Good intentions
Forum Replies Created
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Thank you Dr. Kang, that is a very nice compliment from a man of your expertise. I try to only write about things that I feel I understand, but am certainly learning as I go, and starting from almost nothing.
My thoughts about going back in time with the mesh repairs are based on what I thought were promising early results that drove people to consider the tension-free repair as superior. But your video is very timely in showing how that thought process might be wrong. It is an excellent educational presentation. Thank you for supplying it.
I can’t imagine that the big organizations behind the hernia repair industry would let people go back to non-mesh repairs. The large institutions resist change, if they are benefiting, no matter who or how many people get harmed. It will take time and constant pressure to get things to change, I think.
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Most mesh recurrence problems are not from the mesh tearing. They are from material getting under the mesh and working its way out through the original opening, or from the mesh folding or moving sideways and exposing the original opening. But tearing the mesh should not be your primary concern.
Here is a thread with a comment from Dr. Kang about umbilical hernias. Post #13. https://www.herniatalk.com/5324-non-…pair-questions
“Mesh” is the one-size-fits-all cover-all-potential-defects “cure” for almost any abdominal hernia. I would not recommend it to any family members or close friends. Which, basically, means that I would not recommend it for anyone. Not with the state of the industry today. There is still much denial about potential harm from mesh implantation. No way to predict what will happen. It’s a gamble with a very very high cost if you lose.
Good luck.
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These guys have a description of it. At least. Looks like a very rare condition. Seems like they might know of someone with expertise.
https://transplant.surgery.ucsf.edu/conditions–procedures/flank-(lumbar)-hernia.aspx
Also looks like mesh has found another usage. It’s everywhere. If you’ve read some of the posts on the site, that could be a concern. Good luck.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253923/
https://jamanetwork.com/journals/jamasurgery/article-abstract/560572?redirect=true
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Dr. Towfigh probably knows somebody. She is the administrator of the forum. [USER=”935″]drtowfigh[/USER]
http://www.beverlyhillsherniacenter.com/hernia-education/types-of-hernias/
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Get a copy of your medical records. From the facility where the operation was done and from your surgeon’s office. There might be some details there that will help.
Get a second opinion. Although, I’ve found that sometimes surgeons will easily assume that the “other guy” screwed something up. They can be competitive. Still, worth doing. Did you choose your surgeon or just accept the referral from your physician?
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It sounds like you had a direct hernia. You might recall from before the surgery if yours reduced when you laid down and reappeared when you were standing. If it is just swelling it won’t reduce like the original hernia used to. My direct hernia bump, in the initial stages, would disappear when I laid down. It might be a clue that can reduce some stress for you.
Can you give more details on the procedure? TAPP or TEP, bilateral, type of mesh, direct or indirect hernia, etc.
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quote Milo:Here is my story 6 weeks post op
Overall, very happy with the outcome.
Thanks Milo. I wish you the best. Six weeks is early. Do you have more details on the type of surgery and the mesh that was used? I looked back through your posts and found where you said it was “lap indirect-inguinal mesh repair on the right side”.
Stay in touch. Use this thread to post in every month or so. 6 months and beyond will be interesting.
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Just realized that I was on Page 1. Double posted, told the same story.
The mesh shrinks over time as tissue grows in and shrinks itself. The question of time is a big one, especially since the quantities that are being implanted have grown dramatically. They’re covering side to side and top to bottom now if they can.
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Thanks Damien. I just saw your other post in your original thread. I plan to make a comment there.
So, another successful open repair. Do you remember any details about type and quantity of mesh? Was it one of the two layer systems or just a single flat piece?
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quote Sheraldo:I’m female. Elite triathlete.
ugh what should I do
I’m going to post twice just for emphasis. You really really need to see a doctor that works with athletes. There is a mainstream view on how to deal with hernias and groin pain and there are true specialists.
It might be that what you had done, the procedure used, just needs time. But only a doctor who has seen it actually happen, with one of their patients, can tell you for sure. The mainstream view is to wait and hope things resolve.
Edit – lastly, the mainstream surgeons will not be allowed to remove the mesh, even if they decide it should come out, without putting out huge effort. The medical system today is very formulaic and bureaucratic. Their decisions are all reviewed and actions have to be authorized.
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I still have not heard from the person who had a repair similar to mine. Surprising because he’s usually very responsive.
Still open to hear any success stories. Anything at all just to add some definition to what’s happening. The early open surgeries with small pieces of mesh, the basics of the Lichtenstein method, must have been successful, otherwise, I think, the industry would have stuck with the suturing techniques, and rejected mesh. Yet, somehow mesh became the new thing, displacing the old methods. Where are the success stories?
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Good luck. Here is a story somewhat similar to yours, as far as making the decision. There are many. We are all about the same physically. I didn’t believe what I was reading on the internet either, plus I had a surgeon who had had his own hernia repaired, advising me. I didn’t think that things could be so wrong, fundamentally. It’s like a horror show. Get that evidence of success from your surgeon before you have the surgery done.
https://www.herniatalk.com/7381-mesh-removal
And Chaunce’s recent post and link is worth reading. It’s about the medical device makers and the FDA.
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We posted in your other thread. Can you say what type of organization you were working with? Are they known for working on athletes?
