[ajm222]

I suppose there could also be a benefit to expecting a high level of pain for the first few days or a week and then pleasantly be surprised. I think mild to moderate pain is the most common for the first few days with it getting better shortly after. Severe or very uncomfortable pain is probably a small percentage in the right hands, or with a particularly challenging surgical situation.

[ajm222]

It could be different for local anesthesia compared to general, but I just had surgery yesterday for an open tissue repair (and it’s my third hernia surgery in 5 years – first was mesh, second was mesh removal, both robotic, which I hated because of the whole body swelling), and at my hospital I got some gabapentin when I first arrived which tends to help with preop anxiety and makes you a little sleepy and loopy (but only a little). And shortly before they roll you into the OR, they give you a very nice cocktail of meds to immediately relax you and make you feel good. It usually hits you almost instantly and makes you happy and chatty. Then they start the stuff that puts you to sleep, and that’s it. It’s very easy. Next thing you know you’re waking up after surgery. I’ll also add that it’s been about 17 hours since my surgery and I have almost no pain. I am alternating Tylenol and ibuprofen, but no opioids. So severe pain shouldn’t necessarily be expected. Everyone is different, and it can also depend on surgeon and hospital. But it doesn’t have to be a bad experience. Someone on here recently said they had no pain at all after open tissue repair, and another said it wasn’t bad at all with OTC meds. So it seems common enough that it’s only a mild or moderate pain experience. And any pain you do have even if high tends to improve quickly – 2-3 days and then it starts to quickly fade. I think it’s good, once you’ve decided on surgery, to accept you’re making a good decision and that the surgery is a necessary thing to get you all fixed up, and to try and feel excited and focus on how you will ultimately feel as you heal once you’re past this first few days. And that you might not even experience much pain in the first place. I assume they also give you some feel-good meds if you don’t get general. So either way they’ll likely chemically relax you which honestly is a nice thing. So far (but it’s still early) I’ve much preferred the open tissue repair to the robotic lap experience. Will update when/if that changes.

[ajm222]

Very interesting video. Hadn’t seen that before. Thanks for posting.

I don’t know anyone in the US doing a combo. But that doesn’t mean it isn’t happening.

[ajm222]

Yep. I’ve noticed that recently with several posts, from a number of new members.

[ajm222]

Hey Peter,

I think you mentioned in one of your posts (unless I’m confusing it with someone else) that you had your external oblique opened up on your other side at some previous time in your life and Dr. Brown gave you 80-100% chance of success. Did dr. Brown operate on your other side too? And if so what repair did he do? Have you ever had mesh at any point?

Thanks

[ajm222]

Hi Peter –

Given the spermatic cord situation, do you have any testicular pain? I can’t recall if you’ve mentioned that before.

Thanks

[ajm222]

You sound like a lot of us here – you’re not totally disabled but the results of the surgery have left you less than before, which is always very discouraging. Plus you potentially have some autoimmune issues. The former honestly was ultimately enough for me to get removal, along with a number of other folks here who are generally happy they did. I did not want to spend the rest of my life suffering daily even in a fairly mild way if I didn’t have to. It is exhausting. I was still running several miles, a few days a week. But it didn’t feel pleasant or ‘normal’. And I had a lot of strange sensations that were very disconcerting in certain positions. I had decided the mesh was the cause of my issues and I wanted it out. But I was terrified of removal, and it took me a lot of appts and time to finally do it. Once it was out, I still actually had issues, but I wasn’t worse, and I was also very happy the mesh was gone. After a long time healing I finally got to a place where the tightness and discomfort were much improved and are often totally gone. So I am still happy I had the mesh removed even if I’m not 100%. I am 2 years out from surgery. Took me 3 full years to make the decision on removal. I also had progrip mesh. I actually appear to have a recurrence of some kind and have a surgery scheduled Monday for a tissue repair that I am hoping tightens things up and improves them further even if it means another setback and lengthy recovery. Another forum member also had progrip mesh removed after about 6 months after reading about my experience. He then got a tissue repair later, and now he’s basically back to normal. He was also able to do things normally, but he said it just sucked because there was always that pain and discomfort.

In your case it hasn’t even been 6 months. There is a chance things will improve. I know when I was relaxed and not as stressed, the discomfort lessened a lot. I think I have a lot of tension in my pelvis and the mesh just didn’t agree with me. But I did have times when I felt much better that I attribute to my core being very relaxed. I also think there is a tendency to read about autoimmune issues and start to blame everything on the mesh when maybe it’s something else or nothing. That said, after this amount of time the likelihood that your issues will totally fade away are probably growing slimmer. It may be worth it to give yourself another 6 months and see what changes occur and then make a decision. But I do think removal should be on the table. I think the percentage of people worse off is pretty small. Even if you’re not immediately appreciably better, psychologically you will feel some satisfaction. And later you can still get an open tissue repair if needed (though usually there is enough scarring at first to not immediately need anything else done). If your original hernia was small and uncomplicated and indirect, and you choose a very reputable removal surgeon to remove the mesh lap or robotically, you will likely be fine.

There are I think other options in which a surgeon can go in and see if there’s something wrong with the mesh. I did have a friend where this was the case, and he claims to be fine now. He has no idea what the second surgeon did to fix him, and he struggled even with walking for a good month after that surgery because of a nerve issue, but claims he’s healed. But of course on this forum you will find a lot of folks like me that are more of the mindset that maybe it’s best to just get it out if you’re having complications more than a few months after surgery, and get a traditional tissue repair if needed later and be done with the mesh. It’s a very tough choice though.

