pinto
Forum Replies Created
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You’re welcome, Watchful. You’re a great citizen here and so I’m sure you’re handling things as best as one could. Just a few years ago when I got an IH for the first time, I was so shocked. Never heard of ’em before except for the cautions heard about lifting things. I think Chuck has expressed the angst felt best of all so I won’t try. 😀 You keep positive, fella.
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Watchful, I’m glad your doc is on top of it and sorry to hear you’re in some rough spots. Amazing this relatively ignored part of our body can wreck so much havoc on us. Hopefully you’ve seen the worst of it and daylight just around the corner. I’m pullin’ for ya.
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I second that, great advice by Good intentions.
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Right you are, Mark T, Kang’s survey targeted 1-year-post-op patients, so I focused on his pain percentages provided. The issue is how to evaluate them. One might compare them to mesh surgery as apparently Watchful did with the 15% (as it seems a common estimate).
On the other hand it might make more sense to compare them with pure tissue surgery results. For example, “In 1996, Cunningham et al. published a prospective randomized trial of 315 patients comparing Bassini, McVay, and Shouldice repair[.] … After 1 year, 63% of the patients reported inguinal pain and 12% of patients suffered from moderate to severe pain.” Surely Kang’s patients fared better than the patients in Cunningham et al.’s study (assuming comparable measurement). Perhaps there has been much advancement in the related fields since the turn of the century and today the 63% figure greatly improved (but a huge gap to bridge). We don’t know, of course, how representative Cunningham et al’s study was. Nor do I want to write someone’s medical school dissertation here. Suffice it to say that Kang’s survey, likely exploratory in purpose, produced very promising figures for pure tissue repair and should give confidence to his prospective patients.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754000/#:~:text=Chronic%20postoperative%20inguinal%20pain%20(CPIP,after%20laparoendoscopic%20groin%20hernia%20repair. -
Awesome post Dr. T, thanks.
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Oceanic, btw, I forgot to say thanks for the imaging pic above. It’s helpful for many of us I’m sure. It made me think how placement of incisions are made. Yours seems much higher than mine or maybe you’re a hairy devil. 🙂 If you don’t mind could you tell us about your doc being “enigmatic”?
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About Dr. K’s stats: Watchful makes a good point in cautioning the including of Score 3 in the no-pain category. Let me point out though as the survey comes from the medical literature, it would be interesting to see how other researchers handle the same thing. Is it something generally done with this survey?
An issue I would make is considering chronic pain necessarily applied to cases of just a year post-op. Then too how is “pain” determined or categorized. Knowing the stats for each year esp. years 3 and 4 might be particularly revealing. Maybe these are matters already decided in the literature. Would patients in only the first year scoring 2 or 3 be justifiably “chronic” pain sufferers?
With those thoughts in mind I think Watchful is a little unfair in concluding 16% chronic pain (though he qualifies it with “some”). Much depends, I believe, how the hernia field handles such surveys. Watchful while applauding Dr. K’s survey for being so direct (phone contacts and not surmised data), points out that such appears not generally done by other surgeons. If correctly restated, then I must question Watchful’s 15% for the field. If such is surmised data— well then there can be no comparison. However, doubtless some similar surveys have been made.
Anyway, I think the bigger aspect is that over 90% had practically no pain. Even the 83% painless is certain achievement. Doubtless Dr. K’s survey is exploratory and he probably aims to refine such in the future. We look forward to it.
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Oceanic, impressive. Not only were both direct but you flew home in just a few days. Great achievement. Was the second one found just before surgery or during?
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I feel relief hearing your doc has been on top of it. Has it really been three working days since? It was Thursday last contact then hit against the weekend. I know you probably feel isolated and maybe a little scared but this weekend thing is so common even if big bucks are paid. His “few days” probably has a looser meaning and he might wait to see if his diagnosis was on target. That seems reasonable. Call his office if not already and at least talk with his secretary and press them it’s gone past the “few days” and you need/deserve some assistance. If no go, then I would ask for another surgeon in the same Dept./hospital for assistance. You’ve waited a reasonable time already and deserve attention.
