Chaunce1234
Forum Replies Created
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Chronic RUQ pain
You may want to look for a plastic surgeon with an interest in peripheral nerve problems. Maurice Arregui in Indianapolis is a good general surgeon with expertise in abdominal wall problems. He may not be able to do the injection, but may know a plastic surgeon. Feel free to use my name as a referral to him, and mention hernia talk. DE
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parietex progrip removal, an exercise in futility?
I love the analytical thinking! Unfortunately, it wouldn’t work. The reason is that the tissue actually grows through the pores of the mesh, and that tissue is not dissolvable (at least no way that we know). If it’s infected, that tissue ingrowth doesn;t happen. As for removal for pain, it’s legit, but sketchy, and shouldn’t be done without a very thorough evaluation, particularly looking for other causes of pain. You may want to try the medrol dosepak though – way stronger than aleve. Just don’t take NSAIDs at the same time.
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Possible recurrent femoral/inguinal hernia for female
A ct or ultrasound can miss a hernia as you are aware, especially if they were not done while you were bearing down and/or pushing (increasing abdominal pressure, known as a Valsalva maneuver). It’s possible that the hernia had nothing to do with the pain in the first place. It’s also possible the hernia is back, but unlikely. Sometimes, the only way to diagnose the problem is with another operation, but this should generally be the last resort. I would get an MRI, specifically looking for recurrent hernia, but also looking for surrounding musculoskeletal problems such as adductor, rectus muscle, psoas muscles, inflammations, along with hip or back problems. The test is non-invasive, and has no radiation. You’re primary should push for insurance approval for this.
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parietex progrip removal, an exercise in futility?
marcello71 – I’m sorry to hear your having problems. It sounds like your initial symptoms were not due to hernias. Having said that, without an exam, it’s very hard to know if there were hernias, weaknesses, or nothing. It’s also difficult to know if the mesh is causing the current symptoms or not. In the event there is an ongoing inflammatory component to your symptoms, would consider a month long course of anti-inflammatory treatment. This includes a medrol dosepak, followed by 3 weeks of naproxyn. Myoflex cream or aspercreme topically, and ice/heat used on a schedule based on trial and error as to what seems to help best for you. I have seen this work many times, but not every time. This is easy, and low risk, and if you have any side effects from the meds, simply stop them. These should be prescribed by a doctor who should go over all the risks/benefits so you can decide. I am interested as to what your idea is about separating the mesh from the surrounding tissue. There is no “right” answer to mesh removal timing, but usually, the longer the better, unless it’s within a week or so. Hope this helps!
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to be or not to be a hernia?
jackieg – While nobody can predict the future, the hernias can be a source for your pain. From what I can see on the MRI report, there doesn’t seem to be a problem with the rectus muscle insertion or either adductor tendon that’s causing the pain, although the left adductor was abnormal. As your symptoms seem to be quite significant, it sounds like a diagnostic intraperitoneal laparoscopy, and laparoscopic hernia repair (TAP or TEP) would have a reasonable chance at making a diagnosis and treating the problem. Obviously nobody can guarantee success, but at least they could try. In NYC, you could see Brian Jacob who operated at Mt. Sinai, or one of my previous fellows, Rebecca Kowalski who operates at Lenox Hill. Both will listen, and will sincerely try to help you. Hope this helps!
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Female pelvic pain, hernia?
jlteam5 – Could be a Bartholin’s gland cyst. A gyn doc could help sort that out. Also, you can find surgeons interested in hernia repair at the Americas Hernia Society website. Hope this helps! If I hear of any Iowa general surgeons I’ll let you know. DE
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Inguinal hernia recurrence
Excellent!
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mesh removal
Sorry to hear your having so much pain. There is an expert hernia surgeon in Baton Rouge if that’s closer. His name is Karl LeBlanc, and I’m sure he would be happy to see you for a consultation. Feel free to use my name, and tell him you were referred by Hernia Talk. Hope this helps! DE
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Is this a Hernia? In desperate need of help!
