It is very painful to walk, stand, cough, sneeze, laugh, use the washroom in any capacity and expect from the bruising that this will carry on for atleast another week. The general surgeon I seen advised 6 weeks. 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. In our small study no patient had any pain after 6 weeks. It is supposed to be better than Shouldice. 1/2-5/8 of flesh mounded above the underlying muscular tissue fix. Our first available appointment is in July of 2023. I would not be likely to offer a second hernia repair (with or without mesh) to a patient with risk factors for recurrence (substantially overweight, smoking etc) unless the operation was an emergency. To do less would be to jeopardize the positive end result. Theyre like impossible to find it seems these days. My husband was asked to lose weight for the surgery but still was not skinny. In order to lose the proper amount hed need to eat saw dust and exercise. I higly recommend Shouldice Hospital. I agree with everything that you say. The literature on incisional hernias is where the use of mesh was first tested. Acas; Conducere; Evenimente; Comunicate; Presa; Activiti; ark mating interval multiplier glastonbury vip tickets 2020 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. Last year, it had a record year and performed nearly 7,500 operations. I am not going to comment on specific cases, just generalities here. Visitors are required to wear a mask when inside the hospital. SHOULDICE HOSPITAL CLINIC DETAILS 7750 Bayview Avenue, Thornhill, Ontario. The staff were unfailingly courteous, even when under all-out attack by the annoying. I wonder if a nerve block might be the answer. For personal comparisons I am a 50+ year old male in average/above average health. Sonesta Suites355 South Park Road, Thornhill, ON L3T 7W21-800-SONESTA1-800-766-3782. If their procedure was outdated/inappropriate in anyway, then why are they still in business helping 7000 healthy, wealthy and skinny people (morale issue again) per year have pain free and hernia free lives? We offer a complete and holistic recovery program that promotes healing and a rapid return to normal activities. Large ventral/incisional hernia repair or complex abdominal wall reconstruction- different story. So the idea that you think there some sort of mesh industry monopoly is concerning to me. The technique was designed by Dr.Edward Earle Shouldice and became popular when he opened his hernia hospital in 1945 and his technique has attracted patients from all over the world. No I have not found a way to make any money out of my blog, just doing it for fun at this point. For a reduction in u from 0.90 to 0.80 on the x-axis, find the associated reduction in wait time Tq (on the y-axis). While my knowledge of Shouldice is not direct, it is close to home, and entirely contrary to what you have said. There is some evidence that using generalistsis a cheaper, better way to run a health care system and I believe that. Bed manually adjustable by hand crank at foot of bed not comfortably or easily done post surgery. There are days I literally cannot walk. The more you weigh and the more weight you gain after hernia repair, the more your risk of recurrence rises. I would ask your family doctor for a referral to a general surgeon who does hernias from incisions to discuss the pros and cons of a repair in your situation. Update of previous post. Of course, that is difficult work which the shouldice is not interested in. I dont know where you got your information that the Shouldice doesnt use mesh but this is incorrect. This clinic needs to keep people in hospital to make money. The food was better than I expected. Critiques are always welcome because it can make people think out of the box. 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? NDP Leader Jack Layton acknowledged yesterday he visited a private Ontario medical clinic to treat a hernia in the mid-1990s, but dismissed suggestions it undercut his credibility as a public . Normally, there is no extra charge for semi-private rooms if youre covered by OHIP. I went for consultation at Shouldice in October 2013 for consultation regarding an umbilical hernia repair. Just want to make a correction: they dont provide private rooms, but cramp you in a room with another person. I had researched the different techniques and decided I would rather have small surface area non-magnetic stainless steel sutures vs a plastic mesh. When I went for my pre-op. My husband went in, doctor said lose weight and i will do it. Informed consent is crucial. Many of the patients in my cohort were from the US, one had driven over 2000 km to get the surgery. Just frustrating and agree with you on the best I later found out that my friends younger brother had a repair done at the small hospital and has no complications after 8 months with mesh and I went to the one in the area that is considered the best Ive just come to expect the worse I think I have a cloud that just fallows me around :p LOL. 