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Forum Replies Created
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top hwrnia in wisvonsin
It sounds like you are still seeing Dr. Greenberg.
Where did you have your original surgery?
Did you ask him how many total hernia surgeries he has done since he was licensed in 2011(I think that is the correct year) This is the Dr. doing them. Since this is a teaching hospital a large percent can are done by residents.
Outcomes of the surgeries?
What were the percentages of complications? What type of complications?
How many triple triple neurotomies he had done? Outcomes?
How many mesh removals he has done? Outcomes?
What are the odds that you had your original surgery done by a teacher of your present surgeon over 1,000 miles apart. If I found out that my current surgeon was trained by the surgeon that caused my problems, I would be out the door and never return.
Did you get the proper type of Ultrasound and MRI?
Maybe Dr Towfigh could review the images. It takes a true specialist.
Do they still have a 25 to 30% post surgical pain 1 year post op from hernia surgery?
Maybe they could send you to Germany to have it done. I guess only star athletes get that special treatment.
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AHSQC: Am Hernia Society Quality Collaborative
This is what is scary about having no requirements to become a member except being a licensed Dr. and paying a due.
Again I ask that you read the book Unaccountable by Dr. Marty Makary.
When a patient comes to a Dr. who is a very unique position and the patient puts there life on the line with this person they meet for a short period of time. Trust is the only thing the patient has. If the Dr. and his staff are not truthful it leads to multiple problems.
If I come to you and we agree on a treatment plan and discuss if a resident going to be present and you state they are only going to act as a assistant but I later find out they performed the entire surgery, fraud was used to obtain my consent. Since most hernia surgeries are elective but highly recommended I could hold off on doing this surgery.
Again being a lay person I do not understand all the items that go in medical training but if I am going in for surgery I do not want someone that I have any knowledge of doing any part of the surgical procedure that I am having. This could be their first surgery ever for a resident and one mistake with a medical instrument could be life changing. Even with the best Dr. observing.
According to one surgeon I spoke with after my surgery ghost surgery was not uncommon at the hospital that did my original surgery and backed up by a couple of other licensed medical professionals, GHOST SURGERY does occur in the US for surgeries for both partial and entire procedures . Plus they are billed only as attending participated in the actual surgery.
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Inaccurate medical records
Thanks for looking at the notes. Here is the problem, these are the entire notes from this visit. On the last page it clearly states by the Dr. that he has dictated the progress notes from the visit and signed off on this. Which included going over my medical history, how and when the hernia occurred plus a physical exam of the inguinal area which the Dr. could not find a hernia and asked for me to point out the location of the hernia, which was at the site of the open appendix surgery. I kept asking for his progress notes and was told repeatedly to contact medical records who could not find any notes. Finally I found out he had later stated that it was possible that none were ever taken. The hospital stated that my care was standard and acceptable! I would be more than happy to forward my 2nd and third exam histories, again he did not enter in any progress notes. So I had surgery with no progress notes. Nowhere in my history states which side the hernia is on, type of hernia, his physical findings of inguinal exam, or agreed upon treatment plan. Not sure how a resident could review a patients history before assisting in a surgery and not going to the surgeon and asking about the patients with no medical history.
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AHSQC: Am Hernia Society Quality Collaborative
This might not be the right place for this but my hospital that did my first hernia surgery is participating it the survey, my surgery and care was before the survey started. Came I get involved?
Second part which is a major concern for others to find a surgeon, is what qualification does it take to become a Americas Hernia Society member?
I did some cross checking and found it to be very interesting. I entered in my city on the AHS website and all the doctors that came up in my area were from the hospital that I had my first surgery done at. According to their website they do around 500 hernia surgeries per year with 11 doctors listed. Meaning around 50 per year per doctor. On their website from a few years ago they had an exit survey that the graduating residents filled out the survey that stated up to 90% of the surgeries were done by the residents. That would bring the actual number down below 10 hernia surgeries per year per doctor. Also from this hospital, they did a study that found 25% of their hernia patients had post hernia pain after one year between 2009-2010 and according to other doctors at their facility it was ongoing until 2012.
