Good intentions
Forum Replies Created
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Thank you for commenting Dr. Brown. It looks like Bard has already developed a new product, Modified Onflex, and introduced it to market, somehow. The 510k bypass process again. Overall, each patient with a problem is just an involuntary subject in the device makers’ experiments. It’s incredible that this is now normal. Validating new products is not even necessary anymore. All it takes is an idea and it can be implanted in patients as soon as it’s produced and delivered to a surgeon. It’s hard to read these marketing pamphlets without feeling sick to see how uncontrolled the market is. Complete abdication of responsibility from the FDA, and the community of surgeons that use mesh. Surgeons should be refusing to use these experimental products.
Here is the experimental justification for the new absorbable ring, copied below. Preclinical data on lab pigs. Results may not correlate to humans. But it’s for sale, ready for implantation. Amazing. Any surgeon who reads the fine print is guilty of malpractice I think, if they use this product without informing the patient that it is unproven in humans, even in the short term, let alone long term. Or they can plead ignorance and blame the device maker.
“These images are from a porcine study using Ventrio™ Hernia Patch which contains the same SorbaFlex™ memory technology.*
“* Preclinical data on file at C. R. Bard, Inc. Results may not correlate to performance in humans.”
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The people in Denmark seem to have the tools and the mindset to better define the hernia repair field, as a whole. But they seem to be constraining themselves to defining mesh repair alone. A true research scientist would compare the results to non-mesh repairs also. Many of the studies, like the “International Guidelines for groin hernia management” are disingenuous, in that they ignore the non-mesh methods. It’s a subtle from of dishonesty.
The true and honest name for the Guidelines should be “International Guidelines for groin hernia management with mesh devices”.
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This is a problem also. Industry is driving the use of mesh, not the results of the repairs. They’re not going to be happy funding researchers that show that mesh is bad. It’s a major problem in all types of research.
Conflict of interest
SÖ reports no potential conflicts of interest. KA reports personal fees from Bard outside the submitted work. JR reports personal fees from Bard and Merck, outside the submitted work.
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5-6% still in pain after 5 years, and 34% unknown. And they have defined the pain as “cannot be ignored”, implying that pain was still there for many subjects, but they were able to ignore it. Seems like a pretty low bar. Also, as usual, all mesh types and the two lap methods are balled up in to “mesh”. No definition of the procedures in the abstract. Maybe in the full paper but the authors published in one of the subscription journals so only those who pay can see the results.
Sorry, I am just supplying a counterpoint. The authors write like the results are good news but it looks like bad news to me.
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[USER=”2987″]dh305[/USER] Here is a link to another forum with more stories from people who have had hernia repair. It covers the spectrum from good to bad, it might help you figure out where you are on the spectrum. As you can see, it’s not a black and white situation, it’s a wide range with lots of variation, made even more complicated by all of the different types of mesh that have been developed over the years.
It’s been an active thread for over eight years so there are some long-term stories.
https://forum.bodybuilding.com/showthread.php?t=133353003&page=1
Here’s a link to an article about healing that might help you understand what’s happening. Unfortunately, inflammation is the double-edged sword that the mesh concept uses to get the mesh to attach to the body’s tissue. The mesh is always a foreign body that the human body will try to eject or destroy. The “game” is to try to find that level of activity that allows the mesh to exist without acute inflammation.
https://journals.sagepub.com/doi/pdf/10.1177/147323000903700531
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I got Unapproved again.
Be objective about what is happening to your life. Track your activity and ability levels over time and compare them to your old self. The path down is insidious because your old normal self could get back in shape with a week or two of intense activity, from a weakened level. But your new self can’t do intense activity anymore. So as you get weaker, mentally you think it’s temporary, that you’ll be able to get healthy again as soon as you feel better. But really, the weaker state is permanent, because you never feel better and can never generate the energy to stay healthy.
Plan for the worst, hope for the best.
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Plan for the worst, hope for the best.
Take some time to quantify where you were physically before the hernia and define what lower level is acceptable now. Keep a log of of your activities and abilities to be aware if you are slowly getting weaker and weaker, without realizing it. Without measuring your levels you can easily see a year or two pass that could have been a year or two recovering from a mesh pain solution.
The common surgeon sees so many patients with much worse problems than a hernia repair patient. The fact that you’re alive and functional is a win in their minds. Only you can decide if you need to take more risk to fix your new life.
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There is always hope. But, if you’re having problems now, at three months, the odds are greater that you will continue to have problems. Unfortunately, because the medical/industrial complex refuses to fully acknowledge that mesh has real problems, you will not find much help from the mainstream surgical community. They are not “allowed” to recognized mesh pain as a real problem. Solutions for mesh problems are not taught in medical school.
