John Fortem
Forum Replies Created
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Well written. Thanks for this report. I agree with you on all points. As you know, these points apply to other medical conditions as well. I share your dream, and hate to be the pessimist here, but the world you envision feels very distant. It’s all about the money. Money, money, money. Must be funny. In the rich man’s world. Money corrupts!
I wonder if anyone in Europe knows the Dr. Kang technique? I had my hernia repaired using a modified Shouldice technique, where the surgeon used the Prolane sutures you already mentioned, as opposed to steel sutures used in the original Shouldice. For some context, I had my hernia for almost 10 years, until it no longer was asymptomatic. Similar to you, I also had to go to another country to have it done my way, instead of the standard Lichtenstein with mesh – the patch him up and call in the next technique. It’s been about 6 years now since the surgery and I have not had a recurrence, even though I’m mildly overweight, and I was overweight when I had the surgery too.
Congratulations on a successful hernia repair! Also, congratulations on loosing those extra pounds and getting into better shape. I know I need to do the same, but it’s so easy to gain weight and so hard to loose. I hear maintaining a weight loss is even harder. I wouldn’t know, because I have maintained the same weight for the past 15 years or so, but on the wrong side of the scale. 🙂
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I had a chat with Shouldice Clinic earlier today, and this is how they view the “original” vs. “modified” Shouldice repair and the use of steel wire/suture in the repair. Note that Dr. Hall is the new chief surgeon at Shouldice Clinic since a year ago. Previous chief was Dr. Spencer. This is not apparent from the chat, you have to look it up yourself. I asked them only to confirm.
Me: Who is chief surgeon at your clinic?
Erin: Our chief surgeon is Dr. Hall
Me: Do you still use steel wires for sutures?
Erin: We do use stainless steel sutures. However it depends on what materials are required case by case.
Me: Do you cut the cremaster muscle? I mean in a standard Shouldice.
Erin: I am not a medical profession and cannot answer the question
Erin: Is there anything else I can do to assist you?
Me: Do you do mesh implants? Sometimes? Never?
Erin: We typically do not use mesh unless required
Erin: The only reasons why surgeons will use mesh are:
1. The tissues around the hernias were not viable for a natural tissue repair
2. The hernia is too bigMe: Do you do mesh removals?
Erin: We do not typically do mesh removals
Me: Do you have a certificate program for surgeons who receive training at your clinic and in your methods?
Erin: While there are surgeons who do come in to observe and learn how surgeries are performed here, we do not keep track of the surgeons after they leave our facility.
Me: So any hernia surgeon outside your clinic can claim to do a Shouldice repair?
Erin: While they may say that it is the Shouldice repair, it is most likely not.
Erin: They may have learned from us and do a modified version
Me: I see a lot of these “modified” Shouldice repairs. As a hernia patient myself. But then what is the “Shouldice repair”? Do you have a standard for it? Definition?
Erin: If you are interested in more about the technical aspect of how procedures are done here, please fill out a medical questionnaire for a surgeon review.
Erin: Once completed, a surgeon will review and a staff member will contact you what the next step will be.
Erin: Then you may call our main line at 905-889-1125 and request to speak to one of our surgeon regarding how procedure will take place.
Me: Do you diagnose and treat chronic pain after hernia surgery done at another clinic?
Erin: We do not. If you had a previous hernia repair done that is not a reoccurred hernia, we recommend going back to the same surgeon or to your family doctor for an assessment through them.
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How do you do dumbbell presses from a prone position? Help me understand this. Is this where you lay down on a bench with your face down and then with dumbbells in your hands you move your arms up behind your back or up above your head or to the side? I have seen some pictures on Google, but I just want to make sure I understand this right.
So this very small bulge appeared several hours after this event and it’s on the same side of abdomen as the old inguinal hernia repair, but slightly higher up? When you say you felt a tear, did you also hear a crack and was it painful?
It’s been 48 hours since you posted this, how are you doing now? Do you have any kind of pain or discomfort? I am not a doctor, but it seems to me like it might be a torn core muscle caused by overextension. The bulge you see might be from inflammation and swelling of the muscle. I would still recommend that you go see a doctor.
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Hello! I read the long story version and commented there as well. I’m glad to see you finally got the MRI without contrast, like you wanted.
No surgery is without its risks, unfortunately. Is this the same technique as used by Dr. Muschweck?
