[ajm222]

this is one interesting study on long-term pain and the gradual decrease over much longer time periods.

https://www.ncbi.nlm.nih.gov/pubmed/29744593 [h=4]”RESULTS:
A total of 1383 groins were included in this study, based on a 66% response rate to the questionnaire. The prevalence of pain decreased, especially 3.5 years postoperatively. There were no statistically significant differences when each postoperative year was compared with the second postoperative year. However, the prevalence of chronic pain 3.5-5 years postoperatively was significantly lower (4.4%) than that 1-3.5 years postoperatively (8.1%) (p = 0.014). The prevalence of pain that could not be ignored was still 5-6% in the fifth postoperative year.[/h] [h=4]CONCLUSIONS:
The prevalence of chronic pain seems to decline 1-5 years after laparoscopic groin hernia repair, with a distinct decrease 3.5 years postoperatively.”[/h]

[ajm222]

quote dh305:

It’s strange. Only thing he’s basically authorized is walking. He knows I didn’t have a recurrence since I had a CT scan after the terrible nerve pain arose, so not sure why he’s hesitant. Hope I didn’t screw things up by NOT stretching and exercising!

i wouldn’t worry about the not exercising. as long as you’re not in bed all day that shouldn’t be an issue.

[ajm222]

quote dh305:

Thanks again. The reason I ask is that whenever I see the surgeon and ask about exercise, he says “give it another month until I see you”. I especially think stretching would be beneficial because I do feel “tight”.

You mentioned not really being able to do any damage post-surgery. I’ve always been concerned about that because only a few minutes after I awoke from surgery, the post-op staff had a fixation with me urinating before they’d release me. They were pumping me full of fluids and constantly made me get up to try. Probably 20 times that happened. It was crazy. Since I had so many fluids, when I got home that evening, I must have gotten up 3 or 4 times that night to urinate. Needless to say, getting in and out of bed was not pleasant. Of course I was given no directions how to even get in and out of bed. I’ve always attributed my recovery difficulties to the post-op and that evening. My doctor just shrugs and says “the post-op staff knows what they’re doing.” Do you think I could have done any damage moving around like that fresh out of a surgery?

hard to say but would seem really unlikely. i’m surprised your surgeon has been pushing off the exercise.

[ajm222]

quote dh305:

Have a follow-up with the surgeon in 2 weeks and going to ask him ALL these questions (name of procedure, type of mesh, etc.).

Question: Seems like the lingering discomfort I feel on my left side (only when I am more active) is a long-term thing. I have been avoiding basically everything since the surgery (not lifting more than 10 pounds, no gym, cardio, etc.). At this stage (3 months out) is there much a risk of reoccurence by doing these activities when the discomfort comes back, or should I just push through it and see what happens?

IMO, by 3 months the area should be relatively close to the strength it will have long term (though it will continue to improve over time). i don’t know what the percentages are exactly, but i would think you’d be close to 90% of the way there by now. surgeons i have spoken with have all said that exercise is a good thing, and not to avoid it (at least not after the first month or so). just start slow if you haven’t been exercising up to this point. some expert surgeons don’t even put restrictions of any kind on their patients after surgery, even the day of the surgery, and just say to let pain be your guide. particularly if you had a laparoscopic repair – you won’t do any damage to that unless there was a technical failure of the surgery of some kind caused by poor surgical technique or faulty product. and if that’s the case, probably better to know now and not later. but if that were the case you’d also probably be experiencing symptoms of a recurrence already – like even more pain and a bulge, etc. Exercising and stretching are important parts of recovery. obviously don’t overdo it (don’t squat 400 pounds today), but that’s a rule if you have a hernia or not. it can help to stretch things out as your muscle and tissue are still remodeling, and improve your overall health.

hopefully one of the surgeons will chime in as well, though aside from Dr. Brown, i don’t see them on here any more. even Dr. Towfigh. but i’m sure they are crazy busy.

