Beenthere
Forum Replies Created
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How long did you wait?
My first hernia I started the watchful waiting but the pain and bulge(right under my lap belt in the car)started to get worse about a month after the hernia occurred. With the bulge and the lap belt I was concerned about getting into a car accident that was minor but the lap belt causing more damage to the hernia. So three months in all.
My second to repair to correct what the first surgeon did plus repair a new inguinal hernia on the other side plus remove the mesh took almost two years between bad doctors and insurance issues. Found a great doctor and corrected everything.
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top hernia doctors in georgia or tn
I am not an expert but went through this and did a lot of research starting in 2011 and had mesh removal in 2013. If my memory is correct Dr. Amid was a leading expert and maybe one of the first in the area PHP and based at UCLA. Doctors Towfigh and Chen worked with him, I think. Maybe this is the reason for a west coast bias.
If you have a referral and can afford the time and money take advantage in seeing from what I understand is one the best PHP surgeons in the nation., go for it.
I met with doctors Goodyear, Ramshaw and Yunis on the east coast and would recommend any one from my interaction with them. I also had conversations with Dr G in Cleveland and Peterson in Vegas, they were also very helpful.
One more thing which I highly recommend is reading the book Unaccountable before your next appointment and surgery. I happened to find it at the local library and it made sense of the problems I had with my first surgery for a hernia. I could directly relate every chapter to the care I was given and made sense of the pain and suffering that happened afterward.
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top hernia doctors in georgia or tn
I met Dr Ramshaw and would highly recommend him. I had my Left inguinal, right femoral found while fixing the left side and mesh removed on the right by Yunis in FL and would highly recommend him.
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Encouraging percentages from Docs please!
Some of my recommendations from being in your position and what I learned.
I did what I thought was good research and asked the right questions but found out after my surgery, my surgeon was not the surgeon he or his staff made him out to be.
A few years after my surgery I found the book Unaccountable. This really opened my eyes and every issue the writer presented I could directly relate it to my first hernia surgery and why things turned out so poorly. highly recommend reading it before your search for a surgeon. I would also check out some websites. Dr. Goodyear has a great site with loads of very good information on it. I am sure there are others.
All it takes to be a quote specialist is stating you are a hernia specialist. After my first hernia surgery which had issues starting in the recovery room until my second surgery, I was told by my insurance company and the hospital of my first surgery in my search to find the next quote hernia specialist to fix the problems created by my first surgeon. They had me see five local quote hernia specialists and when I started asking the right questions and knowing what to look for in their answers I found out none of them had any special training in hernia surgeries or any experience in fixing what the original surgeon did. I lived with the pain and suffering until my insurance changed until I found a true specialist. Two of the doctors I saw just a few short years ago are now claiming that they a specialists in this field. I would not recommend them for hernia surgery and one not for any surgery. The hospital from my original surgery, basically stated that if a surgeon is licensed in the state as a general surgeon they are a expert in hernia surgeries.
Infection can happen after any surgery. Not sure if the hospital/clinic will provide that information to you on their known % of infection rate post surgery. Not sure if I have every heard of rejection of mesh but shrinkage. How and where the surgeon attaches the mesh is very important. Triangle of doom.
It comes down to the experience, skill, ability, caring and volume of surgeries of the doctor you chose and still sometimes you might be the one that has issues after the surgery, by doing your research and finding the right surgeon helps your odds. If it is a teaching hospital there is a good chance a resident will do the surgery with or without your knowledge or consent.
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Advice
My original diagnosis was an inguinal hernia but now I am pretty sure it was an incisional at my appendix surgery location.
The first was open with mesh. The second was lap for fixing the new opposite side inguinal hernia(a real one) and he found a unknown femoral hernia on the side of the original hernia surgery. They than went in open to remove the mesh from the original one. My local hospital never found the femoral one or did any proper imaging. Two years of pain and suffering.
