pinto
Forum Replies Created
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@Anthony, you confuse psychological effects with physical ones. You say, “Think of the placebo effect. In drug studies, people have had measurable positive changes after taking a sugar pill.” Yes they are psychological not physical. Once you get an egg-sized lump pop out in your pelvis, no matter how much you cross your fingers and try to wish it away—-it ain’t going away.
You speak of people visualizing their ailments away. How do you know that their original diagnosis was accurate? Misdiagnosis can account as much as “visualizations” for accounting for later improved physical condition.
So I ask again: Where is the empirical evidence for “people [who]…positively change[d] their bodies by thinking it so.” You said “body” not mind. By “change” I assume you mean overcoming physical ailments by which “thinking” eradicated the disease in question.
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@Anthony: “…there’s measurable evidence people can positively change their bodies by thinking it so.”
Change their bodies how? Flutter of eyelashes? Transform disfigured faces to the Hollywood glamorous? And what is this “measurable evidence”?
After centuries of hernia aliments you don’t think that cures through imagination was ever tried? It’s all wishful thinking, so save your money from investing in such advertised “cures” and consider surgery before your hernia becomes too enlarged.
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@Mike M makes a ridiculous statement about my recurrence and my report about my taxi rides:
“The bumpy taxi ride did not cause the issue with Pinto. The hernia he had was called a “sliding” hernia that is rare and was not detected with the initial sonogram. A sliding inguinal hernia is defined as a hernia where part of the hernial sac wall is formed by an organ, e.g., the colon or bladder.”Wow, I didn’t know that Mike M is an automotive engineer and has done credible research into effects of bumpy auto rides on surgery recoveries. If anyone has bibliographical references of his apparent extensive research into the matter, please share them!
Further, apparently he has extensive medical training as well to be able to so authoritatively speak on “rare” hernias in the human body. But that’s not all. His research is so extensive to include the determination of hernia recurrence, such that he can pontificate as follows: “I think there is a lot of blame to go around in regards to a recurrence … and it starts with the patient being responsible for their continued health.”
One of the pitfalls that patients, actually any person, can fall into is wishful thinking. One can wish or imagine so much about cause and remedy of aliments that if not careful one mistakes their wishes as reality. He is not in any position to speak on the severity of the taxi rides I felt because—- he wasn’t there nor was in my physical condition of being unable to walk unassisted from the hospital.
Not even Dr. Kang could know what the cause was; and surely not you, Mr. Mike M. But more than both of you, I know my own body and the sensation of pain. The pain felt in those taxi rides had to be directly related to my surgery because my second surgery handled the same taxi rides quite handedly. Oh but of course, Mr. Mike M, because you experienced surgery in your way that means ipso facto all others must as well. Well, Mr. Mike M, I haven’t changed my idea that those bumpy taxi rides contributed to my recurrence, in the same way that nearly any surgeon cautions his patients post-surgery to brace, hold their pelvic area for protection when coughing, etc. They say that for good reason.
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I didn’t see it as offense to Kang, for I thought you spoke with Stephen. Posters here have applauded him. I highly regard both gentlemen but of course each person will make their own decision. I just hoped that some superficiality wasn’t getting in the way. Again, please see my rebuttal to Watchful’s mention of recurrence. As much as I appreciate Watchful, and I do, one shouldn’t believe everything they read. About my own case, as I stated elsewhere at HT, Kang thought the cause might have been faulty absorbable suturing. About the upset you referred to. It was real but happened during covid and was purely a function of the frailty of human communications. As I have mentioned multiple times throughout HT I highly trust them and so went back. Don’t let that phone call deter you. You might consider re-engaging and try getting further consultation. I hope my post helps.
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Watchful, I appreciate your considerate answer there. Could you elaborate about your ultrasound? Can a radiologist calculate the size of a hernia? Two surgeons independently gave me the same measurement of my hernia from a CT scan. Ultrasound can provide the same data, not just an indication of an abnormality but also measure its size?
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You mention Watchful’s recurrence note but apparently you did not read my rebuttal. You ought to. No experienced surgeon on earth has a perfect record. You ought to read my reviews about the Kang repairs, as they should suffice as to why I went there. Along with that, I share the same reasons as Good intentions mentions in his post above. BTW, Harry, your description above of the non-Native English was a bit over the top, don’t you think? Others here at HT have remarked how fluent he is. And he is. Going abroad will require us to communicate internationally, usually outside of our comfort zone. If you were happen to have Western bias, then it would be to your detriment surely in this case.
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@Harry, that phone call might have seemed salesy but it’s more of confidence from having immense success over many years. You would do well by reconsidering it.
