Good intentions
Forum Replies Created
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Dr. Towfigh has experience with that plug and patch, see her Twitter post below. Maybe she has thoughts about a surgeon who will see you and at least discuss options with you. You might want to give your general location again, maybe your insurance network also.
[USER=”935″]drtowfigh[/USER]
https://twitter.com/Herniadoc/status/1021561699290116097
What do you see?
This is a medium size Perfix #plug #mesh that has balled up, aka #meshoma . It was causing chronic groin & nerve #pain due to erosion into the spermatic cord, so I excised it. He is now #pain free!🙏🏻#meshcomplication #hernia #chronicpain #itsnotjustahernia pic.twitter.com/EgnLh0ULXR
— Dr. Shirin Towfigh (@Herniadoc) July 24, 2018
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That is good advice Lucky46. Have you tried the facility where the surgery was performed? Typically, there are at least two sets of records, one for the facility and one for the surgeon. Even the anesthesiologist might have a copy. Each will have different reasons for keeping them. Call them directly.
I would recommend writing down what you remember also, as your own personal record. I found some discrepancies in my records that make me wonder if portions weren’t “cut-and-pasted” from previous surgeries on other people.
Good to see that you’re still around. You might try to find a surgeon who will help on your own, not through your PCP. Many plans allow self-referral. I’m sure that some clinic or doctors can ask to be referred also. Pull the referral instead of having your PCP push it. Or consider choosing a new PCP, one who can get more done, if you think that your current PCP is stone-walling you.
Somebody like Dr. Petersen in Las Vegas might be worth talking to it you haven’t already. They might have a payment plan since they work outside of the insurance systems. The insurance systems seem to be walling off the conditions that are not predictable. Mesh removal is one of those conditions.
Good luck.
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Hello dog. G-K’s post has been restored in the topic that you started.
Thank you Dr. Towfigh.
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I miswrote above, about the surgeon who said the problem was too big to quantify. It was not an Australian surgeon it was Dr. Voeller of the University of Tennessee. He is also of the opinion that most meshes are the same. He is teaching these opinions, I assume, at the UT Medical School.
“It is most certainly higher, but we will never know the truth in a country with a population of more than 300 million like the United States, since long-term follow-up is impossible.”
I still can’t believe that a professor, at any school in any profession, would say that because the numbers are so large nothing can be learned from them. It’s incredible. This type of thinking is very damaging.
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quote DrEarle:Good intentions – Excellent comment regarding outcomes data. You stated there are “few metrics, despite close to one million surgeries per year”. Hernia repair, like health care in general, is complex. Not complicated, but complex. Therefore, by definition we cannot control it, but we can manage it. But we can only manage it if we have real world feedback (data) from the output of the system, in this case hernia repair outcomes. Only then can we get some really smart people to analyze the data, and gradually improve our application of hernia repair methods to those most likely to benefit. This can be accomplished. However, we need a single medical record (not single payer) to do it. The PPACA required electronic records, but inadvertently created a multi-billion dollar industry who’s own interests are well above those of the public. Not only would this allow continuous practice improvement, it would allow the type of post-market surveillance of hernia mesh (along with all other devices and drugs) we so desperately need.
Thank you for the response Dr. Earle. It is much more constructive than attacking the Shouldice hospital. I posted a link to an Australian surgeon’s comments, who had a similar view – “the problem is too big too handle, it’s hopeless”. But, of course, the individual physicians can easily track their own results, using surveys. The Shouldice hospital does.
As long as surgeons keep repeating the vague generalizations about successful use of mesh implantation for hernia repair, avoiding the chronic pain issue, the drive to find the truth will be weakened. That was my point in responding to the article you posted. She is just repeating something that she read on a medical device maker’s web site or from her training from the device maker. She is supporting, on her blog, what she does, without actually knowing if it’s true. She’s advertising for mesh. I just posted a link about Ethicon and their usage of their “Registry” data to make unverifiable claims about their mesh products. The device makers will sell sell sell as long as people keep buying their stories.