Metabolic stress can indeed play a role in triggering or exacerbating Crohn’s disease. Metabolic stress refers to the body’s response to various stressors that disrupt normal metabolic processes. This can include factors like infection, inflammation, and bacterial imbalances in the gut.
Research suggests that metabolic stress can reduce the function of the epithelial barrier in the intestines, which is crucial for maintaining a healthy gut environment. When this barrier is compromised, it can lead to increased inflammation and contribute to the development or worsening of inflammatory bowel diseases like Crohn’s disease.
Additionally, stress hormones such as cortisol and adrenaline, released during periods of stress, can negatively impact the digestive system, causing inflammation and irritation in the intestines.
Are you an athlete by any chance? I know an active football player who has Crohn’s disease. Crohn’s disease itself is not typically life-threatening with proper medical treatment and lifestyle strategies. However, it can lead to serious, potentially life-threatening complications if not managed effectively.
I’m always skeptical about techniques that have terms like “minimalist” or “minimally invasive” in their name. I initially wanted to have my own hernia repaired using a laparoscopic approach, but could not find anyone who would do it without a mesh implant.
I have seen a certain Dr. Kang here cited as saying something like, it’s better to have a failed tissue repair than a failed mesh repair. That catches very accurately the thought that I was guided by. I’m all about conservative and cautious approach to things that can have major and irreversible impact, in every aspect of life. But in modern times, I think we are often too cautious and we set our standards very high, and yet we still suffer. As always, the key is to find the right balance. Having no cut doesn’t count as surgery.
In the end, I accepted traditional, open surgery in my case. Like in the old days. No minimalism here. I was cut open wide and proper. But I found a very experienced and understanding surgeon. He is trained in the Shouldice technique. But he uses a modified Shouldice technique of his own. He’s like Bruce Lee! Meaning, the man is fluid and adaptive. Like we all should aim to be. He does it without a mesh. But he also sometimes uses a mesh. He does it with absorbable sutures. But he also sometimes uses permanent sutures. He told me the same thing your surgeon did, he would make the decision about what materials to use or not to use once he starts operating on me. It’s called intraoperative decision-making.
But my hernia was a proper hernia, not just a fatty tissue hernia. In fact, I have lived with it for about 9 years, and it started aiming for my scrotum. My brother had the same type of hernia, but his already reached the scrotum before he went in for surgery. That took 8 years I think, but he was about 2 years ahead of me, before I also developed a hernia. So he had his for 10 years in total I think. We both had ours fixed by Dr. Koch in Germany and have been hernia free for 5 and 6 years respectively.
I’m really sorry your own experience with hernia repair turned out so badly, despite being so small. What I think happened is your wound didn’t heal properly. Because you complained about having pain immediately after the surgery, and you continued to be in pain as weeks and months went by. That doesn’t sound normal to me. Perhaps you were allergic to the suture that was used, or the suture was not absorbed fully and properly by the body. Perhaps a permanent suture would have had a better outcome. Perhaps making the cut wider and deeper would have promoted faster healing and with less tension. Who knows at this point? There are a lot of things that can go wrong in a surgery, and every patient is different. For what it’s worth, I wish you a continued and full recovery.
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quote Km8888:Yup, same side. My brother also had a hernia operation on the right side as an infant.
I also remember having “episodes” of strong, sharp pain in the right lower groin area while playing soccer as a kid (ages 7-12) that would go away in 2-5 minutes, similar to cramps, but always on the right side. Those went away during my teenage years. I don’t know if it was gaining weight, or not playing soccer as often after I moved to the US.I lost a lot of weight over the last year and significantly increased my physical activity, including doing squats with weight at the gym, and squat-jumps without weights on my lunch breaks.
I believe this is what put me over the edge and brought back the hernia, or worsened it to where I now have symptoms and a bulge I can feel whenever I stand for more than 30 seconds.I have a consultation scheduled for August 20th with Dr. Brown, who I now see actually posts on this forum, so hopefully sometime soon I can get the hernia repaired without mesh and it’s associated side-effects and dangers.
That’s interesting. My brother also had a hernia, also on the right side. Yeah, I know I also gained some excess belly fat in my early 20s. As I recall I was 23 when I got my hernia. I used to train and compete in athletics from when I was 14 years old up until I was 19 years old. So I was definitely less physically active in the years that preceded my hernia formation.
