want to avoid surgery

[Charles]

Hi

Any help/advice in avoiding surgery VERY DEEPLY appreciated. I'm [b]terrified[/b] of plastic mesh, after seeing all the "horror stories". Really scary.

Two doc's + specialist/surgeon have ok'd "watchful waiting" for now, as the hernias (bilateral) are still small and almost completely asymptomatic...so far. I was diagnosed a year ago....I may have had them for longer (?).

I'm wondering what exercises, etc, are safe. There is so little guidance. I don't want to wrap myself in cotton wool and become an invalid, but I don't want to tempt fate, either........

If surgery becomes an absolute "must", has anyone got any info on the new "bio" meshes, especially Permacol, which is produced in Hampshire, here in the UK?

I've read these are provoking far less of the strong foreign body reaction associated with the plastic ones, which is apparently the cause of the chronic pain syndrome affecting up to 1/3 of people having the op (according to many studies in a variety of countries).

I personally know of two people who've had horrific mesh problems (one possibly fatal).

I'm hoping for a miracle that will allow me to avoid surgery....however I would like to have things "in place", just in case. If anyone knows of a "bio"-friendly surgeon/specialist in the Brighton area, can you please let me know? Many, many thanks, and good health to everyone out there!

[Ron]

I'm on kind of an intensive program to avoid surgery, though it hasn't been going on long enough to claim success. I have a hernia that is small and intermittent, though not quite asymptomatic.

I believe the advice on this web site is good. I've worked on increasing fresh fruits and vegetables and fiber in general to get my "transit time" down. I'm also taking psyllium husks. I definitely feel the difference in reducing the weight of my intestines. That seems to help in keeping the hernia from showing up.

The exercises here are good, though I think that it really pays to look into further Pilates. Pilates is all about building up your core muscles. There are four layers of muscles in your abdomen, three of which are related to your inguinal canal. Take a look at "inguinal canal" on Wikipedia. This is no simple tube or hole that we are talking about here. It is at the juncture of several different anatomical elements.

I think one of the most valuable things that I did was to learn to recognize the feeling of the intestine as it just enters the inguinal canal. Pay attention. If your day permits it, I believe that it pays to lay down for a bit right when it starts to enter the canal and see if you can get it to go away at that point rather than waiting until you see a bulge. It seems to me that to stop this thing we have to keep it from getting into the back end of the canal and not just trying to keep it from coming out the front end. If you can learn to recognize the feeling associated with it going in, you have a chance to do that.

That, at least, is the theory that I'm working on.

[Charles]

I see your point, and yes, in theory all that is probably accurate.

I'm wondering....is there any real way of controlling those precise internal muscles to that degree?

I agree with you about laying down when a bulge is likely to start appearing. Again, however, this is often somewhat impractical........

I'm now taking Hawthornia. It's supposed to tighten the lower abs, including the muscles in the inguinal region. I've been using it for three days, and the entire region does feel "tighter"....however it also feels slightly achier than normal (?).

There is so little guidance. We really are like people in a rowboat in mid-sea, without a compass. There's been no "scientific" research into non-surgical alternatives.

"Watchful Waiting" only started to become even slightly medically- acceptable since Dr Robert Fitzgibbons' study/trial results were published in January 2006. 99.9% of what you still read refers to surgery.

[Charles]

I've also been drinking a lot of fennel tea, which is made from fennel seeds, and eating fennel from time to time.

Fennel reduces wind (gas) in the intestine, thus reducing pressure. It's a key ingredient in Hawthornia.

I now avoid big, heavy meals and foods that the intestine finds slow to process, such as red meat, cheese, etc. I do think that by eating & exercising correctly it may be possible to keep hernias under control, perhaps for a very long time. I know people who've lived with hernias for years, including one doctor.

Actually, I currently know several people who, like us, are living with them because they're very concerned about the risks associated with surgery, especially mesh. However actually healing them, meaning physically sealing up the gap(s).......................

I keep hoping for some kind of miracle..........

[Ron]

In understanding how we control the muscles that are involved and how we work them, I found very useful "Anatomy of Movement" by Blandine Calais-Germain.

Also, you don't have to work those muscles one at a time. You can work them in groups. You just have to find exercises that actually work all of them.

I would be interested in that study that you mention about "watchful waiting" and any further information about how practices have changed in response to that study.

[Charles]

I have tons of info. I've been doing exhaustive research for a year. I've got some of it in PDF form, including extracts with the URL's for each site.

My email address is: cwdf38@btinternet.com --- if you email me, I can easily send you the info.

