Good intentions
Forum Replies Created
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There is no way to know. At 9 months the mesh should be firmly locked in to place and surrounded by collagen. “Incorporated”. A sudden sharp pain could be that something got strained or that the mesh rubbed something raw. So, like any injury, rest and hope are probably recommended. Might also be that an absorbable suture finally let go, apparently they can take longer than predicted to be absorbed, sometimes.
Wait, rest, hope. You could also contact your surgeon. They might have seen this before.
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The type of surgery and materials, if any were used, matter. You’ll understand more if you get those details. There are scores of different combinations of material and method and each surgeon can choose within those combinations about things like fixation, placement, neurectomy, etc.
Most people with chronic pain from mesh do not have torn mesh or hernia recurrence. Everything is correct, mechanically, as far as plugging the hole is concerned.
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Get the details of the method and materials. There might be a clue there. “Laparoscopic mesh” covers so many variations. Your surgeon might have done other things or even made mistakes. That information should be in your surgery notes.
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It’s good to see you back [USER=”1916″]Chaunce1234[/USER] . I understand your point about recording these non-mesh techniques, for those surgeons that want to learn them but were not taught them in medical school or residency. It would help counter what seem to be the efforts of the device makers to wait out all of the old-timers so that the knowledge of non-mesh repair techniques is lost and only mesh repair methods remain. It sounds far-fetched but that is really how large corporations work.
Edited – I went a little bit beyond the scope of the request.
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I think that only surgeons who remove mesh, or stay in touch with their mesh repair patients, or device makers and insurance companies with deeper accounting of mesh “failures”, know the answer. The truth is out there somewhere for certain professionals with the guts to face it and expose it. But, people like myself and you and others on this forum only know of the few cases we hear about or read about on the internet.
I suspect the the device makers know the answer but probably convince themselves that it’s only minor discomfort, not ruined lives, that people are describing. Even surgeons, like Dr. Felix, have suggested the people who complain about mesh discomfort just need to “toughen up”. I wonder how he is doing with his mesh repair.
My symptoms were similar to yours. I even had times where I felt like just walking across the United States. Just continuous walking because that is the only time I felt “right”.
I think that if you keep a log of your activities you will find that the discomfort is delayed from the actions that cause it, and that the feeling good is just a transitory time after activity, but with some amount of rest. Then, eventually, you feel the urge to be active again and the cycle starts over. There is not steady state of feeling good, It just passes by.
The people who would know are people Dr. Brown or Dr. Billing or other surgeons that remove mesh. They have heard the histories and know the timelines of many many patients and also know the results of the mesh removals. I would seek out their opinions. Write a good letter to them that they can review and ponder and I think that you will get some answers.
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It’s probably too expensive. Cost is a big factor in mesh device choice. Purchasing departments often are the ones making the medical device choices for large practices..
PVDF as a material is not much different than the other thermoplastic fibers. And, with no data collection of real-world, long-term results, there is no “proof” that it has advantages. There is no valid justification for its usage, as there is little valid justification for choosing any mesh device.
Mesh for hernia repair is run as a business, not a medical procedure. Marketing and sales drive the new products in to new markets, not results.
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Hello Jennifer. You described a clinic, the same clinic, and a different clinic, and the title of your post says “they”. You also mention “the rules”. It looks like you are depending on “the system” to fix you, but the system is just a collection of surgeons who have learned the minimum necessary to pass their classes and their residency. Their skill level should range range from very poor to excellent. A normal statistical distribution.
I think that you should do some good solid research to find a specific surgeon who can help you and seek that surgeon’s help. The system has failed you, you need to get out and make your own path, I think.
Dr. Muschaweck, maybe, in Germany and Dr. Martindale in the states are good starting points. Focus on abdominal wall reconstruction. Find surgeons who specialize in that, not general surgeons who will “give it a try”.
https://www.aspetar.com/person-profile.aspx?id=125&lang=en
https://www.ohsu.edu/providers/robert-g-martindale/332DF38FFB324681949B3E75BD3B492B
[USER=”3032″]Jennifer[/USER]
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Hello ajm22. I’ve thought about your situation over the last couple of weeks and realized that you might not get as much relief from a mesh removal, compared to, for instance, me and jnomesh. We both had significant and severe effects from the mesh, making it obvious that it needed to come out. In my case, I was on a slow and steady decline so, at the least, I hoped to stop that. In your case, since you seem to be in a steady state of fairly mild discomfort, the risk might be more than the potential benefit.
