[joep]

Hi [USER=”2608″]dog[/USER] , i am using Arnica Montana 30C (3 times daily), Colocynth 30C (3 times daily) for pain.

please note that homeopathy in its strict sense is not “evidence based medicine”. nevertheless i decided to give it a try because of my history of side effects and allergies.

[joep]

Thanks [USER=”1916″]Chaunce1234[/USER]; for that wonderful post, and taking time to write it. that was truly informative and kind.

Thanks [USER=”935″]drtowfigh[/USER] …. i did consult a homeopath for my pain after this post, and i am now taking the prescribed remedies. Will see if the pain subsidizes, before going for consultation with a conventional pain specialist. reason why i want to avoid taking conventional medicines is because i have a history of gastrointestinal bleeding/ulcers and other allergies.

[joep]

Hi Ddot14, according to HerniaSurge, as per the evidence published so far, Shouldice technique is the best non-mesh repair. They concluded that Desarda repair, at this point, simply do not have required data regarding its outcome, and shied away from recommending it.

https://link.springer.com/article/10.1007/s10029-017-1668-x

[joep]

just sharing some experiences that i came to know. i have two neighbors who have done open mesh surgeries in the past year and both told me they were back to 0%pain by 2 months post-op. They dint bother to ask surgeon why they did open/what mesh was used etc.

i have 2 friends from my college days, where one did open mesh while other laparoscopic repair. the one who did open mesh told me she cant actually remember how long it took her, but she is sure all pain when away before end of 6 months. The one who did lap surgery (a male) told me he had pain for may be 3 months and discomfort close to 2-3 years post-op. According to him it may be because he was so much into sports those days and was quite active. But still he told me the discomfort for 2-3 years was not limiting him from his daily life. Anyways now its been close to 10 years for both of them now, and both are doing great now. They too are not sure about which meshes were used.

I guess all i can say is that, most people are lucky and will get through this surgery just fine. But the unlucky few (10-15%), are unfortunately cursed with complications. Wish the medical community actively try to reduce that rate further, to say down below 5%.

[joep]

quote Good intentions:

It is surprising how the mesh problems seem to be getting worse over the years instead of better. One thing that I became aware of as I was searching for a repair method is the increase in the use of laparoscopic methods, and the associated growth in mesh coverage area. Laparoscopy allows a much larger area of the abdominal wall to be covered and the literature seems to supports placing as much as the surgeon can fit, even to the extent of what looks like prophylactic dissection (take a look while we’re in there) and placement (there’s a sign of a potential future hernia). Of course this is just a view from internet stories and research. This type of correlation would be readily evident if a hernia repair registry was in use.

My surgeon actually seemed proud of the size of the pieces of mesh he was able to use. I made a comment about how a 4″ x 5″ piece of mesh was pretty big, and he corrected me to “no it was 6″ x 6” “. Before my surgery he had remarked about how he dissected a space and cut the mesh so that it “couldn’t move”, and that he was doing things differently than he had the year before. I should have asked more questions then but I assumed that he was perfecting a good technique. In retrospect I think that he was adjusting for past problems.

not sure about the conclusion that increasing laparoscopic surgeries are causing more mesh complications. several studies have shown that post-op chronic pain is less after laparoscopic repair when compared to an open one.

[joep]

Thanks [USER=”2019″]drkang[/USER]. The problem is surgeons who practice non-mesh surgeries are very few now, and this skill is largely lost from most surgeons. Most patients cannot afford to travel to these specialist clinics (who practice non-mesh surgery). Hernia repair is one of the most common surgeries performed in world, so unless non-mesh repair is more practiced around world, there is not much patients can do about it.

[joep]

Re posting again as my prev reply got somehow flagged as spam

Thanks John Fortem for that link and paper. that was informative :)… anyways some of my recent update below:

i was able to visit a Hernia specialist. He told me his main experience is in laparoscopic mesh repair. First he asked me about how i got the pain in the first place.

I explained to him about my incidence in gym. I was lifting weights (dumbbell), using my left arm, and during my last rep i was unable to lift it, so i used my abdomen muscles to slightly aid my biceps just in the last rep (in summary it was improper lifting). Immediately after that i felt the pain. Surgeon told me that was unfortunately and silly. He told i might have gotten a grade 3 muscle strain (complete rupture). Then he asked me if the pain have subsidized since it first occurred. It has been now over 3 months, and i told him that pain was about 60-70% of the pain in initial days. He told me that my abdomen muscles are still not recovered, and that could be a contributing factor to the pain (in addition to nerve irritation caused when fatty tissue protrudes). He told me grade 3 strain might need 4-6 months for pain to subsidize. He asked me to come back for review after 3 months (so total 6 months after accident).

As per this surgeon, i will still probably need surgery. That hole for sure wont close itself. But there is a good chance that i might become asymptomatic or under very negligible pain within few more months of waiting. And i do have the luxury of waiting as my intestine/bowels have still not come out and as there is still no visible bulge. He agreed with me doing surgery with pre-op pain, would only increase the risk of chronic post-op pain. So its best to wait for now and to do surgery when the pain have subsidized.

Will sure post my update within next few months.

Thanks all for the advice and info.

[joep]

Thanks John Fortem for that paper, it was incredibly useful. Some of my recent updates below:

I had sought out a hernia specialist surgeon, and had consultation with him yesterday. He told most of the procedures he have done are laparoscopic mesh surgeries. From his experience, the patients who would come with chronic post op-pain is around 6%. Although most patients he told, will have some mild discomfort for 1-2 years, but for most the disabling pain (pain relevant enough to stop physical activities) is almost all gone by 1-2 months post op.

Then he asked me about the first instance when i got pain. I told him i was at gym, and doing dumbbell lifting using my left arm. During my last rep, i was unable to lift the dumbbell and i used my left abdomen muscles to aid it along with my arm (in summary, that was improper weightlifting). He told that was quite unfortunate and silly. I might have a grade 3 strain (complete rupture) of muscle, during that weightlifting which gave raise to hernia. The pain that i am having could also be because muscles are still not fully recovered, and the nerves might still be sensitized (in addiction to the nerve irritation which can happen when the fatty tissue protrudes during physical activities). A grade 3 strain might take 4-6 months for it to be pain free. Then he asked if my pain have decreased from the first day of accident. And i told him yes, its almost 60-70% less than the first few days. As its about 3 months now, since the accident, he told me wait for 3 more months (so total 6 months after incident). And come back for review.

He told most likely i will still need surgery, as hernia is present. That hole sure isn’t gone to close itself. But as my pain have been decreasing since it first occurred, there is a good chance that within few months i might become asymptomatic or at least very mild pain. He agreed with me that doing surgery with pre-op pain will only increase risk of getting post op chronic pain. And its best to wait few more months, especially as my hernia is small and intestines have not yet come out.

I am quite happy so for with his reply, usually the doctors i met before would be quick to suggest surgery. But at least here he explained well, seemed honest, and told me to wait.

[joep]

thanks Good intentions and Jnomesh. I guess my search begins. It is a little frustrating too, initially when i was diagnosed with hernia, i dint worry this much. I though it was a routine surgery and medical community by now would have made it to a stage where risks are low/acceptable. But a quick google search about hernia surgery taught me that its still not “routine” in terms of post surgery risks.