[Casimir]

Could anyone chime in? 🙂

[Casimir]

@drtowfigh I’m sure you are far too fine of a person to come out and say it…after my experience I also have a hunch the surgeon, facility and aftercare is also a major factor…

I am seeing on FB and elsewhere so many people who are searching, many know they are uninformed — as unfortunately, I was uninformed too, but really didn’t know it after I thought I had a solution. I learn by experience in business and we rapidly iterate, and that unfortunately just doesn’t work well in this model, there are no trials — you have to really dig to get even basic info that is relatable to other parts of the journey and not just a clinical definition in isolation, and to be able to compare… it’s scattered, and people are busy with life.

What do you think of this?
An infographic of repair techniques, and as you say with pros and cons of same, the types of hernias and subsets (direct, indirect, more if there are), and which techniques match up generally to which, maybe with some other info to help when choosing the type of repair to consider. And what info to gather initially; questions to ask upon exam perhaps, in order to use the infographic properly, like what kind of hernia do you have, size, and subset so it makes sense and gives a good starting point on someones journey to get well. Along with corresponding Drs names and contact info if they choose to be on it — that do the techniques noted.

I think this — without exaggerating — would save many peoples lives, or quality of life. Which can be close to one and the same…

To make the right choice and be your own advocate, without being armed with the basic information or general roadmap, is hard if not impossible. So many are so desperate and scared… I have been trying to help with what I know, which is limited, but many questions are basic, and answers can be suggested, and if I can help… well I can do that at least. I have been pointing people to this fantastic resource as well to get answers that should be far better quality than what is generally available on FB too. Thanks for putting it together and keeping it going.

[Casimir]

Thank you for your reply again @drbrown

[Casimir]

@alephy I was told by a surgeon that small ones are very often more painful. Maybe there is more compression held in a smaller area…? I don’t know why. Your comment about a nerve getting compressed vs not would seem to be a major factor. I’d imagine like how a herniated disc can cause incredible pain or almost none, depending on it’s interaction with a nerve in your spine? Just my 2¢.

[Casimir]

Hello @drbrown and @drtowfigh
I was reading about Percutaneous Electrical Nerve Stimulation (PENS) and it is presented as it offers hope for relief. Can either of you, or any other doctors comment on it please? I had not heard of it before and it seems promising. Thanks in advance.

[Casimir]

@alephy I think in Germany I heard they try to identify their locations before surgery. And they do ultrasound before surgery to understand as much as possible the lay of the land.

[Casimir]

@andrew1982 Something happened to us. I would like to know what it was, though probably never will.

Yet, unless I am missing something, I can say that there was already a mistake before surgery even started —— in the operative report / records, my initial surgeon had it noted from my exam that I had a reducible hernia. Yet, it was not reducible, ever.

The hernia sack was very high up, a few inches at least, above the hernia location, which was indirect. It never was reducible at all. Unless I’m missing the definition — but as I understand, that means you can push it back in, and it was for SURE not going back in, anywhere. It was so far away geographically firstly, and just not going to go in as the hernia was small, even if you could could have somehow shoved it over through the skin. That was never done, I would never have let anyone even try that.

I wonder if he saw in his records that it said “reducible”, that he might have cut an incision starting higher up than needed, thinking the hernia was under the sack, and reduceable. The more ground covered, I’m sure must be the greater the risk. He said something to the person with me that the incision was a long one. I always wondered why, since I had a small hernia.

My 2nd surgery incision was considerably shorter and there was more to do.

Actually, they made two errors before surgery. They didn’t realize I was there for surgery the day of surgery — and thought I was there for a consultation. The person I was with thought that was a bad omen, and I SO wish I had walked out then.

[Casimir]

@andrew1982 He isn’t entirely sure what is causing it, he says the repair of the recurrence is rock solid and I don’t doubt it, that seems good.

We have a plan to see a back and hip specialist and then check into the nerves. I am pretty sure it’s the IIN at least. It was always buzzing in the groin when I did the treadmill after the first surgery. I will probably end up trying ablation. And pray. I saw your posts… I hope you are hanging in there?

[Casimir]

@andrew1982 Stopped doing physical things. A lot of burning. Pain is marginally less because I am not doing much of anything. :-/

[Casimir]

@alephy Got mesh in the end. Yes, in the US for the first.

[Casimir]

@alephy I can share what Dr Grischkan who does non-mesh told me, which is that he won’t do that because he said they will pull each other apart. He said at minimum need to wait 6 weeks.

