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  • drtowfigh

    Moderator
    January 4, 2017 at 10:14 pm in reply to: Epigastric hernia number 3

    Epigastric hernia number 3

    Abdominal wall hernias typically recur at the lower edge of the repair. That is where gravity has the greatest pull.

    The causes for recurrence vary per person. I would highly recommend that you do not undergo any further operations until all risk factors for failure are addressed. Weight is one of them. Nicotine use is another. Constipation is a third.

  • drtowfigh

    Moderator
    January 4, 2017 at 10:13 pm in reply to: Not feeling well 2 months after hernia surgery.

    Not feeling well 2 months after hernia surgery.

    Seeker,

    Have you seen your primary care or gastroenterology physician? I would seek other reasons for your symptoms. They are not typical of hernia surgery, even laparoscopic.

  • drtowfigh

    Moderator
    January 4, 2017 at 10:11 pm in reply to: Post op ilionguinal neurectomy

    Post op ilionguinal neurectomy

    So sorry to hear this story, Manda.

    Just to give some perspective:

    There is no hernia-related pain that radiates down to the ankle. That is usually a back issue, so don’t forget to make sure everything from the back has been worked up.

    Usually, hernia-related pain after surgery so many years ago (2008), is related to a hernia recurrence.

    Now that he has recovered from the neurectomy and exploration surgery, how are his symptoms? I assume the swelling, etc., has improved.

  • drtowfigh

    Moderator
    January 4, 2017 at 10:08 pm in reply to: My hernia recovery

    My hernia recovery

    This is a great post! Thanks for helping provide some balance to the patients who view this site and others.

    Best of luck to you!

    If you would like to share your Doctor’s name, I am sure he/she will appreciate it and so may other patients who may live nearby.

  • drtowfigh

    Moderator
    January 4, 2017 at 9:03 pm in reply to: rectoceles/pouch of douglas hernia

    rectoceles/pouch of douglas hernia

    Enteroceles are pelvic floor laxities and/or defects that are best approached by a colorectal surgeon who specializes in this type of operation.

    I would search for colorectal surgeons (MD’s with FASCRS or FRCSC) skilled at laparoscopic/robotic surgery who also perform pelvic floor surgery. Some sites that may provide guidance include http://pelvicpain.org/patients/find-a-medical-provider.aspx or https://www.fascrs.org/find-a-surgeon

  • drtowfigh

    Moderator
    January 3, 2017 at 8:03 pm in reply to: parietex progrip removal, an exercise in futility?

    parietex progrip removal, an exercise in futility?

    This is fantastic. Thank you for sharing.

    Fortunately, you are in the majority. Though there is a lot of online traffic discussing failures and chronic pain after hernia repair, the majority of patients do quite well, which is why hernia repairs continue as they are. I am glad this rings true for you.

    The more time passes, the less likely you are to have hernia repair-related complications. For inguinal hernias, most problems are obvious in the first few weeks. And almost all by the first 6 months.

  • drtowfigh

    Moderator
    December 18, 2016 at 10:51 pm in reply to: Possible hernia – worried

    Possible hernia – worried

    A picture would be very helpful at this stage, as the area you are explaining seem not to be consistent with areas for a hernia. I wonder if you had a seatbelt injury that bled or caused swelling in the area due to soft tissue injury.

  • drtowfigh

    Moderator
    December 18, 2016 at 10:44 pm in reply to: Pain after surgery

    Pain after surgery

    It’s important to be evaluated by your surgeon.

    That said, mesh causes inflammation upon initial implantation. This usually resolves with time. Some of these symptoms may be related to the mesh inflammation and therefore should reduce with time.

    Again, it is important for your surgeon to examine you and determine if these symptoms require attention or will resolve on their own.

  • drtowfigh

    Moderator
    December 18, 2016 at 5:12 pm in reply to: Hernia surgeons in London,Ont, Canada area?

    Hernia surgeons in London,Ont, Canada area?

    Did some research for you.
    Here are some names in or about London, Ontario:

    John Morrison, Chatham
    Chris Schlacta, London

  • drtowfigh

    Moderator
    December 17, 2016 at 5:21 pm in reply to: Inguinal hernia – pls help with advice

    Inguinal hernia – pls help with advice

    Yes. All core strengthening exercises are considered protective of hernias. In some situations, hernia pain resolves with appropriate exercise and strengthening.

    The recurrence rates vary from surgeon and based on patient factors.

    Most reported recurrences for mesh repair range from 0.5% to 5%. Usually 1%.

    For nonmesh the reported recurrences range from 1% to 17%. Usually just under 10%.

  • drtowfigh

    Moderator
    December 17, 2016 at 4:51 pm in reply to: Hernia surgeons in London,Ont, Canada area?

