Mike M
Forum Replies Created
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Budget eyes vs non budget eyes
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Hen sized egg is how it was described to me for the direct hernia.
I also had my belly button hernia repaired which was 1cm, pretty small?
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Corrections: Sizes (not side stupid autocorrect) and Dr. Edward L. Felix, MD and *NOT* Dr. Voeller. Not sure how youtube sent me to the wrong interview* https://www.youtube.com/watch?v=mbgzMlPQcuU
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Pardon my ignorance but is the AI also making a mistake regarding Dr. Kang Kim ? This should be Dr. Kang in South Korea I would suspect?
I started to research some of those names after Dr. Towfigh’s corrections peaked my interest. I watched some of her youtube sessions with a few of the surgeons mentioned.
Dr. Voeller seems very accomplished but I got the feeling he is “compromised” when it comes to being open minded about possible solutions to hernia repair that did not involve the mesh industry. I feel like he is stuck in the late 1980s when mesh might have been a breakthrough discovery?
Dr. Michael Rosen with Dr. Towfigh youtube interview was impressive. A lot of back and forth and very reasonable open minded dialog in regards to the different types of hernia repairs and their applications. All of the feedback, open discussion, etc. was very insightful and genuine. Dr Towfigh makes a very striking point whereas if you have a hernia the sides of the width of her shoulders is mesh still not a solution?
Not that it matters but I really have a respect for both of those doctors after watching that interview.
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“Uncorrupted” Bassini is the direction I would have gone if I had not visited Dr. Kang. It seems the least evasive open tissue no mesh repair in the U.S. that is still effective.
Desarda – I read some pretty extreme mishaps with that procedure from patients. Also there was mention of being more delicate in the initial years than the other methods by members researching it on these forums as well as Dr. Kang’s concerns.
Mesh – Seems safe and the most reliable until its not. Biggest concern is entanglement near “sensitive” parts or your bowel getting perforated by even the most expert of surgeon (albeit very “low risk”)
Bottom line: We have to commend Hernia Doctors who are continuing to innovate and make all types of Hernia procedures more accessible and safer. Patients are going to rule out types of procedures that are not going to be acceptable to them for varying reasons. This is an area of healthcare where there needs to be real and effective alternatives. Hernia doctors do not always get the same type of acknowledgement and compensation from the mainstream health insurance industrial complex as other procedures even less complicated ones. Hernia surgery is a *major* surgery that involves operating near critical key areas easily damaged and directly responsible for long term quality of life.
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@Ajm Also most patients were damn near doing barrel rolls immediately after the surgery from what I witnessed. My buddy helping me on the trip was making fun of me as I was walking out of the hospital from surgery. He was telling me I was giving Americans a bad name. lol meh I knew I was coming into it a little bigger and my hernia was probably larger than most.
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@Pinto The reason I am pointing at the “coughing” is I had never experienced even a hint of a hernia at any point in my life. It was the furthest thing I thought possible. However I was forcing myself to cough in a pretty extreme manner over a long period of time (2 months) because I was annoyed by the simple cold / covid remnants. I never got sick outside of a tickle cough I thought (moronically) I could solve by increasing the intensity of my cough. Like you said it could be a culmination of time, a little age, and other activities but there was no indication prior.
Also you had a “sliding” hernia if I remember correctly? A little tricker to detect and possibly took extra steps to resolve? It is where the floor is made up from tissue from other organs?
@William Bryant I plan to go back to doing similar things you mentioned at 100%. I already am lifting massive spools of utility wire when I help my workers load up. No issues. I am not going to live my life restricting my activates because of the possibility of a recurrence. However I need to lose about 20lbs before I do anything too extreme to soften the load on that area.
“Bad pain” (but what I expected) the first 48 hours. Standing the first few weeks for over 15 mins would tense up the area and I would have to sit down for relief. That all went away with time no issues at all. Nothing was overwhelming or more than I anticipated. Only time I really needed help was the first 24 hours.