I than looked up each ones bio and found most had graduated in the last 3-6 years(very little experience). Not one listed hernia as a major aspect of their surgical interest, research or practice. I believe I also know which doctor on the staff is their director and he does not even state this on his bio. I than looked up the bios on Towfigh, Ramshaw, Yunis and Goodyear, what an interesting contrast. Their websites shows that they are really specialists in hernia surgeries. One Dr. stated he does around 650 hernia surgeries a year. How many has Dr. Goodyear done-15K plus?
Be very careful when selecting a specialist. Paying a yearly due to join a Society does not mean the doctor is a specialist. I also found in Dr Towfigh’s bio her CV. Never heard of that before but all doctors should provide this, I found it very interesting and informative.
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Inguinal hernia mesh removal
i understand the feelings you have and feel for you. Everyone thinks and says it is just a hernia. I did not like discussing it, I think one is the location and second no one believes you on how bad can the pain be and life changing. I was bounced around to 7 doctors, OT, PT, ART, acupuncture, Reiki, graston, message, pain management, drugs, nerve blocks, lidocaine infusion all to find no relief. I think I might be missing a couple of other treatments.
Without answers to how, why, what is wrong and any course of fixing it by my world renowned hospital and Doctors I was lost. Your life changes completely everything suffers. I did get into pain management group sessions to discuss on how to live with disabling pain for the rest of my life. Everyone in the group you could see the problems they were having and seemed in much worse shape than I was in, I felt guilty for being in the group with them, they seemed to be much worse off than I was, I just had a hernia and again how much do I want to discuss in a group about the location of the pain and suffering. You go in for this supposed simply surgery with very little side effects and come out in pain and suffering with no answers. I started to say my surgery was semi elective. This in not like having a blocked artery that has to be fixed. Some of the studies have post surgical pain at 30%, did your surgeon tell you that?
Again you need to see someone that is very specialized in this. It was not funny but when I was working with both the GS and Urologist both stated the problem was for the others specialty to figure out what was wrong, it was not their part of the body they fix. They also kept saying no big deal in losing a testicle, you have two but did you read my complete history, low T. I would have liked to have said since both were male doctors If I lose one of mine by your surgery than you will have no problem losing one of yours.
You need your records. Do not be surprised if they are not complete and can not answer your questions. After my surgery things the doctor told me did not make sense. I kept asking questions which he could not answer as to explain the surgery again and why did you do this aspect of the surgery. Finally I was told under no circumstances to ask him about the surgery anymore. I would to try to make an appointment with the surgeon and have her go over what she did and why. Use your cell phone to record with permission so you have a record. I think a lot of Doctors think a lay person can not understand what they might explain to you. For the longest time I could not figure out about the Lipoma that kept coming up and why during open surgery it was removed and with lap it was not. I think Dr. Earle on this site explained it, so everyone could understand it. I too had a Lipoma removed or the Doctor stated it verbally but was not in my OR records. Why I asked. He said it is so common during a hernia surgery he does not tell the patient or note it in the records. If it happens so often the patient should be told in pre surgical consult so when they read the op reports they understand why it occurred.
Not knowing the exact type of pain you have and being a lay person, one treatment to look into that is done for PVP is denervation of the spermatic cord. Again there are only a few top doctors that do this or I would trust . I think the leading expert in the US is in the Orlando area. This is one treatment one doctor thought might help in my case but I backed out when I did not feel comfortable and is this the correct way to go and when the surgeon stated unlike other doctors at this hospital” I will be in the OR for your entire procedure”. Meaning the resident will by doing the surgery. Been there, done that and I was screwed, NO THANKS. Come to find out, I had a different type of hernia which you do not fix with denervation of the spermatic cord. Was the surgery really for me or for training a resident.
