Good intentions
Forum Replies Created
-
Many people have problems with mesh. It’s unclear why. There are many different types of mesh and many different techniques for placing it. Generally, anecdotally, athletic people with low body fat have more problems with mesh. More chronic pain. You can find a many success stories and many horror stories. So many stories that there will be no clear “winners”, or losers. Recurrence is only one aspect of a successful hernia repair. The other big one is chronic pain.
So, your surgeon might have done you a favor, in the long run. If he is trained in the various mesh placement techniques and uses mesh, but he chose the modified Bassini repair he must have thought you were a good candidate for it. Mesh is generally considered to have a lower recurrence rate, and seems to be the “safe” route to take, based only on recurrence rates.
You should really be focused on the long term, not the next two weeks, or two months, or the fact that you’re losing your conditioning. If you go too fast and create problems you could have serious regrets, and be out of running for much longer. Maybe forever if things go really bad. Hernia repair is simple in principle and description but complex in practice. I was a very active runner and soccer player until I had laparoscopic mesh implantation with Bard Soft Mesh. It ruined me for athletics and running and hiking. It’s hard to say that you’d be better off with mesh implantation.
Good luck.
-
Here’s another reason to maybe wait a while. These things have to come to a head eventually. Wait, let the bad ones get rooted out, there will be a period where things are better, and safer. Then the whole cycle will probably start over again.
Notice how the physicians are at the mercy of the device makers. They can’t even save themselves.
https://www.nytimes.com/2018/01/13/opinion/sunday/can-your-hip-replacement-kill-you.html
-
Here is a good overview, from somebody who’s apparently been around long enough to see the whole field develop (edit – no offense to those who are fairly new to the field). Published less than 2 years ago, ~July, 2016. After I had my surgery, in late 2014.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5000866/
Here’s an excerpt –
“If the incidence of chronic pain after mesh repair approximates 16.5%, then a very significant number of patients will have debilitating pain resulting from the procedure when most patients likely had little or no preopertive [sic] pain.
This possibility presents a potential time bomb for the surgical community and medical device suppliers. Hernia recurrence has been largely reduced by the use of synthetic mesh for repair, but a new problem, chronic postoperative pain, has arisen to rival recurrence as a serious consequence of surgical intervention. ”
From Chronic Pain Following Inguinal Hernioplasty by Michael S. Kavic, MD.
-
quote ajm222:i’ll say that i know several people personally who had mesh repair and haven’t had any further issues. some of these had the surgery done 5 or ten years ago, and some almost 20. so i guess it depends. the bigger question is: is non-mesh repair any better.
Seems like you, and many of us, might be getting overwhelmed by all of the information out there, and are trying to generalize it down to something useful. You’ve distilled everything down to “mesh repair” and there might be much more to it than just mesh.
Saying that “all mesh is bad” is not good enough to make progress in getting rid of the bad materials and methods. Many people are happy with their mesh implantations. But many are not. We need to find the correlation between the unhappy people and the materials/methods used.
If you read through all of the mesh removal and mesh problems threads on the site you’ll find that many, 4 of 9 for removal, are for Bard 3D Max. I had problems with Bard Soft Mesh. Bard has a very large presence in the mesh market place. Many surgeons are stuck using the material of the device maker with which their organization has a contract, and contracts are awarded based on cost. So you could find that experienced expert surgeon but he/she will be inclined to use what their organization has contracted to use. One more way the big device makers can control the situation. Read the article in this link, from just two years ago, and you might rethink who you choose. There’s a definite view of “any and all mesh is good”, and “all that matters is surgeon’s skill”. It’s actually scary to read, considering all. http://www.generalsurgerynews.com/Ar…rticleID=34826
Alternatively, if all mesh really is the same, then the 15-20% chronic pain number is your chance of getting it. If you thought you had a 1 in 6 chance of chronic pain would that sway your decision? Because without a correlation to specific brands of material, that’s where we’re at. Take a single die and roll it one time.
So, besides the general advice to find a happy person and use their surgeon, it would be reasonable to avoid Bard 3D Max. It seems to be one that often causes problems.
Good luck. Whatever you do, don’t just decide to roll the dice and see what happens. There are no do-overs.
