Good intentions
Forum Replies Created
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There’s really little point in being concerned now. If you had the surgery over a few months ago and you’re in good shape now then any ill effects will be slow in coming. There are, apparently, combinations of patient, surgical method, and material that work well. It’s unclear what that combination is, so there’s no readily apparent way to avoid the bad and seek out the good. That’s one thing some of us are trying to do via this forum, is to identify the good and the bad so that people can make better choices.
Can you get a copy of your medical records and post the details of your surgery? There might be some clues there that will give some ideas of what to expect. Type of mesh, extent of coverage, TAPP or TEP.
Good luck. Don’t worry too much about what is past. Please share more details if you can though.
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Two clinics that seem to have much experience in that area are OHSU, in Oregon, and the Carolinas Healthcare group, in North Carolina. Dr. Martindale and Dr. Heniford. Abdominal wall reconstruction is the topic you want to focus on, I think. The University of Tennessee Health Science Center also seems to have a focus in that area. Dr. Voller.
This video is scary but gives some idea of how far they can go to solve a problem. Find an expert soon, I’d say, and don’t feel bad getting a second opinion. And don’t spend too much time trying to make insurance work for you. Our compartmentalized insurance system keeps people from finding the specialists that they need.
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quote Jnomesh:Hi good intentions as someone who had his mesh removed 2 summers ago In which it was found to have curled up k to a rock hard ball I think knit would also be interesting to find people who have had successful mesh removal and more to the point successful recovery of symptoms prior to mesh removal.
That would be a good thread topic. We could offer details about the experience, including what to expect over time, after mesh removal. I’m finding that the normal time to healing, after working the area, is much longer than for other types of injuries. Maybe due to lower blood flow, and the fact the area doesn’t move a lot while recovering. Unlike a limb or a muscle.
I feel like I might be overposting on the site as-is, but would certainly add to a thread on that topic. Could you start one? Excellent idea to round out the topics.
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I can only give an opinion based on my experience of having a mesh implant. After tissue ingrowth the mesh gets stiff and inflexible. It pulls and pokes at the tissue at its perimeter. I think that when surgeons say that the mesh is not causing the pain, they are only thinking of it as a primary cause, not a secondary cause, meaning that the strained tissue at the edges is a secondary pain, caused by physical movement, not by the mesh itself. It’s splitting hairs for sure, but that’s how things are done. I suspect that Dr. Earle is also focused on the secondary tissue strains, as potential hernias, causing pain, but not yet palpable. One common method of fixing those mesh edge-induced hernias is to cover them with more mesh. Dr. Towfigh has said in previous posts that mesh-induced pain can be caused by pulling on nerves. It might be that your injury and rehealing has caused tightness that is pulling on nerves.
As far as mesh repairs “failing”, it’s really a matter of definition. If the original defect is still closed up, that will not be seen as a failure. If new hernias are created by the stiff mesh that will be considered a new problem. If the mesh stiffness itself causes inflammation during activity that will be considered a “mesh reaction”, a new problem.
In the end, after mesh implantation, you have to develop a much higher awareness of what’s happening in your abdomen, to decide what to do about it. Over the curse of the three years that I had mine at times I could feel tissue rubbing across it where it sat on my pubic bone as I pedaled a bike, I could feel it poking in to my groins when I crouched. I could feel the seam down the middle between the left and right side pieces at times. It turned in to a stiff plate-like material across my whole lower abdomen. Like a plastic bucket.
In many ways, the reasoning and solutions to the mesh problems show that the dynamics of the abdomen aren’t being considered. They are thinking of it as a static “bowl” that just needs to be patched up. Considering the fact that when they do surgery there is no movement, it’s not too surprising. Dr. Brian Jacobs even described moving a patients leg while operating to see what moved inside. A crude, and irrational way to learn, considering that there was no muscle tightening or tension, or torso twisting, or heavy breathing, just moving a lax leg. But it showed how he thought the abdomen worked while a person moved, like a static non-flexing bowl. Just a leg moving back and forth. It was surprising to see, it’s in the video I posted a few days ago. Having had the mesh inside my while I moved I know that’s not how things work.
So, you probably already know what’s happening inside you. If you think that it is a stiff piece of mesh poking and pulling, well it’s not going to get softer. It’s going to stay that way. Since you had both sides done, you can compare one side to another to get a better idea of it’s the mesh or not, if the pain is caused by tightness or just movement. I found that I could reduce my problems by reducing activity, but they came back with resumed activity. I suspect that many people who don’t report problems just aren’t very active.
Watch Dr. Kang’s video in post #8 of the link below to get a better idea of how it works. Since you had a very small piece of mesh implanted, 1×4″, compared to 6×6 inch pieces implanted laparoscopically, it almost seems like a surgeon would want to remove it just to get it out of the way so they can find your real problem. It’s probably about 3/4″ x 3″ by now.
Wish I could add more. It’s really an individual decision. Good luck.
Here is the link to Dr. Kang’s video, post #8. https://www.herniatalk.com/7365-please-watch-60-minutes-sunday-regading-mesh-in-the-human-body
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I’ve been browsing threads and found a success story. But I don’t know the details yet, beyond that it was performed by Dr. Goodyear, and might have used Ultrapro mesh (he was not sure in one of his posts. “pro” is used in many mesh brand names). And the description sounds like a direct hernia. Another post about scar tissue sounds like an open repair. Three years as of August 2017. I sent him a message, hoping for a response.
So until corrected, another open surgery that has gone well.
https://www.herniatalk.com/5335-3-years-after-surgery
https://www.herniatalk.com/5099-femoral-hernia-new-to-all-this
https://www.herniatalk.com/5953-how-long-for-bothersome-scar-tissue-to-go-away
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Here is an old thread that I just came across.
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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.