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I feel a personal obligation to write this diary of my recent experience with the corporate health care monopoly. I hope to offer a different view of 'health care reform' by addressing the 'health care' itself. I look at the corporate influence over which care we receive – regardless of who pays for it.

 I acknowledge, from the start, the dedication and competence of the innumerable health care professionals everywhere on our Earth; I applaud them. I do say, with few remarkable exceptions, that the “Health Care Inc.” monopoly subsumes them all. And while I judge no individual, I accuse the corporate control of the system of putting profit before patient. This is my health care version of “J'accuse”.

What follows is my experience in repairing a male inguinal hernia (there are many kinds of hernias). I do not touch on the women's hernia issues; but I hope to invite (if not  incite) some edifying expositions in the comments section. All “hernia” references here are to a male inguinal hernia.

 It all started when I noticed a sub-dermal bulge my in abdomen above my groin. It turned out to be an inguinal hernia: 'a gap' in the muscles holding my intestines inside my body (i.e. my insides were pushing out through a 'hole' in my inner abdominal muscles.

 I was (gleefully) diagnosed with an inguinal hernia, and was 'rushed' to get a mesh implant surgery immediately. It was presented as a common, and trivial procedure. But! Any delay chanced extreme death by strangulated intestines, or worse, an emergency room “visit”.

 To the best of my knowledge the medical monopoly procedure is a mesh (fabric) that is inserted across the opening of your containing muscles and either stitched or stapled in place. For some reason this is necessarily done by snaking a remote controlled optical cable (a laparoscope - a sort of reverse periscope) up through a cut in the groin. With various other insertions surgeons unfold a plastic mesh and secure it in place.

 All this remote control toying is being done less than a half inch under the skin. But the “toy” is inserted through a hole some six inches away. Why? Ostensibly this is done to avoid an open cut through the abdomen (which is acceptable in innumerable Caesarian sections done every day). To me it looked like it was being done to pay for the stupid laparoscope.

 Every insurance plan covers the high cost of this procedure, and the cost to me would be minimal; I just had to hand over my body to the high priests of received wisdom for 'business as usual'. Indeed I found no other choice offered or available.

 I 'ran away' and searched the web.

  I found that the monopoly surgical procedure is statistically regarded “a success” if the patient gets out of the operating theater 'alive' (without complications). At that there is a 5% fail rate. Too often the surgeon bumps into a nerve (or staples it) or some other essential scrotum tube is damaged. And the piece of fabric (mesh) can be misplaced, or move. Surveys that include hernia recurrences and patient post-operative pain report a 30% failure rate. Surveys comparing pain and discomfort between men who have had inguinal hernia mesh implants and those who chose to live with, and manage, their hernia find that the two are comparable (i.e if you can manage to suffer a little, you can do it for free). I didn't feel lucky.

 The causes of an inguinal hernia are not even known. The old canards about lifting too much weight do not address the real causes (e.g. weightlifters usually do not get hernias). I found no research into the causes of inguinal hernia; it is apparently too profitable to cure. I found that hernia surgery is one of the most common surgical procedures performed on the planet; identified as one of the largest money makers. Worldwide laparoscopic/mesh hernia 'repair' surgery is Big Money.

 Consequently, there is a monopoly on the surgical procedure performed. In the spirit of 'Poor Bill Gates'; mesh repairs are a mass marketed flawed procedure requiring many fixes, on which you are the test site; all at your expense.

 I was appalled. I lay prone, I stopped eating (not putting something into me to fall out), I searched the web for alternatives and found none! So I revised my query, I followed web links after links. I found yoga sites, herbal sites, personal testimony sites, but my hernia was still getting worse.

 I found several traditional surgery techniques offered around the world. Evidently; before the 'mesh monopoly', there were many long established hernia surgery procedures. They usually cut you open, pull the gap closed (tension), and stitch you up. I found a Canadian clinic using the Shouldice technique (stainless steel sutures). I made a tentative appointment and continued to search.