From what you describe your Doctor might have been over her head when doing your surgery and was unprepared and did not have the knowledge, experience or ability to do the correct procedure once see was faced with reality of the situation, you get to suffer, how fair is that. I found this out after my surgery. Thanks Doc for not telling me the truth about yourself. A little late now that your PA tells me you told her I dont know what could be causing the problems since I do so few. Before the surgery you told me you were a world class hernia specialist that does this surgery all of the time. Maybe your super ego and you do so few is the issue. When I spoke with Dr. Goodyear who has done what 15K hernia surgeries or so. I told him my surgeon for open stated he removed x body part. Dr. Goodyear said he never had to do this, it might occur when doing it by Lap but not open.
Hope this helps and again good luck.
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Inguinal hernia mesh removal
You may ask. May hernia occurred in the fall of 201x. I saw a quote hernia specialist about 5 days later. Watchful waiting. I did this but about a month but later it seemed to be getting larger and painful, so I decided to have the surgery during the winter so I could be recovered for summer. The surgery was in the Feb.. Recovery was not as fast as the Dr. stated but getting better until 7 weeks later. While driving it felt like a knife slicing or ripping in the surgically repaired side. The pain was around 8 or so. Nothing relived it. This was on a Sunday and I called the Dr. office Monday morning and they downplayed it. For the next 2 years I saw 6 different so called experts from the hospital to figure out what was wrong. They never did the proper imaging. It did get somewhat better but I could not walk normally. We came to the conclusion that it might be the mesh. They also found a hernia on the other side. So I found a great Dr. another state. He fixed the hernia on the other side but found a Femoral hernia on the side of the first hernia. This could have been the problem that went undiagnosed. He also went in and removed the original mesh. Felt so much better in the recovery room. They basically had to hold me done I was feeling so much better right away. That weekend I spent an entire day walking and standing.
Feel free to ask any more questions. Writing is not my thing, as you can probably tell.
Good Luck
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Inaccurate medical records
This is interesting since I was going to write a note asking if I could post my medical history since most of it is not in the history or made up the Dr. and his staff and when I complained the hospital told me to write a correct history but they could reject it and file it in my medical history. They also stated that this was standard and acceptable. I am reposting my first exam notes from this Dr. . Let me ask the Doctors on this forum. If I was scheduled for surgery and my surgeon was unable to perform it and you were asked to step in to do it, would you do it after reviewing the attached records?
Again now I know better get copies of you medical exam records before surgery.
Would it be acceptable to post my medical history with the names of the Dr., staff and hospital to make the public aware of what type of care they might be getting? Would the readers of the forum be interested in seeing them?
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Chronic pain risk lower in no-mesh repair or mesh?
I think I asked the question before. Mesh has up to and maybe more post surgical pain of 30% but a much lower chance of recurrence. No mesh much lower chance of pain but higher recurrence. Myself I would risk the no mesh if you can find an excellent no mesh surgeon, which in the US is very hard. I lost two years in my middle age would rather have it when I am older and less active. No good answer but find the best surgeon and go with what they do best.
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Inguinal hernia mesh removal
Make sure you get a copy of all of medical records from this surgeon that did your first surgery. I found my pre surgery ones had no information in them and my op report not very truthful but you need the records as a starting point and any imaging done for your next doctor.
Again I recommend reading Unaccountable.
Good luck
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Inguinal hernia mesh removal
Yes mine was successful. You need to find a doctor that does a lot of hernia surgeries. There are some quote experts that have done very few. I was referred to one a few years ago as a hernia specialist that had done zero at the time to fix mine. I put off the surgery until my insurance changed. Glad I did but out of pocket was $1,500. worth every penny not to be a used as a training tool.
Not sure were you are located but Dr Towfigh, Goodyear, Ramshaw, Yunis, Dr. G in Ohio, Chen and other moderators on this site would be great starting points.
Not sure were I got this but a Professional is someone when doing a job on how close they come to perfection and an amateur is judged by how many mistakes.
A lot of Dr., clinics and hospitals might say they are a specialist but to do this type of surgery needs someone that does them frequently and a lot of hernia surgeries.
The moderators came give you their professional reason for the mesh but my guess they might have found a need for several reasons as predisposed to having one in the future or a need after trying to find a hernia.