I think that many of the problems with mesh come, also, from the dissection process itself. Creating the space for the mesh. If you told somebody that you were going to open up a large cavity in the abdomen between the peritoneum and fascia or within layers of muscle, that alone would be a significant trauma, probably causing lasting effects.
I think that goal of getting the mesh in, seeing it as a miracle fix for the hernia, clouds the common hernia repair surgeon’s judgement. The large dissection zone alone is a major trauma.
Something to consider. I think that you might be in limbo until things get better or worse. Good luck.
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[USER=”3038″]dixonv66@email.com[/USER]
Can you get the actual details of your surgery, including the type of mesh used? There are many different types, even for open surgery. The Prolene Hernia System (PHS), “plug and patch” (with a variety of mesh designs within that category), Onstep, flat Lichtenstein-type mesh placement, etc. Plus the different knit patterns and material type (polpropylene, polyester, PVDF, etc.) on top of the forms. It’s chaos.
It sounds like you had a preventative triple neurectomy, which is a way for the surgeon to feel like they are removing the pain transport method, but ignoring the potential for neuromas caused by the cutting. Most surgeons, Dr. Towfigh included, say that preventative neurectomies are not the “standard of care” for hernia repair. But it sounds like you got a maverick surgeon.
You should get your records and consult with a mesh removal surgeon. Not that they will remove the mesh but they will be more open-minded to the cause of your pain. Your original surgeon has a vested interest in avoiding a mesh-related problem, or even a surgery-related problem. The current meme for hernia repair is that only poorly skilled surgeons will have patients with problems. It’s a meme that keeps surgeons quiet and afraid to acknowledge problems.
Good luck.
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If you search “Pure tissue repair: A hernia mesh alternative” using Google the article will be the first link.
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Both links work on my laptop with Windows 10 and Chrome browser.
Thanks for posting that dog. Interesting that it’s in a Texas media outlet. Georgetown, Texas, by Austin.
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[USER=”3031″]Launcelyn[/USER]
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If you choose the Shouldice method you should go to the Shouldice hospital itself. Depending on your insurance plan you might find that it will actually cost less. You might also find that your insurance will not cover a non-mesh repair. When you’re calculating costs be aware that some of the cost estimates you receive might not cover “incidentals” like anesthesia. All of the procedures I’ve had since I got involved with the medical system due to my hernia have cost more than the original estimate.
Finally, calculate the long-term cost, mentally, emotionally, physically and financially, of a low quality repair, even if it is a non-mesh repair. Minneapolis is not far from the Shoulidice hospital. If I had could start over with my direct hernia repair I would go to Shouldice, Dr. Brown, Dr. Kang, or Dr. Muschawek.
As far as getting back to working out soon after surgery, I would not even think that way. Plan for years of good life after the surgery, don’t make a choice just to save a few months of down-time after surgery. A poor decision will affect the rest of your life. At 55 that could easily be 30 – 40 years.
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Not duplicate now – The new tissue is one of the main purposes of the mesh. It will not go away while the mesh is there. More tissue might actually be created over time as foreign body irritation continues. In my case, wherever there was mesh the tissue got very stiff and tight. My lower abdomen became taut and flat and thick, not in a good way.
It seems very contraindicated for a surgeon to place another large piece of mesh after a mesh removal. Most surgeons who do mesh removal don’t do anything, no repair attempts. until the body has adjusted over time without mesh. I would find a new surgeon and get a new opinion. I think that the surgeon who did the removal then placed mesh via TEP probably screwed you up even more. The first mesh repair probably moved because your body was rejecting the mesh. Putting more mesh in after mesh removal seems somewhat ignorant of the known problems with mesh and how the body can react to it..
Many surgeons have strong opinions about the way that they do things and think that the “skill of the surgeon”, their skill, is the key to success. They don’t understand the false story, spun by the device makers, behind mesh repair. Yours might have let his passion for laparoscopy get in the way of logic.
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That sounds like nonsense. The mesh materials would have to be much hotter than is possible in the body before they would be affected.
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[USER=”3030″]Luke7[/USER] [USER=”2580″]DrBrown[/USER]