Bravo! Always nice to get back to a normal life. That is why we do it! Thanks for the update. DE
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Ventral incisional hernia
I’m sorry you’re going through this.Sounds like you had a painful incisional hernia that was repaired with a technique (no mesh) that is known to have a high failure rate. Incisional hernia is unfortunately a common problem that is frequently misunderstood by both patients and doctors (including surgeons). There are however many techniques that use mesh that all have relative advantages and disadvantages. Sometimes a physical exam is all you need in order to proceed with an operation, but each case is unique. Best to find a surgeon that has training and experience in multiple techniques in order to pick the best one for you. This process includes identifying what your goals are for the surgery, sorting out you medical history, then choosing a technique that will have the highest likelihood of success for your goals, then choosing a mesh that is appropriate for that technique. You’re goals will be centered around symptom relief, but may also include restoration of a more normal abdominal wall contour if there’s a large bulge, revision of a wide scar, etc. You can find surgeons interested in hernia repair at the Americas Hernia Society website. Hope this helps!
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Chronic RUQ pain
Katie – I wish I knew why. All I know for sure at this point is that since it is a diagnosis of exclusion (can’t find any other reason), it’s really hard to say why this happens. It could be the way your anatomy was put together in utero, or something that happened during life, or some combination. In any case, it’s almost certainly not a hernia, but I would definitely do the MRI, and keep looking for an answer. May some sort of physical therapy, or alternative medicine things such as acupuncture as one example. Topical agents, ice or heat based on trial and error. Maybe even a steam bath or hot tub. Whether or not you go through a diagnostic laparoscopy will depend on the severity of symptoms, and your own risk/benefit assessment. I wish I had a magic wand, but hang in there, and don’t give up! DE
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Chronic RUQ pain
Katie – I’ve heard this story many times before. My best guess is that is a muscle spasm. I usually recommend myoflex cream or aspercreme. The knotted, spasmodic muscle feels like a lump, and can sound like a hernia. Hope this helps! DE
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Hernia or Psoas?
If you’re willing to travel, consider Melina Vassiliou in Montreal. She’s a general surgeon who will listen, and is an expert in hernia repair. Hope this helps!
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Learning about various techniques: Dasarda Technique versus Mesh surgery?
Dan – Let me put it like this. I too am active, and fit. I know all about the risks of mesh, and have seen patients with mesh complications. They are however the minority, and when I got my hernias fixed, I had them done lap, with mesh. You’re free to choose whatever technique you want, and it is important you are comfortable with your decision. Hope this helps! DE
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Questions to Ask General Surgeon
ASk if you can have an MRI to look for other causes, such as musculoskeletal problems in the adductor tendon, psoas muscle, rectus muscle, hip or spine. They would need to ask the radiologist how to order the test to get the proper information, including hernia. These (with the exception of hernia) are not seen on ct scan. The other alternative, and you may end up with this anyway, is a diagnostic laparoscopy with or without hernia repair. Sometimes the fat in the preperitoneal space can cause groin pain in women, and there is about a 60-70% chance of improvement with lap hernia repair in this situation (provided the pain is groin/pelvic). An intraperitoneal diagnostic laparoscopy can also look at the appendix directly, along with the ovaries, as well as for endometriosis. If it comes to this, may want to also ask if the case could be combined with a gynecologist. Hope this helps!
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Inguinal / Femoral hernia?
Excellent! Please keep us posted as to what happens. Best of luck. DE
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Persistent Pain in Upper Right Abdomen – Hernia in Abdominal Wall?
Ok thanks. Good luck.
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Persistent Pain in Upper Right Abdomen – Hernia in Abdominal Wall?
It’s almost certainly not a hernia. I have seen muscle spasms in this exact location mimick a hernia. Pain associated am with a bulge. The bulge turns out, is the muscle balling up in a spasm. Usually massage helps. It’s a good idea to see a surgeon anyway to get a more complete evaluation. I would recommend Dr. Ashtosh Kaul at Westchester County Medical Center in Valhala. Feel free to use my name, and let him know you were referred through Hernia Talk. Hope this helps!
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Small Umbilical Hernia Repair Advice
Still looks normal.
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Groin Pain – 4+ years of pain and frustration
That’s quite a story. I’m sorry you’re going through this. Consider trying a Medrol DosePak, followed by 3 weeks of naprosyn twice per day. Use ice, heat, and myoflex cream on a schedule to be determined by trial and error. This is a one week course of oral steriods, followed by nonsteriodal anti-inflammatory. I like to think of this like there are still hot coals under dirt put on a fire, and the oral medication is like water seeping down through the dirt and extinguishing the hot coals. I have seen some remarkable success with this, and some that didn’t work. It is easy, and low risk. It could be this simple…