Dr. Meyers on the east coast, and Dr. Brown on the west coast are your two best options, I think. They are both focused on athletes but are very aware of mesh complications. Good luck.
https://www.herniatalk.com/7260-bila…hernia-repairs
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Damien, I had that problem, among others related to that area, when I had large pieces of Bard Soft Mesh inside. It was associated with physical activity, like running and biking. Maybe just general edema from tissue damage, producing an inflammatory response. After I had the mesh removed the problem went away, and I became normal again, although it did come back for a few days while I was healing from the mesh removal, when I must have strained the tissue down by the pubic bone. I had soreness, the problem signs started to come back, but it resolved like a normal injury would, after a few more days. I was worried.
And it wasn’t just erectile dysfunction, it was a loss of overall sensation for everything in that area. Like the penis was dying and slowly losing all vitality. It didn’t respond normally to any stimuli; cold, heat, or sexual. Even the normal sleeping reactions were diminished.
If you have had good results with your mesh implant over nine years then you’d hope the problem would resolve as the strained area heals. You probably don’t want to try to make it heal through more activity though, You might start a bad cycle of constant inflammation.
I would let it rest and see if it resolves. Just my view, from my experience. Good luck.
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Your questions are very specific.
The last one though, isn’t really specific to hernia repair. It’s just pros and cons of anesthesia type. General is more risky, as I understand things, but necessary for laparasocopy. It’s not necessary for open though, so it isn’t used, just for general risk reduction.
The first question is actually two questions combined. Self-gripping mesh vs non-gripping mesh, and polyester mesh vs polypropylene mesh. It can’t really be answered directly.
Good luck.
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Thank you Momo. My comment about the engineer was more about how 60 minutes asked him to comment on a very complex science problem, the potential degradation of polypropylene in the body, when that is not an area that a plastics engineer would have expertise. Then they made it worse by oversimplifying it down to “oxygen eats plastic”, which is,of course, a gross oversimplification. But that’s how TV shows work, they need a catch phrase. The plastics expert should have said “that’s not my area of expertise”. His comments about identifying that the material was counterfeit were on target though. But plastic has been used in the body for many years, for a multitude of purposes.
It’s actually a big problem with much of what’s happening in the overall mesh travesty. People are oversimplifying, when they should be defining the fine details.
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Thank you Khernia, for bringing that to everyone’s attention. I actually got texts from family members when it came on, to watch it.
It was much better than I thought it might be. Very on-target, with the corporate greed and criminality, and the incompetence of the FDA. There are weak points, though, for example, having an engineer portrayed as an expert in polymer science. But, still, the story is clear. An unproven product, and counterfeit materials, pushed to market, to make money, at the expense of patients. People from Boston Scientific should go to jail.
One major shame of the whole situation, assuming the origin of the idea for this mesh is Lichtenstein’s work, is that Lichtenstein’s original work actually had value, and still does. The concept is valid and proven, but it has been exploited to where the good, and the potential good, is far overshadowed by the damage being done by the device makers’ devious methods to get market share.
Here is another link to the story for anyone that missed it. https://www.cbsnews.com/news/boston-scientific-gynecological-mesh-the-medical-device-that-has-100000-women-suing/
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Professor Sheen, aka Herniator, is in Manchester. He was on the site just a few days ago. [USER=”2016″]Herniator[/USER]
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Any tissue damage will cause some “free” fluid. Bleeding or just the body’s response to damage, I think. I have watched free fluid from large bruises travel down my leg. “Peritoneal fluid” seems like an odd term to use. It implies another hernia or a breach of the peritoneum. I’m not a doctor.
It looks like they’re just saying that they saw some fluid that shouldn’t be there but it’s not clear where it came from.
“anterior to the common femoral vessels at the prior hernia repair” means the fluid was in front of the femoral vessels. The mesh is placed behind the femoral vessels, so that means the fluid was between the mesh and the abdominal wall. Which implies that the mesh might have torn free from the abdominal wall and there is a damaged spot. Again, I’m not a doctor of medicine, but in view of how the mesh is supposed to work, the simple fix would be to get it to reattach itself. But, in the big picture, if that is the case, the question is “why did it break free?”
Anyway, it’s good to collect lots of information before making a decision. Good luck.
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Here’s a very good video description of the two basic types of inguinal hernia. I’ve noticed that most descriptions of hernia generally stop with showing the abdominal contents just starting to poke through the superficial ring. With the indirect it’s obvious that everything ends up in the scrotum.
But I haven’t seen a good description of where the direct material ends up. Where does it go after it gets free, which way? After it passes through the external oblique, it must be either under the fat layer or between the skin and the fat layer. Or maybe it’s bluntly dissecting its own pathway directly through the fat layer. In my case, it felt like the material was being pushed medially, toward the center. The initial bulge was peaked and distinct but eventually, as I tried to live with it, it grew to be broad and shapeless. After the hernia repair, when the swelling went down, I could see what looked like the shape of a deflated balloon under my skin. This area would get irritated and swollen with activity, then shrink with rest. Eventually it ended up as a small solid lump under my skin. I would probably make an interesting autopsy case for any students studying hernia repair. Hopefully far in the future, studying the ancient techniques that didn’t work.