[Alephy]

So I will be tested for a possible allergic reaction to some types of meshes….I am not saying I will get surgery, but at least knowing if a mesh might cause me allergic problems will be helpful…
I still wish there was some certainty on the long term outcome: I have been told/warned of a chronic pain rate of 15%, which is a lot higher than all the other numbers I was told before, so I guess this one time I got the facts and not some marketing bullshit…wish I could get numbers for chronic pain with and without mesh, although the mesh extra factor naively would make me think of a higher risk, and mounting with time…

[Alephy]

I am still baffled by the fact that many surgeons/doctors still talk of a hole for a direct inguinal hernia.
Is it because they only use meshes these days and do not get to delve into the anatomy anymore?
Is it an attempt to simplify things for the patient?
Is it because maybe sometimes there is a kind of “a hole”?
Is it because effectively during surgery they will make a hole in certain procedures?

I truly do not understand it!

[Alephy]

Again going back to the knee analogy, removing the damaged meniscus will make you pain free, until the remaining cartilage layer will wear out…after that you will be permanently in pain (this is what happened to many people in the past I think)…

I am not saying that a mesh surgery will certainly give you severe pain in the years to come, I am saying that we (and the doctors too) do not know for sure, as much as the doctors in the past ignored the significance of the meniscus. I agree that an abdominal surgery will give you pain for some time (and it would be nice if people were told the truth about it, instead of “you will go back to full sports activity in few weeks, no problem etc etc”), the point it may or may not give you pain in the years to come (again, why can’t they say it out loud in the open?)…

I also agree with Goodintentions about wanting the nitty gritty details (that’s where the devil lies, as always…)…

you know what? with enough info to match my conditions I would also not rule out a mesh, if one could make an aducated choice about it…(educated==enough information to weigh risks etc)

[Alephy]

The problem is you are against the health insurance system coupled with the maximal profit tenet of the medical industry: the first want a low cost quick and simple procedure for the massive volume of hernia surgeries while the medical industry wants to make money. The little science that squeezes in may take years before seeing the light. Apart from the different volumes it is not so different from the knee surgery industry: back in the 70s people with a meniscus tear were often sold the idea that the meniscus could be safely removed as they believed it did not play any functional role; they then realised how wrong this assumption was but all were into the new era of keyhole surgery that promised to shove an athlete back into actions in days after knee surgery. Then with passing years they started realising that a damaged meniscus was perhaps still better than a partial healthy one, and that physio therapy was just as good as surgery. I would also add that today’s expectation is that one can go back to full blown activity in a matter of few weeks: I suspect the reality is that hernia surgery is not trivial, that you won’t be back to your previous level before few months, that complications are a definite possibility, that you might have to pay serious money if you want to avoid the low cost health insurance driven procedure. As for the legally binding consensus in the US they have seen this for many years, and there have been even talks on the subject (on how to avoid law suits that is)….this is one interesting aspect of how a pure US specific trait (how medical care is provided in the US) might affect the rest of the world considering some of the big medical industry corporations are American. There will be eventually the latest brand new state-of-the art technology/device/technique /whatever you want that will come and replace the current situation, with new pros and cons with it (hopefully a lot more pros than cons) but I doubt this fight can be won or let alone fought based on purely moral grounds (you have my sympathy for thinking of trying though)…

ps: one would think the scientific method/approach would be solidly embedded in our thinking but it seems not so:(

[Alephy]

Not bad

[Alephy]

The one problem I have with the mesh fallout is that there are still many doctors who would not hesitate to tell you right in your face that there are no complications with mesh or that the percentage is very small ie 1% or 2%, that it is inert etc etc…this behavior still shocks me! I spoke to few doctors and this is my experience…

[Alephy]

Interesting! Thanks for sharing!

[Alephy]

Well these numbers require a time window though….85% to 90% have no problems after 1 month,1 year,5 years…? Can a mesh cause problems after that? Can any doctor say that sax 80% of patients with a mesh will not have future problems with it?

[Alephy]

The neurolysis of the nerves was planned or deemed necessary during surgery?

[Alephy]

I understood indirect ones are the majority…

[Alephy]

@drbrown is it also normal for both types to reduce it by contracting the abdominal muscles? Thanks again!

[Alephy]

Thanks for sharing! If I may ask did the surgeon cut the cremaster muscle?

I am also wondering what will happen after brexit is finalized as far as getting surgery abroad is concerned…here in Switzerland there is no way for me to reclaim back the money for the procedure even if far less expensive than here…

[Alephy]

This is the first time that I hear of a clinical trial for a mesh before being used on patients….while I should be happy about this the thought of those animals suffering makes me shiver…

[Alephy]

Yeah Salmon is great! I always eat some when I feel sore

[Alephy]

When I had joint pain in the past due to injury I found great relief in an omega 3 rich diet (eg fish)…more than stretching I would try some specific exercises aimed at strength…the slower the movements involved the better…as this might take a long time it’s best to gear the exercises towards a more general goal than recovering (in my case I aimed not just at recovery but improvement in certain movements and feeling)…my 2 cents

[Alephy]

Age certainly plays a role, although being young vs old is often a stereotype (is 40/50 old/middle aged or even young?) and considering that we live longer and longer and so having a surgery at age 60 might mean dealing with the aftermath and possible complications for another 20 or more years…
what would be important to me is that this or that doctor, whatever the procedure, tell the patients BEFORE going in: if they take the nerve out as a planned action, the patient MUST know that they will do that! If not, it is a criminal action in my opinion

[Alephy]

I think any such list should always start from the medical problem first eg direct vs indirect IH, recurrence vs incisional, age weight etc. One of the few things I got loud and clear is that the hernia treatment requires a tailored approach to be successful. I personally think that the problem is to find a doctor that does that which would mean getting out of the numbers churning mill, which requires money as health insurances might not support you. That patients should be kept in the dark or even worse be lied is something that is not far from criminal…also having myself a scientific background to see people publish papers on small biased samples or even without any accessible and verifiable data makes me shiver….

[Alephy]

I agree and I in fact did…I still think it’s better not to be too open at times based on my experience especially when seeking a second opinion

[Alephy]

And if you tell the surgeon you read this or that on a forum with doctors they might get angry and dismissal 😡

[Alephy]

So basically we just can hope AI will eventually be able to replace humans. How does one become a radiologist??is this once again a cost cutting problem?