Although, according to some studies the risk of developing a hernia is higher in people who are physically active such as athletes than in sedentary and obese people. They suggest that the fat somewhat acts as padding that suppresses herniation. I’m not sure what to make of that… but I am pretty sure that if athletes are more likely to develop a hernia then it is not because they lift heavy weights, but because they have poor form and body mechanics. It is a common misconception, almost a universal one, that hernias form by lifting heavy weights. That’s a myth! The best recipe for hernia formation is asymmetric overload in the lower abdomen/groin area, especially in a person who already has a weakness there from birth.
I have read great things about Dr. Brown. I think he is one of few surgeons in the US who does mesh free repairs. It’s a smart move finding a surgeon that fits your criteria and not prolonging the inevitable, you should not wait any more than you have to, especially if you already have bad symptoms from your hernia. I wish you good luck with everything and I hope you will get well soon!
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quote Km8888:Interesting… I’ve always been able to clench like I’m performing a kegel, and have my right testicle ascend upwards. Now I have a right inguinal hernia.
On the same side, right? This is a sign of weakness, and it’s likely that you were born this way, with inguinal ring not properly closed off. And as we age, the risk of developing a hernia in this area only grows bigger. Especially if you are not even aware of your weakness.
I am convinced that doing certain exercises can aggravate the already weakened tissue and cause a hernia. I know what finally caused my tissue to give in and cause a bulge (which I later learned is called a hernia). I was doing an asymmetrical stretch of my abdomen and legs. At one point I just felt instant pain in the right side of my groin, it felt like a tear, like quickly pulling up a zipper. I could instantly see and feel a small bulge, less than an inch in diameter underneath the skin. It was painful in the beginning, as the hole was still small and the pressure was high. I asked Dr. Google what it was, and that’s when I learned it’s a hernia. I never went to a doctor for this until later in life when I decided to take care of it. Like most men I presume, I didn’t feel comfortable having a doctor examine my junk. I just dealt with it on my own for about 8 years. I had it repaired 2 months ago, without a mesh and without cutting the cremaster muscle.
If you have a hernia, I would recommend having it repaired. Don’t play the waiting game, even if it’s asymptomatic. You will have to do it sooner or later, and sooner is much better. Just make sure you do it as naturally as possible for best possible outcome. First and foremost, that means doing it without a mesh, at the hands of an highly experienced surgeon.
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quote kaspa:About your aggressiveness to me, it seems inadequate to the forum, so any dialogue is finished now.
I am not being aggressive, I just don’t agree with you.
quote kaspa:I don’t mean people who drive Rolls, of course (I thought that was clear). I mean people who plan and build a Rolls Royce.I can see that now. I’m sorry, but English is not my first language.
quote kaspa:I’m talking about engineering. What it has to do with hernia surgery? Well, I wouldn’t like an engineer to repair my hernia. I’m talking about perfectionism and yes here they share that with people from Shouldice Clinic.And “here” is?… at the Rolls Royce factory? UK?
quote kaspa:Shouldice Clinic is a reference in inguinal hernia. They’re a highly trained team who only do that and they’re as paranoid as people in Rolls Royce. So, one single doctor, however good he or she can be, will have a hard time formulating a sound argument they’re wrong. If they say something is important, chances are more than 99% it is.And “they” refers to Shouldice Clinic…
So let me get this straight…
1. You equate Shouldice Clinic (surgeons!) to Rolls Royce (engineers!). (You made that comparison, not me. I never suggested you would want an engineer to repair your hernia, I thought you were talking about car drivers, not car engineers.)
2. You like Rolls Royce for its perfectionism. Therefore, you align your preference in surgeons to your car/engineering preference. (Shoot for the stars! I get that, and I don’t blame you for wanting the best.)
I can finally see what Rolls Royce has to do with hernia surgery. Perfectionism! Like I said, I don’t blame you for wanting the best. But don’t ask me to agree that Shouldice Clinic is the best. Especially not on the basis of one single patient report of bad outcome and at the expense of one surgeon’s private clinic. And we have not even filled in the missing details of this patient report, or heard the other party (surgeon).
By the way, I don’t think that Audi engineers are any less of perfectionists than Rolls Royce engineers. If we are going to compare things, then we should make sure to compare apples to apples and oranges to oranges. Both groups are perfectionists, simply because they are engineers. It’s in their nature. In order to become an engineer you have to be more interested in things, and less interested in people. In order to become a doctor (of medicine), you have to be more interested in people than things. And I don’t think Dr. Koch is any less competent, any less skillful or any less interested in people than any one of the surgeons that work at the Shouldice Clinic. I don’t understand why someone would even question that. Based on a single case report?
