Chaunce1234
Forum Replies Created
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[USER=”1593″]mamadunlop[/USER] any updates on your case? I hope you are doing well. Keep your head up!
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Echoing [USER=”2686″]tenreasy[/USER] comment, Dr Bruce Ramshaw in your home state of Tennessee is a very highly regarded hernia surgeon, perhaps you can try reaching out to his clinic and getting an appointment to check things out.
Good luck and keep us updated on your case and progress.
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quote tenreasy:I had laparoscopic robotic surgery done 8 weeks ago for an inguinal hernia on the left side. After the surgery I had minimal pain; only needed tylenol once in a while. I am pain free – back to 100%. Started working out ago a few days ago. My surgeon was Dr. Mark Toyama in Chicago (Northwestern Hospital). I highly recommend him.
Thank you for reporting back your experience and the name of your surgeon.
Out of curiosity, was your hernia painful prior to surgery?
Keep us updated on your progress!
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quote Good intentions:Here’s a story I just came across. It’s not a mesh story but it is about a surgeon whose name comes up. Dr. Meyers of the Vincera Institute. A young soccer player, Kellyn Acosta, who just got selected to the US Mens National team had surgery on February 22 and is almost back to full speed.
I see these stories and often wonder if “sports hernia” is used to cover all types of abdominal repair procedures these athletes have. I would guess that they report pain and the doctors do whatever they need to do to get them back to full performance.
Not to drag this thread off topic too much, but Dr Meyers is well known for returning professional athletes back to their respective games. From the standpoint of the pro sports team, each player is a significant investment worth huge sums of money to their business, so there must be something to the approach that Dr Meyers takes that they trust. And yes, Dr Meyers repairs regular groin hernias as well as core muscle injuries / “sports hernia”.
One way you can see the many pro athletes who are or have been treated by Dr Meyers is to use Google News search, go to the Sports section, and search for “Dr William Meyers” or “sports hernia.” If you follow pro sports, athletes you know and watch every week will often show up.
And somewhat funny but interesting nonetheless, the next time you’re in the grocery check out line, pay attention to the tacky tabloids with non-airbrushed half-naked celebrities / athletes pictures splashed across the covers, you’ll see a lot of open hernia repair incision scars on those abdomens. Of course it’s harder to see laparoscopic scars, but I’m sure they are there too…
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You should definitely follow-up with the surgeon.
Where is the pain? Is the pain in the same location always, or does it move or change? Can you pinpoint it?
What does the pain feel like? Can you describe it? Dull? Aching? Stabbing? Sharp? Throbbing? Tingling? Hot? Searing?
When did the pain start? Is it constant, or does it come and go?
Does it respond to NSAID (ibuprofen, naproxen, etc)?
Does anything make it feel better? Either an activity or otherwise?
Ultimately you’ll want to be able to describe the pain/discomfort as much as possible, as well as any alleviating or aggravating behaviors. It can help your doctor and potentially others as well.
Common things to try initially may be things like:
– extended course of prescription strength NSAID (30-60 days), assuming you can tolerate it. This can dramatically reduce inflammation if that’s the issue.
– if the pain is bad/annoying enough, then nerve block / steroid injection, sometimes repeated several times over the course of time particularly if the first one was even somewhat effective
Anyway good luck and keep us updated on your case.
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quote mamadunlop:Have you seen the documentary on Netflix called “The Bleeding Edge” If I had only known 7 years ago, what I know now. I am always wanting to find a way to get a story out to the news or the papers… it is so unkown and untalked about. You never see a news story about the dark side of hernia repairs….
[USER=”1593″]mamadunlop[/USER] I have not seen that documentary yet but thanks for the recommendation, I will put it on my watch list.
I did recently hear a disturbing podcast called “Dr Death” about a spinal surgeon which is an absolute horror show and really exposes some of the many serious flaws in the US medical system. I am not sure if I would ‘recommend’ the podcast, but it’s certainly eye-opening and disturbing… hopefully these kind of shows and productions will lead to some positive change where it is needed.
https://itunes.apple.com/us/podcast/…h/id1421573955
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quote paco:Many of my friends who have had hernia repair on the early days before the advent of meshes are all perfect and without recurrence or pain after years. So after all such techniques maybe are not so bad.