@ajm All the things you mentioned are common from what I was told and experienced. It all fades with time. Some people freak out about a sensation of “movement” or a “popping” etc. Just scar tissue, nerves, and your body trying to adapt for the most part. I walked up 10 flights of stairs 5 days after the surgery and thought I was doomed because of a little swelling. lol Follow up Ultrasound showed perfect repair.
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Chuck on a related topic to your reply – you ever watch some of the youtube “doctors” such as Dr. Berg? A lot of the vitamins and suppliments regimens sound too good to be true. But I did try one recently suggested and admit I do feel better, less tired.
The biggest things I found are:
#1. Minimize Sugar
#2. Watch carb intake on non work out days
#3. Avoid Alcohol
#4. Dont sit for long periods of time
#5. Minimize anything processed
#6. Watch your weight
#7. Get atleast 6-8 hours of sleep, keeping the same schedule
#8. Walk 10,000 steps per day with about 2 steps per second.
It is hard to follow all the basics sometimes a busy work scheudle.
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I agree. Chuck if you have people interested in learning more – direct them here (not the opposite.)
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Also –
The transparency and willingness to maintain an open forum dedicated to discussions of all types of hernia topics speaks volumes about the character of Dr. Towfigh and her practice. I don’t think this gets mentioned enough on these forums. It is a big risk with limited personal reward but a huge benefit to her patients and all patients seeking hernia repairs. Dr. Towfigh is also a doctor I would trust if I was inclined to seek the type of repair she offers.
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Chuck –
I concur with Pinto on his statement. It goes back to who you trust. I trust Stephen and Dr. Kang 100% based on my research as well as my direct experience. I would not go to anyone else for no mesh tissue repair. Too risky for me especially after hearing all the horror stories. I am convinced there are just a handful of competent no mesh tissue repair doctors left in the world and even less that can operate on a wide variety of patients and hernia scenarios successfully with no mesh.
It is my experience the “Kang Method” is the best “one size fits all” for hernia patients determined to forgo mesh no matter what scenario is in play. That is not to say mesh is better or worse for certain situations as well as the type of mesh surgery.
I was determined not to have mesh surgery under any circumstance as well as no cutting of nerves, cremaster, etc. That limited my choices significantly but also funneled me into the best possible scenario for a doctor for my specific choice.
MRI vs. 3D Ultrasound I am not sure which one is more advantageous for trickier hernias. Based on my layman’s understanding I would trust both scenarios with either doctors and if one ruled it out (and I still had problems) I would follow up with the other method of imaging as a second opinion.
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The two biggest issues in a “perfect” patient body scenario are:
#1. Repair tissue dying due to lack of blood flow.
#2. Minimium Length of recovery for a “strong” repair outcome (years).
This is my understanding from feedback from the leading tissue repair doctors mentioned on these forums and the limited research information previously posted on these forums regarding that specific repair.
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Alan I am glad to to hear your operation was uneventful. Heres to you feeling better soon and a perfect follow up!
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notanewbeeok – it sounds like your experience with surgeons / high level medical staff is similar to mine. I was able to observe from “behind the scenes” as an enterprise technical engineer and administrator covering multiple main campuses and 100+ offsite professional locations. I engaged with high level staff resolving all types of technical technology requirements as well as the working with the general administration supporting the base IT infrastructure. I do not have a medical degree (EE, CS) but you learn a lot regarding the competency of a doctor through basic conversations “off record”.
University and training hospitals with large student facility were the worst case scenarios. Not to digress into all of those horrific stories but needless to say anytime you fill out a form you always want to cross out “training” in any capacity on the permission to treat. Trust me. If you want to have X person in training to assist then have the doctor and/or professional staff intervene BEFORE specifically outline who it is, why they are there, and what they will be doing *exactly* during the procedure. Additionally if you do give permission you want to make sure all “trainee” assistance is documented specifically in the medical records for anything they do. Standard practice but you would be surprised.
The hospital experience has a lot of pros but for me there were too many cons for my personal preferences. It would have given me too much anxiety knowing specifically what I would have to control before even entering into that environment.