That’s why I suggest finding a surgeon who has experience in solving mesh problems. They will have the past experience from numerous patients to recognize your symptoms and may also have seen correlations with the type of mesh and where it was placed. The standard of care today for laparoscopic mesh placement is to place the biggest piece of mesh that they can fit in to the space they create. It’s all about preventing recurrence, very little focus on chronic discomfort and pain. That’s why your surgeon keeps putting you off. He’s hoping that you’ll accept your new diminished life and go away,
I wish I could offer words of encouragement. But your best path forward is to find that experienced mesh pain surgeon and let them help you. The mainstream medical community will be of little help.
Coincidentally, as I write this, an ad for hernia mesh problems litigation has come on to the television….
Good luck. Get out of the system and chart your own path.
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It’s the interpretation of the image that is most important. Dr. Towfigh has written and presented quite a bit about how it takes specific training to interpret images.
She has offered to examine people’s images in the past. I think that you can send them to her after you get them from the facility that took them. Don’t trust the interpretation of the staff image reader of the day at the facility that did the imaging. Get your images to an expert in hernias. Good luck.
https://twitter.com/Herniadoc?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor
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I wrote a good post but got the Unapproved green screen.
Move on from the surgeon who implanted the mesh. He has reason to reject you because it is implied today that mesh problems are caused by the surgeon’s skill level, Not the material itself. It will be a black mark on your surgeon’s record to admit that you have problems.
Find a surgeon who deals with mesh problems, they will have ideas. Get your medical records in the meantime so that the fine details of what was done will be clear. Your story is just “mesh implanted laparoscopically, now I have problems” without the details. There are scores of different types of mesh out there, and two main types of laparoscopic techniques, TEP and TAPP.
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Your surgery notes might have some clues. A better description of what he found, how much mesh was implanted, the type and brand of mesh, whether or not fixation was used, etc.
Your story, as you probably realize, is very similar to those of us who’ve had long-term problems. Unfortunately, today’s surgeons aren’t trained in how to deal with problems after the implantation process. It’s get ’em in, get ’em out, pass them on to pain management. Pain management will probably be the next thing recommended if you persist. Your surgeon might even suggest that you learn to live with your new debilitated life, like mine did.
Mesh implantation is taught as a procedure that is almost perfect if the surgeon has the appropriate skill level. It’s a meme that has been created that actually makes it more likely that a surgeon will reject a patient’s problems. Because it is implied that problems are from the surgeon’s skill level, not the material itself. So you will very likely receive very little help from the surgeon who implanted the mesh, as you are finding out now.
I would move on to a surgeon who has experience dealing with mesh problems. They will recognize your symptoms and have potential solutions ready.
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quote Bestoption:With recent long awaited appointed, the general surgeon had a very little interest in what I had to say. The worst part was that he wasn’t prepared and had no idea as why I’’ve been appointed to him.
He told me that it doesn’’t matter, as the procedure works the same for all types of hernia.
I was told that once cut open he could fix both at the same time.
I was told that to think about my further years without heaving reoccurrence.
The surgeon that you saw is today’s run-of-the-mill mesh implantation “mechanic”. He has been trained/convinced/persuaded that mesh is a one-size-fits-all cure-all. He is the worst kind of surgeon, not a true physician, just a medical professional who performs procedures. It might be his inherent character or he might be burned out but he does not have your best interests at heart. You should avoid that surgeon, he will probably implant as much mesh as he can fit, to avoid recurrence, and will reject any pain or discomfort problems that you have with his work.
It is good though that you’ve experienced how bad things can be, before you had surgery. Find a true doctor. Good luck.
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[USER=”2967″]MeshMangledMerritt[/USER] notification.
Good luck.
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I can’t answer your questions specifically. My surgeon left as much intact as possible when he removed the mesh and did not cut any main nerves, as far as I know. One thing that I’ve noticed and that makes sense is that with the mesh gone other parts of the abdominal wall will feel new stresses, because the reinforcement/stiffness of the mesh is gone. So I’ve been in a cycle of stressing new areas, letting them adjust and heal, then going through the cycle again.
Basically it’s just a long-term adjustment process but in a way that makes sense, with a reason for soreness, and soreness that resolves with rest, like a normal body would. The difference from having the mesh in place is that with mesh I always ended up in the same spot after activity that caused soreness or pain. It wasn’t an adaptation to new stresses, it was a wall that couldn’t be overcome. With the mesh gone, the response is more normal, like recovering from any other injury.
My key point was to be happy when you feel good and to have faith that you’ll feel good again if you have a setback. Unlike with the mesh where you know that you’ll never really feel good again.
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Sorry wth I don’t have any specific exercises in mind. I think people have described them in different topics on the site though.
Dr Towfigh is at the Beverly Hills Hernia Center. A good starting point for you,. And Dr. Bill Brown is in Fremont. He can differentiate between a hernia and sports pubalgia (AKA sports hernia). They are both true hernia experts.