Not sure if I should say but one in Florida.
Be careful, my local hernia center states they do sports hernia repair but when a top student athlete needed a sports hernia fixed they sent him to Germany.
Again I am not a Dr. but I think sports hernia have more to do with tears in the muscle or tissue in the groin area from movement- repetitive, sudden change in direction or stopping but let the experts chime in on this. I do know from research from trying to find a Dr that I think Dr. Billings was a noted hernia expert in the Northwest but he might not be doing hernia surgeries anymore. Dr Meyer in the Philly area is again I think known for his expertise in sports hernia surgery and I think he does a lot of pro athletes.
Good luck. Let me know if you have any other questions. Skill, knowledge, training, volume and known outcomes is very important. Again in most cases it is necessary but elective surgery. For some reason a lot of people blow this off as just a hernia and is the most basic surgery but from my research it is an area that is a very tight space with a lot going on.
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Encouraging percentages from Docs please!
Hi,
I am not a doctor but my hernia original surgery was a horror story. Not sure on Doctors in Boston but if you can travel see one of the highly recommended docs on this or other forums. I met the Dr. Goodyear, Ramshaw and Yunis for my second hernia and mesh removal. I would go under the knife with any of them or ones on this website. My decision came down to having a place to stay for a week for recovery. This second surgery went great. Was active within a week with mesh. There are other great ones across the nation.
Been There
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Advice
I hope this is OK that I am attaching my first office visit for evaluation on my hernia.
This doctor who did my surgery but has since moved out of state and is currently working at a hernia center.
This is the hospital that I had my surgery at and markets themselves as one of the best in the nation. They have also stated that my care was standard and acceptable. Also according to this hospital that as recently as late in 2012 they had a known 25% or higher post surgical pain after 1 year according to their own survey(found this out after the surgery, they stated all complications under 10%). They also state they are a hernia center.
In my notes from this office visit it does not show which side the hernia is on, location, size of bulge or diagram showing location. The doctor did both a standing and lying down exam of the inguinal area on this visit and one more. Maybe it is coded in the documents and only medical professionals can read it. No progress or patient notes!
Some advice to patients looking for a doctor, if you feel things are not right, ask for another doctor. I learned this too late, I had this feeling but was told by the doctors staff how great the doctor was, performed hernia surgeries all of the time and excellent outcomes. Afterward I found this was just standard information they gave to everyone. GO with you Gut feelings. In most cases this is necessary but still elective surgery on how soon you get it done.
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Laparoscopic mesh removal vs open removal
Not sure if I can be of much help on the subject.
My ordeal started early in 2011 with a quote right inguinal hernia and surgery. Not sure if I ever had an inguinal hernia. Right after my surgery things did not seem right and had a slow recovery until 6 weeks post surgery while when driving I had what I would call a knife slicing or ripping feeling in the surgical area internally and extreme pain. The Dr. office downplayed this change in recovery as just normal but the pain was intense and did not get better and even affected my walking. For 2 years I did everything to resolve the pain and suffering. The hospital and the Dr.’s never ordered an MRI to find out what was wrong. In mid 2011 I had extreme pain on the left side and a CRT found a small inguinal hernia. Finally I had my insurance changed in 2012 for $1,500 deductible I could go any place for surgery. I met with three surgeons that were highly recommended on other hernia websites. I decided on one Dr. and we agreed to fix the left side via lap and remove the mesh on the right side via open(original was open on this side) at the same time early in 2013. The findings post surgery were surprising since he found a femoral hernia on the right side during the lap portion and fixed that and still removed the mesh via open surgery( I only wanted to under the knife once). In recovery I could tell things were better and within days I was walking without the pain I had before the surgery and could walk normally again. In fact within a week I was shooting a vintage car race at Sebring and climbing over the short chain link fences in my way(no Dr.s orders against this but I am sure not approved)
My removal surgery went very well but since I think most if not all of my pain and feeling being very tight in the area was from the femoral hernia. That’s why I think my case is different than most suffering from PHP. But I did go through all current medical hoops for PHP to relive the pain and some that most have not, like ART(long list). If the Dr. had ordered a MRI it could have been found right away that I had a femoral hernia and fixed but they kept stating they wanted area to be completely healed before they would agree to any imaging and than they never did. I never had any visible bulge for any of the hernias I had.
