Good intentions
Forum Replies Created
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Sorry ajm222, that’s my negative view, the other side of the argument.
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I think that most surgeons don’t think out the full cycle of damage and healing. or they do and just pretend it doesn’t exist. When we exercise we damage tissue, very small tears and cell damage. Normal healing results in stronger muscle and other tissues like ligaments. They get thicker and stronger. With mesh the damage reinvigorates the foreign body response, plus, since the polymer fibers of the mesh are essentially inelastic, any pulling inward of the mesh that happened with activity gets locked in by the new healing response as more “healing tissue” is added on. You can also easily imagine how the edges of the mesh can get pulled inward and folded, since there is no mechanism except the fibers’ stiffness, to push the edges back outward.
Most of the problems of mesh are easily explained by standard physics, mechanics, and material properties. I think that most of the success stories out there are really stories of people drastically reducing their activity levels.
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What did they find from the exploratory surgery? You’re implying that they found nothing. Was it a laparoscopic procedure?
More details would allow someone to give a more specific answer. “Well-known for hernias” could just mean well-known for mesh implantation, not necessarily expertise in diagnosing hernias.
Good luck. You can notify people using the @ symbol then typing their screen name after it. A menu will appear to choose the name from. [USER=”935″]drtowfigh[/USER] [USER=”2910″]21Tara[/USER]
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quote M.G.:I was told that in my case the only solution to remove the mesh was removing the abdominal muscles with it,
This does not seem technically correct. It might be that removing the mesh would be very tedious and time consuming and they don’t want to put in the time and effort, or don’t feel confident in their ability. The tissue that grows in to the mesh is not muscle tissue and it should be possible to separate it from the muscle tissue, leaving functional muscle behind. Whoever said this might really mean that they would take the short path to removing the mesh, leaving you with further damage. The job is too difficult for them.
I think that you need to find the right surgeon, who will take the time to get the mesh out with the least damage.
I am not an expert in anatomy or physiology though. Maybe others can offer better thoughts.
[USER=”2580″]DrBrown[/USER] [USER=”2019″]drkang[/USER] [USER=”935″]drtowfigh[/USER]
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Thanks for posting that. It has Dr. Billing’s current information, he has moved from Eviva.
Dr. Ramshaw really should have added notes about their specialties. Dr. Billing is known more for mesh removal than hernia repair, I think. His specialty is actually weight loss surgery.
Here is a link to his new web site. https://transformweightloss.com/
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Forgot [USER=”2795″]bmul100[/USER]
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[USER=”2580″]DrBrown[/USER] inquired recently about CBD products and got some good responses. It was a couple of months ago, maybe he’s seen some results.
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As I understand things, both Dr. Brown and Dr. Kang understand groin anatomy and the various named techniques well enough to produce appropriate variations as they see fit. They asses each situation as they go and choose the most appropriate way to solve the problem.
Also, as I understand things, the “Marcy” technique is used for indirect hernias. So the type of your hernia will matter.
Both Dr. Brown and Dr. Kang have seen the damage that mesh can cause and have made a conscious and informed decision to avoid using mesh if possible. Named techniques, by their nature, are self-limiting. I would choose a surgeon who knows all of the techniques, and understands the basis behind them, and uses them in the way that is best for the patient..
Good luck.
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If you’re traveling to Shouldice Hospital you might as well consider [USER=”2580″]DrBrown[/USER] or [USER=”935″]drtowfigh[/USER] . Worth talking to for sure.
https://www.sportshernia.com/sports-hernia-specialist/
Good luck.
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That would be a fascinating position from a sports-based physician. It’s been stated that professional athletes get mesh for hernia repair and they would probably be more core-strength focused than anyone, besides maybe a construction worker. Seems contradictory, how would they train?
Chiropracty though, no offense intended, is thought of by many, for whatever reasons, as “fringe” medicine. You should get more specific information if you can. Offhand comments should be backed up by research. He or she should have some data behind their statement. It might be firsthand experience with athletes, who knows.
Good luck.
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quote allj:New surgeon is going to put in a heart skin muscle from a pig covered with a plastic mesh. He wants to cut the inguinal higher and thinks the sensations that are being picked up are from the iliohypo nerve and wants to cut that up. If I understood him correctly he said the new mesh and skin will make it difficult if not impossible to do the ilihypo later if that is causing a problem.
Good luck Alan. You are far in to the realm of experimentation. As has been written on the site by real surgeons, the various nerves are not distinct and separate. There is “cross talk” and interconnectivity.
Why is he planning to implant more mesh, for a pain problem? Do you have another hernia? I would be worried. Consciously or subconsciously, older people are seen as not worth as much time and effort as younger people. There was an article very recently in one of the major publications, the NY Times I think, about it. Your surgeon is planning to use a new and unproven (in humans) material and cut nerves that he is unsure of, creating a situation that will, by his own words, be permanent and unfixable. I don’t see any good coming from his plan. Lots of guessing and hoping.
Read mamadunlop’s stories and plan carefully.
https://www.herniatalk.com/5197-6-hernia-surgeries-6-months-post-op-new-pain
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quote allj:Dr. Towfigh – The surgeon wants to re-cut the inguinal nerve higher up and the iliohypo at the same time. He said if it isn’t done during the lap procedure it will be buried in the mesh and difficult to impossible to do later.
Hello Alan. Did you mean scar tissue when you said mesh? Your first post said you’ve already had a mesh removal.
