[paco]

Glad to hear you are better.

Attached photo of my incision site.

I take this opportunity to update my state after my mesh removal, neurectomy and Shouldice repair with absorbable sutures.

Well, 1 month and 15 days exactly after my surgery.

There is a huge difference between mesh vs non mesh. During mesh dressing… no walk, no sex, extreme pain, no no…
Now… walk, run, activities, etc.

Pain, marginal. Only slight discomfort sometimes.

The only problem not related with the current surgery is that my systemic inmune disease and damage caused by the mesh is still present, but slightly and slow improvement however. My IgE levels are going down slowly.

If I could turn back time…

[paco]

The anethesia team shaved all my right leg and put me various electrodes. I listened some of evoked potentials (potenciales evocados) to avoid problems.

maybe because in my particular case I needed general anesthesia, because I suffer from spinal csf leak for more than three years, so epidural anesthesia is contraindicated to me in order to avoid another dural tear.

But maybe evoked potentials could be used also to monitorize wrong nerve damage or similar, as I’m pending of another surgery in Switzerland to treat my years chronic spinal tear and neurosurgeons explained in a preoperative paper study the usage of evoked potentials among other things.

But I do norte really know what it’s for.

[paco]

Of course Chaunce1234

Dr. Egea previously performs a dermatomal sensory map and pain trigger points before surgery, I think in order to identify affected nerves and their branches. The red dots are painful triggers, blue ones represents either no-pain and maybe a hesselbach or neuromuscular triangle matrix or whatever, I don’t remember so well.

Is performed with a kind of pen or a tip, pressing deep and then marking with color markers in response to pain.

My previous excruciating testicular and inguinal pain is almost gone. Now I can walk normally without looking like John Wayne. I’m also able to join my legs, cross, extend, etc. without see the stars
But I have certain post-operative pain and pricks in the middle of incision. I must wait 3 or 6 months to better realize if all were successful.

However, my acquired systemic immune disease due mesh (excessive sweating, intolerance to cold, prostatitis like syndrome, and other uncomfortable symptoms in my whole body) and central pain senstill remains, but slightly better. But I’m warned that due oxidative stress damage suffered while “wearing” the mesh those diseases may take years or become permanent.

Attached my nerves identification procedure. Seems to be that there is normal slightly anatomical variations from person to person of the nerves location.
In my case my surgeon used evoked potentials in my right leg to avoid problems.

[paco]

It could be the loss of cremasteric reflex. I think sometimes it can happen when labouring the cremaster muscle in Shouldice technique or with certain nerve branches neurectomies.

Does your sac rise in response to cold? If so, there is no problem.

[paco]

The lump could be internal serous fluid or a seroma. Ask your dr.

Do you perform your daily cures?

My indications were first cure and clean after 48h, then daily (or alternate days) cures untill one week after sutures removal. By the way, they imply removal and renewal of tape or dressing. Shower must be without direct water on scar and clean with soap.

[paco]

Yes all of my internal sutures are absorbable (Novosyn), because seems that I reject every material they put on or inside me (including the mesh I’ve have had extracted also). According to my surgeon, usually as Shouldice clinic states, they must be metallic or polypropilene, but I have allergy to metals and polypropilene, so it was compelled to use absorbable ones.

Only the external skin sutures of the scar are made of polypropilene, yet removed, wich are visible in the first photo. You can see redness on my skin due such sutures because my allergic reactions to polypropilene.

I think remember that 75% of tensile force at 14 days and 50% at 21 and 0% at 35 days. Fully absorption takes about 60 days

[paco]

I also underwent “Shouldice” repair and “mesh removal” at once 16 days ago, also with absorbable sutures because my “all and every kind of material rejection”.

In my case no swelling and no blue sac till now. Only a minimal redness around external sutures due my allergy. But I’ve heard that is quite normal to have swelling and blue sac, and usually go away about 15-21 days gradually.
I think that wear slips is better than boxers for testicles swelling, and lie down with legs slightly upper than head to allow liquid recirculation.

The most important is to avoid constipation.

I also have some pain, somedays better others worse, but mostly muscular type.

Attached photos of my scar after 7 and 15 days respectively.

[paco]

Some more better photos of my alien mesh.

[paco]

I think the future should be something like taylor made mesh with autologous stem cells culture in a cell matrix, stimulating the right type of fibers (through CRISPR or whatever). But it sounds like Sci-Fi.