[ajm222]

I have always been told that the older you are, the less likely you will experience chronic pain or other issues. Hypothetically because older folks are less active. Also, apparently, if you have pain before surgery you are more likely to have it after. I had some pain before. But there are so many factors with all of this – age, type of surgery, type of mesh, type of sutures, other health issues, mental state, etc etc.

i don’t know to what extent my recovery is normal, or if at some point in the future I will be revisiting possible solutions for my issues again as time passes. I seem to go a few months and just sort of accept any discomfort, and mostly ignore it. then I start worrying again. My issues have always been less pain and more related to strange sensations on my right side that just feel ‘weird’ – like tightness and heaviness. But it extends beyond the hernia and the mesh as well. It makes it difficult to explain during appointments. And there have been times it has mostly or completely abated for a while. But there’s definitely some achiness and soreness off and on still. I’ve read some studies suggesting after a few years most people report recovering from lingering pain. And one study showed zero pain at ten years for the respondents they tracked, even those with severe pain. Though exactly what that means to each individual person is potentially up for debate. And then other doctors have suggested any pain at a year is less likely to go away. It’s all very confusing.

there’s a famous hernia doctor in Florida – dr Tomas I think? May no longer be practicing. If you search the forums he shows up a lot.

All that having been said, I think at least a couple more months would be illustrative. If you’re still improving then, you’re probably going to be just fine. Just my two cents.

[ajm222]

my previous post is gone (not sure what happened), but long story short I think 3 months is still early. for some people it just takes longer. the mesh itself along with the tissue and nerves can experience changes for up to and over a year or even more. some folks have seen improvement over quite long time horizons. if things are improving albeit slowly, that’s a good sign. it’s actually not uncommon for people to have soreness with activity or just in general for quite a long time after the surgery. this is reported quite frequently, and most surgeons typically even tell people that for a year or more they may have uncomfortable sensations now and again. most of those folks seem to get to the point where they feel back to normal, but i’ve seen quite a few say it took a year or even two or more. just depends on the person. just keep an eye on it. you can certainly look into pain management. but i think if it’s mild to moderate, and mostly just moderate after more vigorous activity, i don’t think you’re doing any harm waiting for a few more months to go down that road. but getting the pain under control could potentially have some benefit as well. i think there’s evidence that working to diminish lingering pain earlier on could have a better long-term prognosis. pain can become chronic in a sense that it’s learned. but just speculating based on some of the things i’ve read.

FYI – i am a year and a half out and still have soreness off and on. i visited the renowned dr. belyanski in MD and he examined me and my scans and said he wouldn’t recommend doing anything in my case. i think most of the cases he accepts for mesh removal are folks who have been suffering for quite a while and would categorize their pain as pretty severe and debilitating. i don’t think he does pain management but maybe offers referrals. i have often wondered to what extent my pain was psychosomatic and to what extent it’s ‘real’. pain is a complicated thing.

where are you located?

[ajm222]

quote dh305:

Thanks so much. Good information. Didn’t even know there were different names for the procedure.

However, the main question is is there any hope for a full recovery if it hasn’t happened in 3 months? I seem to be getting better after the 7 week mark, but still not there fully.

IMHO 3 months is still early. Healing of various types can continue for over a year. People have reported improvement after a year or even two or three. Every one, and every situation is a little different. Your pain sounds like it’s on the moderate side and not severe. That’s a good sign. I’d see how you feel in a few more months. If you continue to improve, even just a little, that’s also a good sign.That said, feel free to seek a second or even third opinion. People often report aches and pains for many many months after surgery, particularly after increased activity.

[ajm222]

quote MeshMangledMerritt:

My primary care acted perplexed by this and honestly I am as well. Why is it mesh doesn’t show on a CT?

I sent my CT scan in to Dr. Belyansky and he said everything looked good and that ‘it was a well-placed mesh’ and hadn’t migrated or balled up or moved. So he clearly was able to see it. I think as Jnomesh said, it takes some special experience and training to see mesh on a ct scan, or at least see it in a way that helps diagnostically-speaking. And even then I guess there are times when everything looks ok even when perhaps things aren’t. Unless of course there is an issue with the scan. I guess it matters if the person reading your scan said they couldn’t see it, or if they said they couldn’t see any issues. Two different things as well.