Why do we even trust the Shouldice Clinic so much? Are they really above everyone else? Are they really the top authority when it comes to hernia surgery?
quote kaspa:So, one single doctor, however good he or she can be, will have a hard time formulating a sound argument they’re wrong. If they say something is important, chances are more than 99% it is.You have to understand that Dr. Koch clinic is not a one-man shop. You can’t do surgery without a team of people. I don’t think he is any less of a perfectionist than the surgeons who work at the Shouldice Clinic.
I think the Shouldice Clinic is a good option for people who live close to it or who can afford the treatment at this clinic. Not many people do. But honestly, I think the Shouldice Clinic is glorified too much. That’s not without reason of course. It has played an important roll in pushing back against the “mesh empire”. It is still influential that way.
The name “Shouldice” is one of the main selling points for the Shouldice Clinic, along with its low recurrence rate. To the point that people avoid other clinics unless they use the “original” Shouldice technique. But remember, Shouldice would be nothing without Bassini. Which serves as an excellent example of that single doctor who went against the establishment at the time and paved the way for what later became known as the Shouldice technique, and fast forward a few years and you have the Shouldice Clinic. Was Bassini wrong?… did he make a sound argument for his technique? Why didn’t other surgeons pick it up until after his death?
quote kaspa:You’re happy with your repair, and I appreciate that. But many people here are still making decisions.I understand that. But suggesting that the outcome is much better if they receive the original Shouldice treatment at the Shouldice Clinic is not doing them a favor. So what? We should all travel to Canada and have it done at the Shouldice Clinic? That’s just silly, and not everyone will be able to afford that, and even if they did, it does not guarantee a positive outcome. There are no guarantees in surgery. At best there are some statistics and there is probability. Let me know when the recurrence rate at the Shouldice Clinic drops down to 0%.
quote kaspa:It seems clear that Baris case was perhaps complex (not that sure), but it’s a surgeon’s task to explain that to patient (before surgery) and even reject it if they feel incapable to repair it. I’m sure surgeon already had a lot of info from Baris even before they met.We still don’t have all the details, and if you want to be the judge you better gather as many details as possible, and you have to hear out both parties.
A surgeon cannot know what the eye can’t see, and neither does the patient. Some things are only understood in the middle of a process as you are doing it. Which is why my brother and Dr. Koch agreed to decide on surgical technique and suture material intraoperatively. Yes, my brother had his hernia repaired by Dr. Koch as well, and his hernia went all the way down to scrotum, but he is fine now.
quote kaspa:No one feels much comfortable about Baris case, as you can understand. For people who are deciding, all experiences are worth the same, and it’s good yours is positive.Agreed! But they should be uncomfortable for the right reasons. Not that I want them to feel uncomfortable of course… and I have given them more than one reason to feel comfortable about going to Dr. Koch.
I have said it before, but I don’t mind repeating it again. What really made my decision easy is when I read about a number of cases of mesh repair where one surgeon would put the mesh in but refused to take it out because of the difficulty of such operation, so the patient would travel to a different surgeon to have the mesh taken out. I can assure you that Dr. Koch is not one of these clowns who put the mesh in and then refuse to take it out or redo the surgery. Mr. Baris reported himself that Dr. Koch worked on him more than once. In fact Dr. Koch is one of the surgeons in Europe that people come to visit when they want the mesh to be removed. During my visit in fact, he had one such difficult case of mesh removal, where he had to transport the patient to a university hospital in a different city so he could remove the mesh. I know because he told me so, and he was late for my checkup. He had been gone for almost entire day.
Look! I am not Dr. Koch’s lawyer. If it makes people feel better, more comfortable, knowing that they received the “original” Shouldice treatment and they can afford it, then by all means, have them travel to Canada to get it done at the Shouldice Clinic.
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quote DrBrown:The cremasteric muscle does not have to be cut during hernia repair. I agree that the shouldice clinic advises cutting the muscle, but I do not feel that cutting is necessary.
Regards
Bill Brown MDAs someone who had an inguinal hernia repair done 2 months ago, I can agree on that. I had the “fake” (as some patients on this forum will suggest) Shouldice repair done in Germany, without steel sutures, without a mesh and without cutting the musculus cremaster. I’m a male in my 30s and I train 5 times a week (strength and conditioning), and I have not once had a problem with my testicle migrating up into the abdomen. And let me tell you, I should know what that feels like, because as a young teenager I used to play ping pong with that thing, my testicle would slide up into my abdomen and drop back out as if it was nothing! It’s only later in life that I got my hernia and that I learned that this is not exactly normal and something to consult a doctor about. It’s not something to laugh about and have fun with, that only aggravates the condition.