-
Prof. Aali Sheen (aka Herniator) is from the U.K. so might know of somebody. But, he is a believer in the use of mesh so there might be some reticence to advising you. Worth a try though, and he is on your side of the Atlantic. You can click the box by his name ands send a message to him. He posted in the “mesh removal” thread I attached below.
People have waited much longer than 5 years to have their mesh removed. Good luck.
-
quote WorriedWife1:I’m concerned that he is moving forward with the hernia diagnosis
If he got the vasectomy so that you two could have a better sex life, then you should be very concerned about today’s hernia repair method of choice. Laparoscopic implantation of large pieces of mesh can impact the penis and surrounding body parts. It did mine. The more active I was the worse it got. And it wasn’t the type that a pill can fix. So, your husband’s physical type of work is going to make these problems worse if he has them. He won’t be able to stop sports or working out and just spend more time at a desk so that he can have his penis back. The inflammation affects all surrounding tissues, and gets worse with movement. It’s not a problem that most men will talk about, but if it doesn’t work there’s no point in not talking about it.
The big risk for both of you right now is that the majority of surgeons out there who do laparoscopic mesh implantation will seem very confident in the materials and method. You will feel very comfortable that he or she is going to fix him. You’ll feel relieved once you choose a doctor to do the work.
If you go for a consultation the surgeon will probably discount stories of dysfunction or chronic pain as internet rumors, or from the past. They might cite research work that supports what they plan to do, but not the research that describes up to 20% chronic pain. They might have hundreds of surgeries under their belt. Mine had over 400, I believe, so the advice to look for an experienced surgeon does not guarantee success if you find one. I had my surgery in 2014, and they still do things the same way.
Watch this video and you’ll see the guidance to place large pieces of mesh, even on the side that is asymptomatic. Sponsored by a medical device maker. Click anyway, even though it’s intended for the professionals.
http://www.ethiconinstitute.com/node/885/asset
If he does decide to have surgery, find a surgeon who can say that they know their past patients are doing well, years later. “I don’t know, I haven’t heard anything bad” is reason to keep searching. Find a friend or colleague who has had successful surgery, and does what your husband plans to do, and get the exact same surgery. Make sure that your surgeon knows that their method and material choice work in the long-term, and that recurrence alone is not their criterion for success.
Good luck. Be careful. The news these days is full of stories about the big corporations of the medical industry pushing sales over patient welfare. Opioids, birth control, trans-vaginal mesh, and hernia mesh among them. Even the physicians are trapped in the mess. It’s up to the patient to find somebody that they can really trust.
-
quote Ddot14:I’m located in Minnesota and would obviously love to find a surgeon in-state, but am willing to travel if necessary to see an experienced, talented, and supportive surgeon. I would like to find someone in the Midwest someplace (Minnesota, Wisconsin, North or South Dakota, Iowa, Illinois, Indiana, etc) if possible, but will consider traveling farther if I need to. I’m aware of Dr. Kevin Petersen in Las Vegas and Dr Robert Tomas in Florida, but I’m unable to fly and the long drive with a hernia isn’t very appealing if I can find closer options. But I’ll do it if I need to!
Just had another thought also. Don’t be too economical or “practical” when making your decision. The effects of a poor decision will last for the rest of your life.
I think that one of the problems with today’s hernia repair with mesh method is that it is so easy to do the repair quickly, with no short-term complications. It’s a battle of short-term results versus long term results. We all tend to think in the short-term, and even long-term to most of us is months or a year or two. Both patients and doctors tend to lean toward the mesh repair, I think, because it gives immediate relief and seems so simple. Just get that mesh to cover the defect with a lot of extra just-in-case material, then get out. The patient only has to plan for a few hours away from home. It all seems so simple. The protruding abdominal contents are placed back where they should be, the mesh covers the hole, and the access holes are sewn up. One to two weeks later the patient is functional. But the relief is not full or complete. The patient ends up at some lower level of the person they expected to be, with no apparent solutions.
So, even though you’re avoiding mesh, to avoid long-term problems, you’re still planning in a short-term, convenient, way. I did the same thing when I had mesh implantation. I was close to traveling to the Shouldice Hospital but then a different easier path appeared, with confident people telling me it was safe and effective.
