Im on the fence with going back to Shouldice or going with the local doctor. All three were done by general surgeons, and I can honestly say I would have been better off not getting any surgeries from the beginning. The more you weigh and the more weight you gain after hernia repair, the more your risk of recurrence rises. But ask yourselves this: is it really that important a year later if you slept in an uncomfortable bed for a few days if you have no chronic pain or ever have to worry about developing it? Seventy years of existence can be touted as a measure of success and justification for the status quo Smith-Corona felt the same way about the typewriter. Sexual activity causes no issues and my testicles are no longer sensitive. When needed, a hernia weight loss diet is individualized for each . Thanks for your comments. OIS Exam 1 Flashcards | Quizlet The Shouldice clinic admits patients the day BEFORE their surgery. Inguinal surgery 4 days ago at Shouldice performed by surgeon with 10,000+ hernia surgeries performed. I then met the doctor who told me to lose 25 pounds and return. Under carefully managed routines, most of our patients are back to normal activities in less than a week and often back to work as soon as they are discharged. Toronto Transit. (Wait time "explodes" the closer utilization gets to 100%! They do the surgery anyways. So you are absolutely right, there should be requirements for all surgeons and health care providers to follow evidence based medicine and try and make patients better. Thank you for this post. Yes, some implants are great achievements like one of my friends who is 38 and got a pacemaker at 29, but I believe others have no place when they can be avoided with proper training. Wait Times | Ontario Health You see the full range of personalities there. We have just reviewed 400 consecutive patients from 4 years ago and our recurrence rate is 2%. Our clinic offers hernia examinations by appointment or on a limited walk-in basis. I tell women who may get pregnant after a repair that there is a higher risk of recurrence of the hernia because of the stretching of the abdominal wall with pregnancy. Certainly your hernia is symptomatic and should be repaired. So there isnt a problem with mesh? Shouldice Hospital Case Report Free Essay Example - PaperAp.com Hi there what do you believe offers the least chronic pain for hernia surgery (inguinal)? Thanks for sharing your positive experience Kram. I have just been chastised online for daring to criticize the Shouldice clinic on Twitter. At Shouldice, we recognize many of our patients have family and friends with them. We offer a complete and holistic recovery program that promotes healing and a rapid return to normal activities. When you say walnut size that may mean the size of the sac which can and often is larger than the actual hernia itself. And while I agree with you on many of the double-standard, private taxing points surrounding Shouldice, I disagree that general surgery or mesh related surgery is in any way a better option. Please bring your health card, your family doctor's contact information, and details of prior surgeries and current medications. It smacks of the sort of paranoid anti-science conspiracy theory sentiment which we are seeing rise around other health issues such as vaccinations and water fluoridation. This is directed towards user, Toronto: I had my inguinal hernia operated on after much internal (and external debate with various health professionals) by the Shouldice clinic. Update to the above. This is why they went to Shouldice in the first place, in the Toronto area it has a kind of mythical acclaim. Want fast and effectively perfect hernia repair? I do believe mesh allows me as a surgeon to do a tension free repair which causes less pain, both acute and chronic, post op. We have a full range of activities in addition to organized exercise, to make recovery enjoyable, including billiards, shuffleboard and a putting green. Pioneering for-profit Shouldice hernia clinic sold for $14-million Personally, put in a holding pattern until surgery in the afternoon. If that is the case, I would rather stay in NYC but I guess I will have to make the trip to find out. Sadly neither Shoultice or any surgeon will perform the surgery. We have provided this list as a courtesy to our patients and their guests. EMR should allow for reporting of all surgical complications and feedback to the surgeons on their complications, including how many of their hernias recur. 6) People continually come from all over the world to have their hernias repaired at Shouldice. Very very rarely will I feel a twinge of pain, but 99.5% of the time, I feel as good as new. I love doing a variety of different procedures in patients of all ages, sexes, shapes and sizes. Or it isnt the mesh itself so much as the insertion procedure? During the first week if I was too active Id feel soreness but with a few hrs rest it went away. I guess my point is that everyone who goes to the Shouldice is going to have a good outcome, because they are doing the slim patients. In our small study no patient had any pain after 6 weeks. Thirty five is a fair number if done completely by the surgeon in question I would think. Change), You are commenting using your Facebook account. Physicians cherry pick their patients. Shouldice, like you said, does not do that kind of thing. They have permanent audit staff and know their outcome details. Here are some numbers to call if you would like to book tickets while youre in the Toronto area: These suggestions are provided only as a courtesy to our patients and their guests. The benefits of mesh far outweigh the risks for the vast majority of adult hernia patients. For the first couple of weeks I stayed under the 10lb limit for lifting, now I