Good intentions
Forum Replies Created
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quote MeshMangledMerritt:.I don’t know who else to turn to and hope someone in here can assure me that I’m not crazy and that is the mesh and operation that has left me crippled and walking with a cane these past 14 years.I think that you can read through the many posts on the forum and see that you’re not crazy. The device makers, the ones who profit from the mesh, have woven a powerful narrative about mesh and convinced many medical professionals that it is problem-free. If your doctors believe you than they also have to believe that they have been fooled.
What you need at this point is a surgeon who can help you with your problem. There must be a surgeon within the VA system that knows the truth and can help you. Hopefully somebody out there can point you in the right direction. Good luck.
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quote DrBrown:[USER=”2758″]
Complications from mesh are rare.
Regards
Bill Brown MDHello Dr. Brown. I asume that you are talking about short-term immediate complication, not long-term chronic complications. The number that seems to fit the complication rate for mesh is 15%. Some studies show it’s even higher, maybe up to 30%.
Even the vocal proponents of mesh, like Dr. Voeller, agree on a 5% debilitation rate for mesh. He says that’s not a big deal though, 1 of 20 patients ending up weakened and unhealed.
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Mesh typically tightens up the surrounding tissue and will create a tugging sensation,along with a sensation of something inside you that doesn’t belong there. “Tension-free” used to have real meaning, to surgeons, but today it’s a marketing term, used to sell mesh. Mesh does create tension during the healing process that’s why they put in such large pieces, to account for shrinkage and movement. The tension that is being referred to, in “tension-free”, really has nothing to do with a tugging sensation. No offense. It refers to sutures pulling on tissue to close the hernia.
Don’t get caught up in the “back to action in days” meme either. It’s actually an absurd and disingenuous way to sell a procedure to a patient and is really meant to sell the procedure to the insurance and healthcare providers. It means less monetary expense for them in the short-term, with fewer short-term complications. But it works well on the patients also. It sounds attractive and implies that there are no long-term consequences. Get ’em in, get ’em out, let the patient deal with it in the long run.
Your decision will affect the rest of your life, not just the week or two afterward. Focus on the long-term results. Good luck.
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[USER=”2777″]Mariel[/USER] notifying…
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quote Mariel:[USER=”935″]drtowfigh[/USER] originally diagnosed me With bilateral inguinal hernias.
I had a laparoscopy repair with polygrip mesh for a right sided painful inguinal hernia (fat containing). Said they didn’t find any others.
It might help to get your surgery notes. Surgeons have leeway to try many different things, like the patient who got Parietene mesh for an inguinal hernia repair, even though it’s not indicated for inguinal hernia repair. And some of them don’t have faith in the advice to avoid fixation and will fixate anyway. Plus they might have done other things besides just place the mesh.
I think that you probably meant Progrip, not polygrip. The notes will have the details. Good luck.
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Good luck Forest. I hope that you’ll stay in touch with the forum, good, bad or mixed results.
It would be very interesting, and potentially helpful to many, if you could supply the fine details of your procedure and the material used. Even some background from your surgeon on his past results.
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You can name names. Nevada is probably Dr. Petersen.
Don’t overlook Dr. Brown in California. Don’t overlook the Shouldice Hospital in Canada.
Also don’t overlook that you can always do mesh if a “pure” repair fails. But you can’t go back from a mesh repair. The effects are permanent and last a lifetime.
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It sounds like you’re saying that you had discomfort that was not resolved by the gall stone removal, and that you’re fairly certain that the lump was there before gall bladder surgery. Are you sure that the lump is not a scar from the entry point of the tools for gall bladder removal?
Here is a link that shows the approximate areas for certain types of hernias. Yours sounds kind of like a direct hernia. You will probably be recommended for immediate mesh implantation or exploratory surgery, maybe even if they’re not positive it’s a hernia. So read up on the many various hernia repair techniques before you see the doctor. Once you get in there things can happen quickly, and there might be talk of life-threatening strangulation of your intestines. Be prepared. Good luck.
https://www.epainassist.com/abdominal-pain/stomach/different-types-of-hernia
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quote mattl:However is it common to get an MRI? I would like one to get a accurate diagnosis. I did read sports hernias do not show bumps, I do not have a bump at all..
Any guidance would be appreciated. I requested a MRI from my primary to get a accurate diagnosis.
Read more Topics on the site and you’ll see that diagnosing hernias from imaging is not an easily acquired skill. Many hernias are missed until a hernia expert gets involved. Don’t depend on referrals and the “system” to solve your problem. You’ll just end up getting a mesh repair.
:”Sports hernias” and real hernias have different symptoms. It looks like you are just learning about hernias and might be making many common mistakes, not really understanding the differences and the possible repair methods. Be careful. Good luck.
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You’re doing things right by collecting as much information as you can, from varied sources. You can either keep learning until you feel confident in a path forward or find a surgeon that you really trust. Your description is somewhat vague and glosses over some important points. You’re only 38 and you’ve already had two open abdominal surgeries. So, much damage has already been done, which is probably why the “doctors” are suggesting abdominal wall reconstruction. And you haven’t supplied any details of what was done in those surgeries, just the fact you now have what appears to be a ventral hernia. More detail about what was done and the time it took to rehab from those surgeries might help with your decision.
Also, it’s not clear if the doctors you’ve talked to are surgeons who specialize in this field or if they are general practitioners who are not experts, and are just guessing. Make sure that you talk to some true experienced experts in the field.