    Hernia surgeons in London,Ont, Canada area?

    Sorry. Only hernia specialists I know are in Montreal or Toronto.

  • drtowfigh

    Moderator
    December 17, 2016 at 4:49 pm in reply to: Inguinal hernia – pls help with advice

    Inguinal hernia – pls help with advice

    You’ve done an excellent job researching. I understand it can be difficult to get perspective as to what is important.

    Mesh repair is the gold standard for inguinal hernia repair. It provides the best outcome in terms of recurrence and also recovery time.

    Mesh problems can occur. But it’s important to appreciate that chronic pain also exists with non mesh repair.

    Best option is to find a surgeon you trust and follow their recommendation. Best if it’s a hernia surgeon who is facile with lap open and non-mesh repair. In that situation, the surgeon can provide you with whichever option may be best for you. For example, non mesh repair is not a good repair option for certain patients, such as obese with large hernias or strong history of collagen disorder.

  • drtowfigh

    Moderator
    December 16, 2016 at 5:03 pm in reply to: Pain after surgery

    Pain after surgery

    what type of hernia repair did you have? laparoscopic or open? mesh or no mesh?
    some symptoms are expected after surgery and eventually go away.

  • drtowfigh

    Moderator
    December 16, 2016 at 4:54 pm in reply to: Ultrasound says hernia, surgeon says no

    US says hernia, surgeon says no

    Just to give some perspective as a surgeon: your surgeon is not necessarily saying that you don’t have a lump or you don’t have a hernia. your surgeon is just saying that there is not enough information for him/her to operate yet. A better clearer roadmap of the problem, the area, and therefore the best plan of care, is necessary.

  • drtowfigh

    Moderator
    December 16, 2016 at 4:54 pm in reply to: Ultrasound says hernia, surgeon says no

    US says hernia, surgeon says no

    Just to give some perspective as a surgeon: your surgeon is not necessarily saying that you don’t have a lump or you don’t have a hernia. your surgeon is just saying that there is not enough information for him/her to operate yet. A better clearer roadmap of the problem, the area, and therefore the best plan of care, is necessary.

  • drtowfigh

    Moderator
    December 16, 2016 at 4:53 pm in reply to: Ultrasound says hernia, surgeon says no

    US says hernia, surgeon says no

    1. Agree that 2 inches below the belly button is not where hernias naturally occur. Did you have any incision in that place? That is the only way that you can get a hernia there.
    2. The ultrasound, if positive (i.e., shows a hernia), is usually correct. However, visually, it is hard to grasp by most physicians. CT scan is much more intuitive and a better roadmap for most surgeons.

    Since the clinical situation doesn’t make anatomical sense, I agree that a CT may be helpful. I wonder if you have a wide diastasis recti and this is what is bulging at times.

  • drtowfigh

    Moderator
    December 14, 2016 at 5:00 am in reply to: How long can I wait?

    How long can I wait?

    The affordable care act prohibits a waiting period longer than 90days. So your insurance carrier and your employer cannot legally demand more than a 90 day waiting period.

  • drtowfigh

    Moderator
    December 5, 2016 at 5:59 am in reply to: Possible Hernia, But With Odd Symptoms?

    Possible Hernia, But With Odd Symptoms?

    Short answer: No to all your questions about hernias, fat, etc.

    Exercise usually does not exacerbate hernias. Search our prior posts as we’ve said a lot about the protective nature of exercise.

  • drtowfigh

    Moderator
    December 2, 2016 at 7:56 pm in reply to: Possible Hernia, But With Odd Symptoms?

    Possible Hernia, But With Odd Symptoms?

    TomTomorrow:
    Glad you got some concrete evidence to move forward with.
    Yes, to all your questions except still cannot explain the pain that is relieved with ejaculation.
    But everyone is a bit different, so perhaps that is how your body is experiencing the pain.
    Have an open mind if you undergo hernia repair in that it may not address all of your symptoms– if you’re lucky, then it may.

  • drtowfigh

    Moderator
    December 2, 2016 at 7:54 pm in reply to: Pain/tender 2 years post open repair w/mesh

    Pain/tender 2 years post open repair w/mesh

    Plan of care depends slightly on type of repair you had, i.e., what type of mesh was implanted, too.
    Pain radiating in upper inner thigh can be ilioinguinal or genital branch of genitofemoral nerve. The genital branch is difficult to block unless you are experience.
    Also, as with any hernia repair, a recurrence should also be checked out as a cause.

    Near your area, I recommend Drs. at WashU: Michael Brunt, Jeff Blatnik.
    Other surgeons can be found on https://americanherniasociety.org/find-a-surgeon/

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