The take home message here is two-fold:
1. Cutting the cremaster muscle contributes nothing in preventing hernia recurrence. If anything, it should be cut long before a hernia develops in the first place… which doesn’t help someone who already has a hernia, and when the repair is done right there is no reason to cut the muscle if you’re a skillful surgeon. I would argue that if the cremaster muscle contributes to hernia formation at all, then it does so in the very early years in life, and in cases where the internal inguinal ring is not properly closed (which is the primarily what we have in indirect hernia cases in males).
2. Migrating or traveling testicle is an early warning sign. It’s a sign that this person may develop hernia later in life and therefore it should be taken seriously. I strongly believe that if insightful and knowledgeable advice is given at this early stage, it may help someone prevent hernia development later in life, or at very least postpone it. Like many ailments, hernia develops cumulatively. But clinically, it only becomes a “hernia” once it’s too late to prevent it. That’s all the more reason to catch the early warning signs. After all, prevention is the best medicine! And finally, of course, if we ask the Shouldice clinic, any young person that presents with a traveling testicle should have the cremaster muscle cut… just in case! It tells you something about the medical community and especially the Shouldice clinic. But who knows, at this stage, cremaster cutting may even be effective.
Disclosure:
I am not a doctor. I am just an average John. I know just enough about the topic to get by. And then there is my own personal experience of course, which gives me some insights that average doctors don’t have. Then finally, there is that thing called common sense… which sadly is no longer as common as one might think. -
quote UhOh!:But isn’t that an anatomical feature exclusive to men? Is there a female equivalent? Otherwise, wouldn’t apply to the OP.
Exactly! That’s anatomical feature in men. I wouldn’t know what the equivalent female version of that is, but the only reason that’s even brought up in discussions is because inguinal hernias are primarily a male problem. Primarily! But apparently women can also get inguinal hernias, but it’s far less common then in men. I can see now that the poster did report having an inguinal hernia, I didn’t see that at first or neglected that fact (lost in details).
I did a quick web search and found some interesting information:
“The cremaster develops to its full extent only in males; in females it is represented by only a few muscle loops.”
“In female humans, the cremaster muscle is smaller and is found on the round ligament.”
So as it turns out, women also have the cremaster muscle and while it’s anatomically or even physiologically different then in men, it’s situated in roughly the same area.
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Spot on! Recurrence is often used as the primary outcome measure in these statistical studies of hernias. When what they should be using is as primary outcome measure is pain and other long term complications. Of course, reinforced concrete is much stronger than just concrete alone! But should you ever have complications from bad reinforcement and decide you want to get those rebars out of your concrete… well… good luck getting that out without damaging the concrete.
Don’t look only at the recurrence rates. That’s the trick! You have to look closely at other factors and take them into account.
I could also have done my hernia surgery for free in my home town like most people that live here. But the surgeon I met could not even tell me what kind of mesh would be installed in my body or what material it was made of. So much for “discussing” the “options” with my surgeon.
I have a relative who had a hernia repair with mesh, open surgery, and he told me he never had any issues with it. He did his several years ago and he is in his 60s. But why play dice? You need to know what the risks are if things go wrong. This is something that upsets many people who had mesh repair that are now against mesh repairs. They were never told of the disabling complications that can arise from mesh implants.
I went out of country for my surgery. And what really made my decision easy is when I read about cases where one surgeon would put the mesh in and refuse to take it out. There was one woman from my own town who got mesh implant for urinary incontinence, and she had to seek help out of country to get that thing out. The first surgeon refused simply because the procedure was too risky? Dear God! So I knew right then what I had to do.
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quote jzinckgra:I’ll spare you my long story, but yes, I had lapro mesh repair in June 2016 for left side IH. Two weeks later, started feeling and seeing right side issue. Drs all said no hernia, CT scan showed otherwise. Didn’t do anything about it then cause it sorta went away for over 2 yrs until this yr. Started getting dragging feeling, bulge, some pain in right side. Ended up getting open mesh procedure two weeks ago to fix it. Oddly and somewhat frustrating to say, I’ve had pain again on left side and hoping I don’t have recurrent one. These hernias are a PITA. In case you’re wondering why I went open vs lapro 2nd go-around was because I heard recovery time and pain levels were slightly less with open procedure. I can tell you for me, that was not the case. While the open wasn’t/isn’t terrible, I have more pain during recovery mostly due to the 1.5″ incision at 2 wks post-op then I did with lapro.