I think the CT is just one piece of evidence in trying to identifying the true source of pain and discomfort. It can be useful to know the mesh hasn’t migrated or balled up. That information can be used along with many other pieces of info in trying to create a fuller picture that explains your troubles. So it’s probably good you had it done, even if it didn’t show anything. And you can now share those images with other surgeons and physicians as well.

[ajm222]

quote Hiway40blues:

Thanks for posting this-very interesting. I have been reading your posts, since I have some of the same issues. I am at @9 months after open surgery, and still have sporadic pains and a feeling of tightness. Speaking of foreign body sensation, I wonder how common it is to ‘feel’ the patch of mesh in your groin when you lie down at night. I sleep on my back, and when I lie down it seems I clearly feel the patch, under everything else.

given that your repair was open, that is probably more likely than it is with a laparoscopic repair as it’s on top of the muscle and not underneath it. it’s my understanding that the lap method puts the mesh in an area that’s less likely to have that sensation. still possible perhaps but unlikely. and dr. belyansky said that younger people tend to have a higher likelihood of being able to feel the mesh. but i imagine over time that probably often goes away as your body incorporates the mesh and sensations evolve and neuronal connections are reduced or eliminated. i think in my case, upon further reflection, i’m not really feeling the mesh. just feeling changes within the body that have resulted from either the surgery or my response to the surgery or both. and i think it’s something i can probably ignore that i hope will fade over time. i tend to be very sensitive to these sorts of things and i think i’m noticing things and reinforcing things that most people would have ignored.

i think tightness, so long as it doesn’t go hand in hand with pain at all times, and doesn’t seem to be impacting digestion or other bodily functions, is something that isn’t serious and should get better over time as things change and evolve. though i will be the first to admit that when i am feeling particularly stressed out and focusing on this stuff more, even tightness can be very stressful when you worry it will never go away.

[ajm222]

Just a quick update. Went to see Dr. Belyansky yesterday. About a two and a half hour drive north. He’s super nice, seems very bright, and has an excellent bedside manner, just as Jnomesh had said. He’s a young guy, too (I think he’s basically my age – around 42 or 43). I think he also does a lot of bariatric surgeries from what I could tell.

As a reminder, I spoke with his office in the middle of last week and they scheduled an appointment for yesterday – so less than a week later. I didn’t have to wait long at all to be seen once I arrived. I first met with one of his Physician’s Assistants (a woman, can’t remember her name). I gave her a quick rundown of my history and primary symptoms and she did a very quick exam after asking me some follow-up questions.

Then Dr. Belyansky came in and chatted with me. He ultimately probably spent 20-30 minutes with me I think. Side note, he used to live in the same part of town that I live in now when he was in medical school in my city. Anyway, he had already looked at the scans and gave me my first big reassurance – that it appeared to be a very ‘well-placed mesh’ – no shifting or folding or anything like that had occurred since it had been put in. He said whoever did the surgery did a god job. Nothing on the scans looked concerning. I was expecting he’d say he couldn’t tell or couldn’t really see anything, but apparently he could.

I explained my main physical symptoms and concerns and he then did a thorough physical exam. He said no hernias were apparent of any kind (though my left side is a little weak and may or may not herniate eventually someday, but I guess it hasn’t happened yet). He felt around and said that normally people who are candidates for removal have a lot of issues with pain on the exam and I didn’t really have any pain. At one point he was pressing down and I barely felt it and he said that he was actually pressing quite hard and many people with problems wouldn’t be able to handle that kind of pressure. Though I already knew my issue wasn’t nerve-type pain. I then had some follow-up questions myself and some very general mesh and surgery-related questions, and he listened intently and answered those very carefully and thoroughly.

Ultimately he said that (despite the fact he’s usually very successful) mesh removal is a risky surgery and can have lots of unpredictable consequences and the potential for loss of testicle among many other things and that he reserves that for people whose quality of life has been considerably reduced and are experiencing quite a bit of pain and discomfort. He said he wouldn’t recommend doing anything in my case as he didn’t see enough of a reason to consider it. He did say however that (probably because of word of mouth) about 20% of his practice is now mesh removal. He said he does them every week. He said it’s usually due to poor surgical technique, though it depends on the circumstances.