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Not until recently had I heard that Dr. Towfigh also does pure tissue repair. Could it be that she is a “unicorn” mesh doc in the same way that the great Yutani baseball player is called that—-unusually adept at two very different approaches? All the mesh docs I talked with spoke as if there was no other possible approach. Would a mesh doc even risk professional standing to be seen appreciably offering it? I know of a non-mesh doc who spoke of feeling ostracized because of his choice. Would Dr. Towfigh also feel some pressure within her medical circles in the same way if she spoke too positively about non-mesh surgery?
Another point concerns Marcy repair mentioned. I believe someone posted that Dr. Towfigh considers that repair suitable for children but not adults. Yet above in this thread, a post reports that she identifies Marcy doable with slim women patients. If these hearsay reports true, then why not also for slim men? And as I recall her saying, Kang repair seemed Marcy-like, thus questionable. (He though posted at HT his is not to be so characterized.) Any ideas for tying these loose ends together?
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Watchful, your echo here is pertinent. You have been in this hernia “business” most of your life, right? Although sometimes we have disagreed, we share much in point of view. However much I appreciate your view (though not always 🙂 ) your outstanding feature is not your knowledge, though considerable, it is your truthfulness. Corralling one’s bias is difficult for anyone, so I applaud you for being exceptional in this regard.
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Both Good intentions and Watchful make reasonable statements from their particular standpoints here. GI is wanting specificity about claims of chronic pain for tissue repair. That is quite reasonable, quite.
Watchful in response does not directly satisfy but I am appreciative of Watchful’s overall view of tissue repair. Plain and simple is a fact irrefutable, I believe: All patients are not equal; some have conditions more difficult (or advantageous) than others. Generally surgeons say that obesity, for example, is less advantageous. So Shouldice Hospital has a restrictive policy in that regard. Logically therefore chronic pain may differ accordingly as well. Before the advent of mesh, it was generally recognized that IH surgery had imperfect results. Even Shouldice Hospital says per their website that mesh is sometimes unavoidable. So the debate will continue.
GI calls for supportive data in regard to chronic pain and tissue repair. Such may not be available unless I’m unaware of the contrary. It would be helpful if someone could offer some references of related sources.
Let me reply to @Mark T: Please be careful when calling someone arrogant when you yourself at times appear out of your depth when dealing with technical material. While it is true that one could reasonably fill-in the terminological gap in Netto et al.’s report, it would be in the case of like-minded readers or as known in scientific circles, “sympathetic readers.” Science is not exclusively for sympathetic supporters—-rather it also includes those non-sympathetic. That’s the hallmark of science: Researchers must spell things out. Readers are not mind-readers. They should not have to do mental gymnastics to disambiguate key scientific terms. Unfortunately Netto et al. require it and so makes the study inconclusive.
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To @Mark T, in the spirit of community and sake of discussion, I shall address questions you posed to me. Because of the flurry of posts by other members, I’m just getting to it now.
First you say you know what a scientific abstract is: “I [Mark am] well aware of what an abstract i[s]…and what it is not.” Are you sure? I must say frankly you do not know. You did not recognize how really unusual is the style of the journal, Hernia. Let’s look at what is considered “standard” style.
From “Scientific Literature” (google), it states the standard format for scientific papers is as follows:
• Abstract: a one paragraph explanation of what the paper covers. Readers will use this to decide if they want to read the whole paper.
• Introduction: why the problem is important, and a summary of what progress has been made on it.
• Main body: what they did to solve the problem.
• Evaluation / Results: experimentally determine how well they solved the problem.
• Conclusions & future work: what remains to be done on the problem.
• References: citations to prior work. These are essentially hyperlinks, but are designed to survive for the 100+ year lifetime of the paper. They’re often a good way to find more good papers.”
https://docs.google.com/document/d/1giquxftXXTF0V1c3qEDZdcLaJzSxkjsOuS3LUmxVo-0/editTwo points notable: the abstract tends to be a paragraph and does not include sections such as “Conclusions” or other Sections. The journal Hernia is quite different in having an “abstract” in report style that includes main sections of a scientific paper (e.g., Methods, Results, etc.). I almost never have seen another journal style like Hernia’s. From the standpoint of scientific journals, surely experienced readers would view Hernia’s abstract style more as a report than an abstract. However, Hernia’s style is more informative than typical abstracts, which invites critiques where appropriate (of course).