I’ll tell you what though… I would likely have been much better off with the laparoscopic / mesh. Open carries it’s own risks that are considerable. I think Dr Towfigh said mesh and no mesh are statistically the same re chronic pain. Sounds like the doctor is the most important variant.

• This reply was modified 5 years ago by  Casimir.

[Casimir]

@drbrown Can you advise what sort of success rates are achieved by ablation, as a long term solution? Does that mimic the sensation of having had a neurectomy?

At what timeframe someone could be pretty sure it’s not going to improve, left alone? I’m thinking of the IIN.

Is nausea a known effect of IIN disruption or damage?

Thank you Dr Brown.

• This reply was modified 5 years ago by  Casimir.

[Casimir]

@drbrown Thank you. Is laparoscopic without mesh possible or a thing done?

[Casimir]

Thank you Dr Brown.

[Casimir]

[USER=”3125″]Alephy[/USER] Apparently he is really popular with the body building set, and runs pretty much on referrals, which to me speaks very favorably. I so wish I found him when I was looking, and I’ll add I so wish I had also known of [USER=”935″]drtowfigh[/USER] as well. And the other doctors on this forum. And this forum itself. Lot’s of “I wishes”.

[Casimir]

[USER=”3125″]Alephy[/USER] He does a modified shouldice, if it’s a first operation is my understanding.

No one felt I had a recurrence; told no recurrence by more than one surgeon. By the time he did operate he said he needed to use a small amount of mesh as there wan’t enough tissue remaining to do it his normal way.

By the way I posted this post twice — I attached the operative report on the other post, if interested. The incisional, the report goes into detail on that.

I am seeing him Wednesday for a followup. I am hoping and praying this needs time, and that time will heal.

[Casimir]

[USER=”935″]drtowfigh[/USER] This is exactly the type of information to have as a resource here, IMO.

I was recently speaking with a surgeon from Munich, and he said he was giving a presentation to a large group of hernia surgeons here in the US, and he asked by a show of hands how many perform ultrasound before surgery to know as best as possible what is going on prior to cutting — he said he was shocked when NONE raised their hands. Not a single one — and there were hundreds he was speaking to. He said they always do and would not consider otherwise.

It seems knowing what type you have is the critical first step (and how to find out).
And then, understanding the types of treatments available for that type – with pros and cons.
And lastly, knowing who does them.

I tried before my surgery to get a lot of info, and was literally unable to from various surgeons locally, other than yeah, you got yourself a hernia, time to do laparoscopy with mesh, so when do you want to schedule.

I didn’t know, what I didn’t know.

Therefore, I thought I did the right thing by getting a desarda on what was a quite small, indirect hernia. Which failed — and led to a huge incisional hernia. My story is posted elsewhere here, but suffice to say, it’s literally devastated us — far too many tears to count. It was a needless solution to my problem. And the aftercare was literally nonexistent when I did need it.

I always wondered why it never hurt lifting anything heavy, never ever hurt hiking, biking, running, and nothing ever happened when I coughed. Only now, only after reading through this forum, it’s all starting to make sense. Yet, not one single surgeon here took that as a hint, whatsoever. Not one suggested ultrasound to find out. I was close to understanding something wasn’t adding up — I sensed it, I was almost going to back out day of surgery, but, I was not close enough.

A resource here to help people understand the critical aspects in choosing a path forward would literally save some peoples lives, and their families. A life in pain is a life gone, and harms far more than that one. I can’t imagine how many others are in the same situation, needlessly. I so wish to God I had known a general outline in making a plan. Please consider it.

Thanks again for sharing your expertise and time on this resource.

[Casimir]

[USER=”935″]drtowfigh[/USER] Do you mean that indirect hernias are generally stitched up with suture, not like a Shouldice etc., and they cannot be done laparoscopically?

[Casimir]

[USER=”3124″]HollyH[/USER] Thank you.

[Casimir]

@good-intentions – This is just stunning the more I read. It is incomprehensible to me that, for instance in my case, I had an indirect hernia to your point, that was also small, and yet neither surgeon I saw — one wanted to do lapro w/ mesh, and the other does desarda — attempted to even determine the type or mention that there even are different types. Neither shared any information about the importance of that, or matching it to the proper repair technique. They knew I was strong though, and didn’t have much pain and still: They were were a hammer, I was a nail. I always wondered why I could lift things etc without a problem.

Previously an avid hiker, I can’t walk for any distance, am in constant pain. Sometimes I am literally on the floor writhing. I cannot fathom how people work this way. As a business owner I trusted that other professionals would show the same respect as I do for others, especially (if not even moreso) those operating on others. That trust was a mistake I and my family will live with likely the rest of my life.