[pinto]

Best wishes on your recovery. I’m glad things are looking up for you. Among all you wrote, which was quite interesting, I was taken by this:
I may actually go for a very short jog today to see how that feels.
But he did say that running is rough on the body and I may want to
consider something else like biking, swimming, etc, going forward.
He even suggested some of my issues might have started
after I took up running, which I did shortly before all
this happened.
Remarkable. Multiple doctors, directly and indirectly, have indicated to me and others that running is fine. When I hear that I think of jogging not the 100yd dash. Did he mean jogging as well? And does that match up with what you had heard about it before?

[pinto]

Let me clarify again, please: the “complaint” you refer to by surgeons was not about mesh. My understanding from reading various accounts by patients was that IH size is not irrelevant. Indeed you will find medical researchers using IH size as a variable in the study of treatment efficacy and so on. Further you yourself found one or more surgeons who indeed consider size an important determinant in treatment:

I have seen this myself i.e. … this-time-mesh surgeon saying at the same time that it was too big for a pure tissue repair)

While you support, perhaps unwittingly, my assertion about the importance of IH size, let me be clear that the patient reports were not about treatment per se. Rather some of the patents lamented that they may have waited too long before surgery (given surgeon/doctor reactions). Because IHs cannot/do not heal naturally, a certain percentage of patients ultimately turn to surgery. I suppose mesh methods allow a longer waiting period than pure tissue repair (cf., your own report).

I am still uncertain about early surgery vs watchful waiting, especially when there are no symptoms:

Then you can wait. You have the backing (from my experience) of the UK national health system and scores of medical opinions I have seen about this. My personal view is that we must weigh how much we trust the local emergency hospital room for surgery. It can happen.

My own dentist had to get emergency treatment. He didn’t seem to mind that mesh was used. But in such case even if mesh, you have no choice about the type and the manufacturer of the device (besides the fact your surgeon will likely be inexperienced and training to become a “jack of all trades.”) On the other hand, larger herniae might be less risky than small ones (please confirm with your doctor). Here again IH size is an important factor–risk assessment for strangulated IH. I rest my case. 😀

[pinto]

Let me clarify: “need” differs about meaning or context. Reading across the internet various IH accounts, I found a common thread about surgeon comments reported by patients about size, such as the lament that certain patients hadn’t come in sooner or that smaller ones were less complicated than larger ones. So I agree that size doesn’t necessarily mean the need for surgery, however if one wants pure tissue surgery, the smaller the IH, the better based on those patient reports.

If your report accurately reflects Shouldice, it makes sense that they would do so. Watchful waiting, for example, is the preferred approach by the UK national health system, meaning that patients necessarily need not rush into surgery. If an IH is small and not “symptomatic” (not troublesome), one can confidently wait. But again if talking about pure tissue repair, there must be a point when waiting becomes dangerous. Surely a bowling ball sized IH is greatly more concerning than a pea-sized one. All of that, however, is made mute by mesh. But D’s reporting shows preference for pure tissue repair, thus my original post.

[pinto]

>Size is not a determinant of need for inguinal hernia surgery.
Isn’t that assuming mesh surgery? But I believe it’s different for pure tissue repair, D’s apparently favored approach.

[pinto]

My own dentist needed emergency IH repair. I assume a dentist has infinitely more access to a local medical community and medical awareness than many of us. He likely did some watchful waiting. Alex, you are moving in the right direction. Make sure you feel right with your ultimate decision. Good luck.

[pinto]

JKirby, I think you made a good decision. Best of luck forward.

[pinto]

Alex,

I highly recommend that you forget watchful waiting. Any worsening of your condition is very unlikely to be reversed. The worse the condition, the less successful repair will be. Most troubling is if you ever need emergency surgery when you are very unlikely to even know the surgeon let alone choose a method or competent surgeon. (I talked with enough general surgeons that convinced me about the latter point.)
Good luck.

[pinto]

[USER=”2531″]Feuermann[/USER], Excellent account. Watchful waiting is often used as the default but much depends on how stable. You might have done well by what you did. Pretty frightful is the thought of going to the local emergency ward for surgery, even if pure tissue repair (of course very unlikely). Whatever the method, however successful, most patients will never be perfectly immune from further complications. As I wrote elsewhere, we are all enslaved for life to the prospect of hernia.

[pinto]

@Sicily63 thank you for the good laugh. I am glad you are healthy and hope you will continue to be so. Sometime if you are able, it would be nice to hear from you what most led you to do mesh and if your surgeon had really informed you about the issues some of us raised. (Or if even you had been aware of them.) Best of luck to you all the same.