Post your general location and people might have suggestions. For example, in the Northwest there is Dr. Martindale at OHSU. Members of this forum have had abdominal wall reconstruction by him
While you’re learning you should get ready for surgery. They’re calling it “prehabilitaton”. Good luck.
https://www.ncbi.nlm.nih.gov/pubmed/30138261
https://www.ohsu.edu/people/robert-g-martindale/332DF38FFB324681949B3E75BD3B492B
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Seems like it might be laparoscopy but they picked the wrong word.
” It features the use of endoscopic minimally invasive devices to carry out the finishing of the deep muscle fascia and hernia rupture, and the finished natural tissue is then used to achieve a three-dimensional structure reconstruction with the minimally invasive devices from a special angle.”
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It’s hard to tell. They use words like “minimally invasive” that are generally used to mean laparoscopy but their description is unclear. And they don’t offer any numbers, just percentages. Could be based on 100 procedures performed or 1,000.
The Center is in Taiwan. They do have testimonials from a variety of people but, really, it’s just a nice web site, with a good story. A lot like any mesh surgeon’s web site. Needs more detail and better numbers.
Thanks for sharing it though, it looks interesting.
https://joshuahernia.com/surgery-method/
https://joshuahernia.com/testimonial/
[USER=”2817″]columb.if[/USER]
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It’s difficult. You have to know how your insurance system works if you want to stay in it.
But the first thing you have to do is to learn about what was done to you. You might find that your procedure was unusual and might be the cause of your problems.
The more you learn the better your chances are.
You relied on Dr. Jacobs for the diagnosis but his repair method might be no different than that of someone in your insurance network. Why not ask him for a referral to someone in your network? He should be okay with that. If he refuses, that’s a sign.
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I would not choose a surgeon on reputation alone. I would do as much research as possible and choose the one that fits your needs, for the long-term. Many good surgeons just aren’t as visible as others. Dr. Jacobs presents at the meetings and is vocal and well-known but that does not mean he is the best for your problem.
I think the fact that he does not deal with the insurance companies is a sign that he is not 100% working for the patient. The health care system is part of life for the average person. Only the wealthy can afford to pay cash or take on extra debt. Refusing insurance just cuts out the lower classes. It’s not a good quality for a physician.
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I would get more details on your first hernia, the type of mesh used to repair it, your second hernia, and the type of mesh that Dr. Jacobs plans to use. You need to get in to the details in order to make a good decision.
For example, if your new hernia is actually a recurrence it might be because your body is rejecting the mesh. Not “incorporating” or being enveloped in to the body tissue. So it might do the same with the second piece. Or, if the new hernia is of a different type, indirect versus direct for example, a suture-based repair might be simpler and more effective.
When all you know is a hammer everything looks like a nail. Dr. Jacobs does laparoscopic mesh implantation and mesh removal. He seems like a good person but he has to keep his distance from your personal needs. He’s described a long path, doing what he does and isn’t sure that it will work. Nothing wrong with getting a second opinion.
You have to go beyond just “hernia” and “mesh” and laparoscopic and open. It’s much much more complex than that.
Good luck.
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“inguinal hernia repair” is a very broad and undefined term. Many surgeons, apparently, according to various descriptions of technique, routinely perform neurectomies, of varying degree, during hernia repair. This would probably cause numbness in certain areas.
There is so much variation in the field of hernia repair that without asking specific questions of each surgeon you just don’t know what you will be getting.
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Was the mesh implanted laparoscopically? Consider Dr. Peter Billing or Dr. Shirin Towfigh. Both are experts in laparoscopy and will remove mesh, and that’s how it should be removed if ti was placed that way.
Mesh removal recovery is generally a long drawn out process. Much tissue damage is done during implantation and while the mesh is in there, and removing it does more. But, the positive is that after removal the path is constantly upward, although slow and bumpy.
Good luck.
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quote mattl:I was told that its not possible prior to surgery… I assume this is not true?
My hernia was obviously a direct hernia. There is a bump in a certain spot and the sensations are specific to a direct hernia.
I think that what your doctor might have really meant, and what kaspa was implying, was that “it doesn’t matter” for mesh implantation. The mesh implantation is the same for many different types of hernia. That is why it is popular, it’s a “one method fits all” procedure, a lowest common denominator type of procedure, which can be learned and applied in an assembly-line type of fashion.
That is if he is talking about laparoscopic mesh implantation. You need to get more details about what is planned. I assume that your next step is referral to a “specialist”? The specialist should be able to tell you what type of hernia you have, and describe in detail his/her surgical method and materials.
Just be aware that today’s “standard of care” is to go directly to laparoscopc mesh implantation, for a wide range of hernia types. Odds are that that is what will be recommended for you, and that there will be pressure to schedule surgery as soon as possible. Wait and learn if you can.
Good luck.
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[USER=”2804″]pinto[/USER] I misunderstood the point of your first post. I apologize.
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The acronyms can be undefined. Most of them refer to placement of the mesh. IPOM is, apparently, still an “intra-abdominal” laparoscopy method, as opposed to TEP which stays between the peritoneum and fascia, never entering the abdominal cavity. The work is done inside the abdomen.
So, adhesions are one possibility for pain. That’s the main reason for the coating on the mesh. Also see where the sutures are placed. We just had a short discussion about tension in another topic. If he mesh shrinks the sutures on the corners get pulled, along with the tacks. That seems like potential for discomfort.
This video seems informative. I assume that there are variations, of course.
https://www.youtube.com/watch?v=I_kSyqdpROE
[USER=”2871″]Runner123[/USER]