 By pure chance (grace?) I fell upon a 'no profit' self help page with a personal testimony of a distinctly different “alternative surgery” method. Indeed this author's personal initiative brought the new 'Desarda' surgery technique (which I eventually received) to the USA. But his site led me to a now defunct clinic in California (which still posts a dead “ghost” url and web page).

 However; I did eventually find the real, one and only, Dr. Mohan Desarda at the Pune Hospital in India. From his desarda.com I learned everything I never wanted to know about inguinal hernias. What Dr. Desarda does differently (by my limited understanding) is to stitch some of part of your openned muscles to a very strong adjacent ligament, then stitch you up 'in place' on that new foundation. The Desarda technique is a 'no laparoscopy, no mesh, no tension, local anesthetic, absorb-able sutures, permanent, painless repair'. The recurrence rate is less than 1%. That's what I wanted.

 At that time I even noticed a link to (the real) “Desarda Center USA” at the Ufirst Health Clinic in Fort Myers Florida; but by that time I had become averse to the chimera of “Health Care Inc. USA”. I asked to be treated by the original master, and was welcomed.

 I planned to fly to India; I booked the operating theater, I booked an Air India flight, renewed my passport, and applied for my visa. Ah; the India Visa Center, those unfathomable circumlocution offices of the Indian version of “how not to get things done”. They stopped time. Suffice to say I never got a visa in time .

 Reassured by Dr. Desarda that Dr. Tomas was equally master of the technique - competent and committed - I overcame my aversion to American medicine in a blink; my hernia was still getting worse. Indeed; the ultra efficiency and speed of the Ufirst clinic services became a welcome comfort.

 I flew to Florida and stayed at a hotel that is a virtual annex to the clinic. The Desarda Center USA has a modest appearance. It is the only doctor's waiting room I have ever been in where the prevailing feeling was relief rather than anxiety (both men and women); Dr Robert Tomas created the general surgery 'Ufirst Health Clinic' together with his wife Dr. Anne Lord-Tomas.

 I walked in for an examination one fine day. The next day I walked in for a bi-lateral (double) hernia surgery and walked out in less than an hour. The next day I took a walk. I dined out for a couple of nights (fearlessly filling my guts). After a post-op examination I flew home. I never once experienced pain or discomfort, then or since.

 This cost a lot; out of pocket. Medicare would have paid for part of the surgery, but only for a displaced “Hospital” surgery that could not include the practiced team at the clinic. My veteran's coverage would have paid for a decent traditional surgery. I got the best help available in the world and I do not care who paid for it. Health Care is not a business, it is a healing art; a human right. A human need.

 The Desarda technique benefits the patient using simple surgical techniques available to any surgeon with the mind and will to advance health care science over corporate profits. This hernia repair technique has been available for decades and has been adopted around the world, but in the USA it is all but invisible. In the USA, no matter who pays for it, you buy only what they're selling, at any price they set.

 Dr. Desarda is a hero of social justice. His perseverance in educating the worldwide medical community has benefited patients around the world. His persistence has been untiring; and his discovery has certainly not made him rich.

 Dr. Tomas' adoption of this technique in the USA should have a seismic impact on USA inguinal hernia repair. He is what I love about us here in the USA; some unanticipated free mind always steps through the veil of monopoly proscriptions and makes a better future real - for us all.

 Nowadays every other man I meet has, or has had, an inguinal hernia. Most are happy with their mesh surgeries (or obediently endure some discomfort). Their eyes assume a ”Manchurian Candidate” glaze as they speak of their doctors as “the kindest, bravest, warmest, most wonderful human being I've ever known in my life...”. Some, however, have been severely damaged by mesh surgery. All are ignorant of any alternatives to using mesh.

 There is no reason for this viable procedure not to be offered to all patients in the USA; we taxpayers are usually paying for it anyhow (one way or another). There is evidently a worldwide epidemic of male inguinal hernias; they should not be cultivated as a renewable revenue stream.