That is the real battle. Against the medical device makers’ propaganda. They have no reason at all, besides moral reasons, to discover if their products are better or worse than simple suturing techniques. If sutures are better, considering both recurrence and chronic pain, they don’t sell as much mesh. It’s really that simple. They have no reason to disturb the growth of the 5-6 billion dollar market. They don’t want to know the truth.
But the individual surgeon does. Because they took up their profession for the good of humanity and have taken the Hippocratic oath to confirm this. But many have been duped or coerced by the device makers. It’s “do things the device maker way or life will be very difficult”. They have co-opted the profession for their own benefit. It’s the great failure of the unregulated free market economic model we use. Business concerns are controlling the health care professions.
Good luck and please stay engaged in this issue. The truth is easy to see for those who want to see it.
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G-K I saw your post and had planned to ask you about the method for the original surgery. If I recall right you said that it was 34 years ago. So about 1984. Was it a pure tissue repair? No “other materials”. How was life for the those 34 years? Success stories are good to hear. 34 years would be a success, I think.
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This is the thread which had G-K’s post deleted as SPAM. [USER=”935″]drtowfigh[/USER] [USER=”2781″]G-K[/USER]
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Notice that she does not give her name on the blog. But it is linked indirectly. It would be interesting to know how her hernia repairs are doing. She said that she had two. That is the main problem with the industry today. It’s all internet stories, with few metrics, despite close to one million surgeries per year.
Here’s the quote. The blog post was May 2015. So it’s been at least three years. It sounds like a lap procedure. Notice the focus on the scar.
“So one last confession. I had two hernias repaired in November last year. I got a colleague to do it, with mesh, and a general anesthetic, as day surgery, in one of our local hospitals. I went back to work in less than 48 hours and I am very happy with my scar. I would recommend this approach (and frequently do) to anyone, including my patients”
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My post just got flagged also. Certain words like m e s h seem to get flagged.
I saw your post and it was very reasonable. dog’s reponse to your post is still there. Very strange that it got flagged late like it did.
Dr. Towfigh is the moderator. You can click on her avatar or use the @ symbol. The @ symbol doesn’t always catch though.
[USER=”935″]drtowfigh[/USER]
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Dr. Towfigh is the site moderator. I have found that certain phrases might be the cause, like “mesh …. removal” or “mesh … implantation”. She can often release them for publication. I try to remember to copy the text of my posts before I try to post them so that I can repaste and try again with a few words removed.
The site uses the “@” method for notification. Sometimes you have to wait for it to pick up the sign though. You can also send Dr. Towfigh a message by clicking on her avatar. [USER=”935″]drtowfigh[/USER]
I think that I saw your post. dog responded to it, his response to you is still there. Surprised that it got flagged later. It seemed reasonable, maybe somebody thought it was a sales pitch. Thanks for posting though, and good luck.
https://www.herniatalk.com/9141-no-mesh-hernia-repair-experiences-with-dr-william-brown-others
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In the United States the FDA would be the organization expected to monitor the safety of the various manufacturers’ products. But they generally rely on self-policing by the device makers themselves. It has been well-reported that the FDA is very lax in actual monitoring of product safety, only acting when publicity gets too extreme. Consider opioids and trans-vaginal mesh. They rely on reports from end-users like us, the patients, or from the surgeons who actually implanted the devices to inform them of problems. They are a reactive organization, not an active enforcement agency.
Unfortunately, the impression that the FDA is watching and keeping everyone safe is also shared by many in the medical community.
Your best source of information, sadly, is the various social media sites across the internet. Running enthusiast sites, weightlifting, mesh specific sites, hernia repair sites like this one. There is no “official” organization that has the mission of proactively seeking out that type of information.
As a result, all of the mesh products have the same low level of safety information. They’re all a gamble.
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The study is scheduled for completion in December 2021. Ethicon is already using the data, in vague claims, post above, to sell their mesh. But nothing is said about their failures.
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[USER=”2727″]kchabot[/USER]
Didn’t work above but looks like it did here.