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. Surgeons need to do emergency work or perforated appendicitis, gangrenous gallbladders, and blocked bowels (sometimes stuck in hernias) would not be dealt with, and patients would die. I hear that the wait time is up to a few years for the surgery itself. Morrison said studies show 10-20 per cent of people are left with chronic pain. 2016 Feb;59(1): 19-25. Please call 905-695-4911 to book a time. Even with insurance in the USA, high deductibles and co-insurance means hernia surgery is still a very hefty expenditure well into the thousands, it could easily be the price of a Shouldice repair, but performed by someone with not nearly the expertise. 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 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. I play sports 3 days a week, I run competitively, etc, and virtually no pain. I was extremely excited to not have to wait a long time to get in for an operation as the hernia was making it almost impossible to drive. Here you will find current wait times for Niagara Health's Emergency Departments and Urgent Care Centres. The Shouldice clinic is a good example of that. http://Www.desarda.com. Found a surgeon in Sarasota, Florida who does non-mesh hernia repairs (Shouldice). I dont think it has been around that long. Change), You are commenting using your Facebook account. [1] The hospital specializes in hernia care. By the time my son was 10 and we moved to Peterborough his hernia was the size of a pineapple infact it looked like he had a bag in his pants! The Shouldice will not be handing over their data anytime soon, unless forced to, I can say that with confidence. Now patients will generally think that more care is better care. Sheraton Parkway600 Highway 7Richmond Hill, Ontario905-881-21211-800-668-0101Call hotel for special Shouldice rate.2.5 miles from the hospital. Anecdotal reports from those who have had this problem make it sound like a real living hell. Comments Off on shouldice clinic wait times; June 9, 2022; My biggest concern is chronic pain, and the medical papers I have found do not give the Shouldice method the best score. (LogOut/ To see how we do a Modified Shouldice visit http://www.herniaoperation.co.uk Why? Sorry your husband had such a tough time with his hernia, hope he is doing well now. Im probably an anomaly in the hernia world, but my story is horrific and Im still passing through it. Toronto Transit operates a bus from Yonge St at Dundas St East to Steeles Ave East Loop every 30 minutes. Shouldice is a business and I understand that like any business its primary goal is to make money. Update to the above. It may be in part an attempt to keep a surgeon ratings list from being established, as patients are not allowed to pick a surgeon. Now as a confession of a conflict of interest here, I am a general surgeon who does lots ofhernia repairs at a hospital about an hours drive from the Shouldice. In fact, that is the only operation it performs, and it performs a great many of them. shouldice clinic wait times. From the research Ive done, nearly 70 hours of it; Shouldice offers distinct advantages over mesh repair in the following ways: 1) No concern from implant of foreign object; ie fear of allergic reaction to mesh, worry of mesh erosion over the decades and nerve damage caused by mesh. Finally, I am sorry you are experiencing problems and I sincerely hope they are at the lower end of the spectrum. Staff was decent, Now the Cons Shouldice is licensed by the Ontario Ministry of Health, which covers the entire cost to Ontario residents of hernia operations there under OHIP, the. Shouldice is the gold standard of no-mesh hernia repair. 14 Weeks with mesh. Answer: Yes, but I was at the higher end of the range and one other fellow in our intake was even worse. The Shouldice Hospital has been a family-run private enterprise since its founding in 1945 by Dr. Edward Shouldice, who developed a reliable technique for repairing hernias during World War II.. 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. As I said at the beginning, this blog is my opinion and I have a conflict of interest BUT evidence based medicine would say you need to be doing hernia repairs with mesh. I went for a long walk after the surgery. Last week, the family that owns Shouldice Hospital announced that it would like to sell its facility to Centric Health, a for-profit company traded on the Toronto Stock Exchange.. Shouldice, a Southern Ontario facility renowned for its care of patients with hernias, was founded by a surgeon in the . If that is the case, I would rather stay in NYC but I guess I will have to make the trip to find out. Having been an aircraft accident investigator I provide this comparison/critique in a strictly evidentiary way based on my experiences and observations from having had both procedures. Also billing data was used for the study, which is a notoriously inaccurate way to study surgical outcomes. I discuss chronic pain issues with patients before surgery and try and make sure the nerves are away from the repair. The Shouldice Hospital in Thornhill, Ont., is world renowned for its treatment of hernias. That is tough. Or it isnt the mesh itself so much as the insertion procedure? Having said that, the risk of recurrence is much higher