Good intentions
Forum Replies Created
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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.
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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.
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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.
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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?
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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.
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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Dr. Peter S. Billing in Edmonds WA might be close to you, a surgeon with experience in removing mesh. He knows the signs and can offer good advice. There are many others listed on this site, that you could talk to via phone or email. You just have to take the step of calling or writing a letter and initiating a discussion with someone who has the proper knowledge. The hardest part might be accepting that they might recommend what you already suspect. That the mesh needs removal. Another surgery.
There are very few surgeons who understand mesh problems and/or will remove mesh to solve the problems. There are several posts about the issue, within the last few months, and one just a day or two ago.
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quote mulligan22:I visited my surgeon again in August and he did have an ultrasound performed on me, with valsalva, and it showed nothing of concern to him. He isn’t interested in having an MRI or CT scan performed. I look normal, no bulges or discoloration. Bodily functions are normal. My surgeon isn’t offering me anything now except trying pain management shots.
Find a surgeon who removes mesh and also repairs hernias. Your surgeon did what most hernia repair surgeon’s typically do – confirmed that his repair had not failed (recurrence is the main official failure mode, pain and discomfort don’t count), and offered medication to cover up the symptoms. Only a surgeon who has accepted that the mesh repairs can fail or have problems, and that some people’s bodies will not accept certain types of mesh will be able to give you good informed advice. Many surgeons who use mesh are in what looks like some form of mass denial about the flaws of such a very widespread, and growing, hernia repair method. It’s a difficult subject to deal with, but they’ll have to come around eventually.
Chaunce1234 has put a list together which you can find on this site. A few doctors that remove mesh and also repair hernias are Dr. Towfigh, who often posts on the site and is a moderator, I believe, Dr. Peter S. Billing of Edmonds WA, Dr. Brian Jacob, in NY, (he actually lists mesh removal as one of his procedures on his internet profile), and Dr. Igor Belyansky, in MD. There are several others. They have seen the signs of bad mesh and also the results of removal so they should have the best perspective. Doctors who only do mesh implantation, like your surgeon, generally don’t want to, and don’t know how to, deal with mesh-related problems. It’s just the state of the industry at this time.
I’m not saying that you will need or want mesh removal. But getting an early evaluation and gaining knowledge now will help you in the long run. If your body is not dealing with the mesh in the right way, time will not help much besides getting used to a diminished life, and it might make the mesh more difficult to remove.
Your situation is very similar to mine, in all aspects. It started about started about three years ago, with Bard Soft Mesh and a direct inguinal hernia. Good luck.
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If I were you, in your part of the country, I’d try to get up to see Dr. Brian Jacob in New York. I don’t know how the insurance systems work out there, so he might not be an option.
The more I learn, the more I realize that there are surgeons who are on the mesh program and there are those who realize that there are flaws with the mesh program and are trying to address them. You want somebody who realizes that mesh is not the fix-all that it’s described to be.
https://www.nychernia.com/our-surgeo…t-brian-jacob/
https://www.sages.org/video/laparosc…-chronic-pain/
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Here’s another thought – talk to a surgeon who removes mesh, even though there are few. You’ll probably get more in-depth advice one-on-one than on the internet. Most of them also use it for repair, from what I’ve been able to figure out, so should know what to use and how to use it. They will have seen what can go wrong and might offer some advice on how to avoid the problems. You might even decide to have them do the work if they’re available. Get several opinions, if you can.
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quote kevin-pa:I’ve been to my PCP and the nurse practitioner for the surgeon I have chosen. He is the chief of surgery in a medium-sized city hospital. They all advised me to get it fixed, but also if it’s not painful then waiting is fine until a better time.
I have scheduled a surgery date for Nov. 30th of this year, but I do see the surgeon in 9 days to discuss.
I am just extremely worried that I am rushing into this. I’ve read all of the horror stories about chronic pain, and I will regret my decision so much if that happens.
The number of permutations of “hernia’ and “mesh’ is huge. There are many different types of mesh and surprisingly large amounts can be placed if the doctor chooses to do so. Trust but verify, I would say. Find a doctor who can say that they have talked to patients years after the surgery and can verify that they are satisfied. You’re only 30 years old. The stories you’ll find around the internet about surviving the first three months after surgery are pointless. It’s the long-term that matters. The surgery itself is not bad, nothing compared to how you’ll feel if you get the wrong combination of materials and surgeon.. You’ll be looking forward to surgery if you have problems with the mesh implant.
Read through the link below, and search “SAGES” and “hernia” on youtube. There is much change happening in the field, and it’s not all good. Good luck.
https://www.herniatalk.com/5577-researching-surgeons-what-questions-to-ask
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I ended up with full coverage of both sides using Bard Soft mesh. Pubic bone to pubic bone and down to the bladder. The “cover all of the possible future hernia sites” approach. In hind sight, more focus on future recurrence than quality of life of the patient. Very conservative approach, professionally.
Don’t overlook your own physical characteristics. Even Dr. Towfigh has repeated the somewhat anecdotal view, as my surgeon has also, that low body fat people tend to have more problems with mesh, and that there is a view out there that lightweight mesh is best for them. Anybody, please correct me if I’m wrong or have misquoted. There are different 3D devices, some light weight. I mentioned early on that my surgeon had planned to use a light weight mesh but had decided on Bard Soft Mesh after seeing the defect. Maybe he had planned to use the light weight 3D device on me, but switched.
http://www.medline.com/product/3DMax-Light-Mesh-by-CR-Bard-Davol/Z05-PF69428#mrkSpec
That link I provided was really meant, even by the authors, to show the improvement of survey techniques. It’s only 136 samples, from 9 years ago. I would not put much weight on to the data provided at all. It shows though, that there’s a weakness in the feedback cycle to the surgeons and the industry.
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I’ve written this before, but if I was convinced that it was time to get the hernia repaired, I would find somebody that you trust who has had a hernia similar to yours repaired (distinguish between direct and indirect, they’re different), and have that exact procedure done by the same surgeon. Don’t be part of the experimenting that’s going on. There are still recalls happening, on mesh products that have been released to the public, for fundamental flaws in design. They don’t work in the real world.
That was the rationale that I used when I had mine repaired, but my reference person was a surgeon who had had a hernia repaired, but was convinced that the new ways were better. He guided me away from his successful procedure toward the new ways. He meant well but even he didn’t know.