Good luck, I know this is extremely frustrating and hard to get answers and find a great Dr. to help.
Many thanks to Dr. Towfigh for this forum.
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Importance of lipoma of the cord
I missed your response. I wrote about some of the experience under Wisconsinherniadoc. Not sure if I should start a separate conversation for more of my experience. It was short being only two years but I had to fight the whole way to find the answers and have the original surgery redone. Thanks your interest.
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What ?s should surgeons be asking their patients?
Thanks for the reply’s. What concerns me is a multiple of issues in my long hernia journey. My case should have been I think pretty straight forward, if I had been given a Surgeon according to my very specific requests. I was told by the person who set up my initial appointment that he was a highly trained hernia specialist that performed hernia surgeries all of the time. I just found out that he had performed 0 in the 18 months leading up to my presurgical consult and that it was known that this quote world renowned hospital had a known 25 to 30 percent 1 year post surgery pain rate. Here is some background. My hernia occurred during a bad coughing spell at the site of the surgery for aN open appendicitis operation about 30 years ago. I will use this from another post ” It is just right of midline between my belly button and pubic bone”. My GP’s PA did the initial diagnosis and said it was a inguinal hernia. The quote expert hernia GS did two separate inguinal exams on different dates both lying down and standing and could not find anything and asked where is the bulge and I pointed to the spot described above. In his notes there is no mention of this, his findings or diagram of the hernia location. A couple on months later it was getting slightly worse for protruding and pain, plus when driving the top of the lap belt ran across it. So I decided to go ahead and have it fixed. So here is were this leads to in this post.
I was told by every staff member of this Doctor by phone or during consults which there were three, how great of surgeon, his current training and knowledge, that he performs them all the time and excellent outcomes at this clinic at 8% or less total problems and/or complication. So after the surgeon and his staff went thru what to expect and was given the little booklet here are my questions to the doctor which I asked.
When I left the first consult watchful waiting and open surgery.
This is what I asked to his PA and what I was told. second consult for surgery work up
How many has he done – performs them all the time since coming to the hospital about 18 months.
Will he perform the entire surgery – we do not have techs so a resident will only assist. She also stated that the resident would be the only non licensed person in OR. It would only be the surgeons highly trained and experienced team in the OR.
Gave the name of a class mate that is anesthesiologist that I would not be comfortable with doing the gas – Agreed but not noted in notes plus told the that it would be a highly experienced general anesthesiologist doing the gas.
Asked about metal-no metal to be used – absolvable sutures were to be used.
What is there are complications or pain post surgery – we have a world renowned specialist on staff for post pain to resolve the issue.
Surgery changed to Lap.Second consult with surgeon 3rd total. Changed back to open surgery. When I asked why no reason given. But again this is supposedly one of the best hospitals in the nation and being told constantly how great my surgeon is I except this.
Questions I ask the surgeon.
How many times have you done this type of surgery – well over 1,000
Are you going to perform the entire surgery – yes according to their residents exit survey the residents might perform up to 90% of the surgeries at this hospital.
What about current training – I am up on all current techniques for open hernia surgery
What or how do you deal with the three main nerves – We agreed he would locate and preserve. When asked after the surgery about why no note in post op about two of the nerves were not reported I was told not in the surgical field of vision.
What type of mesh to be used – We agreed on lightweight mesh. Heavyweight(PMII) was used and he could not answer why but another PA stated he performed so few since coming to this hospital that he might not have known approved types available.
Time of recovery – 6-8 weeks to be fully recovered.