I also understand your point of the “surgical centers” being the new “urgent care” of hospital ORs. You have a lot of valid points and if something serious were to happen even by no fault of the doctor – critical care could be too late. Also if the doctor encountered something that needed resolved unrelated to the hernia repair specifically but still relevant to that area of the body they may or may not be able to solve the issue prior to closing you up? Obviously there are varying degrees of what your permission would allow or not allow them to resolve depending on the severity / time. However I wanted everything that area to be fixed regardless of circumstances if viable.
The great thing about Dr. Kang is he runs a state of the art 6 story hospital that specializes in specific areas of care such as hernia repair, cancer screening, EKG screening, etc. It is very capable but also personalized. Dr. Kang has extensive knowledge repairing that part of the body including procedures not specifically related to hernia damage. His hospital gives you the best of both worlds where you have the very personal, specialized care, without dealing with the systematic monstrous environment of your average US hospital. Dr. Kang runs the show and all aspects of the hospital. This solved all of my anxiety related issues with the surgery, recovery, and follow up. It was a huge issue for me going into this entire ordeal outside of the outcome itself. Doctors and staff in the US are phenomenal at gaslighting patient concerns. My friend who has a medical background and a wife who is the chief nurse at a major local hospital was skeptical. He became a believer after he experienced Dr. Kang, his hospital, staff, etc. with me during my trip. He now regrets not having some procedures completed by Dr. Kang while we were in South Korea. He still putting them off in the United States.
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Alan – Reach out to Stephen Kwon prior to your trip if you have not already. Stephen is awesome and a great resource for overseas English speaking patients. He will make sure your trip goes smoothly.
I stayed at the CoEx which had everything I needed within walking distance (including a mall below the hotel). Rates were pretty reasonable through an agency or Priceline. The hotel has laundry service, a lot of English speaking staff, and a lot other amenities that made my stay effortless. Coex is close to the hospital but about 30mins drive time due to traffic.
One of the best Korean BBQ places I found was walking distance from Coex. It was a smaller shop but probably the best I had on my trip next to BBQ near the Lotte Tower.
There will be a lot more open sightseeing attractions with your trip. Back in April they were just opening tourist areas back up to the public.
Lotte Tower, Temples and Palaces, JSA, Observatory, White Jade mines in Chuncheon, etc. there is a lot to take in but you should be able to see a lot in 2 weeks. I was pretty conservative the first week but 2nd week I was talked into walking up to the top of the Lotte tower. A lot of stairs but no real issues. Just had to take it slow.
Gangnam-gu is the south side of Seoul where the Coex is located. It was awesome and very amenable to a noobie traveler from the U.S. like me. Load the SHUTTLE food app on your phone too if you like Doordash / Ubereats. It is the best app I found for English speaking travelers. They deliver all over the city.
Dr. Kang is exactly as advertised. You made the right decision imho.
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@watchful Just to clarify I have no lingering pain and no real pain after the first few days. Also nothing of what I would consider of consequence after the first few weeks. The outcome to me was as “perfect” as I had hoped.
Keep in mind prior to surgery I was to the point (pain wise) where I wasn’t even sure if I would be able to make it on the plane to South Korea. Size doesn’t always tell the full picture imho.
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@chuck
Dr. Kang’s repair that is similar to Marcy is only if you have indirect.
Dr. Kang repair is closest to Bassini for direct hernias.
Pain was only bad that first week. Some tension the weeks that followed and then it fades into nothing. I can still feel something in that area but nothing of mention. You can only really feel the scar tissue the first few months maybe. The nerves seem settle down and accept the repair after a while. I am starting to “forget” I even had hernia surgery now which was the end goal.
I know his son is completing the Kang repair now. I do not have any other information on that but maybe Dr. Kang can comment.