with umbilical and epigastric hernias in pregnancy than with groin hernias. Pure tissue technique, according to yourself and other general surgeons, has the risk of recurrence. To increase the text size, press and hold down the command key on a Mac or the windows key on PC, then press the plus (+) key. Staff is helpful but not pleasant or friendly. Now some of the Shouldice clinic patients come from out of country and should be paying forall of their carebut what this percentage is, I do not know. The surgeon indicated that when they went in to operate they discovered I actually had two hernias (one direct and one indirect) and he repaired both. I have a hernia (incisional/abdominal) that needs to be repaired, with several other smaller hernias, however, my visit to the Shouldice sent me searching for the right General Surgeon instead. The problem is that the mesh industry is so powerful it is impossible to get anything published that doesnt involve a mesh. You see the full range of personalities there. 3 weeks after surgery, I was starting to return to running, but still avoided lifting anything heavy. Straight truth from the USA here folks. The data we need are the rates for chronic pain which is very hard to come across for any of these techniques. Mesh has become widely adopted because it decreases recurrence rates of hernias, not due to concerns about chronic pain. The body can react to a foreign body (Plastic) Mine also is touching the nerves that run in that area. Realistically, I am 50, 57 and 163 pounds, am I really going to lose 30 pounds and keep it off for the rest of my life? 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. Id love to send my husband there! Awake and aware during surgery, no pain but the feeling of pressure and intense tugging. https://www.ncbi.nlm.nih.gov/pubmed/10452261. Recovery done at home, pain meds prescribed, incisions very tidy, standard sutures, little to no swelling or bruising. Hernias do just get larger, and there is also the issue of not being able to travel if you dont get it fixed (pre-exisiting condition). colonel frank o'sullivan interview; beverly hills high school football The issue is really about the size of the facial defect vs the risk of recurrence with and without mesh. Sadly once you get the mesh and have issues with it the medical community doesnt know what to do. I have had a right side inguinal hernia for 1.5 yrs and am scheduled for mesh repair locally end of May (bumped from mid-May). The recurrence rate with Shouldice techniques was higher than mesh techniques (OR 3.80, 95% CI 1.99 to 7.26) but lower than non-mesh techniques (OR 0.62, 95% CI 0.45 to 0.85). I will really appreciate your informed feedback and sincerely hope that maybe more folks will follow your lead in helping make society better informed. Considered the same as Shouldice. It seems you did your research thoroughly and are maybe one of the unfortunate ones. Its not much. And I agree that we need to have tracking of surgical outcomes to verify the success of various techniques, whoever does them and whereever they are done, but making everybody do emergency & other more involved surgeries doesnt address that. I do not feel Shouldice does an honest job of their success rate, but they are not the only place or surgeon to do that for sure. I am very happy with the outcome and am glad I didnt go for a mesh repair. Your post here changed my life, my plans, in a good very good way. But the patient should be made clear of the longstanding post-op, well documented issues of the real probability of chronic pain. You, and others like you, in other words. 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. Fill in your details below or click an icon to log in: You are commenting using your WordPress.com account. The repair is based on the Bassini repair with some modification. ( I know I already said that but they were really that bad). Also, I would check w your insurance company before travelling. You are correct, I lived in Australia and know even gap fees can bankrupt people with insurance. .1st operation to save my life. Meaning the hernia comes back, requiring a second repair. 2 The Lichtenstein procedure was learned from a book, 10 instructional videos, and personal communication with Irving L. Lichtenstein, MD. Polypropylene can cause many issues later on down the road research is finding and for those of us with mesh it could be a time bomb waiting to go off. Thank you. Tell me about it..I had an accident at work. Do the surgery again big deal! Pick a curve, any curve (say, the red one). The average North American is gaining 1-2 lbs per year, and obesity is a clear risk factor in hernia recurrence. Im on the fence with going back to Shouldice or going with the local doctor. Lastly, I really feel strongly that clinics and surgeons which do not do emergency on call work should not be allowed to operate on an elective basis. 