DrEarle
Forum Replies Created
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top hernia doctors in georgia or tn
Momof4 – In Virginia – Sharon Bachman can help you out. If you wanted to come to Massachusetts, I would be happy to see you. Just call rae at 978 632-0123.
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New diagnosis
Great choices Dr. Towfigh
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Diagnosing
Goldenmsc – An inguinal hernia is a hole in the abdominal wall in the groin area through which abdominal contents can pass, and cause pain, discomfort and a bulge. A sports hernia is a term used for a variety of conditions that cause groin pain such as a muscle tear, tendonitis, hip or back problems, and sometimes even an inguinal hernia. Since hernia represents only one cause of groin pain in athletic individuals, the diagnostics usually include an MRI for sports hernia, and not for a straight forward inguinal hernia. Hope this helps!
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Have I messed up my hernia surgery?
aminuts – If you’re gardening and lifting heavy rocks, it sounds like you are an active woman. You cannot hurt the hernia repair. It is done. The laparoscopic method places the mesh behind the hole, same as fixing a car tire, so no worries there. There is no logical physiologic explanation to tie your symptoms in to a single diagnosis with a cure. If you’re able to remain active, maybe you should just keep on going, and accept minor aches and pains, as long as you can still live your life normally. If the problem is more severe, keep looking in to it. It is normal to have some aches and pains for many reasons, including previous surgery, but not if they are severe and/or preventing you from living your life. Hope this helps!
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Hernia – Newbie questions.
donjack – small hernias in men can be safely watched for a time without activity restriction if minimal or no symptoms. We don’t know if that’s the same for women, and we think the risk is higher for watching hernias in women. While there’s no hurry, a consultation with a general surgeon can give you more info to make an informed decision about repair or watchful waiting. Hope this helps!
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Finding no-mesh inguinal hernia surgeons on west coast?
Chaunce123 – Excellent perspective. I would also like to reiterate that if you ask a surgeon his/her rate of chronic pain two years after operation, few, if any will know. So if they tell you it’s zero, they are not telling the truth. If they state they’re in a small area, and surely their patients would return to them, therefore their numbers are accurate, they are not. If someone advertises on the internet and has a bunch of patients from out of town, they definitely do not know. Just though I would mention those things as well when asking your questions.
Something else you should think about is the rationale for your desire not to have a mesh. If it is because someone you know had a bad outcome with mesh, you should know it’s more about the technique and surgeon rather than the mesh. Having said that, mesh can cause problems, but they are uncommon when you look at those definitely related to mesh only (excluding technique/surgeon), and the denominator of the hundreds of thousands of pieces of mesh used for hernia repair every year.
Hope this helps!
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Umbilical hernia + diastasis
Lonnie – You mentioned diastasis in you title, but nothing else. A diastasis is when you do a “crunch”, and it looks like a big bulge from your breast bone all the way to the belly button. This can vary in size. It is of no physiologic or anatomic consequence whatsoever. It does drastically increase the risk of recurrence after mesh-less umbilical or epigastric hernia repair, which you had. There are many mesh products specifically designed for this type of repair, and you should have one of these placed if you’re going for another repair. It will not get better with anything except an operation. If you choose to watch it a while, that’s fine. Seek medical attention if starting to cause pain/discomfort, or enlarging in size. When I get to another computer, I’ll post an article written for surgeons that you may find interesting. It has some photos of these mesh products in it. In the mean time, you may find this article interesting.
http://www.ncbi.nlm.nih.gov/pubmed/25217109 -
Day 3 – post bilateral inguinal hernia surgery
Justadude1973 – I’m sorry you’re having a tough time. This seems to be excessive pain based in your description, and an earlier follow visit is in order. Call your surgeon and ask to be seen tomorrow.
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Autoimmune Watch wait or fix
Goldenmsc – mesh repair has a lower risk of chronic pain, and lower recurrence rate compared to non-mesh repair. I wonder if your neurologist has any experience or data to back up he recommendation of a non-mesh repair, particularly because the sutures used for non-mesh repair are made from similar material. Jake Greenberg and Carla Pugh in Madison, WI can give you a more thorough evaluation. You could also try Eric Hungness or Nathaniel Soper in Chicago. Hope this helps!
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Encouraging percentages from Docs please!
gretarae – First of all, don’t worry. You are fine, and a small, asymptomatic incisional hernia has a low probability of becoming worse in a short period of time. Second, the best study with long term follow-up of incisional hernia repair with and without mesh shows a 63% recurrence rate for the suture group and a 32% recurrence rate for the mesh group. This study however has many flaws. And most importantly regarding all the statistics is to know that they do not predict what will happen to you, because you are not a statistic, but an individual. The options are many, with relative risks and benefits of each option. By applying the following algorithm, you and your surgeon will make the best decision for you. You as an individual. Not for your hernia. 1. Identify what your goals are 2. Apply the clinical scenario related to your medical history 3. Apply the details of your hernia – location, size, position of rectus muscles (seen on ct scan) 4. Choose a technique (there are many) that fits your clinical scenario, hernia details, and is likely to meet your goals. 5. Choose a mesh (if using mesh) that is most appropriate for that technique. There are many choices here as well. 6. Have a plan B.
Very few surgeons know enough about the prosthetic choices, and have limited knowledge in their practice for the variety of techniques available. In my repair of hundreds of recurrent hernias, I have also seen many occasions where the surgeon and patient goals were not necessarily aligned. There are many reasons for all this, so I don’t want to sound like I’m pointing any fingers, just stating frequent observations. Given your aversion to mesh, you could even be a candidate for all absorbable material along with the adjunct of Botulinum Toxin A in the oblique muscles to allow healing before the can pull the repair apart.
In any case, you have found an excellent resource Dr. Towfigh has created, and I commend you for taking an active part in your health care. Again, don’t worry – you will be OK. Feel free to call 978 632-0123 for a formal appointment if you would like. I’m in Gardner, MA