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Chronic pain

January 22 2017 at 9:19 AM
from IP address

Is there any new treatment available for one suffering from chronic pain as the result of mesh implantation (lower abdomen 20 x 22 cm Parietex mesh and an upper abdominal mesh 12 cm diameter- overlaying top portion of first mesh)? I am an inconsistent participant in my own life since these surgeries. I have been diagnosed with intercostal neuropathy and ridiculopathy.
I have had:
3 medial nerve branch blocks
5 level cryo-ablation
Therapeutic massage
Spinal cord stimulator implant
These methods of treatment offer little to no difference in the pain experienced daily. The only method that offers freedom from pain is inactivity coupled with ice packs and pain medication.

Obviously, inactivity is not an option. Previously, I was very active riding a bicycle and walking no less than 5 x weekly for 35 years before surgery. And I was an on her feet school teacher for 30 years.
I am approaching my 3rd year of retirement- resulting from these mesh implants and subsequent pain. Is there any new medical to offer me at this time?
Please respond.
Donna Swartz

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Re: Chronic pain

January 23 2017, 8:12 AM 

I heard both Dr. Goodyear (North Penn, Philly, PA) and Dr. Ramshaw (Univ of Knoxville Surgery center, TN) can remove your mesh and correct things for you. I had my surgery with Dr. Goodyear and so far I have no problems. Since you already tried using some therapies, try contacting these physicians and see if they can help.

Sometimes removing the old mesh is a better way. Let us know how things go. Also you may want to contact Dr. Towfigh of California - and see if she suggests better options.

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Re: Chronic pain

January 24 2017, 12:08 AM 

I've been through the chronic pain issues post hernia surgery. My first advice and in my opinion the most important is you need to be seeing a psychiatrist. Patients with chronic pain are almost guaranteed to develop depression, and do to the make up of the brain once depression develops the pain signals get amplified. Once my cycle of depression was treated I saw a reduction in my pain levels.
I am not a medical professional but with all the therapies you have tried you may be an excellent candidate for repeat surgery. For this you needed to pick a highly skilled surgeon with significant experience in the hernia field. I would highly recommend Dr. Goodyear if your previous surgeries were done using an open technique. If they were done with a laparoscopic technique you would need to look for a surgeon using a laparoscopic technique. Repeat surgeries have the best chance of success when its done using the same technique.
What type of scans have been done, MRI 's, cat scans, etc. and have they shown anything? Unfortunately when it comes to pain post hernia surgery it can be very difficult to determine the cause, and may not be determined unless there is repeat surgery

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SIN Syndrome

May 1 2017, 7:58 AM 

It has been researched in the field of pain medicine that SIN Syndrome may occur in a small percentage of patients. This is a chronic foreign body response to the mesh that will send pain signals constantly to brain. The brain responds producing more Nerve Growth Factor and sets up a cascading affect of pain. Basically, the nerves become really sensitive to pain and even minor issues with mesh cause major pain problems. The pain can also travel to other parts of the body as the NGF can be released into blood. It is usually recommended to remove the mesh and use body's tissue to repair hernia. This used to be the technique used by all surgeons before the mesh was pushed as the "gold standard". The mesh does decrease hernia recurrence, but also seems to cause pain in a subset of patients. Therefore, it is questionable whether the mesh should be used in patients who are experiencing chronic pain before surgery. They have a high percentage of SIN Syndrome and usually suffer many years until mesh is removed. There have been a number of suicides do to mesh pain syndromes. Therefore, it should be taken seriously by physicians despite the lack of training in chronic pain by most surgeons. The National Meshoma Foundation is a good place to start looking for answers.

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