[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, 8 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]

Thanks! Dr. Belyansky is the surgeon. He did my removal.

I’ve heard initial pain is higher (and of a different nature) than with robotic surgery, as you might expect. But I know a number of people that kind of preferred the discomfort of the open repair (tissue or otherwise) compared to lap/robotic. I personally hated the robotic surgeries because they made me feel terrible and like my whole torso was swollen for several days. I just felt incredibly uncomfortable.

I’ve also heard some folks say that after a few days post tissue repair, while they still had pain, it had improved a lot and they were up and about and in some cases even doing light lifting and walking several miles. I guess as with everything your mileage may vary.

[ajm222]

My understanding (and I’ve seen it reported in studies and journals and mentioned here by doctors) is that it takes about a year to achieve maximum strength after tissue damage of the sort involved in hernia surgery, but that within a couple or a few months the great majority of the strength is there. After a year there will often be remodeling of scar tissue and such that could indeed go on for multiple years.

[ajm222]

Thanks!

And I think I knew there were some
options when it came to absorbable sutures but didn’t realize there were so many.

[ajm222]

Definitely. And thanks. I think I’ve decided that if I go through with this surgery, and all goes well, I’m going to convert from running for exercise to brisk walking. And will take extra care whenever I do anything very strenuous. I’m almost 47 and after everything I‘ve been through I will just be thrilled if I am mostly pain free and hernia free. I’ve never needed to be extremely active, and just want to take care of myself in order to avoid any further complications in this area. So exercise is important but I think my running days may be over. Add back issues and plantar fasciitis, and I think it’s time for some changes. As long as I can mow the yard and rake leaves and walk a few miles, I think I’ll be happy. So absorbable may be fine. But again, I’ll check with my surgeon and get his thoughts just to be sure.

[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.