 We talk about the money. We gamble with the odds makers who “sell” insurance. We count the costs. Shouldn't we review the health care that is provided? I do not know anyone who would not welcome a doctor's care in an emergency. I simply ask the question; where art thou 'Health Care Reform', quite apart, and separate from, the circus of 'Health Care Costs Payment Reform'?

 I am well, thank you, and trust you are too.

Brian Hayes

P.S. It occurs to me to make it very clear that the views herein expressed are solely my own. I write it without the consent or knowledge of the doctors mention. I strongly suspect that they might disagree – at least in part - with my characterizations and criticisms. They are  public figures and I mention them as such. My reflexions on my experience are mine alone.

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Comment Preferences

  •  Tip Jar (2+ / 0-)
    Recommended by:
    jayden, isabelle hayes

    We all win or we all lose.

    by Utopia or Oblivion on Tue Jan 14, 2014 at 06:26:00 AM PST

  •  My personal experience... (3+ / 0-)
    Recommended by:
    ZedMont, shmuelman, claude

    ... is that the mesh repair was effective and relatively easy to recover afterwards.

    My hernia developed after I went over the bars riding my mountain bike and suffered a blow directly at the sphincter where the vessel leading to the testicle lies, the injury didn't appear immediately, but the next day I was running and I felt a tear or twinge in my abdomen, and I could feel my guts tryna protrude thru.

    I was semi-indigent at the time, the only reason I wasn't homeless because I had friends looking out for me.  I checked around about getting it fixed, found out it cost thousands, just began living with it for at least a year, maybe more.

    After a while, the protrusion increased and my friends started nagging me to go get it fixed, so I went to the County Welfare Dept and they reviewed my case, said they couldn't help me, but how come I didn't goto the VA, since I was a veteran?

    Well, I figgered that they wouldn't help me because I'd been cashiered for pot and hadda less-than-glowing discharge, so I never considered even asking them, but the County worker told me that my other discharges from previous terms of service qualified me for treatment at the VA, so I went to them and they agreed to treat me.

    The procedure was the "model ship in a bottle" method of repair, took a couple of hours and sent me home with a bottle of pain-killers (which I only needed for one day).

    The surgeon told me that I was very close to developing complications, that the "bag" that surrounds yer guts had badly protruded from all the "re-stuffing" I'd been doing to live with the issue and he'd had some trouble repairing it and stuffing it back in, but that it had been successfully fixed.

    My recovery was relatively pain-free, and I was riding my bike and painting apartments again in two weeks, and exactly thirty daze after the surgery I rode one of the most difficult mountain bike races in California, the Downieville Downhill, which is about 35 miles long and starts with a five-thousand foot climb (!) then follows fairly deranged legacy trails thru rocky terrain back to the valley below, a ride that took me about five and a half hours (the animals who win this race do it in about THREE) and the only discomfort I experienced was from my fanny-pack buckle irritating one of the surgical wounds below my navel, and even that wasnt much of a problem cause I'd anticipated it and brought spare dressings for it.

    Over the years, (it's been eighteen years) the only thing I've noted is that once or thrice over all that time is that the mesh seems to have re-adjusted a small amount with a small twinge, but it hasn't failed.

    My late father had three hernia repairs, each one a different method, one of which failed and hadda be re-done, and none of them were the laproscopic method (cause it hadn't been invented yet) and ALL the surgeries took WEEKS of recovery before he could even get up from the dining room table without painful stress on his repaired area, while I was back at work in TWO WEEKS and going on INSANE mountain bike rides in a month.

    Draw yer own conclusions from my experiences...

    "Ronald Reagan is DEAD! His policies live on but we're doing something about THAT!"

    by leftykook on Tue Jan 14, 2014 at 07:16:33 AM PST

    •  Most are successful (0+ / 0-)

      Thanks for the experience; if I had been less provacative and spoke more to the varying degrees of success the diary would have been too long.

