drtowfigh
Forum Replies Created
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Most of my patients find it completely worth the trip.
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Yes, thin patients are easier to operate on than obese. That’s not why thin patients have more pain.
We don’t know enough about ethnicities and their different reactions to an operation. As far as I know, there is no difference.
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There is very little in the literature about this to date. We have published two papers so far. Dr Tervaert has just published as well.
It is a rare problem and every patient must be worked up for another diagnosis first. Symptoms typically begin weeks weeks to months after surgery. They include a syndrome of chronic fatigue, joint pain, extremity swelling, headaches, hair loss, rashes, difficulty sleeping, bloating, and so on.
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All hernias.
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A lot of great comments.
A surgeon hernia specialist is the best starting point as they will know whether you need a rheumatologist or allergist to get involved or if the mesh or operation needs to be surgically addressed.
In my my experience with mesh reaction patients, and we have published this, the blood tests are all normal.
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For the record, insurance payment to the physician is not linked to whether complications or other treatment is resolved or completed.
[USER=”2803″]kevin b[/USER] Hope you get better. Sounds like you had urinary retention and a deep venous thrombosis. Both are serious and I’m glad you’re getting the right attention. The cord-related pain should resolve within hours to days. If it does not, then it’s important to figure out the cause early, especially if it’s severe.
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As I mentioned in my post, we don’t have numbers to quote you. In the US, we don’t have a national system that mandates gathering such data. There isn’t even a good chilling code for mesh reaction or mesh-related complication. The AHSQC attempts to gather mesh-specific complications, but not enough surgeons are entering their data into it.
This, I am not able to provide you with numbers. What I do know is what I see. I suspect, based on my experience, that true mesh reactions or allergies are in less than 1% of all patients. The mesh-related complications have been reported to be in around 12% of patients. These are gross population numbers and likely vary within patient subgroups.
And the article you you post basically addresses how much burnout there is among physicians in the US. It’s a stressful job. Many quit, become drug addicted, or commit suicide because of their job stress.
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Though microscopic pathology will show that mesh results in a foreign body reaction at the tissue level, that does not necessarily mean that the patient will clinically manifest a reaction to the mesh. The majority of patients fortunately do not clinically react to the mesh. Those that do react must get their needs addressed by a specialist, as it’s an uncommon problem and specialists are the ones who see this problem more often and have an algorithm to address how to manage it (including need for surgery).
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1. It happens. Presumably it happens less with more experience. No data on this.
2. Most often does not cause any symptoms.
3. Would never address it if it’s asymptomatic -
Generally speaking, it’s possible for a CTs can to be interpreted as negative. Dr BRIAN Jacobs can help you figure this out.
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Nope. No risk.
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The robot is an excellent method to remove mesh that can also be removed laparoscopically. Onlay a open mesh placement usually requires open mesh removal techniques
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No one can operate using the da Vinci robot unless they pass a series of online and hands-on training sessions, pass a test, and then perform a series of proctored operative sessions.
I do teach our residents and fellows on the da Vinci robot and have helped teach courses that use the da Vinci robot.
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Correct, Lexington.
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From what i understand, Dr Ramshaw’s protocol submitted all patients with chronic pain into a Cognitive Brain Therapy session. Once they completed that, they were ready for their surgical care.
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[USER=”1605″]mela414[/USER] sounds complex. I’m happy to review your situation and help you reach a cohesive assessment of what’s going on and a plan Of care.
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Excellent hernia surgeon in Louisville: Dr Scott Roth.
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Dr Ramshaw’s discussion about neural wiring is based on his research and that of others:
Patients with chronic pain suffer from somatic and neuropathic pain in their body. They also suffer psychologically from the chronic pain. This manifests in depression, PTSD, anxiety, insomnia, etc.
he he has shown that patients who can get attention to the brain-related negative effects of chronic pain will have a better outcome from the surgical approach to treating the chronic pain (eg, by mesh removal). As you know, many undergo what we believe is the right approach to address their chronic pain but they are not cured of their symptoms. Dr Ramshaw has shown that that negative result may be related to the unaddressed neural wiring side effect of chronic pain that is not addressed by the operation.
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That’s correct. Migration is not a consideration or concern in these cases. Each patient’s outcome is unique and not strongly related to a single or dual layer repair.
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Thanks for joining our Forum. It’s packed with a lot of great information from patients like you and surgeons like me.
Mesh removal is best done done by a skilled surgeon wary of all the different options for removal and repair and highly knowledgeable about anatomy. It is also important that your evaluation is complete so that the risks and benefits of removal are very clearly outlined.
If you are referring to inguinal hernia mesh, an open approach can remove an openly placed mesh that has two layers. Sometimes both layers do not need to removed if the reason for the mesh removal is pain. If you are having autoimmune type problems then all of the mesh must be removed and you should make sure your surgeons is planning on removing all of the mesh.