Can I travel by plane in 10 day s- no problem
Side effects and complications – listed seroma, hematoma and infection as the three main ones. The writer of a study that found they had a 25% post pain issue was in the consult room at the time and said nothing. Also I had two previous surgeries in the general area and never mentioned a possible loss of testicle. Less than a week after the surgery the doctor stated he inserted the mesh a tight as possible
Pure tissue surgery – no can not be done that way.I now know that I forgot to ask two important questions-Why are you recommending open over lap and if doing it open why are you recommending a general over local.
I think I asked the right questions and was given the answers they wanted me to hear, that led me to consenting but after my surgery and reviewing my history plus what I have found I believe I was intentional missed informed.
That is why I stated this and Dr. Goodyears forum along with the book unaccountable should be required by consent it obtained.
Doctor Towfigh if you or the other mediators would like to review my history I would be more than happy to forward them to you.
Thanks again for all of your time and help you provide to this group
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Importance of lipoma of the cord
That may be the best short answer to the difference in why in open surgery it is removed and lap surgery it is not. This response should be a sticky. One more question on this is a lipoma the same as a hernia sac?
Not sure if you or anyone else would want to hear my op report and any of the history before and after the surgery.
Thanks again for the excellent response.
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No mesh tissue repair surgeons in Washington or Oregon?
I hope we are not looked at on taking over the forum. I can not help on your question but there is a question that I have wanted to ask that ties into this.
From my research in postings on this site and others, it seems that with mesh surgery post long term surgical pain can be 20% or higher with up to 3% disabling, with a very low recurrence rate. Or a pure tissue hernia surgery done by a highly trained hernia expert seems to have almost the complete opposite numbers under 10% pain and maybe a recurrence rate of 20%. As a patient I would go with the second option if I had a choice. I was told by my surgeon no to pure tissue surgery. My guess that he did not have the surgical skills to do a pure tissue surgery. Can the experts shed any intelligent reasons for mesh that outweigh the aspect of incidence of higher pain that might be life long and change your lifestyle? If in 15 or twenty years I need have it redone so be it.
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What ?s should surgeons be asking their patients?
I hope this is not breaking any rules of the forum. My first searches and information came from I think the forum herniawebmd and than Dr. Goodyears website. From the people who had the same problems many names came up multiple times. I started contacting them: Dr. G in Cleveland he spoke to me at least twice(maybe 2 hrs) in the evening going over multiple issues and was very helpful and never a charge, seemed more concerned with helping me than his time or money. Dr Peterson in Vegas I had contact with but was I think he was no insurance. On the list but I never contacted were Dr.s Amid, Chen, our host, Billings in Seattle and a couple more.
When I found out my insurance was changing I narrowed the search to Dr. Yunis, Ramshaw and Goodyear. Spoke to all three at length and than spent the time and money to meet with all three in person. All were excellent and made the choice harder. Hate to say it but it came down to my in laws had a place within 1 hour of one of the Dr.s so I could spend over a week recovering and see the Dr. before returning to home. I think any the list I described would be excellent choices.
Before my insurance changed it was a complete CF or SANFU. After finding out about my original quote expert I was not about to be screwed over again. I referred toat least five quote local experts and found they all were just general surgeons without any special training or experience with correcting post surgery pain and discomfort from hernia surgery. One supposedly a leading hernia experts, had a total of 75 hernia surgeries and when it came to triple neurectomies and mesh removal surgery he had performed none. Another again with no triple neurectomies or mesh removal surgery done but stated it would be an easy surgery to perform without any supervision from a true expert.
Make sure you ask very specific questions and if you have any doubt ask again and again. If you still have that gut feeling something is not right find another Dr. Your health is too important. Also in a teaching hospital get it in writing that the expert surgeon will perform the entire surgery and read the informed consent very carefully and redact any item that does match the agreed upon treatment with your surgeon. This is the fall back and out for the Dr. and hospital that you were fully informed and signed this contract.
