drtowfigh
Forum Replies Created
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hernia specialist in New Hampshire
Hernia-related pain does occur during intercourse and with orgasm in men and women. In my opinion, I do not believe inter course is actually doing more harm.
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Surgery with Chronic Fatigue Immune Dysfunction
These requests are all doable. We will assign you to an anesthesiologist to make sure all protocols are followed. I’ll have my office set that up for you.
No worries about Cedars-Sinai. With good communication, everything will be just fine. It’s a fantastic hospital with excellent nursing care.
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Trying to Get A Hernia Diagnosis
Yeah! Please spread the word to your doctor and your friends!
As for the Trocar site, it sounds like it may be a hernia. An exam by your surgeon should be all you need. And/or an ultrasound. Those are easy to fix.
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Could this be a hidden hernia ?
Dr Bruce Ramshaw is an amazingly knowledgeable and talented hernia specialist. He is in Daytona FL. He can help.
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hernia specialist in New Hampshire
1. Try Dr Gina Adrales at Dartmouth. She is a talented surgeon with interest in women with hernias.
2. MRI is recommended if Ultrasound is not diagnostic. If trappings shows hernia, no need to do further imaging. In fact, my research paper “role of imaging in the diagnosis of occult hernias” published on JAMA Surgery this week. Show this to any entity or person who refuses to order MRI to help you.
3. Abdominal core exercises may improve your muscle strength around the area of you hernia and improve
Hernia symptoms.
4. Yes! Your prior laparoscopic operations do not prevent you from having laparoscopic hernia repair.Talk to your surgeon. For thin petite women, I do not recommend mesh repair unless it’s done laparoscopically and with lightweight mesh. Other option is non-mesh open repair.
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What ?s should surgeons be asking their patients?
Hi all. Please welcome Dr Greenberg. He is a friend and colleague of mine and I respect all of his expertise.
So glad to have you on board, Jake! -
Hidden hernia or pudendal pain symptoms?
Thanks for your reply.
Which part of your leg does the pain radiate to? And which part of your back?
Numbness of the buttock is not caused by hernias. I would look into spinal issues.
Pudendal neuralgia is a very difficult diagnosis to make. Dr Michael Hibner in Arizona is a world expert on it. I recommend you go on his site and see if you relate to his information. -
Trying to Get A Hernia Diagnosis
Is the bulge at the incision? I can’t tell if the incision is there. If so, then yes, that’s a hernia at
The Trocar site. -
Surgery with Chronic Fatigue Immune Dysfunction
Of course.
So glad things are movingbalongvtowards a cure to your pain.
Looking forward to your operation. -
Chronic pain and recurring Hernias
First of all, if you are in chronic pain and debilitated, then every effort should be taken to help relieve that.
If it is from the tacks, they can be removed. It is not like finding a needle in a haystack as they can be seen on X-ray if they cannot be seen upon initial laparoscopic exploration. If it is from the sutures, those can be removed, too. If it is from the mesh, the mesh can also be removed.
If performed by a skilled surgeon who has done this in the past (ask them specifically), then you will be in good hands and any risks would be diminished.
Dr. Peterson of the UW Hernia Clinic is an excellent resource. Please let her know that you have been posting on HerniaTalk and ask her to join the discussion group as one of our surgeons!
Let us know what she recommends.
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Could this be a hernia?
Yes! Pain with opening heavy door: Classic. Female in the family with hernia: strong link. Pain at labia: absolutely. These are all symptoms which are typically seen sming my patient’s with hernias.
I recommend you start with a dynamic hernia ultrasound. If it’s “negative “, then MRI with valsalva.
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Occult or hidden hernia?
– MRI is much better than CT to detect abnormalities in the muscle and soft tissue. I recommend it.
– injection therapy may be helpful as a diagnostic and possibly therapeutic modality. Be careful that any steroid injection, if performed too superficially, may cause fat necrosis and a permanent deformity of your skin. Discuss this with your Pain specialist. -
Could this be a hidden hernia ?
No no no. You are not crazy. Your pain is real. You do not have to live with it.
In fact, your story is a textbook case of a hernia. It’s been a long time since I have heard a story that points to a hernia from every single aspect.
First, examination must be done standing.
Second, your story is perfect for a hernia.
Third, CT scan is very poor and inaccurate for smaller occult hidden hernias. We just published this data last month. Look up “Role of Imaging in Occult Hernias” in JAMA Surgery. MRI with valsalva is next step. And of course a skilled radiologist or surgeon specialist should interpret it.
Do not give up. Find a surgeon who is a “believer”, as I call them, get your hernia(s) repaired, and move on with your joyous pain free life.
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Chronic pain and recurring Hernias
Curious to know what your CT shows. A rock in the abdomen is not normal. It can be a recurrence or a ball of mesh. And you should not accept chronic pain as something you have to life with.
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Surgery with Chronic Fatigue Immune Dysfunction
Such a pleasure to have seen you today. Hope to be able to help you.
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Mesh and Surgery Concerns
Yes to all. The recurrence rate of tissue repair is highly variable from surgeon to surgeon and depends in the patient’s risk factors, tissue quality as well.
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Pain after mesh repair
Great question.
Interpreting an imaging study can be like looking at a work of art. It’s really an interpretation. However, if the symptoms are real, there are examination findings that are real, and the imaging does not support any of those, then it must be re-read or another imaging must be sought. I don’t think it’s fair to have patients suffer from pain. -
Occult or hidden hernia?
Hi there.
Please let us know how your appointment went with the doctrine in Indianapolis.
Your pain may be due to a tear in the muscle or fascia with or without nerve injury. Treatment is usually nonsurgical. Nerve blocks should help. If severe and debilitating, local exploration and repair of a tear or cutting the nerve may be helpful. In the meantime, wear no compressive belt etc over the area.
MRI with Valsalva (pushing belly out) is most sensitive study to detect such a tear.
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Surgery with Chronic Fatigue Immune Dysfunction
Thank you for your post and details and links provided.
Chronic fatigue and fibromyalgia are certainly under appreciated as an important syndrome that should be treated with caution and quite differently than other diseases. The possibility of imparting chronic pain on such a patient after an operation is very high.
I am experienced with this and so I am keenly aware. We can discuss your possible diagnosis and treatment plan when we meet. I look forward to seeing you.
In the meantime, I hope others can get information from your post to help them with their peri operative care.
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Mesh and Surgery Concerns
I absolutely agree with your pain management doctor. Multiple studies looking at chronic pain after open hernia repair with mesh show the incidence is highest among the young an among women. See below for links.
In my practice, for super thin women, I offer open tissue repair (no mesh). For thin women I also recommend laparoscopic repair with lightweight mesh. Open mesh repair, especially with normal heavyweight mesh runs a high risk of chronic mesh-related pain among women and I do not recommend it
Some links:
http://m.generalsurgerynews.com/Article.aspx?d=In+the+News&d_id=69&i=May+2012&i_id=837&a_id=20819