Good intentions
Forum Replies Created
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It sounds like you still had a seroma, or something has torn loose. If it gets exposed to outside infectious agents you could end up with a real problem, especially if they used mesh to repair the hernia. I would contact your surgeon immediately and keep the area clean. I’m not a doctor though so can’t say how critical things are for you. I would leave a message with his/her answering service right away and let them decide.
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Have you contacted Dr. Towfigh directly? A link to her practice is at the bottom of the Hernia Surgeons’ page. She might even take a look at your images.
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quote BobbyO:It has been 8 weeks since the corrective surgery. Do you think I should wait 3,4,5 months to let things heal more before going to another Dr.?
How would you know if the mesh should be removed?It probably depends on if the type of pain is different or the same. If it’s the same then the last surgery didn’t really do anything. So you’re really on the 2 year time-frame. I had two laparoscopy procedures within one month. There’s no reason to wait if the pain is the same.
That’s why I suggested finding a very experienced hernia repair surgeon. They will recognize the symptoms and won’t rely so much on the mechanized diagnostic tools, like imaging.
It sounds like the doctors you’ve seen don’t want to consider that the mesh could be the problem. I think that it’s best to have a surgeon that will consider all possibilities and choose the one that is best for you.
I am not a medical doctor, just a guy who had a by-the-book standard of care mesh repair that my body would not accept.
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Dr. Peter Billing of Eviva is also a good resource. He will respond to a well written description also and will remove mesh. He is the one that removed my mesh, he is in Shoreline WA.
https://www.evivamd.com/about-eviva/meet-our-physicians-providers/peter-s-billing
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The actual measured number is 10 – 16%. Here is a recent review of how to deal with chronic pain, linked below. But, since your pain is so specific you might want to choose more carefully. Has all of the mesh been removed? I mention this often in my posts but the training and the mantra today for the mainstream surgeons is that mesh is inert and any problems must be caused by something else. Even though it is known that the mesh fairly rapidly stiffens in to a boardy less flexible structure. It sounds like your surgeons are trying to “salvage” the mesh. That is a word that they actually use – salvage. The mesh is meant to be a permanent part of the body, so removing it is one of the last resorts, when maybe it should be the first.
Regardless of the reasons for the thought processes, I would at least get more opinions. Try to find a surgeon who has actually worked on a case like yours. It sounds like your two surgeons have just gone to the books and are telling you what they read there.
Here is some reasoning, in question form, for having all of the mesh removed – are there cases of injury where scar tissue alone was enough to justify either of the two options you described? Auto accidents, stab wounds,other types of surgery, etc. Because if you have all of the mesh removed that is what you will end up with. Scar tissue that will restructure and adjust to get back to its original form. That, to me, seems like the logical approach. Remove all of the foreign body that started the problem. Then consider drastic measures. The surgeons will want to try to solve all of the problem in one shot. It’s up to you to slow them down, to try to save your parts. Having an orchiectomy will probably affect you psychologically also. Complete mesh removal before an orchiectomy seems logical. It’s surprising that any surgeon would consider the orchiectomy alone, first.
Get more opinions. Send a message to Dr. William Brown at his practice. He will probably respond. Include your phone number. Don’t try to stay inside your insurance plan, be willing to travel. It’s the rest of your life.
I had two very large pieces of mesh removed and the only area that still gets sore is where a mesh fragment is. It’s been seven months and it’s stayed in the back of my mind that I will eventually have to get the last small piece removed. I can still feel it at times and don’t know if my body is going to adapt to it or not.
Good luck. Do more research. Your problem is not a “by the book” problem.
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I see now. He/she was probably referring to the Kugel technique, not the Kugel plug. I linked to Bard’s page below. The number of combinations possible for hernia repair is incredible, and apparently, none is significantly better than another.
I like to use Google Scholar to see if the person in question is still publishing. If they are then they are most likely on top of recent developments. I linked to Dr. Rosen’s results also. It looks like he favors laparoscopic implantation, but hasn’t published within the last few years. Still, researchers tend to stay up to date, as a matter of course.
Of course, you might be getting ahead of things. Knowing if you’ve had a hernia recurrence as opposed to just mesh pulling free is probably important. Chaunce1234 has a list of surgeons who will remove mesh. Search his past posts. I had mine removed by Dr. Peter Billing of Eviva in Shoreline, WA. Dr. Towfigh will remove mesh if necessary. She is the administrator of this site.