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You’ve gotten over the worst of it and seem to be making good progress though incremental. I hope the discomfort is becoming manageable. I salute you for taking the challenge and once you’re able to leave all this behind, you gonna feel fantastic. Focus on that forward. BTW, you referred to your surgeon as enigmatic. He’s not very forthcoming about your condition or the surgery? Or is that his reputed disposition? Good luck with everything. I hope you’re pain free soon.
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Good intentions, you are welcome. Let me clarify your opening statement:
“The description of immediate pain after the first surgery was a distraction….” You must mean “no pain” immediately afterward surgery because I had no pain factually. “Immediate” can have different senses; hopefully we mean the same here. You make a good point about language used for recurrence and so on. Dr. Kang was satisfied based on imagining that it was indeed a recurrence. I have always known the word to mean the original hernia. As far as I know that is how it is used technically. -
@Chuck, however you choose a surgeon is your own concern. It has nothing to do with me. You asked me multiple times about my condition. I tried to be transparent and be an open book (hopefully others will do the same in turn). Unfortunately you twisted this into false claims as I previously posted. I feel violated and used by you.
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@Good intentions, as you say, you were not reading postings regularly for a couple of years and apparently jumbled up some of my information.
Let me simplify for you: Both my Kang surgeries were painless. After the first week both were painless post-op. Never had I or have the need for pain meds. Recurrence of the first was never immediate nor can be described as so.
GI: You ask a good question: “prior imaging showed a sliding hernia and that Dr. Kang would have known this[?] Is this the case? It implies that Dr. Kang’s initial thought about how to repair a sliding hernia were not good enough or that he missed the sliding hernia. Did he say which it was?”
Unrelated to my hernia and before surgery I had a CT scan. Later, one internist looked at it at my request but could not find a hernia. He said prior he might want a scan for that specific purpose. Later I found hernia surgeons could identify one. Being so naive at the time, I never asked them anything other than about size. Years later when I had the recurrence, it dawned on me to show that scan to another hernia surgeon. In our talk he said he could recognize a sliding hernia. I never stated nor implied anything about Dr. Kang’s imaging of my hernia as sliding. I have no knowledge he knew before surgery. He told me about it only afterwards. Apparently you didn’t read my thread about sliding hernia. Your questioning makes it sound as though sliding hernia is unusual. It should not be nor difficult for the experienced surgeon.
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@Herniated, you state: “Yet the anecdotal reports in this thread indicate that recurrent patients have been seen in clusters.” What reports are those?
GI, please see my thread “Sliding Hernia…” for it’s not as fearsome nor rare as we might think.
https://herniatalk.com/forums/topic/sliding-hernia-part-1/BTW, the CT scan about my own was done before my original surgery, identifying my original IH. So the 2nd surgery was for recurrence not a missed one.
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roger555, thank you, an apt way to put it. A million ways things could have turned south. A surprising thing I found having become a hernia statistic is once in, you’re in for life. Once an IH, then we have a high chance of having one on the other side. So I became a lifer. Who knows when my other side will pop.
@Watchful, you’re comment is disingenuous and shirking of responsibility. Quite unbecoming of you.
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Watchful, good of you to clarify my reference to you. However, I wish to point out you were really not faithful to your original report (numbered #33613 here). At the start of reporting your colleague, you stated that “most of the [reviews] he found were good.” Today, you started off negatively by saying two reported recurrences. Positive note only came at the very end. Perhaps merely accidental but there is a serious flaw how Chuck has used your reporting, some of which is your responsibility.
More importantly however you neglected today to include an insightful comment you made previously: surgeon names were unreported in the reviews. Thus these recurrences might not have been Kang’s at all. Moreover you were entirely wrong in your original report in falsely claiming that the recurrences were likely Kang’s or his son’s implying that there are only two surgeons at the hospital. I myself had contact with two others neither of whom were Kang.
