

DrBrown
Forum Replies Created
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[USER=”2482″]katiebarns[/USER]
What does your primary doctor say?
Please post a photo so I can see the site of your pain.
Nerve pain will often cause skin sensation changes. Does your skin feel numb or burns when lightly touched?
Muscle pain usually gets worse with activity and improves with rest.
Regards.
Bill Brown Md -
[USER=”2777″]Mariel[/USER]
It often takes a long time to heal after hernia repair.
I would advise you to return to your surgeon.
If the pain is related to a nerve, then a nerve block can be very helpful.
If the pain is related to the mesh, the mesh can be injected with steroids.
You can be checked to be sure that the hernia has not recurred.
Regards.
Bill Brown MD -
[USER=”2967″]MeshMangledMerritt[/USER]
If you can make he trip to see me, I can examine you and then write a letter on your behalf that you can use to try to get the VA to let you go outside of the system.
Also, complain to your local congressman/woman.
Regards
Bill Brown MD -
[USER=”2851″]alliecook[/USER]
Elasticity
The abdominal wall stretches and contracts with every movement. In an ideal situation, the mesh should contract and stretch with the body, otherwise, when the abdominal stretches and contracts and the mesh does not then there will be shear stresses where the abdominal wall and the mesh meet. Unfortunately, even the best mesh will stretch only half as well as the abdominal wall. Why use mesh when you know it can decrease the performance of an athlete? [h=2]Shrinkage
In your mind visualize a piece of mesh that has been used to repair a hernia. It is usually placed in between the muscle layers and there are many sensitive structures nearby. Then imagine that mesh shrinking. As the mesh shrinks, it will pull on everything nearby. If the mesh pulls on a nerve, then there will be constant burning pain. If the mesh pulls on the spermatic cord, then sex will be a distant memory. If the mesh pulls on bladder, then there will be spasms when you urinate. If the mesh pulls on the abdominal wall, then there will be pain when you exercise. Most meshes will shrink about 40%.
Youths
Since all meshes shrink with time, it is unthinkable to put mesh in an athlete who has not finished growing. What is going to happen when the athlete grows 5 inches and at the same time the mesh shrinks?[/h] [h=2]Foreign Body Reaction[/h]
All meshes illicit what is called a Foreign Body Reaction. It is the body’s attempt to get rid of what should not be there. (It is nice to know that the body is smarter than many surgeons). Macrophages, lymphocytes, and Giant Foreign Body Cells attack the mesh with acid, free radicals, and enzymes. Mesh usually survives this attack, but the attack does result in a chronic inflammation and pain. [h=2]Pain and Mesh[/h]
About 15% of patients after a hernia repair with mesh suffer chronic pain. The pain usually starts several months after the operation. As we discussed, the pain is caused by multiple factors: shrinkage of the mesh, sensitive structures becoming scarred to the mesh, and the result of the Foreign Body Reaction. When the mesh is removed and then examined under the microscope, there are multiple neuromas indicating nerve damage and there are granulomas indicating the body’s attempt to reject the mesh. Unfortunately, even after the mesh is removed, many athletes still suffer from pain.Regards.
Bill Brown MD -
DrBrown
MemberAugust 17, 2019 at 3:36 pm in reply to: pain medications after surgery/anti bruising ointmentsDear Dill.
I advise a list developed by Dr Towfigh.- Arnica Montana, 12C – Take five sublingual pellets three times a day.
- Alpha Lipoic Acid, 300 mg – This treatment can be effective in reducing nerve pain. It is difficult to extract from natural sources, so it is usually chemically synthesized. Take one capsule once a day.
- Bromelain, 500 mg – Take one tablet twice per day.
- Ginger Root, 500 mg – Especially effective in preventing nausea, it can also help reduce inflammation. It is harvested from the rhizomes of the tropical plant. Take one capsule twice a day.
- Super B-Complex – This treatment helps reduce nerve pain. Take one tablet daily.
- Turmeric, 500 mg – Turmeric is also harvested from the rhizomes of a plant grown in southern Asia. It helps the body reduce inflammation and decreases nerve pain. Take three tablets once a day or in divided doses.
Keep your bowels regular with milk of magnesia.
You can alternate advil and tylenol.
Ice packs.Good luck.