Some doctors will reply if you write them a latter or send an email. The more information you get the better.
https://scholar.google.co.uk/scholar?start=10&q=Michael+Rosen+hernia&hl=en&as_sdt=0,38
https://www.surgical.theclinics.com/article/S0039-6109(13)00084-4/abstract
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Your main concern, I think, should be that your doctor will immediately refer you to a surgeon, and the first impulse of the surgeon will be to repair it with whatever method in which they have received training. Once they are in there they might see other defects which will give reason to do more repair. The most common repair method today is mesh. It’s very possible that you end up with coverage of most of your lower abdomen with mesh, if you mention any symptoms of inguinal hernia, like twinges in the groins. I saw a surgeon for a very simple direct hernia, one side, and after surgery I had bilateral implantation of as much mesh as he could fit in to the space.
That would be extreme, I think, for an umbilical hernia, but the training today is that mesh is harmless if implanted correctly, therefore more is better, for prophylactic purposes. The path from consultation to surgery can be very fast and smooth, and comfortable. Hernia repair is a mainstay of many surgical practices due to the high volume. So take your time in making a decision. You will probably hear about how it could get bigger, and strangulation of bowel could occur, and how the procedure is an outpatient procedure with no hospital stay necessary. But the long-term effects should be your main concern.
I don’t have any advice on reducing the bulge. My direct hernia bulge was not reducible either once a certain amount of material got out. I think that if the defect is small the material that gets out can’t be pushed back once the peritoneum gets stretched out of shape.
Dr. Kang has posted on the site about non-mesh umbilical hernia repair. You might read some of his posts. Good luck.
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I would find an older surgeon with lots of experience, as you suggested, an expert. The Onflex device is one of the more complex hernia repair devices and since you’ve had two surgeries already things are probably pretty messy down there. I don’t think that you want somebody with little experience giving it their “best shot”. The Kugel device is not part of the Onflex device portfolio. So that’s confusing. I’ve linked the Bard page below, and another about the Onflex device.
I think that you’ll have to do some internet research. You might also need mesh removal if the current device is causing the problem. Was the original balled-up mesh removed? If you don’t have all of your medical records it would be worthwhile to get them. There might be important details about the two procedures that you’ll want for the next surgeon.
Good luck. Wish I could be of more help.
https://www.crbard.com/Davol/product-search?pg=2&devicetype=hernia+repair+%26+fixation
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Here is a good place to start, use the search tool below. Can you travel? Supply more detail and there might be more specific information. It’s not really clear what you mean by “fail”, or even what type of hernia you had repaired.
There many different types of repair materials, and methods, and several different types of hernia. Information about yourself, the activities that caused the problem, and the repair itself will all help in finding an appropriate doctor. Good luck.
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Hi msp. Your story did not come through.
Good luck.
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If you’re still having problems it would be worthwhile to get a copy of your medical records. The facility where the surgery was done should have them, with information about the mesh including lot or serial numbers.
Without more information there are really too many possibilities to guess. Seriously, the combination of hernia types, and types of mesh, and the quantity the surgeon implants, plus the number and type of fixations, is huge. It’s more than just laparoscopy and “mesh”. It really is. Even the surgeons tend to oversimplify the complexity.
Good luck.
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Here is the summary I pulled from your first post. It’s not clear which side had the mesh impanted. I count at least four lap procedures, and six total surgeries. Not clear if they were all lap. Each surgery will create its own scar tissue, which takes quite a while for the body to resupply with blood vessels and nerves.
“39 year old mother of 4 and started experiencing pelvic pain back in 2013.
had 2 lap procedures to check for endometriosis.
every report indicated that I had pelvic congestion syndrome….Interventional Radiologist who treats PCS and ended up having a pelvic embolization in Janurary 2017. He said it was the worst case he has ever seen and actually ran out of coils during the embolization.
New GYN did a laparoscopy in March 2017 to check and see what was causing the pain…nothing really showed up other than an ovarian cyst (normal size for a cyst).
October 2017 I had a sharp, stabbing pain in my left groin area. ..Pain went on for 5 days straight and once it started shooting down my inner thigh I knew something was going on.
Regardless….I had a femoral hernia that I was told had to be fixed before it strangulates!
Ended up in the ER on the (March?) 4th with minor swelling in my left leg
IVUS on the (March?) 7th indicated that I barely had any blood flow in my right and left iliac veins as well as my IVC. Ended up having to get 3 large wallstents placed in my veins and stay in the hospital.
Groin and leg pain was getting so much worse while healing from the stent placement. Hernia surgery was on May 2nd 2018. Stopped the Plavix for a week as directed…Surgeon performed a robotic lap procedure and placed a large 3D Max Light mesh over the direct, indirect, femoral and obturator spaces with sutures. Had to spray Arista to stop the oozing I was having inside and then closed me up. Had severe pain and stayed in the hospital for the night.