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What ?s should surgeons be asking their patients?
HI Groundfaller,
I hope things are better for you. What you describe sounds very much like my experience. As soon as my condition worsened about 7 weeks post surgery I found out the truth about my quote expert hernia surgeon who supposedly performed a large number of hernia surgeries with less than 8% total side effects and complications prior to mine. Afterward when I got worse, I was told the surgeon had no idea what was wrong since he performed so few hernia sugeries. Six years post surgery I just found out he had done a whopping 2 hernia surgeries(just days before my operation) before mine in the previous 18 months. What is also shocking he is now posting online as a surgeon at a Hernia Clinic. And according to a report I received if accurate he did not perform one hernia surgery between 2011 and 2015.
When my problems started it was me that was the problem and was bounced from different specialist to different specialist but when questioned they had no real expertise in this matter unlike the moderators on this site. I finally got new insurance and paid out of pocket to go to one of the real hernia experts to be fixed. Less than a week after corrective surgery I was without the previous pain, walking normally and even spent 11/2 days spectating at an auto race, meaning I was walking the whole day.
I agree with your “First and most importantly, there needs to be more dialogue and more time spent working with the patient. For lack of a clinical term, don’t leave your patient with “lost cause syndrome.”” statement.
I firmly believe that every hernia patient should be given this website address, Dr Goodyears website address and be given a copy of the book Unaccountable before surgery unless an emergency. This would give the patient a much better understanding and true picture of what is to come.
Next there should be a complete checklist that both the Dr. and patient need to check all of the boxes on all aspects of the surgery before the informed consent.
Than the patient should be given a complete copy of all presurgical visit notes and the agreed upon surgical treatment plan to take home and review to make sure it is accurate and complete. I thought I covered all the bases with my surgeon and his staff prior to my surgery, but when reviewing my medical history post surgery I found they failed to note any of the agreed upon treatment plans and none of my history was accurate and no notes by the doctor on the location of my hernia. Here is one example: The doctor agreed that he would locate all three nerves and preserve them. Post op notes states only the inguinal nerve found and preserved. When asked about why the other two nerves were not noted in the post surgical report it was stated that the other two nerves were not in the surgical field of vision on an open procedure.
Informed consent should be given at the last appointment before surgery to be taken home and read at ones own time frame and reviewed by a lawyer if so desired. Instead of being given seconds before you are being wheeled to the operating room.
Again I hope everything is better.
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Importance of lipoma of the cord
I guess I am a little confused and it does not take much for that to happen me. In Dr Goldstein response 2 days ago “They can produce the same symptoms as any hernia except for bowel obstruction because they push on nerves and can even strangulate which causes severe pain as the fat dies. There is no difference between a cord lipoma and a fat containing hernia.” If the Lipoma can cause severe pain and bowel obstruction , why than is it mostly removed during open surgery “and not removed during laparoscopic repair because it is not necessary.”?
So in my case I was told after the surgery that I had an direct/indirect sliding hernia with removal of lipoma. Can that all be happening on the same side without any pain or bulge?
Plus what about the pathology and side effects or complication of removal of lipoma?
Thanks
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What ?s should surgeons be asking their patients?
It looks like Dr. Greenberg has not been on the forum for sometime but wanted to put my two cents in on this. With you being specialist in hernia surgery and as a hernia patient, I would hope that you should cover most if not all the questions I would ask as a patient, since this is one of the most common surgeries. When I do hear all the information from you and your staff than I can formulate my questions and the these would than be answered honestly and completely.
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Importance of lipoma of the cord
If a lipoma is found in 23% of the cases, do you bring this up in your pre surgical consult to the patient?
Is that 23% in males only or all 23% of all inguinal hernia surgeries, meaning in males the number is closer to 50%?
Do you send all lipomas to pathology?
Any complications to removing a lipoma?