In early 2006 a very-widely publicized trial was completed regarding "watchful waiting" vs surgery for minimally-symptomatic hernias. There have been other similar, but less extensive, trials since -- basically supporting the results of the first trial.

Google "watchful waiting + hernia Dr Robert Fitzgibbons". The trial shows up on umpteen medical websites.

Since that time, the med's are very, very slowly coming around the idea that it might not be 100% necessary to operate on every hernia, if they are not causing noticeable symptoms. Until that time, surgery was seen as always necessary, regardless. Most doc's still lean toward surgery. Mine, oddly, don't. However I have other problems that they feel point away from surgery, at least for now.

I'm desperate to avoid the whole thing, not merely out of fear of surgery itself (although this is a heavy issue for me) but mainly due to the serious and prevalent complications associated with mesh. These are turning up all over the place (I know of two cases personally).

Again, I can send you tons of relevant articles, etc.

I am hoping to -- at the very least -- delay surgery until a better, safer method than what's currently on offer (i.e., plastic mesh) becomes available. I've just spoken to a friend whose uncle had a hernia for decades.....he died with his hernia intact (!) in his early 80's. There is, I suppose, cause for hope.......

My preference, of course, would be a 100% NATURAL healing, with no surgical intervention of any kind. Because surgery became so routine, no research has been done into alternatives. We are on the very cutting edge here..........

Emial me and I'll send you all the info.

[admin]

Ron, I am the webmaster for the herniabible.com website. In response to your request for information on watchful waiting studies, I have listed the main ones on the website at http://www.groin-hernia.com/herniabible/articles.html However the page is due for updating. Charles, if you have been researching more articles on watchful waiting, I'd love to see them - please do feel free to post the links here or email me at linda[at]thesupportcompany-uk.com
Best wishes
Linda

[Craigsams]

Charles - healing a hernia does not mean 'physically sealing up the gap.' If you did that then your spermatic tube and associated blood vessels and nerves would be squeezed. The gap is there for a reason, it just loses its tone when a hernia develops and can no longer contract properly to keep the intestines where they belong. Ron is 100% right about working the muscles in groups, they criss cross and pull across the inguinal gap, keeping it flexible and able to open when necessary and then shut tight when necessary.

[Charles]

Hello Craig

I meant sealing up the tear in the abdominal wall, not sealing up the gap in the inguinal canal......sorry for any confusion.

If the gap in the inguinal canal is strengthened, will it be enough to prevent the intestines from slipping through the tear in the abdominal wall?

The way I understand it (PLEASE, correct me if I'm wrong) is that there are two issues here: (1) an actual tear in the abdominal wall, and (2) a weakness in the opening of the adjoining inguinal canal.

As I understand it (I'm not a doctor, so please bear with me) these two issues form the basis of hernia classification. I.e., with "direct" hernias there is a tear in the abdominal wall, however the hernia contents (intestines, omentum, etc) do not enter the inguinal canal. With "indirect" hernias, the contents do enter the canal.

Again, please, do correct any mis-information.

Many thanks for your continued efforts, and very best wishes.....

Charles

[oliver]

if just developed a hernia, after lifting something far too heavy at work last Tuesday. Its already painful and is restricting the smooth movement of my right leg, everything just feels stiff! I definitely don't want surgery because of the same reasons as Charles - is there a bio mesh??

i have already altered my diet and have ordered the flat pad support in the hope that I can control my hernia - with exercise too. The fact that it's causing me so much discomfort already is a real worry!

I am really upset about this as i am very active and was planning walking the whole of the south west coast path for charity this june - at the moment its uncomfortable getting up off the sofa

oliver

[admin]

The discomfort is being caused by inflammation in the area due to the recent injury. Movement and gentle exercise will help to drain away the fluid that builds up when inflammation is present, and that will in turn ease the pressure that causes the discomfort.
If you go to our self-help diet pages at www.herniabible.com (click on "self-help" at the top of the page) you will find information about foods to prevent constipation and other causes of internal pressure.
Hopefully when your support arrives it will hold the hernia securely in place, which also helps to reduce discomfort.
At Herniabible we don't recommend any surgery unless it's really essential. Yes, a lot of problems are caused by the material that the meshes are made from, but as you will see from some of the case reports here, a lot of damage can be caused by the surgical procedure itself.
Wishing you well, and please do keep us posted.
Herniabible Staff

[uh_oh]

Regarding 'watchful waiting', here is a recent abstract in PubMed:

http://www.ncbi.nlm.nih.gov/pubmed/19579198

I will be seeing Dr. Yunis next week regarding my asymptomatic inguinal hernia. It's nice to know that he automatically doesn't reach for the knife, even if it would be in his financial best interest to do so.