      I just found (what I believe to be) a 'better' hernia repair, and wonder why it was so hard to find. I know of some real tragic mesh stories.

      Your experience is the most common, but not common enough. I didn't feel lucky.

      Try the VA again. When I got out (1970) and looked to them for medical help they treated me like dirt. I never went back in over 40 years. Today they seem to really want to help.

      We all win or we all lose.

      by Utopia or Oblivion on Tue Jan 14, 2014 at 10:25:01 AM PST

      [ Parent ]

      •  The VA DID agree to help me... (0+ / 0-)

        the VA in Martinez CA did the surgery...

        the VA has saved my life a couple of times since (penetrating peptic ulcer, severe kidney infection and blockage) so I'm pretty happy with them....in the case of the kidney, they even saved my life remotely, I'd driven up to Wilmington DE from South Jersey the week before to complain about kidney pain, they sent me home undiagnosed, then when the condition returned I was so "out of it" I called the urology clinic nurse up in DE on remote control, she remembered me and recognized that I was WAY FUCKED UP and she called local 911 on me, I woke up in the local hospital the next day wondering how the hell I'd gotten there, I had no memory of calling the VA at all!

        "Ronald Reagan is DEAD! His policies live on but we're doing something about THAT!"

        by leftykook on Tue Jan 14, 2014 at 10:46:48 AM PST

        [ Parent ]

  •  To say that laparoscopic surgery is intentionally (2+ / 0-)
    Recommended by:
    claude, cardinal

    faulty to make additional money for the surgeon and hospital is absolutely unsupportable. It is no better than conspiracy theory to state that surgeons use inferior techniques to increase their income.

    "You can die for Freedom, you just can't exercise it"

    by shmuelman on Tue Jan 14, 2014 at 08:08:40 AM PST

    •  D'accord (0+ / 0-)

      I agree completely; and I wouldn't say so.

      The choices available to surgeons and hospitals are limited by corporate influence. I don't think surgeons or hospitals have much choice in the matter.

      Surgeons, as I know them, are conscientiously committed to their patients health. But few surgeons have the time to survey all the available 'low profile' science papers submitted. They are targeted with corporate media campaigns and provided with corporate statistics and data.

      That most corporations' development staff do “the best they can” for the patient is not in question either (like M$ programmers). I say corporations, as such, have 'no business' researching  the “best that can be done” for the patient. Corporations have a lock on what's available, and shouldn't; that's all.

      I would like to hear of a corporate medical breakthrough procedure that sells nothing.

      We all win or we all lose.

      by Utopia or Oblivion on Tue Jan 14, 2014 at 10:05:45 AM PST

      [ Parent ]

  •  I had my non-mesh surgery done in Toronto (1+ / 0-)
    Recommended by:
    jayden

    at a hospital that pioneered a highly-reliable procedure and now specializes in hernia surgeries.  

    http://www.shouldice.com/

    "Education is a better safeguard of liberty than a standing army" Edward Everett 1852

    by Alan Arizona on Tue Jan 14, 2014 at 08:26:41 AM PST

  •  Had hernia. (1+ / 0-)
    Recommended by:
    cardinal

    This diarist's anecdotal experience is not to be taken as medical advice.

    I negotiated a cash price for the laparoscopic/mesh surgery directly with the surgeon, face-to-face.  About $4000. Outpatient surgery center in my nearest big-enough city.  No problems after 7 years.

    don't always believe what you think

    by claude on Tue Jan 14, 2014 at 09:36:37 AM PST

    •  no hospital and no insurance company (0+ / 0-)

      was involved.  My surgeon was recommended by my doc,  who had had the same procedure done for himself by the surgeon.

      My own anecdotal evidence is, of course, also not to be taken as medical advice.

      don't always believe what you think

      by claude on Tue Jan 14, 2014 at 10:17:27 AM PST

      [ Parent ]

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