I did open surgery but without mesh. It’s been almost 2 months now since I had it fixed, and I have no pain or discomfort. I had it for about 8 years.
My reasoning in the beginning was to do minimally invasive laparoscopic surgery. But as I continued to do my research and learned about the possible complications of mesh implants, I started steering away from both meshes and laparoscopic surgery. I quickly realized then that if I want to do this “my way” I will have to travel abroad. I did look at different “absorbable” mesh options, but I finally decided that it was a futile approach and an experimental product, so I decided to go all-out open surgery and not hold back.
What I wanted to achieve by minimally invasive surgery, and what is often advertised as being the pros of this type of surgery is that it causes less pain because the incisions are smaller (but there are more of them) and that recovery time is shorter.
I decided to throw out all this fancy technology (meshes that “disappear” and surgery without cuts or pain…) and listen to that little voice in my head that told me to go with open surgery, without mesh. “As God intended” if you will… or as it was traditionally done for centuries. Surgery is surgery, is surgery.
I honestly think that open surgery is frowned open more than once, for no good reason, especially in the West where access to advanced technology like laparascopic equipment or even the robotic surgery equipment is more easily accessible. Now let me tell you about this latest cool thing called mesh… dear God!
My incision is just about 4 cm. That’s closer to 1.6 inches. Sure, I did have some pain. It’s surgery! You know the saying, no pain, no gain? I believe that applies here as well. But I was not dying of pain. I did take 12 tablets (6 small ones and 6 bigger ones) of painkillers for the first 3 days, as prescribed by the surgeon. After the first 2 to 3 days I was told to only take them on a need-to basis. I didn’t really have to take them the first 3 days either, it was not that much pain really. I never took the opioid, this one very strong tablet I received.
The way I see things now, I would never trade in open surgery for laparoscopic one, not even robotic surgery. Laparoscopic and robotic surgery come with their own unique set of limitations and issues. And have this in mind! Just because the incision holes are small to an external observer (patient for example) does not mean that a lot of cutting is not going on on the inside and that a lot of difficult cuts and suturing is not performed. Quite the contrary!
So why not make your surgeon’s job much easier by allowing him or her to cut you open so they can properly see and reach in and fix you right up the first time, and improve the outcome of your surgery? Fear? Everything you want is on the other side of fear!
Anyway! Those are my reasons for going with open surgery, and of course part of the reason is that I wanted to do the mesh free, suture repair. To me, that’s the only reason to ever do open surgery anyway. If I wanted a mesh repair I would be indifferent about the access mode. Mesh is mesh, is mesh. Mesh does not become less of a mesh by doing open surgery. I don’t buy that. Sure, having easy access and good view might help you install the mesh correctly, more so than laparoscopically, but if you already have a patient open up right in front of you and everything is so easy to see and reach then you should have a very good reason for installing a mesh in the first place. I believe meshes should be reserved only for very extreme cases, and of course in laparoscopic surgery due to the very nature of that kind of surgery with restricted access, bad view and all that follows with it.
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Her words were, ‘ if u came from shouldice and they cant fix it you might as-well leave now, speaking very highly of the chief surgeon.
Chief surgeon who? Dr. Spencer? They all speak highly of their own. It’s what their patients speak of them that counts.
Dr muschaweck personally spoke to him on the phone as he was supposedly her ‘friend’ as he would not send over surgery reports.
They are all friends. But why would he not send you the surgery report? Reports? More than one report for more than one surgery? How many surgeries did you have with Dr. Koch? Didn’t he hand you the report after the surgery? He gave me my report in an envelope on the next day if I recall correctly. How did you request it? Did he have your right address?
She herself said the whole case is silly from the fact absorbable stitches in a shouldice was used which literally means its on the road to a fail. She told me after i showed my first ever open images dr koch took on the surgery table that my repair could of been done with the minimally invasive technique.
I think she said what you wanted to hear. I took interest and started a chat with the Shouldice Clinic an hour ago.
Me: Do you still use steel wires for sutures?
Erin: We do use stainless steel sutures. However it depends on what materials are required case by case.