Was feeling pretty good after the 6 week mark which was awesome! Few weeks ago I noticed that my BM are changing…have the urge and can’t go. After I do finally go I am in pain. I started feeling sharp pains in my left groin last week (July 4th) and brushed it off hoping it would just go away. I now have the pain in my thigh again and when I stand up or walk around it won’t go away.”
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Hello tship. I took your story and broke it down to the actions with dates just to get a better feel for everything that has happened to you. It looks like you’ve had quite a bit of surgery, and also have a high amount of foreign material inside, the stents and the mesh. Basically, your insides are like a battlezone where the fight has been going on for quite a while. Probably lots of scar tissue taking up space and pulling on various other parts as it restructures itself.
It looks like it’s been 10 weeks since the 3D Max implantation. What sort of exercise have you been doing? I found that just hiking or walking was a good way to get fluids flowing after mesh implantation. After mesh removal I found that once I could start running again, that that was very helpful in normalizing my screwed-up abdomen. In both cases it helped with pain and soreness and also helped with digestion and bowel movements. Sometimes, it was counterintuitive, where I thought that rest would help but after 2-3 days of no change a good long hike or run helped instead. You might try easing in to more activity and seeing what happens.
Since it has been 10 weeks, any changes from now forward will probably be slow. The mesh is locked in to place, aside from slow migration. It might pull free in areas but the bulk of it will not move much.
Keeping a daily log of your activities and the body’s response can help you figure out any positive cause-effect relationships. Even if you decide to have more surgery you’ll want to be in good physical shape, so workng through the pain, if it doesn’t get worse, will still be beneficial, I think. Not a doctor, just my own experience. Good luck. I’ll post my edit of your first post next.
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Your diagnosis is for a herniated disc, in your backbone, not the type of hernia this site is focused on. This site’s focus is about abdominal and inguinal hernias.
You might try one of the bodybuilding sites, they have a lot of heavy lifters, with assorted problems. Good luck.
Still, somebody might have a suggestion so check back occasionally.
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Dr. Towfigh’s practice page has some comments about biologic meshes. Click on “Biologic Mesh” if it doesn’t show up.
http://www.beverlyhillsherniacenter.com/hernia-surgery/hernia-mesh/#1472502219863-73f0cc8a-cd8e
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quote Wolfshole:After having a laparoscopic surgery with a mesh two weeks ago on the left side, I experience scrotum pain. My left testicle is swollen, although it’s not blue anymore.
Does anyone have a similar experience? Does the pain subside?
Can you give more detail? There are many many different types of mesh, and procedures, and types of hernia. It is very common for the scrotum to be swollen and discolored after hernia repair.
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When you talked to Shouldice did you get beyond the front desk or did you talk to a surgeon? Preferably the highly experienced one. At big institutions there is often a basic set of questions that are asked for screening purposes, by the support staff. You’d think the doctor with 20+ years would have offered more.
I’m not sure that Dr. Towfigh is very active on reading the daily posts. But I think that she does check her messages. You can click on her name in any of her posts and there will be an option to send a message. You can also contact her practice, via the link on the “Hernia Surgeons” page.
Good luck. Keep pressing forward.
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I would find an “old head” hernia repair surgeon, a surgeon who has lots of experience with open mesh repairs and also removes mesh if it’s a problem. I think that there are essentially two classes of hernia repair surgeons – those who follow the guidelines and instructions and training to the letter but don’t know what to do when there are problems, and those who really understand how things work and what they’re doing with the mesh when they make the repair. It’s that way in many fields. Profession as opposed to expertise.
It might be that you had mesh shrinkage that is pulling on surrounding tissue. Can you give more detail on the material used? Heavy/light, plug, one of the odd unique designs? And type of hernia, direct or indirect. There might be a clue there. After seven weeks the healing should be pretty far along.
Don’t spend too much time trying to stay inside your insurance system either. Your choices will be limited. Post your general location and somebody might have a good surgeon in mind. Good luck.
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“Sports hernia” is one of those misnomers, like “tennis elbow”. Even athletic pubalgia is misleading. Good luck. The info about the onset of the problem is probably a good clue for the right surgeon.
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I think that you need to find a surgeon with expertise in infections and mesh removal. Dr. Towfigh is one, at the Beverly Hills Hernia Center. She is at the bottom of the page I linked below and is the administrator of the site. Many surgeons are stuck doing things exactly by their insurance programs’ protocols, even in Canada I imagine. They have to fight to get special cases like yours done properly.
There are other surgeons in the states. Can you travel?
https://www.herniatalk.com/surgeons
Click “Biologic Mesh” on this page – http://www.beverlyhillsherniacenter.com/hernia-surgery/hernia-mesh/#1472502219863-73f0cc8a-cd8e