According to you, did I misrepresent the research in question? Absolutely not. Never did I attempt to. As I explained in a previous post, I reacted to this thread’s presenting this so-called “abstract” as possibly matching surgery methods/types of hernias and outcomes. Moreover I was strictly focused on only their use of a single medical term—“open.” As my previous post stated,
“unsurprisingly the summary medical report being considered fails in the same way. Perhaps the actual, full article does better
Repeat: “Perhaps the actual, full article does better.” That of course indicates my statement is limited by not having the entire, full article in view. However, considering the Shouldice Hospital’s own use of the term “open” I questioned,
[https://www.shouldice.com/natural-tissue-vs-mesh-hernia-repair-surgery.html]
then the authors most of whom are with SH, MIGHT not do any better in their full write-up. Your false claim about my using an abstract is completely unfounded (abstract here meaning the standard one).You ask me, “How are tissue and mesh being lumped together under ‘open’ if the categories they used in this study to classify primary repairs included ‘Shouldice’, ‘open mesh’, and ‘open tissue’? A fair question.
You above all, a former patient of SH and posting at HT about SH should know as I previously indicated in the thread that SH performs both mesh and non-mesh surgeries. Thus the single category of “Shouldice” (as you presented it) is unscientific because of impreciseness——the category does not specify which type of surgery——mesh or non-mesh. This however was not part of my original critique. I offer this as a good example for conflating terms.As an example of proper use of terms, I pointed to the article “Mesh versus non-mesh repair of groin hernias: a rapid review,” the link previously provided, in which is stated: “recurrence rates between open mesh repairs and open non-mesh repairs.” As you can see “open” is not a single term but a compound one that distinguishes whether the surgery uses mesh or not. In what I am calling a “report,” Netto et al. in that single webpage use the term, “open” 12 times; only once do they distinguish whether it refers to mesh or non-mesh. Of course sometimes “open” refers to both surgeries and is fine to use that way. A problem occurs because as we all know SH performs both types of surgeries. If you are interested as this thread is in outcomes related to TYPES of surgery then obviously references to “open surgery” by SH must indicate which type——mesh or non-mesh is involved. Not doing so conflates the terms. I checked with the SH webpage and I found no better use of terms. It is unlikely Netto et al’s full paper is any better because the centrality of the term “open” behooves the researcher to be precise——a hallmark of scientific writing——but they fail to do so in their report as I have tried to show.
I believe I have sufficiently shown that the journal Hernia abstracts are more like reports than abstracts (even though termed that way in the said journal), thus inviting critique within reasonable limits, as well as indicating how the term “open” was misused in the report critiqued by being imprecise, resulting in a conflating of terms.
Please note I am not the one who created this thread focused on Netto et al.’s report; it was Good intentions. He did state that the report was not the actual full article. However, in my opinion GI did not read the report (not the full article) sufficiently enough to recognize the conflating of the core concept of “open,” thus likely making the research inconclusive. The article seems promising particularly linking surgery methods and outcomes—-and may actually do so—-but I believe we need to read such more intently than what might seem to be the case.
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William, your post sheds much light on it. Thanks. However, I hope you and @Freeman can be ready for a revelation. It is this from radiopaedia.org: They inform us that pantaloon hernia is not one but mulitple hernias combined:
“A pantaloon hernia, also known as a saddlebag hernia, is defined as any combination of two adjacent hernia sacs of the femoral or inguinal region (direct or indirect inguinal hernias (alternative plural: herniae)) on the same side 2. Thus, examples include: femoral with direct hernias, femoral with indirect hernias, indirect with direct hernias.” https://radiopaedia.org/articles/pantaloon-hernia?lang=usGiven that is an organization of radiologists, we can assume the quote above is authoritative. So, William, both you and Freeman might actually have or had two or more hernias/herniae, as well as explaining the contradictory diagnoses you received.
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@Freeman, congratulations on the success. No surgery is without risk. You are saying you only had one hernia yet the surgeon said it was a combination of indirect and direct IH. From your description it appears you never had an ultrasound (or other imaging) and this “combination” became known only during the course of surgery. Wouldn’t a combination be literally impossible technically speaking? Aren’t they one or the other? Much has been posted at HT, for example, how they merit different surgical methodology. 🙂 This could warrant a thread dedicated to answering this.
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@Mark T, if you critique someone make sure you read what they said. When you state, 1) “Keep in mind an abstract provides only a small amount of *some* key information”; 2) “It is quite inappropriate to make assumptions about (never mind critique), a study from the contents of its abstract, “you can’t be possibly suggesting your statements apply, are you? This thread has not involved the reading of an “abstract”; nor I for one have made assumptions based on any one particular abstract.
Rather than an abstract the article would be more properly described as a “report.” It is intended by the authors to have essential information about their research. I made clear that my critique was based on their report not their full paper and therefore necessarily limited to that extent. However, my critique quite squares with the Shouldice Hospital’s website in regard to the authors misuse of the term “open.” The fact it is a core concept, it is quite remarkable that the authors imprecisely used it in their report (as it imprecisely used at SH’s website).