Good luck
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Post surgery thoughts
WasInTN, Thanks for your writing on this subject. I wish Dr Towfigh and the other doctors plus patients put together a written list of questions to present to the surgeon you are interviewing to put in their hands.
Here are the questions I put forth to my first surgeon and hospital staff.
I was not referred and did enough research to ask for a general surgeon that preformed a lot of IH and specialized in hernia surgeries. They referred to a quote expert that did them all of the time. After my surgery I learned that is told to all patients and that the hospital assigns doctors to patient by doctor needing to fill their schedule not which doctor(s) are the best for the type of surgery.
When meeting with the doctor and staff three times before surgery I asked what I thought were the important questions, as follows. Some background on the the hospital. It is known as one of the best in the nation and has a huge budget to have potential patients already believing they are going to be seen and treated by world renowned surgeons. The doctors page listed IH as one of his specialties and he has over 20 years of experience. Found out afterward he was only licensed about 6 years before the 20 years was from when he graduated medical school.
My questions to doctor and staff and answers.
How many IH surgeries has he done. At this hospital all of the time and he stated he had done well over 1,000 of open IH.
Current training. Up on all current practices in IH
Who is going to perform the surgery. The doctor(he also stated that) resident will act as surgeon tech. and only assist. He could only state the mesh was inserted so tight it would never move.
What about surgical team. His person highly trained surgical team. Found out afterward the team was a circulating of medical staff.
What is there is a problem. We have one of the top post surgical hernia surgeons on staff. No one on staff
Recovery. 6-8 weeks fully recovered.
Complications and side effects. Seroma, infection, hematoma. Nothing about pain or loss testicle(2 previous surgeries in area?
Only licensed medical professionals in OR except for one resident. Looks like 2 medical students present.
How will do the gas. Highly experience licensed Doctor of GA. Found a fellow who had recently been doing nerve block injections.
How do you handle the 3 main nerves. Will locate and preserve. Only one nerve located and could not answer about the other two.
What type of mesh. I requested lightweight and doctor agreed. Only PMII ordered before surgery and was told the doctor had done so few he might not even know which mesh the hospital had on hand.
Will I be catheterized. No
I might have missed a couple but it is close. When I reviewed my medical records none of the questions and agreed treatment are noted or followed. Every question I asked I was not told the truth in order to obtain a consent. The doctor could never answer any of the questions about the surgery, afterward. I did post my first exam notes on this site if anyone wants to see them.
I should have asked why open surgery over lap. Found out he was a lap specialist, so was this for medical student and resident training doing open?
He recommended open and I found out later the best way for open is a local in stead of a general gas, I think Dr G does local. Why general?
Here is a couple scary things that are current with my original surgeon and hospital..
Surgeon. He has moved to another state. He is now promoting himself and as a hernia specialist. From the record I got in a complaint it looks like he had not done one hernia surgery between 2012 and 2015. BE CAREFUL.
The hospital I went to also claims a Hernia specialty clinic that does over 500 per year. They have listed about 10 surgeons basically their GS staff. So that makes about 50 per year per surgeon but in their resident recruitment page a resident exit survey on procedures it shows residents perform almost 90% of the surgeries while only assisting 10%. So if these figures are correct that means each doctor might do as many IH surgeries in a year what Dr. G does in a week or so. Also in this survey, it showed about 50 or types of surgeries. About half the resident never assisted in the type surgery before performing one. There goes what was it read, assist, do one.
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Post-Op Recovery: What to Expect
I forgot to mention in my response about my first surgery. My problems started in recovery and it was very slow recovery with pain until about 7 weeks post surgery. At this time it went south big time. I was in extreme pain and had a hard time walking. The doctors at my quote world class hospital had no answers but a lot of different treatments with no imaging done to find out what was wrong. This Dr. who did my first surgery is now stating he is an hernia expert, funny that is what was said when he did mine only to find out he had not done a hernia surgery in over 15 months during my consults but somehow I was told he did them all the time with excellent results.
This is not typical and most patients never go through this.