I didn’t really get a clear explanation for some of the more unusual symptoms I’ve noticed from time to time, but he didn’t seem to think it was a concern or at least not related to the surgery or the mesh. He didn’t see anything unusual in my appearance. I will say that now as before some of those symptoms have subsided a bit already since the appointment, leading me to believe that perhaps they are in fact somewhat psychosomatic or at least amplified greatly be stress and worry. I’ve indeed been dealing with a lot of work stress the last few weeks, and I also hit another one of my personal milestones recently as well, where I say I’ll wait a few months more and see how I feel, and then I get there and start feeling worse when I think things aren’t 100% better. I also know I have some symptoms related to my exercise routine (sciatica and groin) and the way I carry myself due to worries about the surgery and mesh.

Anyway, I feel better having seen such a well-regarded surgeon, after being physically examined and having my scans analyzed. Will see how things progress from here. But he said to feel free to see him any time, and if I end up needing another repair in the future, I like that he’s an option. He typically uses mesh for repairs but also understands the problems it can cause, so he seems to offer a nice balance.

[ajm222]

quote scaredtodeath:

Keep us posted and good luck I am hopeful for you

thank you! will do.

[ajm222]

Sent my imaging and a letter to Dr. Belyanksy’s office in desperation last week expecting nothing and was surprised to get a phone call today and also find out that a) he has availability to meet with me on Monday, and b) despite being out-of-state he is in-network. Really wish I had known this last year, but despite all my research I just assumed that a doctor in another state would be out-of-network and 10x as expensive. Insurance is confusing. Live and learn I guess, and you can’t change the past. Anyway, will see what he says next week and hopefully he either says all looks great and that I should just give it some time, or perhaps he’s actually able to detect an issue. Not even sure which I’d prefer at this point but glad to have an opportunity to get another opinion from a highly regarded expert.

[ajm222]

quote drtowfigh:

The mesh typically goes no higher than the level between the two protruding pelvic bones in your left and right.

Thank you so much. That’s very helpful. My worry is that these feelings are a foreign body sensation, and a right repair or shrinkage, and at 16 months I’m afraid the ‘tincture of time’ won’t change anything that I’m feeling at this point. Ugh. Going to take a week off from running and see if it helps or hurts. Pain/soreness is very mild. More than anything it’s iust weird feeling like something doesn’t belong, and the tightness (which gets better and worse depending). But I’m also getting some strange feeling much higher up. So maybe I’m just a bit mental.

Just saw a video Dr. Belyansky uploaded to YouTube of a woman who had mesh removed because of complaints about feeling mesh in the groin after laparoscopic placement – a full ten years after. Apparently for her things got somewhat worse and not better.

Odd that I’m having any issues given the robotic lap and progrip mesh. Either I’m imagining things or I’m just unlucky. But I guess it’s complicated.

[ajm222]

also, how far up does the mesh go with a typical 4×6 patch for indirect inguinal hernia inserted via robot? much of my discomfort seems to be coming from my side and higher up than expected. i know that that’s possible but just can’t find good images showing how high up mesh extends typically.

[ajm222]

Considering also giving Zoloft a try again after stopping ears ago as my hypochondria is through the roof and I also think over focusing on the area is amplifying my sensations. Might need to try and turn off those signals for a while and see if that helps. My personality tends to result in very intense responses to things. Could be better than mesh removal or something extreme.

[ajm222]

yeah, i thought lapro and open were totally different and the lapro mesh wouldn’t be accessible if he entered using the open method. also, is it possible to get lapro mesh repair and then lapro again years later? i had thought you kind of had to do open if you previously had lapro on the other side, otherwise it could be really complicated. interesting situation indeed.

i also thought 4×6 was standard size

[ajm222]

And I should add that I also have some sciatica type pain (dealt with this some long before hernia off and on) and a history of some groin pain not related to hernia (also dealt with this off and on before the actual hernia developed). And I even had some testicular pain on and off that may or may not have been related to the hernia (had a vasectomy a few years before as well). So this is all complicated by some other issues and to hard to say for sure where some of the pain stops and starts. And some of the pressure and tightness is further up my abdomen and my right side and almost into my chest, and it would seem strange for that to be related to the hernia surgery and mesh. Pretty sure I’ve changed my posture and my gait as a result of my worries, almost as a subconscious protective measure, so that could be contributing. I know small changes in the way people sit or stand or run or walk (or even sleep) can have big consequences over time in terms of body pain.