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quote kchabot:Thank you for all your help and guidance . My Dad’s challenges are now a “full body” experience. He also has a pacemaker (2013) and bilateral knee replacements (2015). I’m certain we are dealing with an autoimmune response to all his implants. I hope there is something we can do to alleviate his suffering. It is comforting to be validated. Best to you all.
Dr. Earle is newly active. I hope that you sent him a message and that he replied. You can use the “at” sign to contact him indirectly. It doesn’t always work though. Good luck.
[USER=”1292″]DrEarle[/USER]
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I read the article that Dr. Earle linked and can’t get past the fact that even she, the author, “chooses” to believe the story that is told over and over, despite well-documented and available evidence to the contrary. It’s not the mesh, it’s the skill of the surgeon. The cognitive bias is incredible, but understandable. It must be very hard to accept that you’ve been harming one out of six of your patients, by the inherent qualities of the material itself. Not the technique, or placement of the material. Accepting that the device makers have pulled a fast one.
Very frustrating to see well-educated people avoiding confronting a very important health issue.
“The “standard of care” now is to do hernia repairs with mesh, a plastic like substance which allows for less pain (if inserted properly), earlier return to work, and decreased recurrence rates. ”
Any problems with the Shouldice method are completely unrelated to the problems with mesh implantation. That’s where true progress in health care can be made. We should focus on mesh.
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Thank you for commenting Dr. Earle. I think that the more salient point is not that he chose Shouldice, but that he did not choose one of the prevailing laparoscopic mesh repair methods from an American clinic.
Is he really choosing Shouldice or is he avoiding mesh? He is from Kentucky, why didn’t he go to the University of Kentucky’s clinic? Good political publicity, keeping it in state, advertising the capabilities of a state university.
https://ukhealthcare.uky.edu/services/hernia-program
Or he could have gone back to Duke, his alma mater.
So, not only did he miss the opportunity to keep it in state, he even left the country. There are plenty of well-known American clinics that accept cash payment. The stated reason for going to Shouldice seems disingenuous.
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Actually, I just found one. You can click on his name, or the little word bubble by his name,and send him a message. Post #7 from 2016. Sounds very promising. Good luck.
https://www.herniatalk.com/393-chronic-pain-after-inguinal-hernia-repair-boston
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He seemed to be thinking right in 2007, see the image and the first link below. I have not seen a single post from him on this site though. There are posts where people respond to Chaunce1234 (I did once before Chaunce1234 corrected me) as if he is Dr. Earle, but no confirmed Dr. Earle posts.
No idea what his thinking is today. He consults for Bard though, apparently (see the springer.com link below), so might have some internal conflicts, not so free to act on his opinion. Might be a problem.
Good luck to your Dad. Is his problem centered around the hernia repair site or is it a general overall physical problem? I know of at least one person who had a “full body” reaction to his second mesh implant.
https://link.springer.com/article/10.1007%2Fs00464-016-5072-x
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[USER=”2042″]Jnomesh[/USER]
[USER=”2754″]PowerSeed[/USER] -
quote PowerSeed:Also would appreciate comments on…
- Living with it as long as possible vs. actively seeking repair surgery?
- Necessity of mesh removal?
- Patching mesh on mesh?
- Anyone aware of issues with Ethicon’s SecureStrap absorbable tacking system–mine must have come loose?
- Intrigued by simplicity of the Desarda procedure vs. Shouldice but note Dr. Tomas, for one, only removes mesh that is placed from an OPEN surgical hernia repair technique—is this due to liability risk? Are there others who remove lap mesh and do Desarda?
Thanks again!
Bard’s 3D Max product is supposed to be designed to eliminate the need for fixation. Finding a different surgeon certainly seems reasonable.
I would find a surgeon who has experience in fixing mesh failures. The expertise used for laparoscopic mesh implantation is probably quite a bit different than an open repair of a mesh failure.
Jnomesh is deeply involved in the problems with 3D Max. You might check out the Facebook pages he has linked in previous posts. There are probably others who’ve had a failure and had it repaired and might have real experience with surgeons who have that expertise. Experience is supposedly the number one attribute to look for when choosing a surgeon. Find one who has experience in fixing mesh failures.