Good intentions
Forum Replies Created
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You probably meant Dr. Sbayi, not Sabayi. Did you actually talk to him or did you see his comment somewhere on the internet? A link would help a lot. Maybe you misunderstood the comment, it doesn’t really fit.
Ken had a friend from Mexico in a similar situation, seeking mesh removal. Ken seems to have disappeared from the forum though. Is there any reason that your friend couldn’t join the forum? Ken’s friend apparently did not speak English well. The “friend” questions are more likely to be not-quite-right.
Dr. Sbayi has been on Dr. Towfigh’s HerniaTalk Live YouTube channel. Good luck.
https://www.stonybrookmedicine.edu/patientcare/surgery/blog/hernia-talk-live
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Two inches is huge. I don’t think that’s correct. Good luck.
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It’s like removing the patch over a hole from a pair of jeans. The original hole is the same size as it was at the beginning of the repair. Actually, it’s usually smaller, or the tissue weakness is lessened, due to shrinkage and stiffening from collagen deposition.
That’s the premise behind the absorbable meshes. The body’s response to the foreign body causes the defect to stiffen and shrink, then the foreign body, the mesh, gets absorbed. A good idea in concept but apparently not so good in practice.
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What type of hernia? What type of physical activity do you do? Any sports?
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Is that an old image? It doesn’t seem to exist on the ACHQC web site today. And the Contact person today is Nicole, not Aileen.
Is it from one of the social media sites? If you go to the ACHQC main web site as it says to do there is no information anywhere about Seeking Volunteers for that Committee. The Committee seems to exist, but the call for volunteers does not.
I do see John Parker on the committee member list. But there is a person who frequents the forum with many different aliases, trying to create chaos. He has impersonated actual forum members in the past. No way to be sure if you are the real one. Good luck, if it really is you. Please supply a direct link to the ACHQC page that describes the mission and the modus operandi of the committee. How does the committee operate to attempt to achieve its mission? A typical meeting agenda would be helpful. What is expected of the patient volunteers?
“Patient Engagement & Advocacy Committee
Mission: Identify key areas to improve patient outcomes and increase patient education”
https://achqc.org/faqs/committees
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Hello @JohnParker Thanks for the reply. If you want your replies to make sense in a chronological fashion, don’t use the big red Reply button on the side. It will place your post in some random spot in the thread. Use the small Reply button with the backward arrow in the last post. That will place your post at the end of the thread.
Are you able to access the database, as a member of the ACHQC? Do you have the ability to sort the data so that you can see if there is a prevalence of certain types of mesh or procedures or device-makers that seem to give better or worse results? Of course, a proper look would show the rate per device usage level, but the work has to start somewhere.
There has been much talk over the years about registries and some online comments about devices like the plug but nobody is creating something that a patient could use to increase their chance of a good outcome. Much talk and supposed concern but no usable results to help the individual patient. Which is kind of ironic because it makes the overall field of hernia repair look worse. The bad products and methods are staining everybody involved.
Good luck with your efforts.
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Another publication about TREPP and maybe TIPP. Pre-peritoneal both. Dr. Reinhorn is the last author on the list.
These publications seem to have an inherent conflict between promoting the topic under study and objective reporting of results. Very strange that none of the authors see the mixed messaging.
The title states firmly that “Open preperitoneal inguinal hernia repair has superior 1-year patient-reported outcomes compared to Shouldice non-mesh repair.”
But the conclusion seems more reality based. “Conclusion
Our data suggest that OPP is associated with significantly better patient-reported QoL, in the first month after surgery and up to 1 year postoperatively, especially with respect to lesser pain, when compared to the Shouldice repair.”
Also, these authors are still blending superficial concerns in the ACHQC data reporting, aesthetics, with actual performance concerns. Pain and activity restriction. Just report the individual scores. The blending is a subjective choice and waters down what many patients are really concerned about. How can the size of the scar be anywhere near as important as the other two?
At least they are still looking for alternatives. If they could just stop trying to “win” and/or promote what they are doing. Just do the work, report the results, and suggest improvements.
Another pay-per-view article. “Suggest”, “may”, “encourage”. A lot of maybe here.
https://link.springer.com/article/10.1007/s10029-023-02936-3
Hernia
<b data-test=”article-title” data-article-title=””>Open preperitoneal inguinal hernia repair has superior 1-year patient-reported outcomes compared to Shouldice non-mesh repair
- Original Article
- Published: <time datetime=”2023-12-23″>23 December 2023</time>
“…
EuraHS scores were used to estimate QoL, and further analysis on the EuraHS domains of pain, aesthetics, and activity restriction were performed between the two cohorts.