Conclusion: Claims for the negative Korean reviews for thee Dr. Kang are groundless. Chuck, please retract your false claims made.
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Corrections needed about Chuck’s misdirected comments about Kang:
1 Chuck as I have shown in a recent, related post and many of us know, Chuck is prone to exaggerate and be highly emotional. He is also easily swayed by anecdotes without considering their contexts. He has been called by some Members for misrepresenting medical complaints he finds at social network websites, in which case it applied to Shouldice.2 He continues to highly mischaracterize my report about an “unusual sensation” (neither pain nor pleasure) hardly ever experienced into something weird or unsettling. I now believe he hopes that my surgery fails as he can’t believe I have had no pain post-op—not with just one but two Kang surgeries. That’s why he has twisted my words into barb wire.
3 He falsely claims there is “decent risk of recurrance” for Kang. Really? And how does Chuck arrive at the notion the surgeon has a considerable number of recurrence cases? Apparently he went through HT pages and found 7 patients of which included me. Besides 7 might be rather conservative, yes, I had a recurrence but is there a surgeon anywhere who has no recurrences?
4 Next he notes Watchful’s acquaintance, an ethnic Korean, reported he was in a room in Kang’s hospital with a number of recurrence patients. Yeah? Well, what? Wow, a hospital with a room of recurrence patients–imagine that! Really, esp. so that this is a hospital dedicated to hernias, doing thousands of operations a year, headed by a highly nationally regarded surgeon? Maybe Chuck failed Stat 101 or didn’t go to class.
I understand it’s terribly painful to suffer as Chuck has reported to the extent he threatened suicide. I was among those who supported him and was so happy he received further medical attention, lessening his troubles. Apparently not because he appears unstable and I fear that some great surgeons might be hit with false allegations hurting both them and patients who might otherwise choose them. He threatens the viability of this website for offering unvarnished views and reliable information.
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None as you described nor any negativity in my opposite side. Not sure exactly how to describe because is not often and has short duration. I should not have mentioned it because some of you try to make too much ado about nothing. If it was burning, I would have said so. If aching, I would said so. If tingling, I would have said so and so on and so on. As I write this and throughout both sides feel perfectly the same–painlessly normal. 🙂
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Chuck, let’s look what you said:
1 “…unusual sensation??????”
What’s with all the question marks? Those express high emotion, in this case negative!!
2 “that doesnt sound good” … they are unsettling”“Hello, Earth to Chuck, can you read me?” Your statement 2 is a claim. You are claiming my words “unusual sensation” must be negative–in fact you claim they are “unsettling.” I never gave that indication nor implied it. Why not take them positively as a prelude to making wood?
You are on high voltage emotionally. Apparently you cannot interpret words, language as they are normally made because of your state of mind. The word “sensation” is neutral. Often it is used positively as for pleasure: “A sensation is a physical feeling. Floating can be a very pleasant sensation. Synonyms: feeling, sense, impression, perception ….” (Collins).
However it is to be interpreted I gave no indication positively or negatively about it. I said I had no pain. And most often–most often–it’s the same as the other side. You prefaced your remarks that tissue repair requires long time healing. Then why do you call 911 about my painless unusual sensations? Before the fire trucks come, you ought to call ’em and tell ’em false alarm.
I’m trying to help you but it’s counter-productive because you twist my words such that someone who only reads your twisted concoction will draw the wrong conclusion about my surgeon.
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Chuck, you’re being ridiculous, twisting my words to suit some sort of stratagem. Listen I’m gonna tell ya straight—No one on earth can find a 100% guarantee—whether buying bonds, wooing a love interest, or walking into the street. The same applies to you or anyone about surgery. I told you my experience has been painless. I have no issues about my latest repair. Regardless no one can say anything to you that will fully satisfy you. Even if ironclad you will somehow dream up some kind of kink. But whatever please don’t make false claims about me or those I have supported.