Bill Brown MD -
[USER=”2944″]mattl[/USER]
Dear Mattl
Most insurance companies require that you go through your PCP. The PCP can order the test and get the authorizations required.
Regards.
Bill Brown MD -
[USER=”2921″]Hiway40blues[/USER]
The longer you have pain preoperatively, the more likely you will have persistent pain after surgery.
I would advise you to see your surgeon and have it repaired in the near future.
regards.
Bill Brown MD -
DrBrown
MemberAugust 16, 2019 at 4:03 am in reply to: pain medications after surgery/anti bruising ointments[USER=”2758″]Dill[/USER]
I agree that herbs can be very beneficial.
Bill Brown MD -
DrBrown
MemberAugust 16, 2019 at 3:57 am in reply to: Asking Doctors about suture material and removal.@Dill
I meant that the complications from sutures are rare.
I apologize for the error.
I am a strong proponent of pure tissue repairs for inguinal hernias.
Regards.
Bill Brown MD -
[USER=”2958″]GettingAnxious[/USER]
The recurrence rate for indirect hernias repaired with or without mesh is the same.
Since the recurrence rate is the same, strongly consider a pure tissue repair.
Regards.
Bill Brown MD -
Please keep us updated about your results.
regards.
Bill Brown MD -
[USER=”2959″]thkenster[/USER]
The area of your pain is in the distribution of the ilioinguinal nerve.
Ask your local doctor to block the ilioinguinal nerve. If the skin does not turn numb, then the block was not successful.
If the block is successful and you pain resolves for a few hours that is strong evidence that the nerve is entrapped.
If the pain does not resolve then the mesh itself should be injected.
More information about blocks is available at:
https://www.nysora.com/techniques/truncal-and-cutaneous-blocks/truncal-and-cutaneous-blocks/regards.
Bill Brown Md -
[USER=”2967″]MeshMangledMerritt[/USER]
Dear Merritt.
You need to make lots of noise to get the VA to listen to you.
Do not hesitate to contact you congressman or congresswoman with your story.
Your best chance for improvement is to have the mesh removed with a neurectomy.
You can print the following articles as evidence that mesh needs to be removed.
https://www.sportshernia.com/treating-mesh-pain/reference-articles/Regards.
Bill Brown MD -
[USER=”2850″]Sibel[/USER]
A Nuck cyst will sometimes communicate with the peritoneal cavity.
The amount of suture used is minimal. The chances for a foreign body reaction are minimal.
Prolene or a long-lasting absorbable suture are both excellent choices.
Regards.
Bill Brown MD -
[USER=”2777″]Mariel[/USER]
I know that it is hard, but be patient with your recovery.
Give your body more time. It is common to have pain for around 6 months.
Regards.
Bill Brown MD
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There is no literature that I have read that proves that mesh causes autoimmune disease, but I have had several patient whose autoimmune disease became worse after implantation of mesh and improved after the mesh was removed.
Most inguinal hernias can be repaired without mesh.
Large ventral hernias, mesh may be the only option.
Regards.
Bill Brown MD -
DrBrown
MemberAugust 13, 2019 at 3:08 pm in reply to: One surgery for bilateral hernia and fistula possible?[USER=”2793″]spinotza[/USER]
It is not a good idea to combine a dirty operation with a clean operation.
Especially is mesh is used. If the mesh becomes infected your life with be a nightmare.
Regards.
Bill Brown MD -
DrBrown
MemberAugust 13, 2019 at 3:05 pm in reply to: 4 Weeks Post-Inguinal Hernia Repair– New Onset Testicular Pain[USER=”2964″]Nacly[/USER]
Be patient with your body.
Pain is common.
Most likely the pain will resolve with time.
Keep in contact with your surgeon.
Regards.
Bill Brown MD -
[USER=”2959″]thkenster[/USER]
Post a photo of yourself with marks on the skin that identify the sites of your.
Then I can let you know the most likely nerve involved.
Bill Brown MD -
DrBrown
MemberAugust 13, 2019 at 2:41 pm in reply to: Asking Doctors about suture material and removal.[USER=”2758″]Dill[/USER]
When suture is used the amount of material used is minimal.
Complications from mesh are rare.
Regards
Bill Brown MD