Just an observation and maybe a push for you to go a little farther to get what you want.
Don’t overlook also though, that there are many stories of successful open repairs with mesh. But open repair has more short-term risks, like bleeding and infection. It leaves a bigger scar and there might be a bump. Healing is slower. But the long-term results might be better.
If somebody on the inside collected information they might find that there are specific bad materials and/or bad methods. Everybody would benefit if the bad actors could be rooted out. It might be though that the biggest device makers are the bad ones, and they control the field. Until somebody identifies who the bad ones are though many people will assume that all mesh is very risky and avoid it like you are.
Good luck.
-
I’ve read of a few places that use the Shouldice method in the United States so I searched “shouldice hernia repair united states” on Google. Here’s one interesting place in Ohio. No idea about them other than they’re on the internet.
https://herniasurgeries.com/modified.htm
Have you tried sending a message to Dr. Towfigh? She is active in the area of no-mesh hernia repair, as you probably know, and probably knows of others. Click on her screen name and you should see how to send a message.
-
The lack of instruction after surgery is pretty amazing. Don’t lift more than 10 lbs is the common single instruction. Typically, that’s it.
After bilateral laparoscopic mesh implantation via TEP surgery, I was “released” after 3 weeks, to do whatever I felt like doing, but with instructions to “listen to my body”. That’s the other instruction people get. Sometimes the doctor will scribble something on the papers you get before you leave surgery. Have you checked yours closely?
You didn’t say what type of surgery you had, open or laparoscopic. Or how much mesh was implanted. There is a trend to add lots of extra mesh, just in case there are other weak spots. Do you have any more details you can add about your procedure?
I’m a man so my situation is different, of course. But the details might allow better advice. Good luck.
-
Seems like the hernia and the diarrhea are getting conflated. If you went to your GP and said that you were suddenly having diarrhea you would think it would be a concern. Unless you also changed your diet or started taking supplements or some odd thing at the time the hernia appeared.
What type of hernia, direct or indirect, and how bad is it? Just asking for any real doctors that might have a suggestion. You haven’t described much about the actual hernia.
I didn’t even know that I had a hernia (direct) until saw the bump. It didn’t hurt until it got bigger.
-
quote neumannb:I still have constant pain where the mesh was put it. I also have a raised bump under the skin that’s not on my left side. Is that common? The paid is more noticeable when I’m working out. But it’s almost always there. A dull annoying pain. I also have occasional testicular pain and get random pains in the area. My right leg/groin area and weird feelings of pulling and needles every so often as well. I also have a weird feeling this is going to somehow turn into cancer.
Other important notes: Male, 34, type one diabetic for 7 years (very well controlled) A1C below 6.0
Thank you.
What kind of “working out” are you doing? Not really clear what you mean about the bump, and where it’s not. Where is it?
-
quote neumannb:I’m hoping to hear any input, wondering what information I can request from my doctor to learn more about my surgery, and I’d like to request recommendations for doctor’s in the Washington, D.C./Arlington, VA area that specialize in mesh removal.
Your medical records are yours, you don’t need permission to get them. Many facilities have an electronic request form that you can find on the internet. Some will send them with a phone call. Some will email them, some won’t. Some will put them on a CD and send it via mail. But you can always get them and you should. Your surgeon’s organization will have a copy of what they did, and the facility where the operation was performed probably will also, with records and lot numbers of the materials used.
You don’t need to talk to the surgeon, probably just a call to the front office will get it done. Any doctors that you talk to afterward will probably want to see a copy. Sometimes they can request them if the networks are compatible, but it can be quicker if you have them ready.
-
That’s great that it looks like you found a solution. It’s interesting that two tacks were used for Bard’s 3-D Max product. Their sales literature touts the fact that it “eliminates the need for fixation”. One of the major pushes for its development was to avoid the very problem that you ended up with. It’s supposed to fit the space so well that it doesn’t need tacks. And certainly not metal tacks, the mesh is supposed to be incorporated in to the tissue. If a tack was used to hold the mesh it would be an absorbable tack, I believe.