[pinto]

@Sicily63 seems you speak of yourself as “Holding onto the bitter feelings?” (Sorry to hear that.) The emotional/psychological is as important if not more so than the physical. I completely agree. That is why many of us are mutually supportive here. However, this site is titled, “Hernia Discussion,” in which you yourself actively opined about how great mesh is.

So if you expected you could opine without a reply, then you should be aware where you are. (The OED tells us that “discussion” is not a soliloquy but dialogue.) Yes, I expressed support of you, but again as this is discussion, I also replied to your claims. You seem unprepared to hear counter views? Perhaps my observation rings true. Perhaps also your mesh claims might be less solid than you think.

[pinto]

@Sicily63, I’m glad you are doing so very well. But I can’t help but think you’ve done more wishful thinking than anything else. I’ve read the literature too, and my understanding is that mesh is a ticking bomb. You can go completely issue-free for years, but suddenly mesh can become problematic. The body continually readjusts to the presence of a foreign object, a process that can unwind. Can you really be sure your short experience ensures no problems in the future?

[pinto]

Kudos to Good intentions for his very abled monitoring and to Dr. Brown for his kind and of course expert backup. I’m glad when someone’s case like Jennifer’s is not met by silence but with good, solid advice. And best wishes to Jennifer, who obviously shows much courage, for a complete recovery. You can find a lot of patients here who have gone through trying circumstances but eventually got well, really well. I hope that for you too. Keep us posted.

[pinto]

I am sure your post is well intended but I feel a little resentful even though not a medical doctor. Your post is representative of how the internet has spawned a societal attitude that expert knowledge is or should be in the public domain. I am a published author who has received numerous requests that a book or books of mine be simply emailed at gratis to them, complete strangers, let alone that in most cases a publishing company owns the copyright! Apparently these people are so naive not to realize much labor went into writing the prose, let alone the at-times bone-breaking research behind it.

Putting aside the economic/financial ramifications of your proposal, consider this: in most cases, pure tissue, non-mesh docs are likely in a medical minority, likely shunned in the wider medical community. It’s an old story found in nearly any professional field: standard vs. non-standard practitioners. Although many if not all the docs would like their approach widely shown as on youtube, at the same time, they could be opening themselves for potshots by critics without redress or the critics not allowing themselves be equally scrutinized.

Chaunce1234, at heart your idea is a great one. Perhaps it could be modified by being handled by an institutional medical authority sure to protect the integrity of the doctors and monitored for fair representation. A tall order, I know, but I wonder if we as a society may have gotten to ask too much of doctors. Again, I appreciate your pure intentions about it, but there might be some implications possibly overlooked.

[pinto]

@ Julian, you’re hurting; I feel it. It’s natural that you air it here. I can’t speak of the medical matter but maybe I can offer something about constipation. That’s a major issue for most of us. I hear a kiwi a day helps. I eat two plus prunes and I never have a problem. I hope that helps.

[pinto]

@NHC, then why didn’t God heal you already? Your dad was miraculously cured, which you attribute to divine intervention. Have wondered why not you? And as you bring God into it, then therefore later if you are cured, the truss may have nothing to do with it. It would be another gift from God–not from your chosen commercial product. In such case, you would be bringing false hope to many people.

[pinto]

Ezzy, how soon post-op did you start lifting? Free weights or gym machines? Did/do you avoid squats or crunches?

[pinto]

Incision measurement: about 1.5 inches (3.8cm). Perhaps I should have included this in my original report but frankly I didn’t and still don’t know much relative to other doctors, other than those for robotic procedures and a once found generalized statement about pure tissue repair being 3 inches. Although then and now I feel quite satisfied with my incision size, I was without relative information to tout Dr. K’s approach assuredly.

Please note that this pic was taken near the time of my original report about 4 weeks plus after my operation. (Apology to Dr. T for my absence and not replying sooner. My earlier pic failure not the fault of this website.)

Sorry for the long delay of my posting. Of course HT had been closed due to the recent hacking, and thereafter my failed uploading was due to format (tif) being too heavy and then I went out of town on a work trip, totally removed from the net believe it or not. So I am back. Unfortunately, I didn’t have three hands to manipulate my ipad camera together with holding a ruler next to the incision–though I tried!

[pinto]

I’m pulling for ya. That’s great news. Best wishes.

[pinto]

@ texan, you made a helpful report and as noted by another member, flashed a cool Korean ruler. I’ll have to pick one up on my next trip.:)

[pinto]

Tried to post my pic but got nixed. Unsure when I’ll get this through.