80%| 10. Three delicious meals every day, plus an evening snack, An exercise program specifically designed to speed the recovery of hernia patients, Professional advice for a healthy recovery, Access to on-site massage therapy (extra charges apply). Less with lap but google complications of lap inguinal hernia repairs and you wouldnt touch it with a barge pole. You dont find Drs in NY doing hernia repairs without the mesh. I have been taking hot baths daily and massaging the area, but it doesnt seem to help. I am scheduled to have a right side repair done at Shouldice next week. 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. mjk funeral home obituaries; san jose state university graduate programs deadlines Men umschalten. OUR PATIENT CARE When you come to Shouldice, you can expect to have a positive and pleasant experience. The Shouldice Clinic is a private clinic operating in the Toronto area which has been open for decades. The authors looked at repairs in Ontario hospitals over a 10 year period and concluded that Inguinal hernia repair at Shouldice Hospital was associated with a significantly lower risk of subsequent surgery for recurrence than repair at a general hospital. I find this absolutely compelling evidence supporting a visit to Shouldice versus other hospitals in Ontario and, for me, I think its plausible to believe that these findings would not be dissimilar if you were to compare Shouldice repairs versus outcomes of repairs done in general hospitals in the States. He is based in New York and covered by my insurance. But it might also just be for efficiency. Physicians cherry pick their patients. Unfortunately it did not adequately control for risk factors known to be associated with recurrence, including obesity. It was recently taken over by a private company and is no longer in the hands of the original Shouldice family. We have provided a list below of accommodations and we have arranged special rates at some of these. Not speed of hospital discharge. Ive read of issues with all repair methods except for TAPP laproscopic have you heard of it? Which must annoy surgeons who use only mesh). I would also, I hope, be getting angry calls from our hospitals administrators asking what the hell I was doing keeping patients in hospital for so long after such a simple procedure. My hernias were small (umbilical and femoral) and related to pregnancies and not a previous incision. Im looking forward to lesmcc1s response. There is a specialty clinic in Toronto, Canada called Shouldice Hospital. It was then allowed special licence by the Ministry of Health to continue operating. 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). Hilton Garden Inn300 Commerce Valley DriveThornhill, ON L3T 7X3905-709-60083 miles from the hospitalTo receive a 10% discounted Shouldice rate click here. I had an inguinal (opposite side) and umbilical hernia repairs done using mesh two years ago. He takes the time to explain everything to you, during the consultation, before the surgery, and after the surgery. They say Im an unusual case, but 2 years after having an inguinal hernia repaired at Shouldice I am still suffering from nerves entangled in scar tissue. Shouldice Hospital in Canada is widely known for one thing-hernia repair! I asked multiple times to my surgeon prior to the operation on chronic pain and other complications. Two questions: (1) do you think a surgeon who did 30 laparoscopies in residency and 5 shortly after in private practice is sufficiently experienced to do bilateral inguinal hernia repair with the TEP method? Ive had other friends have a nerve block and it helped them for months so it is hard to know the amount of help it may give you. Shouldice Hospital is a bit of curious place. They do this to improve success rates (which of course patients want too) to reduce fat in the tissues which, I imagine you know but others might not, is a factor with or without mesh. Very very rarely will I feel a twinge of pain, but 99.5% of the time, I feel as good as new. I feel like patient quality of outcome should be the deciding factor, not just whether the original hernia was handled. Also, I find there is a lack of information on hernias in fertile women and how to treat. WOW. Good points John. Shouldice Hospital Hospital #1 of 506 Facility in Thornhill, Ontario 3 Doctors Call Clinic View Map & Address Unavailable Ratings Doctors Top Facilities in Thornhill, ON Shouldice Hospital #1 of 506 Sunlight Dental Clinic #2 of 506 Matlis Medical, Urgent Walk-in Clinic, Sports Medicine Clinic #3 of 506 Grandview Dental Care #4 of 506 Shouldice Hospital is not responsible for these services. 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. I have recently had a consult at Shouldice and had some concerns. Overall, I am pleased with both the experience and the outcome. So I am 4 days post surgery from Shouldice.My tackle is extremely bruised so I can not say that I will maintain objectiveness. The limited walk-in spaces are available on a first-come, first-served basis. The Bassini repair, named after Dr. Edoardo Bassini who developed it in the 1880s, was the first efficient repair for inguinal hernia. I also have not had good outcomes with the medical community. Lets pretend that there is no influence of the medical-pharmaceutical industry on advertising about certain methods and medications as well as on the purchase of the professionals themselves, as is the case in several countries. There are certainly many issues to be factored in but as a patient my number 1 concern will always be having surgeons working in environments that are conducive to producing good outcomes for patients and I have not yet seen any convincing arguments for disallowing the development of specialties though I do have concerns about the influence of profit as a motivating factor. We go to physicians expecting a solution to a problem, expecting, sometimes, an unreasonable outcome, expecting physicians to be more than human, expecting them to always do the right thing. Hi thanks for your article. 