tend to lift a bit more weight but still not very heavy weight. Standard rubberized hospital bed and pillow. Also, I would check w your insurance company before travelling. I absolutely follow up all my hernia patients. Pain is tolerable(sensation of burning/stabbing in groin) that subsides quickly with reduction of effort/strain. cost | Shouldice Hernia Repair The type of surgery that Shouldice accomplishes is best suited for a set of conditions: the patients particular physical condition. That is simply how medical innovation for medical products in our capitalist society works. He chose the hospital. I can accept that this is work that should perhaps be compensated at a different level because of its extra demands. (As does everyone). I agree with everything that you say. Have you or your staff followed up with all your patients? in the area have been giving me the run around on who to see so now looking to go where there is someone more specialized. When you come to Shouldice, you can expect to have a positive and pleasant experience. I had minimal bruising and swelling, and am mostly back to normal a few days after surgery. My hernia was considerably large and very uncomfortable (both surgeons recommended it get repaired soon as it was quite large and at risk for obstruction in the future) in fact, I was no longer able to play sports anymore. The worst things said seem to be about the dcor of the hospital, the way the nurses and doctors treat you/pillows too small/beds like rubber etc. It was originally founded during World War 2 to allow for young men to have their hernias repaired before going off to fight. For Ontario residents, the Shouldice procedure is covered except for the cost of the semi-private room which is covered by many insurance plans. Mesh CAN be a nightmare if not inserted properly, and maybe I would be able to get away with not using in a very slim patient, but I consent patients thoroughly to all the risk factors. That is tough. There are many companies which manufacture mesh (hundreds) and yes they like to make money. From what I understand well above 90% of Inguinal Hernia operations are successful, and that this is considered to be a routine operation by the medical profession. Lets start with the Pros Migration can happen . The Shouldice clinic charges patients for a private room for up to 5 days (this adds up to many hundreds of dollars). You are right, there is not a lot of good information for women in your situation. But then you will have had two surgeries instead of one, with the risks that entails. The wait times were significantly higher than normal. I agree with John. An article I just read after using your suggested search term called Inguinal Hernias: A Current Review of an Old Problem mentions recurrence rate at a specialized center (Shouldice hospital) being 0.7% to 1.7%, but Shouldice technique done at a general hospital with a general surgeon was as high as 15%. Did I have any discomfort during recovery? To decrease the text size, press and hold down the command key on a Mac or the windows key on PC, then press the minus (-) key. Shouldice Hospital, 7750 Bayview Avenue, Thornhill, Ontario, Hospitals I am very happy with the outcome and am glad I didnt go for a mesh repair. Wait times, patient satisfaction scores, and the perception of care I just had my inguinal hernia repaired at Shouldice. shouldice clinic wait times. I am still avoiding heavy lifting, but everyday lifting activities (groceries, young children, etc) arent causing any issues. Very interesting. But the patient should be made clear of the longstanding post-op, well documented issues of the real probability of chronic pain. The buddy system helps to reduce stress and anxiety and prepares you for a confident recovery. I have never worked at, or been involved with the Shouldice clinic, so this blog comes from my own professional opinion as a general surgeon/hernia fixerand defender of evidence based medicine and socialized healthcare, discussions with many patients who have gone or are considering going to the Shouldice clinic, going to a talk some years back given by a surgeon who worked there, and the Shouldice clinic website. It has lots of windows and a bunch of couches and chairs to relax in, a television and plenty of magazines and newspapers to flip thorough. This makes any numbers they publish about their recurrence rates completely out of touch with the reality of what myself and other general surgeons are dealing with in our practices. That is why Im looking at surgery but here in the US my surgeon says mesh is the only option and that he will be using a medium (as opposed to ultra light) mesh with plenty of overlap to repair the hernia. ConvenientCare Berwick average wait time Save my spot 65 Briar Creek Plaza Berwick, PA 18603 Phone: 570-802-5590 Get Directions Monday - Friday: 9 a.m. - 7:30 p.m. Saturday & Sunday: 8 a.m. - 5:30 p.m. Closed: Most major holidays Also, he only went there after years of being discouraged by general surgeons such as yourself but after multiple failed hernia surgeries by these same general surgeons. Well keep in touch every year and offer you an opportunity to have your hernia repair checked and monitored by our surgeons. Dr. Shouldice developed his innovative technique during World War II, to help young men who were unable to enlist in the military because of their hernias. Discover the Shouldice Experience We offer a complete and holistic recovery program that promotes healing and a rapid return to normal activities. I havent made the decision yet myself, Shouldice or mesh. The hypochondriac insisting on stronger pain meds and special priveleges to the I dont need pain meds tough guy. You share good times with the people you meet there. ( I know I already said that but they were really