or not is the plan. it truly isn’t an emergency. just want to get on with my life and stop worrying about this constantly one way or another. i could likely put it off another 6 months or more, and may do that. particularly if I am still dealing with this sciatica. i am doing physical therapy now but don’t really enjoy the process, and it isn’t cheap, and it seems like this stuff eventually gets better on its own anyway (whether in a few weeks or a few months). and interestingly i really for the foreign body sensation while the therapist was moving my legs and hips around yesterday. wasn’t painful, just a little uncomfortable. if the tightness is real, and at this point i suspect it is, then i don’t think it will get better after this period of time. if it’s mostly in my head, then i probably need to act. thanks again for your thoughtful comments.

[ajm222]

Wow, it seems there are lots of us out there with this tightness. And you’re already scheduled to have it removed? Who is your surgeon? Will be very interested to hear how you do shortly after surgery. All those I’ve talked to that have been to the surgeons commonly discussed here have done well, though recovery seems to really vary – from immediate relief to a year or two of slow progress.

[ajm222]

sorry, still confused by the layout. meant to reply to the post above. as for the safety of the procedure, i think it’s one of those things that, in the right hands, it’s technically considered safe, typically with good outcomes. but it’s a totally different animal than a routine hernia repair, with more that can go wrong, and less certain outcomes. most people i’ve talked to who have gone to the best people that do this regularly have come out of it much better off than they were. but it’s still a little scary. Dr. Belyanksy said each removal surgery he’s done has been humbling, and it’s not to be taken lightly. each one sounds different. if i get back to a place where it’s really interfering with my life most of the day, or things get worse (which is definitely still possible), or i just get sick and tired of not feeling normal after another year or two, i’ll be going back to him and maybe giving it a shot. but i think i need to be worse off than i am before i do that. i just couldn’t justify it yet. i got freaked out and didn’t think the potential risks were worth it yet. i probably need to take some time off from thinking about it 24-7, and get off the boards, and just chill.

[ajm222]

“curious if you had your mesh removed wouldn’t u have to replace it with something
Either stitches or another mesh”

so in many if not most cases it turns out surprisingly that there is enough scar tissue created by the reaction to the mesh that even once you remove the mesh itself, it’s still possible to be left with enough scar tissue to hold things in – technically no hernia. Dr. Belyanksy refers to this as a ‘scar plate’. it’s anyone’s guess as to how well this will hold things after the surgery, and sometimes you might have a small bulge in that area even if it’s holding things in, but he’s told people that lifetime chance of recurrence after surgery with this scar tissue remaining and no more mesh or tissue repair is between 5 and 10 percent. not sure exactly what he’s basing this on. he can replace the mesh with another mesh, but he doesn’t often do this because if someone had a bad experience with mesh they often don’t want more, or they are more likely to have issues with another mesh. and at that point it’s hard to tell if it was the mesh he put in, or issues still with the previous surgery and product, and things can get confusing. so he prefers to not replace mesh with more mesh if possible when doing a removal. but he will i think in some cases. i believe Dr. Towfigh is one of the few people willing/able to do a pure tissue repair robotically at the time of hernia mesh removal. in most cases a follow-up repair to a robotic or laparoscopic removal would need to be done via the open method as that area wouldn’t have yet been disturbed. so if you had a mesh removal that left you with a hernia, or you developed one later, you’d in that case need yet another surgery. but it could definitely be done, and it could be done as a pure tissue repair.

hopefully that makes sense.