But the nerve entrapment will remain a problem.

[paco]

[USER=”935″]drtowfigh[/USER]

Thanks, I will share this paper with the surgeon who removed my mesh recently, who in fact is a devotee of Dra Towfigh.

Another contribution of my surgeon Dr Prof Moreno Egea about a case of autoimmune disease and scleroderma due mesh reaction, with removal, who also quotes Dra Towfigh. Spanish, English (abstracts):

http://www.sohah.org/wp-content/uploads/rehah/v6i3/08_NC_Hernia_Moreno.pdf

[paco]

Hello [USER=”1916″]Chaunce1234[/USER]

Thanks

Course, I will try to keep you informed with my progression.

I’ve noticed some changes, the first one is for the moment a lot of relief in my groin and testicle, only mild discomfort (not pain, more like a “phantom” or residual feeling, maybe due body memory nature). No either urinary and ejaculatory burn for the moment and I can also sit without feeling pressure pain.
I’m also hungry like a bull at every hour.
However I have typical post-op normal pain, maybe more muscular than related to other nature. This kind of pain doesn’t worry me much.

The day after my discharge, I was able to walk, way better than before considering that I just had surgery 24h ago, an even enjoy a beer outside in a terrace of a bar just leave outside.

In contrast or as comparison, my first surgery (mesh one), I had to leave the hospital the next day in a wheelchair due extreme excrutiating pain. So a big difference.

Note: The surgeon performed to me prior to surgery a “dermatome mapping”. Study of MRIs and CT scans and pre-operative planning.

All my material was removed (plug and mesh) in one piece, cleaned small fibers and nechrotic tissue. What is for sure that my mesh is degraded too and is impossible to know how many of those small fibers (I could see it looking very close the extracted mesh) they could have pierced the tissue or could be into the bloodstream.

—

The other symptoms that I’ve developed with the mesh in my body – as a cause/effect reaction – wich are strongly different in nature are:

– Immunologic disorders of unknown nature: Systemic and Allergic reactions, über high levels of IgE (Immunogloblullin E), and proteinogram, albumin and gammaglobullin alterations…
– Central pain sensitization and body temperature disregulation: all my body is affected and I feel sometimes like cold and hot sensations running through my legs and feet, arms, face, etc. mostly at skin level.
– Axilar and plantar hyperhidrosis as reaction to cold temperatures (the opposite as normal).
– Chronic pelvic pain syndrome
– Other myriad of very strange symptoms wich are systemic in nature

* Many of those rare symptoms were reduced to a certain extent only with daily intake of Tramadol, wich is rare because not all of those symptoms are really considered pain and Tramadol is only for pain, as far as I know. However, the pre-mesh-excision inguinal and testicular pain were no prone to any kind of meds.
Note: Typical neuropathic meds such as Gabapentin and Pregabalin didn’t worked for me as well.

So for now, a few of those specific “rare” symptoms are still present.
could those systemic diseases go away with time? Maybe, but I don’t think so since the damage in my organism could be no longer reversible.
My physicians do not have a consensus, but speculate “Continuous and Cumulative Oxidative Stress” due mess reaction, immunological and or allergic reaction, Central Pain Sensitization, Chronic Inflamatory Systemic Diseases, Mast Cell Activation Syndromes, Dysautonomia, etc. but is complex to demonstrate as far not empirical or lab tests could be conducted.

—

My later surgeon is Dr. Prof Alfredo Moreno Egea, https://www.topdoctors.es/doctor/alfredo-moreno-egea, who is the only (as far as I know) abdominal wall, hernia and pain management specialist surgeon in all Spain who is enough experienced and can carry mesh removal, anatomical repairs and neurectomy.
This is a recent case study (not the mine) of prof Egea, althought it has many cases every year:
http://www.sohah.org/wp-content/uploads/rehah/v6i3/08_NC_Hernia_Moreno.pdf

It seems that young surgeons are no longer trained or skilled with anatomical repairs, do not know mesh excision and older ones changed a long ago traditional practices to quick mesh surgeries and they lost those skills (as one confessed me). They also do not admit in public the bad outcomes of mesh and the vast majority uses plug and mesh because is the most easy and cheap to perform (also only a few are skilled with laparoscopic).
Another problem here in Spain is that “General Surgeons” (not specialized ones) thinks that hernia is a simple procedure and any surgeon perform the vast majority of hernia surgeries like an assembly line.