Read the “sticky” at the top of the forum about sports hernias. They don’t show hernia signs but cause pain similar to hernias.
Good luck.
https://www.beverlyhillsherniacenter.com/
https://www.herniatalk.com/6882-in-depth-sports-hernia-guide-infographic
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I think that the post is interesting but not really useful. We need the name of the surgeon at least. I did my homework and got a bad result. Well-respected surgeon, chair of the surgery department, expert in laparoscopy, numerous surgeries performed, used Bard Soft Mesh in a TEP repair. The results should have been excellent.
Even with the name of the surgeon, the one thing that often gets overlooked is probability. The odds. The odds are one in six, at least, apparently, across the spectrum of mesh repair methods, that a person will have mesh problems. So the homework doesn’t help if we don’t know the details and the results, the history, of the surgeon’s other patients.
It’s still a gamble, with bad odds. The people who get good results can’t change the odds. Only collecting accurate long-term results across a surgeon’s patients can identify how to improve the odds for the individual patient.
The good stories are really just stories of an individual’s luck. No offense intended, but really that’s all there is here. You’re one of the lucky ones.
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quote wth:So far I’ve seen a family doctor, general surgeon, urologist and gastroenterologist.
I also see that you have not seen a hernia expert. That should be your next step. Not a hernia repair method expert, but a hernia expert. You will find many surgeons who have expertise in the latest repair method but not in diagnosing hernias.
[USER=”2976″]wth[/USER]
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quote wth:Hello,
Background: I’m in my early 30’s.
Had a laparoscopic appendix removal more than a decade ago. No complications post surgery.Starting on July 10 I’ve started to experience lower abdominal dull pain (1.5 inch below the belly line to the right or left), tenderness, also feeling of bloatedness and like something is protruding under the skin (no visible bump) from either the right or the left side (on the left side it also seems to also radiate to the groin or left testicle area) that seems to get activated when I do certain physical movements, like like playing table tennis/billiard, sitting on the couch with my back aligned with the back of the couch, bending over, lifting some bag of groceries, moving my stomach to a certain range that would activate it.
So far I’ve seen a family doctor, general surgeon, urologist and gastroenterologist. ….all came back negative and no evidence for hernia (also doctors did a physical examination for a hernia).
Gastroenterologist mentioned it could be Irritable Bowel Syndrome made worst by stress, but I don’t really feel more stressed than usual, also there are no other typical symptoms to IBS such as diarrhea, nausea or anything else. Or he said it could be a stomach muscle strains, but I doubt it can that be felt like it’s from the inside of the stomach and radiates to the groin area.
I got a CT of the abdominal and pelvis with and without contrast, and it didn’t show anything abnormal, no signs for hernia.
It’s been already 6 weeks, and the “pain” is coming on and off. There are some days when I feel better, like I feel normal again, but then after prolonged sitting, or perhaps doing something what I described above, the pain gets activiated, so it then for example would start on the left lower stomach and would radiate down the groin to the testicle area, then after a day, it would shift to the right right side of the lower stomach an below the belly line to the right –
I tried to break your story down to the basic elements. It was a bit convoluted.
I think that as a hernia develops the tissue and nerves in the vicinity get stretched and damaged, causing discomfort and pain. There is a certain threshold I’m sure where a surgeon’s fingers can feel a hernia or where it shows clearly on imaging. But before then it’s just overly stretched nerves and tissue, that look and feel normal.
So, a guess would be that you are in the early stages of hernia development. You might consider doing exercises that help strengthen the abdominal wall, in the hope of preventing a full hernia from developing. The results might also be a clue as to what is happening, If things get better or worse, it might be telling.
Be careful though, in seeking a solution. If you look far and long enough you will find a surgeon who proposes “exploratory” surgery to see if you have a hernia. The end result could easily end up as a mesh “repair” and you’ll be in a whole different world if you have mesh problems.
So, good luck, don’t be hasty, and don’t trust “big medicine”. It’s not designed for the individual patient, it’s designed for the masses,
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That is great news Merritt. Be ready for immediate positive results but a long slow climb back to where you think that you should be. You and your body have been compensating for the mesh pain for many years. Take your recovery slowly and carefully. Take the long view if you have setbacks. I only had my mesh in for three years but still had setbacks up to where I am now. It’s constant progress but I still have a lot of room ahead to be better.
Best of luck in your surgery.
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Dr. Martindale at OHSU might be a good choice if you can get in to see him. Search his name on this forum and you’ll find some things about him.
https://www.ohsu.edu/providers/robert-g-martindale/332DF38FFB324681949B3E75BD3B492B
https://www.google.com/search?q=site%3Aherniatalk.com+martindale&rlz=1C1SQJL_enUS862US862&oq=site%3Aherniatalk.com+martindale&aqs=chrome..69i57j69i58.10795j0j8&sourceid=chrome&ie=UTF-8