Dr. Kang elaborated on the corrupted vs. uncorrupted Bassini on these forums.
https://herniatalk.com/forums/topic/kang-repair-question/“Although I said the Bassini repair belonged to Group 1, the Bassini repair published in 1890 was a surgery that belonged to Group 2. The essence of original Bassini repair was to repair the damaged transversalis fascia barrier. While the recurrence rate of inguinal hernia repair announced by other hospitals exceeded 50%, the same rate announced by Bassini in 1890 was merely 2.7%. Owing to this remarkable performance rate, the Bassini repair quickly became famous and many surgeons adopted it. However, it was unfortunate that the method was ‘corrupted’ in the course of it being widely propagated – the initial (and essential) process of transversalis fascia repair was omitted, and the new main barrier was built by pulling and sewing together the separated muscles and ligaments. Some called so ‘corrupted’ surgery method the ‘corrupt Bassini repair’ and the original Bassini repair the ‘authentic Bassini repair’. Thus, the Bassini repair that was said to belong to Group 1 in the above was actually corrupt Bassini repair. However, the authentic Bassini repair is certainly a method that belongs to Group 2 and should be regarded as the most advanced method in the Group. In fact, the processes of repairing transversalis fascia (the main barrier) under the Shouldice repair and the authentic Bassini repair are almost the same. The only difference would be how to create the auxiliary barrier. Thus, some call Shouldice repair the ‘Bassini-Shouldice repair.
Sadly, the Bassini repair most surgeons learned, knew and practiced was not the authentic type, but the corrupt type.I believe that correctly and strongly repairing the transversalis fascia, the anatomical barrier, is the most important issue in preventing recurrence of hernia. That is why the recurrence rate of initial authentic Bassini repair was only 2.7%, which is an excellent rate even today.
However, as the corrupt Bassini repair became the golden standard of hernia repair thereafter, the recurrence rate had to show a high level of 10 to 30%.” -
@William Bryant
It really depends if he has to absolutely do it (for emergency purposes) before we make it back to South Korea or not.
We are planning to go back next year.
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@Chuck Also in regards to the structure being back to 100%.
Scar tissue is unidirectional vs. bidirectional.
My understanding is because of this the tissue is about 70-80% of what it was previously. However when you add in structure like permanent sutures and the fact the procedure attaches to other parts of the body in that area to provide additional strength? who knows? Optimistically I would hope it was better than prior to the damage occurring.
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@Chuck
The only thing I couldn’t do after a few weeks of recovery was run (not because of pain though). I run just fine now. Lifting, coughing, etc. I couldn’t feel it after the recovery period. I did a little exertion after the recovery period but my goal was to take it easy until after 6 months, which is when the tissue has fully healed from what I understand? Walking and some light lifting at most. 6 months was early Oct so I’ve been lifting more weight now and being a lot more active.
My BMI was at the upper limit of what most doctors would consider for open Tissue no Mesh repair. The upper limit for most places is around 30% not 25%. I’m a bigger dude all around 6’3″. Ideally I need to lose around 40lbs. My hernia was larger than typical, not insane? but it was the size of a hen egg per Dr. Kang.
The pros were – I have no pre-existing medical conditions. Normal Blood pressure, no diabetes, no previous surgery, healthy, and still fairly young? in my late 40s.
No issues but it was a little scary before surgery to consider the points Dr. Kang made regarding weight in the US vs. weight in South Korea. Most individuals in South Korea are in better shape weight wise than in the US (even older patients). You start to doubt if open tissue no mesh could ever work on X patient but it does work. I am definitely not the hardest patient he worked on but I wasn’t a walk in the park either. It goes back to really doing the research and selecting the best doctor with the highest level of surgical skill you can find and access. I can totally see now how a surgery like this could end in a nightmare if you are in the wrong hands.
Funny – I actually lost weight in South Korea (10lbs) in the two week period and I ate rice and Korean BBQ non-stop. I also had pizza a few nights. I should have stayed there a month. I walked around a lot after surgery but nothing crazy.
I have friends who have had mesh and others who have had no mesh repairs. I also read many cases including those on these forums. The consistency in the stories are interesting. Open tissue no mesh – More challenging early on ( even up to the 1st year ) then issues fade to nothing. Mesh – No issues early on then varying degrees of issues ( including debilitating ) after the 1st year.
I will double down on Dr. Kang. He doesn’t cherry pick patients to generate skewed numbers that don’t reflect the results of the population. He is well respected by former patients and other specialized doctors in his field like Dr. Yunis. He has successful completed no mesh repairs in probably the widest variety of patients not seen since the introduction of mesh.