It might be that the metal tacks were used to attach the hernia sac to surrounding tissue after it was pulled back in. Apparently that’s common. But I thought that they normally used the pubic bone. It looks more like your original surgeon just got lost in what he was doing and didn’t even confirm proper tack placement. Or worse, lost them and didn’t take the time to get them out. That stretched tack looks like an instrument error to me, not from the mesh pulling on it. Like he pulled the tacker away before it was clipped. It should have shown up on your MRI too, I think. It’s metal.
I’m not a medical doctor though, so maybe stretched and misplaced tacks are commonly left inside the patient.
Good luck.
https://www.crbard.com/Davol/en-US/products/All-Products/3dmax-mesh
-
The Shouldice hospital is close – https://www.shouldice.com/
Be careful with a doctor who says that they’ll do it if conditions are “ideal”. That just leaves the door wide open for waking up with mesh.
Can you give more detail on your friends who had mesh, then chronic pain? It’s going to take numbers and examples to break down the resistance to accepting that any mesh, anywhere, one-size-fits-all, is guaranteed to give good results. And that chronic pain is more than just minor discomfort. The mantra is so strong that many doctors don’t even see the original concerns about mesh, tacks. See the other recent thread.
The widespread rejection of the thought that a mesh implantation can cause problems is pretty incredible. Highly educated people who just refuse to see it. It makes you wonder what they’re being taught in medical school and residency. Reject, reject, ignore seems very common.
No offense to the doctors here who are listening and thinking. It’s the others that seem brain-washed. Or, even worse, know, but are accepting the failure rate, for the “greater good”. It really impacts a person’s faith in the medical system.
-
The general advice is to “listen to your body”. Your body doesn’t always give you good feedback though, but walking is generally better than sitting around. Blood clots, getting fluids moving to where they can be removed, and things like that are helped by walking. I would just avoid getting too far from home and avoid getting in to situations where you might have to exert yourself too much. Mud, ice, steep slopes, etc. I walked a lot after my hernia repair and never felt ill effects, from the walking. Although I did have problems with the mesh, long-term.
Interesting that you found someone to remove a lipoma after nobody else would. Can you describe the materials? Was mesh used? Do you know what type and how much?
The incisions above the navel are typical of what they call TAPP laparoscopy. They work from inside the peritoneum, the “bag” that your organs and intestines are in and cut through at the points they need to do the work. As opposed to TEP where they create a space between the peritoneum and the muscle wall of the lower abdomen. I’ve had both done. Sometimes they go even higher, closer to the rib cage.
I’m not a medical doctor so some of my descriptions might be off. But I have had a TEP and a TAPP surgery.
-
quote Tmhawrys:I have a pain in my navel that is sometimes unbearable. It is always there and has been for months now,
This pain started in July, accompanied by a lower right side bloating pain, and a low grade fever.
exploratory laparoscopy in which they took out my appendix (they said it was slightly enlarged and had feces in the lumen but that’s it) October 19 th 2017. Well that seemed to solve the problems, but about a month after the surgery when I started feeling healed, the navel sharp pains started again,
I also have seen my urologist who is amazing and listens to everything and takes me seriously, he went through my Ct scan from before my surgery because he wanted to see it with his own eyes, he said he sees nothing abnormal
I also have a colonoscopy scheduled for Jan 4th because they keep telling me chrons or UC
Also, a gynecologist sat in on my surgery and said no endometriosis. I am lost as to what to do next, no one is able to tell me what’s going on and this is seriously affecting my quality of life, I haven’t been able to work more that 4 hours, I haven’t left my house other than work in months and I can barley do stuff around the house, I am a 31yo female who is normally pretty active and very social, I would just like my life back, anyone have a clue if I could have a hidden hernia near my navel?
I edited your post down to the bare facts. I’ve found that people, including doctors, tend to lock on to certain words or phrases, and will then have what’s called “cognitive bias” when thinking about your problem. They’ll subconsciously try to make your words fit what they’ve already decided to be true.
It might help you to sit down and really think hard about whether the initial pain in July is the same as what you feel now, or if it is different. Because your story basically says that you had the pain in July, then a whole bunch of stuff happened, and the exact same pain came back. Which suggests that everything you’re telling your providers about the surgery is irrelevant, and probably misleading and confusing them.