[ajm222]

quote Jnomesh:

I decided to weigh in earlier bc you said you were in some pain/tightness in the area and it’s been a good amount of time since your initial surgery (well over a year ) and in addition most of you your pain I think you said comes after running.
So to me that kind of automatically puts you into a different camp then some people who after at most a few months out from their surgery are say 100%.
Your situation isn’t necessarily something to be worried about and like you mentioned isn’t like a lot of the stories you read on this forum, to me it’s just a reminder that something is being aggregated at the repair site and you are lucky that you have a indentifier that makes the area act up (running).
With those two pieces of information I would proceed to just air on the side of precaution.
Experiment with your running routine and make changes until hopefully you get to the point where You can enjoy running and also feel no pain due to it at the same time.
Good intentions is right in the sense that mesh behaves by its own set of rules and how it acts and incorporates into muscle and tissue and the pain symptoms you are feeling post running can be a reminder of that.
The fact that you said when you take off a couple of weeks from running you feel better to me logically indicates that running is aggravating something and the odds are if you haven’t felt this before surgery then it has something to do with the surgery.
Hopefully, you can modify your running routine to the point where you are pain free.
Best wishes.

good advice, thank you

[ajm222]

i appreciate the perspective. I’ll say that most of the success stories i’ve found on these other forums, however, are people who are very active in the first place, and most of them seem to have resumed their activity to the same or to an even more strenuous degree, and seemed happy with the results, saying they should have done it sooner. i didn’t really see many people (or any) saying they’ve had to be careful or slow down at all. once they got past the first few months they were back on the horse. the worst i saw were people saying they get on occasional twinge or something along those lines. or folks who had multiple hernia operations over the years. it’s an interesting contrast to the stories i typically see here and some other hernia-specific sites. they seemed more representative of the types of numbers i’ve seen in the literature. it’s difficult to make heads or tales of it all, though.

[ajm222]

quote Jnomesh:

I think taking a few weeks off is a very logical way of examining your issues. If you feel better then I would try and change your running regimen and see if it helps-ie maybe less often, more days rest I’m between runs, shorter runs or less stenosis runs.
I enjoyed lifting weights before my mesh hernia surgery and I can say I never felt right post surgery and a lot of my symptoms came about after a workout post mesh repair. With rest they mostly subsided. For 5 years I altered exercises and eventually reduced the amount of lifting weight I was using with better results .
Surgeons Like to make out the hernia repair as of people will be Superman and can do whatever they want. Personally I think this is a flawed reasoning. Understand that you have a piece of plastic in you that is on, attached to and near a whole bunch of anatomical structures.
id try as best it enjoy your hobby and pastime without over doing it and pushing yourself.
Unfortunately for me 5 years after surgery the pain and symptoms I was feeling the first 5 years became 10 fold and the mesh had to be removed as it was eventually found to be balled up and rock hard and on all sorts of structures it wasn’t supposed to be.
And although I’d like to think this was a rare occurrence I do believe it is served as a reminder that you did have a surgery and do have a permanent piece of plastic inside of you-this do your best to lead a balance life when it comes to sports and activity-the pain you are having is a reminder of your repair area-try not to overdo it and push thorough it-experiment and find a balance if there is one between modifying your workout, living pain free, and most of all not aggravating something in that area and making things worse down the line.

Thanks, Jnomesh. The balled up mesh story I most think of is yours. The good news is that I have never been really big into exercise since I stopped playing soccer as a young man, and not the type to spend a ton of time in the gym or running marathons. But I’d like to hope that I can get to a point where moderate exercise is comfortable. I simply want to be active enough to maintain my health. I’m 43 now and it shouldn’t take much to accomplish that.

I don’t think I realized how long your issues went on and that they got progressively worse so long after surgery. Will have to keep an eye on things over time and make sure they’re getting better and not worse. So far I would say that’s been the case, however the progress has been so small and so up and down that it’s hard to quantify.