that bad). The techniques used by the hernia specialists at Shouldice dramatically reduce the risk of recurrent hernias to approximately 1% over a lifetime. It seems to be the same, or slightly worse than the common open mesh repair. Im traveling from the US and paying the entire bill myself (my insurance does not cover non-emergency out of country surgery). shouldice clinic wait times - fmbiochemic.in Naturally Id like to see the same for the hospital system. The 3 scars have pretty much healed up. 0. Most of my comments refer to groin hernia repair and as I said at the beginning, are based on my opinion as a medical expert and fixer of hernias, not on any raw data, which of course is not available. I think is a matter of profit from this industry. Our current career opportunities are outlined below. Has mesh been inside anyone for 40-50 years? Three surgeries at two different facilities using different techniques by no means expertise in either technique. All Drs are well experienced and trained. Is it because they make lots of money off the patients and the taxpayers? Id stick to an open or lap repair with mesh applied externally. 2 The Lichtenstein procedure was learned from a book, 10 instructional videos, and personal communication with Irving L. Lichtenstein, MD. Ive had this hernia since I gave birth to my child 9 years ago and my life has been very bad since. Most of the arguments against Shouldice here seem to have very little to do with the actual technique, pain afterwards or recurrence (irritation, I thought, at the Southfork-like set-up and possibly also at their very existence fuelling endless questions like mine: is mesh a problem or isnt it? They told me they were being charged much less at Shouldice than they would have paid out of insurance in the US. Niagara Health System | Systme De Sant De Niagara http://Www.desarda.com. Which method is the best option considering I want to get pregnant? If I could go back Id take my chances on reoccurance hands down. Sounds like he needs a repair, although you dont need to worry about blood supply usually. DO NOT EAT OR DRINK ANYTHING, including water, after midnight the night before the procedure unless instructed otherwise by your surgeon. The staples are removed (one half at a time) over the two following days. Just returned from Shouldice. I had inguinal hernia repair at Shouldice in June 2017. Thanks for your comments. And it IS true that mesh design has improved not just materials, lighter, thinner, for instance Titanium coatings to reduce foreign body reactions, so problems 2 or 3 years ago may be referring to old technology. If you are unable to submit this document in advance, you will be asked to complete it upon arrival at the clinic. I would like to see much more transparent reporting and rating of all surgeons & hospitals & clinics. Your post here changed my life, my plans, in a good very good way. I since switched meds and lost a bit of weight but Its so difficult to even move with a cantaloupe sized abdominal hernia. I will miss the black squirrels. Slight modifications were made in each procedure but the procedures were similar . (LogOut/ I wonder if a nerve block might be the answer. The Shouldice then also bills the Ministry of Health for each inpatient day a patient stays overnight. All patients will be actively screened at the front door. Mesh has become widely adopted because it decreases recurrence rates of hernias, not due to concerns about chronic pain. I honestly cannot think of anything much to criticise beyond, just possibly, the tendency for some staff to be satisfied with your progress in their own minds, but could convey this rather better to the patient my equipment turned black and trebled in size so I had to get a specific answer to my question: is this normal? I got three different answers from Shouldice on how long I should wait to try and conceive after surgery (4 weeks, 3 months and 1 year). I agree there is an absence of definitive evidence one way or the other, and that some surgeons seem to possess Olympian detachment when confronted with inconvenient statistical irregularity. Given the heightened concerns with the transmissibility of COVID-19 and the pressures on our Emergency Departments, we ask that you consider your healthcare options before visiting the hospital for non-emergency concerns. The facilities are dated, the food horrible, and you may not get the surgeon that assesses you. I did not get a reply what so ever until September 2014 advising me that they can operate on me. He worked at Shouldice for about a year and did several hundred Shouldice repairs. Ive tried to get surgery twice. I went to see my family doctor as I live too far from Shouldice to visit. Thanks Kram. My hernias were small (umbilical and femoral) and related to pregnancies and not a previous incision. To do less would be to jeopardize the positive end result. Here is a run down of my thoughts. Is your problem scar tissue? 