On the other hand, if the pain is actually different now than when it started, then everything about the surgery is relevant.
Those are the two possibilities I see when I read your post.
-
quote Sean85:Hello all.
In May 2016 I had open mesh repair for a left side inguinal hernia and in October 2016 I had the same done for the right side.
The left side healed up perfectly. It’s as if I never had a hernia there at all. But the right side is, and has always been, a bit bothersome.
I’m 32, non-smoker, healthy weight. I had the surgery performed at UCLA by Dr. Charles Chandler. Not seeing any signs of a recurrence visually. Contour is pretty even and I’m not able to reduce anything.
The big question is – why is one side different from the other if the same material and procedure was used by the same doctor? He should have his notes from surgery about what he saw and what he did, and would have the best idea about why there’s a difference. Could be something as simple as a dissolving suture that’s not dissolving. Maybe, I hear they do that sometimes. But, really, your surgeon should be the first person you talk to, in this case, I’d say. You had one perfect result from him, he should be able to get you another.
If you do talk to him ask him what type of mesh he used. Just for reference, for the larger hernia mesh repair world out here. You’ve had the old style repair done, which is interesting in itself.
-
quote kevin-pa:It’s great that the internet has allowed us to communicate quickly, research info, and have forums like this. But it also opens up the flood gates of “what-if’s” and overwhelms your mind in terms of the amount of information. I would bet the internet has drastically increased the number of hypochondriacs on this planet.
I’m going to repeat my recommendation to find a surgeon who can say truthfully that they know their patients are doing well, long-term, and that those patients do the same types of activities that you plan to do. That was my one major mistake in choosing my surgeon. I trusted him for different reasons, but afterward, when I asked those questions, to see if he he’d seen my type of problem before, I found that many of his patients just moved on to other surgeons. I found that he just couldn’t accept that I was having problems, and eventually tried to push me off to other doctors. He even suggested medicating the problems away.
It was just his nature as a person. He was more business and procedure oriented than patient oriented. I was in and out and back home within a couple of hours for the repair, which was impressive. Coming back with problems wasn’t expected. It wasn’t in the business plan. As it turned out, he did have resources to seek advice from, which he eventually said he would do, but he had delayed and avoided for two years. And when he found that I had found another possible solution, he never came back with the information that he said he would.
So, there are very well-trained professionals out there who will do a great job of performing the procedure. But will be completely lost if you have problems. Since you’re active, playing soccer and things like that, I would put extra effort in to finding a doctor who knows that their method works for athletes. I tried to do that before my repair, I was just like you are, an active person who was worried and skeptical, but I couldn’t find anyone. And you can’t just call them up and ask, you have to make an appointment and wait and pay, and eventually your insurance company will stop paying.
The internet, unfortunately, is the best resource for information right now. You just have to sift through a lot of material to find something to grab on to.
-
This is the second presentation I’ve watched by this guy, Dr. Todd Heniford. His other one was about how the problems with certain popular techniques impact everybody, including his own staff. His presentations are very focused on accurately evaluating, with real numbers, how well things work, short-term and long-term.
It’s pretty gruesome, visually, and not directly related to inguinal hernias. But if I was starting from today, I would find a doctor that talks like he does and can back up his or her views with numbers. This presentation touches on many of the issues that have been discussed in various threads across this forum. His approach is long-term care, even suggesting that doctors tell their patients before-hand that they might have to come back later, that there might be problems.
It’s worth watching just for the views on the industry and how people try to simplify complicated subjects. The talk really starts at about 4 minutes.
-
quote LeviProcter:You will be fine.
You seem to be overlooking completely the views of us that weren’t fine. I had my surgery in 2013 from a skilled well-known surgeon, using state of the art materials and methods. Nobody can guarantee that somebody getting hernia repair will be fine. There is still much luck involved, and many surgeons can’t really say if their past patients are fine or not. Nobody is keeping track. I wish it wasn’t true, but I’m a pretty smart guy, and I still got caught. Still figuring out how it happened.
Good luck kevin-pa. Do the ground work, and don’t let your guard down at the comforting words.