…
<b data-test=”abstract-sub-heading” style=”background-color: var(–bb-content-background-color); font-family: inherit; font-size: inherit; color: var(–bb-body-text-color);”>Conclusion
Our data suggest that OPP is associated with significantly better patient-reported QoL, in the first month after surgery and up to 1 year postoperatively, especially with respect to lesser pain, when compared to the Shouldice repair. In specialized inguinal hernia practices, open posterior mesh repairs may lead to better outcomes than non-mesh repairs. We encourage more training in both repairs to facilitate larger prospective studies and evaluation of the generalizability of these results to all surgeons performing IHR.”
link.springer.com
Introduction The Shouldice method for inguinal hernia repair remains the gold standard for prosthesis-free repairs. Nonetheless, international guidelines have favored posterior mesh reinforcement as the standard of care for inguinal hernia repair due to lower risk of recurrence and chronic … Continue reading
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Just another followup. These new things I ‘ve been trying have made me realize that I have been trying to get my body to adapt to the still painful lump of mesh/cord/veins/nerves in my inguinal canal, to get back to my previously normal life. But daily life is better now, taking the odd steps of suspenders and belts and bands to reduce the soreness than in trying to suffer the constant mild irritation of tight pants and belts and normal clothes. I’ve been stuck at 90-95% for years but haven’t been able to work through it. It’s like I’ve been wearing shoes that were two sizes too small for years, hoping that my feet will shrink. It’s not going to happen.
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Here is the latest from the Miller &Zois web site. 600 more cases added. That’s in three months. 200 per month. 2400 per year. Doesn’t seem sustainable financially for the parties responsible. Where is the PR department talking about how they are trying to make things better?
“<strong style=”background-color: var(–bb-content-background-color); font-family: inherit; font-size: inherit; color: var(–bb-body-text-color);”>December 18, 2023: Bard Hernia Mesh MDL Approaches 21,000 Cases
Back in October, the number of pending cases in the Bard hernia mesh MDL decreased for the first time ever. Since then, however, nearly 600 new cases have been added, bringing the total number of cases close to 21,000.”
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Found something. Lasse Lempainen. Looks like it’s just one guy, specializing in lower extremity issues. Seems like he might know who the good hernia surgeons are though.
https://www.lasselempainen.fi/lasse-lempainen/?lang=en
lasselempainen.fi
Lasse Lempainen - Urheiluortopedi Lasse Lempainen
Lasse Lempainen - Urheiluortopedi Lasse Lempainen
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I can’t tell. Not even sure who the surgeons are. I just thought it was interesting that these little pockets of greater ability seem to pop up, while the general ability of the surgeons in the field lags.
It reminds me that the meetings of the big societies like to have these “How I do it” sessions. Implying that each individual surgeon might have a different way to attempt the same task. Which is actually pretty scary for the patient. How does a patient know which method is best for their case? It’s really an absurd situation when you think about it, like a contest for the surgeons, with the patient as the playing field or stage.
Ideally, in my opinion, instead of surgeons demonstrating how they implant a piece of mesh or create a space during a lap procedure, instead they would demonstrate a flow-chart or decision-tree to use for helping the patient get the best result. If A exists then use method B. If C exists, use method D. An overall procedure that starts with the patient, not with the surgeon’s favorite implantation procedure.
I think that most surgeons just use their own favorite method over and over on all of their patients to “get the mesh in”.
Anyway, back to your point, you’d think that if they can learn enough to improve the average hamstring surgery that they might also be capable of improving other surgical methods. I’ll see if there’s more out there somewhere about Reece James. He plays for the England national team. Pretty important to make him healthy again, he’ll be in the news somewhere.
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The suspenders work so well that I have been wearing them every day when I go out. I also ordered a second set.
I had another thought – compression shorts or bike shorts.
It’s surprising how pants have developed and become such an important part of our lives. Now whenever I see someone in public in yoga pants or sweats I wonder if they have or have had a hernia. The waist band of today’s typical pants cuts right across the inguinal canal.
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And here.
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Like here.
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Wellington, Dr. Towfigh has already replied to Ken’s questions. He asks the same questions and makes the same comments over and over.
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Be careful with DM’s Wellington. Don’t share any phone numbers or private information. You don’t know who you’re really communicating with. Thanks for posting your updates. Good luck.
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You’re asking the same questions you’ve asked in the past Ken.
How is Javier doing? Did he choose a mesh removal surgeon yet?
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I got a set of Dickies suspenders (link below) delivered yesterday morning and went for a couple of long walks with the suspenders and the band, then another walk in the evening with just the suspenders. Spent today using just the suspenders.
They really make a difference. The infinitely adjustable flat fabric belt with the buckle set to the side worked well. But having no belt at all is much better. I also found that with no belt the pants I’ve been wearing don’t press on my lower abdomen at the waist line. So the reason for the band is gone.
I’ve been wearing them under my shirt as a test to see if I could wear them discreetly. It works. It’s a little bit awkward using the toilet in sit-down mode since you have to remove your shirt, but it’s worth the extra effort.
So, all three of these concepts work to a degree. Still hoping that a good long run of no irritation will allow the inflammation around the remaining piece of mesh to settle down so that it can shrink and get fully encapsulated.
Overall though, I am way better than I was even just last year. So, if you’re struggling, just keep trying new things. Good luck.
I’ve been using them on Levi 550’s.
https://www.dickies.com/belts-suspenders/work-suspenders/DI5100BK+AL.html
dickies.com
Work Suspenders | Dickies - Dickies US
This polyester & elastomer work suspender from Dickies comes in 32mm with an X back. Features the classic Dickies leather embossed patch. Order today!