Before I clarify further, let me make an important point clear—-the necessity for precisely using “open.” The reason? SH performs mesh surgery as well as well pure tissue repair. If SH did no mesh, then I would not have challenged the authors’ research. So the fact is that SH does both mesh and non-mesh surgery which necessitates distinguishing what “open” means—-mesh or non-mesh. Just as the example from another journal shows: “recurrence rates between open mesh repairs and open non-mesh repairs” https://onlinelibrary.wiley.com/doi/10.1111/ans.17721,
authors Netto et al. were not as careful but should have been.But the problem does not stop there. If @Mark T’s report here correctly represents Netto et al.’s use of “open,” then there is a BIG problem.
From @Mark T: “‘Open inguinal hernia repair includes any technique of primary open inguinal hernia repair excluding Shouldice and mesh repair, performed in patients above the age of 16 years.’ For the purposes of this study, they categorized the primary surgeries as: Shouldice, open mesh, open tissue, laparoscopic, and childhood (all types).”Someone—@Mark T or the authors concerned or all of them—conflates mesh and non-mesh together. What? In the present thread titled “Patterns of recurrence associated with specific types of inguinal hernia repair” the concern is identifying types of repair with outcomes. Obviously mesh and non-mesh are quite distinguished as differing if not opposing repair types. Your conflating them in the case of doing “open” surgery contradicts the purpose of the research and therefore invalidates the study as far as matching type with surgery outcome.
If anyone has made misassumptions, it is you sir, @Mark T. I never said I was critiquing the full research paper by the authors but rather their report, the basis of the present thread. Moreover my critique was of the report not the research paper. Although it is fine for you to point out that the full paper gives greater explanation of “open” than does their report, you have no grounds for claiming I misrepresented the research in question (if you were directing your post in response to the post immediately before yours, namely mine.) In regard to the term “open,” you actually do disservice to the original authors, by not realizing the conflating of terms–possibly due to your inadequate reporting. Someone conflated the terms–you or they–and you should have realized it.
My original critique of the Springer report stands in as far as the term “open” is imprecisely used by the authors, which negates the original purpose of the research in question.
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So?? The authors chose not to pay the journal for publishing it. Nothing wrong with that. Some of the publishing fees can be hefty. Thus your statement in out of line: “It is a pay-per-view paper (you’d think that the Shouldice Hospital could afford to make it open access) so only the summary is shown.”
In fact, instead of a bare abstract, non-paying readers are afforded a great deal of information by not only a substantial summary but the list of references. Incredibly you complain that you are not given free the entire product of their research. Good intentions, you are owed nothing—-but granted quite a lot FREE. Maybe change your handle, to @Free intentions?
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This medical journal article greatly disappoints because its authors misuse terminology, such that it must remain inconclusive or indeterminant about its purpose. It concerns the term, “open,” for which the authors use carelessly.
When they say, “open,” readers cannot know whether it refers to mesh or non-mesh surgery because the authors fail to make the distinction. That the distinction is necessary is shown in this random sampling from another medical journal:
“recurrence rates between open mesh repairs and open non-mesh repairs”
https://onlinelibrary.wiley.com/doi/10.1111/ans.17721This problem of misused terminology is incidentally found at the website for Shouldice Hospital in which it states that “open” can refer to either mesh or non-mesh surgery, but unfortunately fails to distinguish which in later uses of the same term. For this reason, unsurprisingly the summary medical report being considered fails in the same way. Perhaps the actual, full article does better–but I doubt it considering the same at the Shouldice website.
@Good intentions, let me point out that you wrongly disparage medical doctors when you write for example as you did above: “It is a pay-per-view paper (you’d think that the Shouldice Hospital could afford to make it open access) so only the summary is shown.” Neither the hospital nor the authors might own the copyright! If so, it would not be their decision to make. In fact all that you see there is owned not by the authors but by Springer. GI, you tend to overlook such and make insinuations at HT about MDs wrongfully selling their research when in fact it is the publishers doing it–not the doctors. (There are some bad docs just as there are some bad plumbers, but not all doctors are as bad as you think.)
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LC, Welcome!
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C & H have the same writing style? Farthest from the truth I think. Both have
their own distinctions. Also many here share the same opinions, so I wouldn’t consider
it particularly relevant. I’m responding just out surprise and curiosity about GI’s
observation. I’d like to hear what specific features of writing style GI has in mind. 🙂 -
William, you’re much appreciated here, I’m sure.
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@Freeman, I’m glad things are working out for you. Thanks for sharing and in particular the video link.