I would get a second and third opinion. If your first surgeon gets offended then they probably don’t really have your best interests in mind.
I think that cutting nerves is in the same category as amputation. Just cut the offending body part off and the problem is gone. But new ones will appear. It’s a simplistic approach to a complex problem.
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Your mesh removal surgeon would know best. The great irony of mesh removal is that it is not taught in medical school or residency, but mesh implantation is. Mesh removal is a problem that only brave and conscientious surgeons take on. So there is no “best” procedure that has been agreed upon. I think that surgeons who do mesh removal talk to each other, because it is such a difficult and tedious procedure, but not discussed much at the big meetings. You should really ask your surgeon what they plan to do, before surgery.
Good luck. Be aware that the recovery from mesh removal can be slow. The body has been fighting it for as long as it’s been there, and much of that will be undone over time.
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quote Herr87:I have had pain for the past three years following lithotripsy for kidney stones in both kidneys. I have been put on antibiotics, spasm meds, amitriptyline and cymbalta for nerve pain, had physical therapy..but still have intermittent pain, especially with bowel movements or sitting too long or being on my feet too long.
Is the pain similar to the pain before the lithotripsy? Maybe you had two conditions at the same time. In other words, the pain might not be related to the lithotripsy.
If your medical plan allows it try to find a specialist in hernias. Beware the possibility of getting a “repair” for a hernia that does not exist though. Mesh implantation is very popular and very close to being used in a prophylactic manner.
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quote NoMorePain:I had a mesh patch placed in ab in 2011 in Texas. It was to cover an umbilical hernia that happened after natural birth.
A pelvic exam with contrast showed a small amount of fat escaping from the side of the repair/patch. Medical team suggests thats the cause of my discomfort. They also advise another patch placement for that..
The general term for the “fat escaping” would be recurrence. You’ve had a recurrence of your original hernia, a failure of the original repair. You should seek out a hernia expert, since the “standard of care” in 2011 did not work for you. You don’t want to get in to a cycle of repair and failure.
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What part of the world are you in? And what type of surgery the first time, open or laparoscopic?
Some people’s physiology does not actually behave like it is proposed that everyone’s does. The ideal s that the body becomes “one” with the mesh, creating an abdominal wall stronger than ever, with no discomfort. My mesh was constantly inflamed. Constant inflammation means constant weak tissue. More mesh seems like more problems.
You’re in that situation where the surgeons are trying to “salvage” the mesh procedure without really understanding what happened. You might be better off to go back a proven suture-based repair method. There are so many variations of mesh and method that nobody really knows what will happen in any individual patient. Your body didn’t “incorporate” the mesh as planned, no reason to expect better results on the second try.
There are people on this forum who have stories of multiple mesh implantations, with a string of failures. Be careful.
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quote Mariel:just hoping for some reassurance that this is all normal for small person and will eventually go away (?)
Only time will tell. The possible combinations of mesh type, surgery type, mesh placement, and individual physiology is incredibly large. Nobody really knows what each patient’s results will be. I felt like I had a sponge inside me for months. Lifting heavy weights at the gym seemed to squeeze the fluids out and tighten things up. Keep track of what you do and what happens later, and let those correlations guide you.
You’re still very early though. Probably have not even been released for normal activity yet. Good luck.
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quote PeterC:My physical therapist at the time worked closely with surgeons/doctors who work for a NHL hockey team and somehow got me to speak to them because I was on the front page of the newspaper and it got them excited. They had me do an ultrasound with a doctor
who specializes sports hernia. His findings were: Partial adductor tendon tear, partial oblique tear but nothing near the original site of pain. As my situation wasn’t getting better and I was
distressed – I finally agreed for them to do an open surgery on my right groin (because I just needed to get back to dancing asap). they found a tear over my inguinal canal – placed a mesh and voila[USER=”2580″]DrBrown[/USER] is an expert in athletic pubalgia (AKA sports hernia), and also in diagnosing pain sources.
It might help to know exactly what the surgeons found and exactly what they did by getting your surgery notes from the surgeon or the facility where the surgery was performed.
Letting the damage heal and getting back to dancing ASAP sounds like original damage might never have healed. The Vincera Institute in Philadelphia also specializes in athletic pubalgia and they repair the damage then have the patient do specific PT activities.
It sounds like your surgeon(s) found something that they were’t looking for, “fixed” it, but didn’t fix the source of your real problem. The foamy urine might be a red herring also, not related to the pain.
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Both are interesting surgeons, who remove mesh, but also use it for hernia repair. They both have significant involvement at the big surgery meetings, and in the hernia repair societies, and are well-known there.
You will most likely be offered a mesh-based repair by both. Almost certainly laparoscopic, probably robotic. Quiz them on their success rate, in real percentages, don’t accept “most” or “majority” as answers, including length of time that they stay in touch with their patients, and percentages of chronic pain after many years. Reasonable questions for any hernia repair surgeon to address.
Good luck. I think that you’ll find that most of the surgeons that you talk to don’t really know if their patients are doing well, years after their surgeries. It will be difficult to get direct information about the main issue of chronic pain or discomfort.
Don’t overlook the difficulty in fixing the results of each type of surgery if things don’t go well. Even within the mesh repair category, some methods and materials are easier to fix than others. The more they use the harder it is to get out.
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Good luck [USER=”2882″]Colrie87[/USER] . Healing can take a while so don’t worry too much in the first few days. It would be interesting to know what he found and what technique he used.
Take care.