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. minutes at a time, several times a day during the first few days after surgery If you are unable to have a bowel movement following surgery, a mild laxative such as Milk of . I understand that they likely inflate their success rates by choosing ideal patients, but I do not have the technical skills to actually evaluate the efficacy of the proposed mechanism of repair. My first week after surgery at Shouldice wasnt too bad. Your hernia will need to be fixed, no question. Leave jewellery and other valuables at home. The food was good. From studies (which are few and far between), they both apparently have the same amount of chronic pain sufferers. I had a large bruise in the center of my abdomen below the belly button from the surgery and that has now gone away. Shouldice of course sends most of the patients it sees back to where they came from, and does not have to worry about complications or ongoing issues from their repairs. I would have to see why, based on outcomes & diversity of treatments required, doctors/surgeons should have common requirements for their practice. 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. Im sure there are anomalies in either system, but like I said, Im rather surprised to hear that a place that is known for its speed (even among layfolk that have no business following the performance of hernia clinics) is being depicted as slower than public held alternatives. 0. It is a small hospital dedicated only to hernia repair. I had my surgery done at Soldice 5 days ago. Be glad you have the option of this procedure. When you come to Shouldice, you can expect to have a positive and pleasant experience. Hi there what do you believe offers the least chronic pain for hernia surgery (inguinal)? I do not believe in the argument that the Shouldice doing so many repairs allows for more hernias to be repaired in our public system. So firstly, it is always hard in practice to know how many surgeries it takes to be competent? Im not a medical professional of any sort, but Im capable at measuring time the first two (father and neighbour), went to Shouldice and returned within 48 hours and their usual routines somewhat ecstatic about the result, and with no need to revisit the surgeries since. Shouldice, a brilliant surgeon who revolutionized inguinal hernia repair by developing a dependable, no mesh technique back in 1945. The surgeon who performed my surgery has successfully completed over 10,000 prior repairs. The fears of chronic pain and lack of research into Shouldices 99% effectiveness claim are overrated. Now I have mesh and been having issues with it since (6 months) I would of rather rolled the dice on the hernia reoccurring the old fashion way than having something put in me that no one can get out and continues to be an issue. We never rush you through surgery and send you home the same day; thats very stressful for both patients and their families. She suggested that the nerve fibre regrowth in the skin layers around the surgical site may be causing the sensitivity. Are you willing to be more specific about the nature of your problems post op? Our current career opportunities are outlined below. Should I wait or should I see a surgeon right away? We encourage you to take advantage of these beneficial patient programs. View Map We are currently accepting patients in our Examination Clinic by appointment or limited walk-ins on a first-come, first-served basis. The question of the morality of rich families being able to afford private schools, hence their children receiving a higher quality of education is not likely to lay heavily on the mind of any concerned, least of all the children. I cant get a job people think Im pregnant or will need a leave of absence. I hike a lot, mtn bike, lift >100# items, etc. However there is more to it. The beds were terrible. I did not get a reply what so ever until September 2014 advising me that they can operate on me. I have had direct experience with Shouldice where my husband had a large abdominal hernia repair and they did use mesh and the head surgeon gave a long history of their use of mesh at one of our appoinments. If this is an arguement that many surgeons feel should be addressed then of course I would be open to hearing the arguments for it but I believe our health care system should have a structure thats based on requirements necessary for delivering good outcomes for patients at the best cost.
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