Research and ask as many questions as possible, trust but verify and go with your gut or sixth sense. My gut and sixth sense told me something was not right with my first Dr. but every medical professional told me how great he was and my hernia was getting painful and was in a place if I got in a car accident I was concerned with additional damage. Ask to review your medical records before surgery to verify that your history is accurate and complete plus get a copy afterward to make sure your records are accurate. I was shocked to find that no information were in my records regarding recommended treatment, about type of surgery recommended and why this type is recommended, type of hernia, location of hernia, size of hernia, reducible,notes on pain or any notes on my questions and agreed treatment plan- like type of mesh to be used or how does the dr. handle the 3 main nerves. There were no notes about the physical exams or findings. I sound like a broken record but read Unaccountable about your medical care, doctors and hospitals before surgery.
If you go with Ramshaw or Goodyear you will be in good hands.
Good luck.
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Post-Op Recovery: What to Expect
I forgot to mention in my response about my first surgery. My problems started in recovery and it was very slow recovery with pain until about 7 weeks post surgery. At this time it went south big time. I was in extreme pain and had a hard time walking. The doctors at my quote world class hospital had no answers but a lot of different treatments with no imaging done to find out what was wrong. This Dr. who did my first surgery is now stating he is an hernia expert, funny that is what was said when he did mine only to find out he had not done a hernia surgery in over 15 months during my consults but somehow I was told he did them all the time with excellent results.
This is not typical and most patients never go through this.
Research and ask as many questions as possible, trust but verify and go with your gut or sixth sense. My gut and sixth sense told me something was not right with my first Dr. but every medical professional told me how great he was and my hernia was getting painful and was in a place if I got in a car accident I was concerned with additional damage. Ask to review your medical records before surgery to verify that your history is accurate and complete plus get a copy afterward to make sure your records are accurate. I was shocked to find that no information were in my records regarding recommended treatment, about type of surgery recommended and why this type is recommended, type of hernia, location of hernia, size of hernia, reducible,notes on pain or any notes on my questions and agreed treatment plan- like type of mesh to be used or how does the dr. handle the 3 main nerves. There were no notes about the physical exams or findings. I sound like a broken record but read Unaccountable about your medical care, doctors and hospitals before surgery.
If you go with Ramshaw or Goodyear you will be in good hands.
Good luck.
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Post-Op Recovery: What to Expect
I also traveled for my second surgery which was one to repair a new hernia and the second part was to remove the mesh from the first hernia surgery. During this surgery they found a unknown Femoral hernia. on the side of the first hernia surgery.
My recovery for this second and more invasive surgery was very fast. Except for the pain at the surgical incision site was in less pain and more mobile right after the surgery. Within 4 days I was walking without pain and had no other side effects. On 6 days I felt so good I was standing most of the day and walking without pain.
Staying to have your surgeon see you after the surgery is very smart. Mine was 1 week post op but I was lucky I had a free place to stay. Thinking back it depends on your surgeon. My first surgeon throw me under the bus and never did understand the damage he inflicted on me. Day one extreme pain, Day two extreme spasms, Day four something let go internally.
I did meet with Dr. Ramshaw and Dr Goodyear. Both were on on my short list to perform my second surgery. It came down to I had a free place to stay and recover. I would highly recommend both them.
One item I did find out after my first surgery, that the state I live in University employees are given special legal status regards to malpractice. They are considered state employees and the maximum amount to allowable under out state law for malpractice for state employees is a whopping $250,000 so in reality they are untouchable. No lawyer will even look at a case for such a small amount.
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hernia specialists/surgeons in the southwest
How about your great host of the website. Or Chen, Goodyear, Ramshaw, Dr. G in Ohio, Yunis, are ones that have been recommend before and I have seen three of them in person would recommend them highly.
Be careful, there a some who claim they are specialists but have very little actual knowledge in hernia surgery. Ask very specific questions of the Doctor. Number or years practicing, number of times they have performed the type of surgery they are recommending, outcomes and so on. Good luck.
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top hwrnia in wisvonsin
Sorry for the delay in answering. I prefer not to say, but it was one of two in Florida that came highly recommended. One has since moved. Good luck on your search. Again I recommend the book Unaccountable to read about practices in US medicine. Should help out with very direct questions to ask to your doctor.