• This reply was modified 1 year, 12 months ago by  ajm222.

[ajm222]

I’d also kind of be interested in how everyone’s scars turned out. Seems over a couple years most fade largely but it’s a large scar compared to what I had for robotic trocar scars. Also, lots of hair down there and I’d imagine there’s a line where the hair doesn’t grow back. Just curious what experiences you all had with that. I’m sure it’s also parrot surgeon dependent.

[ajm222]

Thanks so much Peter for coming on and sharing your thoughts. I agree about altering the anatomy, which is why I love the minimalist attitude of my surgeon. Avoids cutting nerves at all costs, recommends avoiding surgery altogether unless absolutely necessary, and plans for the simplest procedure unless circumstances demand otherwise. Also comfortable with absorbable sutures if requested.

I did read it takes a couple years for silk to dissolve completely. I also read a couple studies suggesting absorbable sutures work very similar to ‘permanent’ sutures. Statistically very little difference over the long term in terms of recurrences.

As for Dog, at the time he was posting here I did a little research on him and it seems he is or was apparently a successful dog trainer out in LA or something who even appeared on Letterman. And you can find a video of him on the show online, though perhaps he or his account posted that here and that’s how I know. So who really knows. But I do now know several people that have had good results with Dr. Brown. But they had very routine hernia repairs for the most part (though one did have his repair after mesh removal – I’ve spoken with this person privately at length and he’s doing great now). But I take your point. And to someone else’s point above, every super well regarded surgeon in this area has a horror story or three, so you just never know for sure what you’re in for when it comes to surgery.

Thanks again for the advice. I’ve taken a lot from your personal experience in terms of guiding my own decisions.

[ajm222]

Very true, though I do think he’s going to find it’s going to need a full repair. Just a hunch. Which for him would be a two layer Shouldice. But he’s a great surgeon and should know how to avoid all the major pitfalls. And despite the removal, this should all be healthy and mostly untouched tissue. Will see soon enough. I’m very curious to know what he finds at this point. Hopefully in a couple of months I’ll be feeling good.

[ajm222]

Thank you for that! Makes sense. I always imagine the first couple of days are definitely painful. As long as there is faulty fast improvement.

I’m in such a weird place. I clearly have something going on, possibly a full recurrent hernia, because of this bulge that gets fairly large after exercise. But for the first time in years I don’t have constant pain and discomfort. So I’m basically signing myself up for going right back into the fire after finally getting some relief. But I know this thing eventually will need to be fixed and I’d like to do it now before it gets worse and more complicated. But as always, there’s also a chance things go sideways.

Anyway, thanks again. That’s exactly the kind of thing I’m looking for. A variety of individual experiences.

[ajm222]

Actually it was Boston Hernia

[ajm222]

Is also be interested in your pain levels, Mark

And G and others – any specifics on vitamins and herbs? I did read something from the website of a NY hospital about Arnica Montana. Was surprised they recommended something.

[ajm222]

Thanks, Mark!

So those first few days, was the bending and getting out of bed a combination of pain along with tightness? With the robotic surgeries I had very little pain relatively speaking. I’m guessing with open surgery, because of so much external dissection and muscle and such being cut that contain a lot more nerves, it makes sense that it’s be painful. And the sutures could make it tight.

[ajm222]

Thanks, G. Analysis paralysis is definitely one of my biggest struggles. Took me about 6 months to decide to go with a mesh repair, then 2 1/2 years to decide to remove the mesh. And now several months of agony trying to decide if I should have another surgery. Then again, I guess some folks take years before they do anything at all. Which is understandable given how confusing all of this is and the risks involved with any groin surgery.

[ajm222]

Thank you for that! And that’s incredible. I’m quite sure I won’t have that pain free experience with Dr. B, but hopefully it won’t be too bad. Quick question – I’d always thought Dr. Brown used silk sutures. How did he come to use absorbable in your case? Thanks again.

[ajm222]

thanks, GI! yeah, I remember reading his journal actually, and someone else who went to Brown. plus I guess all the Kang folks here. they all seemed to be quite mobile after a week. i think it’s those first 2-4 days that are a little dicey. unless someone has a complication, in which case a variety of problems could drag on for quite a while. hoping to avoid any weird nerve damage or large hematoma.

[ajm222]

Thank you. So I don’t know what he did yet. He went in expecting nothing more than a lipoma on the spermatic cord and some weakness, but I told him I was certain I had a full hernia. I asked if he’d be doing a two layer Shouldice if he found a full hernia, which is what he suggested before. He basically said that all these tissue repairs have a lot of similarities and essentially suggested it depended on what he saw and what made the most sense based on the condition of my tissues. So my wife found out he did find a small indirect hernia (even though bulge seemed big to me). He repaired it with absorbable sutures which we agreed to beforehand because he believes they would be sufficient for my patient profile. But I don’t know precisely what he did to repair it. Awaiting the surgical notes which should be coming soon.

[ajm222]

Thanks again! Very helpful.

[ajm222]

Thank you. I believe it’s because he had a negative experience with a patient who was in pain due to a couple of previous surgeries, and he cut a nerve thinking it would help but it just made things much worse. Ever since I started consulting with him, going back to probably 2019, he has very much been against messing with the nerves if at all possible, and has always taken a very conservative approach with me. He’s been very careful to point out that he will do his best but there is always the possibility of an unfavorable outcome. Regardless of what happens, I’ve appreciated his honesty and realism.