However, my surgeon does not discard radically meshes, but according to himself, age, weight, allergies, precedents, BMI, athletic person, etc. must be seriously considered and studied prior to introduce a foreign material inside. Also not all meshes are equal, both in quality and type suited, material, titanium coated lightweight, heavy, pore size, laparoscopy or open, etc.
He normally states for anatomical in young, mid-age, athletes, low BMI index, chronic pain background or small deffects, as well as immunological suppressed or past cancer history. So mesh usage must be carefuly performed in very selected cases, mostly obese and third age or giant defects.

For example, here in Spain, the top first division soccer players (Real Madrid, Barcelona) do often get care in expensive Sports Centers which in their websites states firmly that hernia surgery with mesh leads to chronic pain in a higher rate. The most contradictory is that the surgeons of such centers who claim those statements, also have consultations in other centers (either public or private) in which they claim the opposite for the rest of the mortals.

[paco]

Of Course

Height: 169cm / 5′ 7″
Pre-operatory weight : 68Kg / 150 pounds
Now: 53Kg / 117 pounds (but gaining weight again)

I’ve lost a lot of weight during my 6 months mesh inferno period (about 15 Kg or 33 pounds).

Mesh type: plug and mesh (Rutkow technique). I don’t know the brand, but the surgeon who performed the mesh removal / neurectomy told me that my implanted mesh is the worst quality of market and recently not reccomended by the European Hernia Advisory Board.

Reconstruction: Anatomical (Shouldice)

The surgeon also cleaned a lot of nechrotic tissue.

[paco]

Anyway, if the list that you provide mention a few disorders, it’s proper to think that they in fact exist.

I’m not a doctor, of course, but an IgE with a value five times over the upper limit (>500 in my case) could be constitutive of some kind of allergic reaction or my body is treating against a foreign body, and I think IgE is very close related to mastocityc diseases. I know it could be due ambiental causes, but having a close cause and reaction such my mesh implant, maybe some kind of vinculus could be elicited.

Thanks a lot!

[paco]

[USER=”935″]drtowfigh[/USER] is interesting you mentioned “autoimmune disorder, fibromyalgia, chronic pain, CVID, mast cell reaction syndrome…”

Just after my mesh surgery (wich I’ve described in other posts), in addition to chronic pain, I’ve also started to suffer a myriade of rare symptoms. My new surgeon thinks iin a systemic foreign body reaction, but my internal medicine physician can’t explain, such as pelvic burning, cold/burn pain and excessive sweeting in my feet, hands and both armpits, skin itching, abnormal corporal thermoregulation (high temp, very low temp) and pain in muscles and puntual scleroderma in different parts of my body.
The only alterations found in my blood test are: very high IgE (>500 KU/l) 5x above the limit, mild abnormal proteinogram, low albumin and gamma globulins, very low transferrin and literally 0.1% eosinophiles.

Could those symptoms and lab test elicit one of the disorders you describe? mast cell reaction syndrome, perhaps?
Mostly due my internal medicine doctors are not able to establish a correlation.

Thanks.

[paco]

Yes Chaunce, good note, you’re right. I had not realize.

Maybe my surgeon warmed me for such reason, not just related exclusively by neurectomy but the Shouldice repair that he intend to perform after removal.

In any case my concern is about how is living without cremasteric reflex, due it is a protective mechanism against twisting (and torsion) and its repercusion when running or jogging.

Thanks

[paco]

The transvaginal mesh is a crime for many women, as like than hernia meshes, since their removal is maybe more complex and difficult to accomplish.
I’ve read “doctors suggesting anal intercourse as a solution”. A total lack of humanity.

I think that all surgeons must consider seriously waste some time performing previous screening tests (allergies, immunologic…) and evaluating age, youth, weight, is patient overweight? skinny?…, physical condition, athlete vs non athlete and carefully choice the type of mesh or “non-mesh at all alternative” accordingly, as well back to faculty and re-learn anatomy and classical anatomical repair techniques before put indiscriminately the first piece of “orange plastic mesh bag” they found.

Many of my friends who have had hernia repair on the early days before the advent of meshes are all perfect and without recurrence or pain after years. So after all such techniques maybe are not so bad.

A question: Would a surgeon allow a mesh to be placed inside its own body? Much as like many ophthalmologist wear glasses, or hair dermatologists are bald like a fucking orange?

Humanity and empathy please. Wish they work on it.