Also, I had my surgery almost 6 years ago now, and it has not failed. I had both absorbable and permanent sutures of the synthetic kind (plastic). My brother had the same surgery 7 years ago and it has not failed, and his hernia was scrotal, and the hole was bigger.
How did you obtain the image? He sent you from his phone? I recall that he showed a picture of my brother’s hernia site when he operated on him, but I don’t think he sent a copy. He never showed me mine. Seeing how this can be used against a surgeon, I understand why they don’t normally do this and don’t give you a copy of the video if they do it endoscopically. Note that I’m not here to defend anyone but myself, but if I were a surgeon, I would need to have a good reason to hand over copies of such material.
Another thing to keep in mind, I think, is that Dr. Muschaweck may not know all the details just by seeing a picture of an open wound no matter how experienced or skilled she is. Why don’t they perform surgeries remotely with Da Vinci robot via Internet then? Without seeing the patient first? Such pictures can be deceiving. For example, my hernia was reducible. It would slide back in when I lay down on my back for about 30 minutes. So unless he’s fast with the knife, and camera, he might not ever have seen any hernia protrusion just visually, on the picture. Just stating the obvious. You don’t get the full picture with… a picture.
She also presumed that the mesh was used as the second surgery was done too soon and the muscle hadn’t healed up the sutures wudnt of held. When i went to shouldice they were shocked i had mesh as they said my muscle was very strong it just needed healing time.
He said, she said, they said… I’m sorry, but what you’re doing here is trying to piece together a picture of the events that will fit your own belief or theory, using authorities like Dr. Mushawech and the Shouldice Clinic (possibly Dr. Spencer) to back it up. Hey look! She agrees. Look! They are shocked. That’s what you sound like when I read this in my head.
On the second surgery I was told to take out a european health insurance card by dr koch. When i got there he told he will admit me as an emergency so they wont charge me and he wont incur costs. We had to act as if i had a strangulated hernia.
Why would he do that? I’m not an expert on the topic, but your insurance will cover the costs if you’re a citizen of an EU member state. And not only in case of emergency, but also in case of planned treatment, which is what you likely had. But getting reimbursed for planned treatment can take some time, and some paperwork. That’s if you pay out of your own pocked beforehand. If you get the… I don’t know what it’s called… statement from your insurance that they will cover the cost, form S2 I believe it’s called, then they will cover pretty much all your expenses, including surgery and accommodation (which is normally not covered if you pay up front, I learned that by own experience). So maybe he was trying to save you the paperwork and bureaucracy? It’s still wrong.
Why did i go through that stress? Wasn’t he supposed to do it free of charge anyway as he had guaranteed 3 years no reoccurrence?
Did you have a recurrence? I still don’t know how many surgeries you had, and with what doctors. But I do recall that he has a guarantee like you describe.
Lastly if you are working for bio hernia or dr koch or if they see this please respond to my email as the following month i will start legal proceedings for medical misconduct neglect and fraud.
Who are you asking? Me? I don’t work for BioHernia or for Dr. Koch. I don’t work for anyone, I am self-employed. But I’m curious how it went with your legal action?
I am about 6 years late with my reply to you. Do you think I would care to reply to you after this long time if I was in any kind of affiliation with BioHernia or Dr. Koch? Think about that.
It may sound like I’m favoring this one doctor, and I am biased, because I had my own surgery with him. But I was just weighing in on the topic with my own experience. I am truly sorry about your bad experience. I can tell you that not everything is perfect with this arrangement of BioHernia and Dr. Koch, but I have run out of steam now. I might tell about it later.
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The topic got heated slightly and it is perfectly understandable regarding the subject.
The topic went off topic before it got heated. That’s usually what brings on the heat.
I am not going to take any sides but I would really like to read more posts and impressions by Dr Koch’s patients.
Well you got at least two: one good and one bad. It’s a 50/50 split. Why do you think I weighted in with my experience of Dr. Koch?
You sure you don’t mean to say you need more impressions before you can take a side?… need more for statistical analysis of outcome? That’s very ambitious. I have long thought of organizing the forum by different surgical techniques or by different doctors. That would have helped you.
John Fortem, due the vast of information you poses of Dr Koch and his procedures, I was wondering if either yourself or your brother are perhaps working for Biohernia? My question hasn’t got negative implications.”
Right. Your question has no negative implication(s) whatsoever. Of course not. If you say so.