2015 surgeries (inguinal, umbilical) performed at local Ottawa hospital by general surgeon, with some specialization in hernia repair. Only 5 days, so still too early to comment on final result, but: I slept very well there (pain meds are handed out at need, in other words you had to ask for them, after day of surgery very many forgot to ask shortly before bed and so had a bad night). This is so important, but our electronic medical records do not allow that to happen at this point in time. Often times we do not own up to our own responsibility in the situation. I will stop by here at the 6 month point to provide another update. He takes the time to explain everything to you, during the consultation, before the surgery, and after the surgery. Suppose you had a recurrence after a tissue repair. You are correct though, there are not good studies comparing the two methods. She examined the surgery site and indicaed that my incision site was in good condition without any signs of infection. Update of previous post. I wonder what steps should I take once Im ready to see a new surgeon in Ontario? Shouldice would take me again, the surgeon Im scheduled with said ideal patient, all these things mean is low risk for the actual surgery, doesnt mean itll work or not give you issues down the road. Complications after a mesh surgery can drive the cost of a simple hernia repair into the hundreds of thousands of dollars. Visitors will not be permitted in the patient rooms. Following this summers logging and landscape work I will report the status of all three repaired hernias. As a specialist, I am not allowed tobill OHIP to seepatients without a referral from another doctor, and so we see the double standard growing. It is located in Toronto, Ontario, Canada north of Highway 401 on Bayview nearer to Highway 407. Very interesting and enlightening article for a soon-to-be operated-on groin-hernia sufferer like me. Obviously varies. You . You have to follow patients for decades to know your real recurrence rate, and patients also are not likely to go back and see the same surgeon (or a clinic) once they have had a recurrence. We are committed to recruiting and retaining the most talented people and are focussed on creating a workplace where people enjoy the challenge of their career, create and engage in best practices, and are treated with respect. Others who have had surgery at their local small hospital and everythings good. I dont know what the exact policy is on inpatient stay at Shouldice, the website said at least one day pre op, and an unspecified number post op. I also saw the ambulance chasing lawyer ads in the US regarding mesh failures. The class action lawsuits in the US are concerning to me. A lot of nerve damage occurred to my femoral nerve, and the mesh they have inserted is extremely painful. In speaking with their surgeons, they are looking to have their technique more widely adopted and have recently had visiting doctors from the UK and are making efforts to have the technique more widely known. My hernia is fixed and I have a verbal confirmation that I could lift weights directly after surgery. That's a lot of lost revenue, so it's understandable for practices to schedule as many patients as they can to mitigate the financial losses from missed appointments. I have only good things to say about the Shouldice! A friend of mine had the mesh technique and it resulted in a tumour growth that was quite complicated to resolve. I agree with Toronto that it is hard to find any real data on the Shouldice clinic. Once youre admitted to the hospital, youll meet other hernia patients. Unfortunately it did not adequately control for risk factors known to be associated with recurrence, including obesity. Your stay at Shouldice includes a number of patient services to enhance your care and comfort: Weve followed up with our patients for many decades and time has proven that the patient-focused, Shouldice approach is the key to a complete and successful recovery. Please call 905-695-4911 to book a time. The mesh industry is too powerful and monopolize the medical society. Our first available appointment is in July of 2023. Critiques are always welcome because it can make people think out of the box. I had a double inguinal done at Shouldice 10 weeks ago and was in a fair bit of discomfort for the first 8 weeks but am feeling much better now and am thankful I have no mesh to disrupt things down the road. Shouldice Hospital is returning to Vancouver to conduct examinations in March 2023! Less with lap but google complications of lap inguinal hernia repairs and you wouldnt touch it with a barge pole. She commented that the incision was very near and well done. Understandably, patients like their surgeon to appear omniscient and surgeons rather like that, too (jokes about the God complex). You can travel with a hernia as long as its been 3 months since you were seen for it. Laparoscopic repairs are reported to have the lowest occurrence of chronic pain in the papers that I read. To the wife of the husband with the augurales hernia. This makes anyones numbers on hernia repair difficult to interpret, but the Shouldices number in particular should be viewed with a grain of salt. I did that search, and Im not sure if I saw exactly what you saw, but yes even though Shouldice method (performed at the Shouldice hospital specifically) has a very low recurrence rate, certainly mesh will have the lowest recurrence rate. http://www.ncbi.nlm.nih.gov/m/pubmed/15243743/ There are many reasons why mesh is used and many people do fine with it. Shouldice Clinic Hernia Repair - August 2020 - YouTube Mesh does reduce the risk of recurrence but does not make it zero. It doesnt matter what method you have these days the recurrence rates are all about the same,low. So this is a tricky situation. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727805/. 14 Weeks with mesh. Here, you can leave your busy schedule behind and enjoy a restful and relaxing recovery in fact, many people compare it to visiting a beautiful resort. Safe for airport scanners AND MRI. As for my health state, today is two weeks and I am still having significant pain from the muscle lump. The Shouldice will not be handing over their data anytime soon, unless forced to, I can say that with confidence. The Shouldice Clinic outside of Toronto, Canada has demonstrated extraordinary safety and durability with their technique. shouldice clinic wait times sam quek strictly come dancing Staff was decent, Now the Cons When asked about mesh and its complications I was told not to worry about them or the mesh as its good. Thats the bunch of b.s.