Anecdotally, and I will preface this by saying that none of them are particularly overweight, but everyone who I personally know who had a classic non-mesh repair has never had any pain or recurrence, granted most of those repairs were done 15+ years ago when it was still routine to use a tissue repair. That could suggest that back when non-mesh repairs were routinely taught in medical school and practiced regularly, it was a perfectly acceptable solution for most patients who are/were not obese, with very low complication rates.
The tissue repairs are very complex, it is an art and a skill that undoubtedly requires practice and extensive experience to learn and master. Clearly it is still relevant and desired by many patients, so it’s a shame that it is not as widely available today.
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[USER=”2707″]fidel18[/USER] Have you discussed this specifically with your PCP doctor? Perhaps ask if they will fight the insurance battle on your behalf for what you feel is necessary for you? It’s worth asking them. Share your concerns, do some research, make your case, be your own advocate.
Do keep in mind that is increasingly difficult to find non-mesh hernia repairs in the USA, so depending on your location that could be a hurdle if there are no practitioners who are able to perform that procedure near you. It’s also possible that it’s not the ideal solution to your case or your hernia, particularly if you’re obese where data shows the non-mesh repair is less effective.
Anyway, good luck and keep us updated on your case and progress.
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Best of luck, and let us know how it goes!
If you had a positive experience, consider sharing the name of your surgeon and their location as well.
Take care.
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quote Bure96:I had a my repair done at Shouldice and my testicles still shrink up when I’m cold and hang loose when I’m hot. I honestly haven’t noticed much, if any, difference in that regard.
This is great to report, indicating that whatever Shouldice does will not have a serious impact on normal anatomical function.
Additionally, I believe the scrotum itself has a separate mechanism of raising and lowering that is not related to the cremaster muscle/nerve branch, so that could be why a proper Shouldice repair has no apparent impact on whether testicles are appropriately responding to temperature differences. Alas I am not a doctor so I could be wrong about the precise anatomical functions and nerve branches.
On a somewhat unrelated note, it might be an interesting conversation topic if you [USER=”2600″]Bure96[/USER] were to report your specific experience with Shouldice and the repair, any outcome, thoughts, etc. I am sure many would be interested in reading it, and it could help other patients.
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From my own web-research it appears that Dr Grischkan has a huge volume of experience having performed something like 20,000+ hernias repaired, which is just a staggering number that one could reasonably expect conveys a significant level of hernia expertise.
As always do your own research, maybe try to talk to a patient or two.
Unrelated to Dr Grishkan but related to absorbable sutures and hernia repairs, I do recall reading another post here on these forums from a European who had a Shouldice repair with absorbable sutures that ended up failing, so perhaps consider permanent sutures, or at least discuss the options and potential risk/benefit with your surgeon.
Of course you could always consider Shouldice in Toronto Canada as well.
Good luck, and keep us updated on your case and decision making.
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I have seen Dr. John Etlinger in San Antonio, TX mentioned here and on other forums before, I believe he is able to perform both a mesh and no-mesh procedure on eligible patients. It may be a good starting point.
Perhaps another forum user will have more information for surgeons in Texas.
Best of luck and keep us updated on your case and decision making!
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I believe it is standard for the Shouldice repair to cut the entire cresmasteric muscle, which presumably removes its functionality and reflex even if the nerve is intact. One might think if it was a problem then Shouldice would have addressed it, but they may have something specific to their method that avoids that.
I think I recall reading at one point that at Shouldice they ‘pin’ the remainder of the cremaster muscle up so that a testicle does not dangle too far, but a surgeon who performs the procedure would be a much better resource to discuss this, and whether it may relate to neurectomy?
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Related in terms of mesh, unrelated in terms of the same surgery, is an interesting new article from BMJ titled: [h=1]”How mesh became a four letter word”[/h] https://www.bmj.com/content/363/bmj.k4137
“When it was introduced in 1998 as a novel surgical treatment for stress urinary incontinence, the polypropylene mesh sling was hailed as a quick and easy remedy for women and eagerly adopted by surgeons. Twenty years later, amid claims that it has left many thousands of women around the world irreversibly harmed, mesh is at the centre of a storm of protest that has launched tens of thousands of compensation claims, divided the medical profession, exposed major flaws in regulatory procedures, and raised serious questions about the financial relations between clinicians and researchers and the manufacturers of devices that outraged campaigners say are not fit for purpose.”