Look at it this way. If I am working for Dr. Koch and BioHernia, then Baris is working for Dr. Spencer (recently replaced by Dr. Hall) and Shouldice Clinic. No?
So where does your loyalty lie then? You’re merely an observer? You’re free to believe whatever you want. Like I said, I only weighted in with my own experience. I don’t work for BioHernia or Dr. Koch. Why is that hard to believe?
My “vast” information on Dr. Koch is not as vast as you may think. I don’t know what he eats for breakfast. But I am curious, observant and I ask a lot of questions. He who asks knows, and he who doesn’t, doesn’t. I knew beforehand what was awaiting me on the operating table. We discussed this in detail. I don’t know what went wrong in Baris’ case, but it’s quite a different story.
What I recall about Baris’ case:
He had two or three inguinal hernias. Possibly two indirect and one direct, or I may have misread/misunderstood? He met Dr. Koch for the first time for his second hernia. Dr. Koch used a hernia mesh for his repair. And this was against Baris’ wishes, and totally uncalled for from what I’m getting? So I don’t know exactly what went on, I would have to re-read the old posts and comments again, and it’s not an easy read quite frankly. He later went to Dr. Muschaweck for a consultation and to the Shouldice Clinic for another repair?
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This reply was modified 3 days, 9 hours ago by John Fortem.
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This reply was modified 3 days, 9 hours ago by
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When was it upgraded? What in particular is wrong with it?
I joined in 2018 and I seem to remember that it was better before. I think it was running on vBulletin and now it runs on WordPress. I was absent for about 4 years, and I logged back in just this week after resetting my password. I have noticed a few problems caused by the migration. For instance, clicking on certain old links returns a zero, a plain and simple zero on a blank page. I think it was a notification link in this case, so viewing content I was notified about 4 years ago is not possible. But at least they didn’t nuke and pave, and that’s honorable.
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Yeah, that must be it. I seem to remember they had something like a white powder poured in and mixed with water. I think I had Gadolinium myself at one point. But I think I did a CT scan, not MRI. Not sure if they use the same stuff for both CT and MRI. They injected something in my vein, and I remember feeling all warm inside. They did warn me that it would have that effect, and that it might make me want to pee.
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What was the suture thread made of? Absorbable sutures don’t last longer than 3 months, and by then they have lost most of their strength. If they last longer than that, then they are probably permanent sutures.
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Where are you getting these numbers from?
On average, people are exposed to about 2.4 millisieverts (mSv) of natural background radiation per year. This exposure comes from various sources, including cosmic radiation from space, terrestrial radiation from the ground, and small amounts of radioactive materials in the air, food, and water.
In some places, the average annual exposure can be higher due to factors like altitude and local geology. For example, people living in areas with high levels of radon gas or at higher elevations may receive higher doses of background radiation.
https://en.wikipedia.org/wiki/Background_radiation
The amount of radiation you receive from a CT scan depends on the type of scan and the part of the body being imaged. For example, a typical CT scan of the abdomen and pelvis exposes you to about 10 millisieverts (mSv) of radiation, which is roughly equivalent to 3 years of natural background radiation.
Different types of CT scans have different radiation doses. For instance, a head CT scan exposes you to about 2 mSv, which is equivalent to about 8 months of natural background radiation.
So, while CT scans do expose you to more radiation than other imaging tests like X-rays, it’s not quite as high as 7 years’ worth of natural background radiation in a single scan.
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Good question! Was this in Germany?
My brother was pretty much refused an MRI scan if he didn’t take
Gadolinium. At one point, he came so close to getting on with it. He came to the hospital for his appointment, and they brought out the stuff. I drove him there so I followed him in. I may be confusing something here, because when I google it now I see that Gadolinium is injected into one of your veins. I remember they had a pitcher and a cup on a serving tray. He had to drink it. He was hesitating and refused in the last minute. He had to take it some time before he went in for the scan.This was some years after his indirect hernia surgery and he complained about some abdominal pain, and the doctors thought it might have to do with his hernia surgery, which he had in Germany actually. Thankfully his symptoms cleared up after about a year or two, he told me. I spoke with him about this a few weeks ago.
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Do you guys have an MRI machine at your clinic? If you do an MRI scan without contrast, can you assess possible hernia recurrence?
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I never got around to thank you for your reply. It confirmed my suspicion. So for what it’s worth, here I am, 6 years later. Thank you!
I went back in time to find the Twitter post you mentioned: