August 30, 2012
When mesh doesn't mesh with metabolism
General and robotic surgeon Rick Low, MD, left, and patient Jay Long are happy after Long's successful recovery.
Sometimes things that sound good in theory just don't work out that way. Then, if it's your body where things didn't work out, you need someone with a deft surgical touch to fix what unexpectedly went wrong.
Just ask Jay Long about Rick Low, MD, whose superb surgical skills resolved years of pain and other complications, what the medical profession calls "adverse outcomes" from prior surgeries.
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This article appears in the September - October 2012 edition of HealthBeat, John C. Lincoln's free health newsletter.
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It all started eight years ago when Long needed a simple surgical repair of a hernia that developed as a result of over-ambitious weightlifting. In an effort to strengthen Long's abdominal wall, surgeons reinforced his tissue with a synthetic mesh.
But the mesh didn't mesh with Long's metabolism. Over the years, he went through three different surgical procedures to remove the old mesh and replace it with a new variety, in hopes that the new would not continue to make him sick. But eventually each of the repairs ended with the same result.
"By April of 2011, I was back in the emergency department, throwing up blood," he said. "The surgeons said I needed a fifth surgery to remove the mesh and replace it, this time with a Gore-Tex implant."
It didn't work. Inside of 30 days, Long was sick again. "I was throwing up so badly that I ended up in emergency departments of at least three Valley hospitals," Long said. "They tested me for everything — GI problems, small bowel tests, anything it could be other than the mesh. I was taking antinausea medication, but it wasn't working."
Finally, Long's primary care physician suggested looking outside the Valley for help. He went online and discovered a surgeon in Chicago who had a successful track record in removing mesh and performing reconstructive surgery without mesh to solve similar patient problems.
"I called his office," Long said, "and they told me they'd be happy to help me, but as long as I was already in Phoenix, it might be easier if I contacted surgeons they knew right here who could do what they do. They recommended two John C. Lincoln doctors — reconstructive surgeon Louis Andres, MD, and general surgeon Rick Low, MD."
That's when Long's day began to brighten.
Drs. Andres and Low admitted Long to John C. Lincoln North Mountain Hospital, where they surgically removed the mesh and ordered cultures of the tissue in Long's abdomen. Testing showed massive bacterial infections, which the doctors treated with antibiotics before further surgical repair.
"I spent more than a week at the beginning of January on the hospital's fourth floor unit where I had the most professional, best hospital experience ever," he said. "Unfortunately, I've become a bit of an expert on hospital care and I tell you, the nurses were unbelievably good. I loved the team!"
In planning Long's surgical repair, Dr. Low said "in my professional opinion, mesh was not fixing the problem. What Jay needed was abdominal reconstruction."
Dr. Long and Dr. Andres used donor tissue to rebuild Long's abdomen without mesh, he said. And it worked.
"Dr. Low and Dr. Andres were just amazing," Long said. "I have not thrown up since surgery at the beginning of January. I'm going to yoga again for the first time in five years. I feel terrific."
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