This is for vaginal mesh…. but does this not sound familiar in terms of hernia mesh issues?
I wonder if women are just much better at organizing around an obvious problem to get it addressed? Perhaps a similar movement will eventually organize around hernia complications.
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quote VegasHernia:Have put the robosurgery on hold. Wasn’t sure the rules in discussing specific doctors. Heading to SoCal for a business trip and plan to have a consult with a “hernia doc”. Unfortunately my insurance is out-of-network for my first choice. There is another one in OC that’s in-network, will follow up with them over the next few days.
If you’re heading to Southern California anyway, you might want to see Dr Shirin Towfigh in Beverly Hills or Dr David Chen at UCLA, both are well regarded.
Good luck and keep us updated on your case and progress.
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Shouldice has a much longer track record of success compared to Desarda repair, which is relatively new. I am not sure if there have been enough long term studies on Desarda repair, but it certainly seems promising. There is always the Bassini and Mcvay repair as no-mesh options as well.
Ultimately you have to do what you’re comfortable with, and with a surgeon you trust.
It is increasingly difficult to find no-mesh hernia surgeons in the USA however, so you may need to travel.
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Shouldice surgery performed at the Shouldice clinic has something like a 1% recurrence rate, I would not be overly concerned about recurrence if you had the procedure done in Toronto.
If recurrence has been ruled out, have you tried an extended course of NSAID (anti-inflammatory) to treat the symptoms? Or nerve blocks? Anything of that nature?
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I’m sorry you’re going through this.
Regarding an occult hernia: you might want to request a dynamic valsava ultrasound of the inguinal region where the location of pain is. It is essential that it is done with valsava (sometimes even while standing) so that adequate intra-abdominal pressure may reveal a hernia. You might even want to aim to schedule the ultrasound while you’re actively the most symptomatic, so if you know you’re most symptomatic during menses that could be the timeframe to schedule the ultrasound for. Just a thought.
Ultrasound of the inguinal region should be pretty effective at finding an ‘occult’ hernia, and they’re cheap enough that insurance usually doesn’t fight the imaging request.
Here are some potential resources for hernia surgeons on the west coast that may be a helpful starting point:
– Dr Sean Orenstein in Portland, OR
– Dr Robert Martindale in Portland, OR
– Dr Paul Dally in Vancouver, WA
– Dr Peter Billing in Seattle WA
– Dr Michael Mastrangelo in Bend, OR
– Dr William Brown in Fremont, CA
– Dr Shirin Towfigh in Los Angeles, CA
– Dr David Chen in Los Angeles, CA
– Dr Edward Phillips in Los Angeles, CA
– Dr Robert Burns in Newport Beach, CA
Good luck and keep us updated on your case and decision making.
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If you’re in Los Angeles consider seeing Dr Shirin Towfigh for a consultation, she is adept at diagnosing hernias and very well regarded (and also runs these forums)
Elsewhere in California, a variety of other practitioners who have been recommended by various patients on these forums or elsewhere:
– Dr William Brown in Fremont, CA
– Dr Shirin Towfigh in Los Angeles, CA
– Dr David Chen in Los Angeles, CA
– Dr Edward Phillips in Los Angeles, CA
– Dr Robert Burns in Newport Beach, CA
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[USER=”2721″]paco[/USER] I’m sorry you’re going through this.
You’ll read mixed reports on mesh removal, and there are good and bad stories. If you are considering it, be sure to find an experienced surgeon to consult with that does a lot of hernia re-do surgeries and that has significant experience in mesh removal.
Unfortunately I don’t know of any surgeons in Spain, but there are several well-regarded surgeons in Germany:
– Dr Ulrike Muschawek in Germany
– Dr Andreas Koch in Germany
Dr Muschawek performs many surgeries on professional athletes, including mesh removal. They may be a good starting point and perhaps has a network in Spain or closer to you as well.
Good luck and keep us updated on your case.