My redoing of the original surgery has been a great success for the past fours years but my original hernia occurred from coughing, so every time I cough or sneeze I always am concerned.
Let me know if you have any other questions.
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top hwrnia in wisvonsin
Dr Towfigh,
I am going to respectfully disagree with you.. Maybe things have changed.
Again, I refer people to the book Unaccountable and there is a chapter of Hospitals and clinic hanging the sign out that they specialize in an area but it is just a sign and the patients suffer or worse. As far as I know there is no standard for any Dr, clinic, hospital to be quote certified as a specialized clinic just a marketing department and ad budget.
I was one of the first patients in UW Health Complex Hernia Clinic. After research and being bounced around for a year, I could cut through the BS from the medical professionals like a surgical knife through skin. I held off until my insurance changed and went to another state for corrective surgery.
Do a google search on Post Hernia Pain when using alt. saline solution, done by AJ Russ on outcomes at UW Health. According to two of my Dr.s they still had issues with this late in 2012. The two Dr.s in other areas stated it was closer to 30% 1 year post hernia pain from this Hospital.
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top hwrnia in wisvonsin
Avoid UW Health at all costs. Up until 2012 had a known 25% post surgical pain. According to their own resident exit survey, residents do a very high percent of the surgeries. Dr. Goldblatt in Milwaukee. If you can travel look at the names that keep coming up on this site and go to them.
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How long did you wait?
Dr Gould and Dr. Gold______ and one other, I think they work together at Froedtradt. I did see Dr. Wallace who was highly recommended but not sure if he is still practicing. Nice guy. I was lucky and could go to anyone the second time. If you can travel to see Dr. Towfigh or some of the others that post on this site, go . My experience was 3 years ago so some of my information might be out of date.
There is only the first time to get it right.
Not sure were I found this That a professional is judged by how close they come to perfection on their job and an amateur is judged by how big the mistakes they make on their job. I find this explains my first surgery(A) to my second(P).
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How long did you wait?
You can check my other posts but it is a long story which I still do not have answers to.
About 6 weeks after my original surgery which seemed like a very slow recovery, I was driving when a very sharp pain occurred in the groin area like a knife slicing through or being ripped. The remarkable surgical team just put it off and did nothing, no imaging but put on drugs. With the pain also came not being able to walk normally. My walking stride was reduced to half and my mom with bone to bone in both knees could walk faster. Pain scale was about a 7-8. About six months after the first a new hernia occurred on the other side. Very small but very painful. ER visit with CT.
According to my original surgeon he stated he inserted the mesh so tight it would never move. This was open with PMII after we had agreed that he would use lightweight mesh and identify the three main nerves, according to him when asked afterword about the nerves “no nerves were in the surgical field of vision”. I also found out after the surgery this clinic had a 25-30% 1 year post hernia pain, told 8% total problems.
My insurance changed after 2 years and I was able to consult with Goodyear, Ramshaw and Yunis. I would recommend all 3 but it came down to I had a place to recover near Sarasota which is how I made my final decision.
The second surgery was Lap and they found a femoral hernia on the side of the original surgery with open removal of the mesh on that side. I could tell right away that things were much better on the original side.
Ask a lot of questions and go with your sixth sense. I should have(sixth sense) but I was getting the same answer from everyone I asked about the original surgeon. That he was an expert with excellent results and performed hernia surgeries all of the time and was fully trained on all current procedures. Found out afterward he had not done one in about two years plus he never documented any of my history prior to the surgery.
There are a couple of Dr.s in Milwaukee, I would skip Madison and I am not sure on N.IL. this is my personal experience and research(I am a patient not a doctor). Anyone one/ clinic can or call themselves an expert. I have found a couple that are members of the hernia society or whatever the name is, does non mean they are an expert, they pay the membership costs. I will recommend again read the book Unaccountable. At this time I want to help and inform as many people as possible. This not the surgery I was told about when growing up that it is just a hernia, one of the most simple surgeries.