When needed, a hernia weight loss diet is individualized for each . I feel like patient quality of outcome should be the deciding factor, not just whether the original hernia was handled. You . They were everywhere in the very pleasant grounds. Best of luck Dean. This involves making an incision . This is why mesh is now preferred. The Shouldice Clinic outside of Toronto, Canada has demonstrated extraordinary safety and durability with their technique. Drs. But then you will have had two surgeries instead of one, with the risks that entails. Same nurse. Please mention Shouldice Hospital when you make your reservations. It is nice to have met your surgeon before any surgical procedure though. I believe every patient has to make their own decision. I wonder if they know about him, or does he go into their success pile? Your post here changed my life, my plans, in a good very good way. So yes, that is you, the taxpayer, footing the bill for unnecessary care being provided by a private company. My doctor wants me to lose 50 lbs and ive tried but I cant and I have never found diets to be successful. I play sports 3 days a week, I run competitively, etc, and virtually no pain. 7) Its difficult (not impossible) to find anything negative written about peoples experiences at Shouldice its predominantly positive what they say/write. In fact, after asking permission and explaining the purpose, they live-streamed my operation to a Surgeons conference in Victoria, BC. 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.. I wonder if a nerve block might be the answer. Toronto Transit. Kyle, If you need help to lose weight before your operation, one of our surgeons will refer you to our diet counselling services during your initial examination or you can contact them directly at (905) 695-4914. The whole experience was quite pleasant, and Sarasota, Florida is a beautiful, wonderful place to visit. 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. 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. Be glad you have the option of this procedure. In addition to issues of capacity and organizational analysis, describes a well-focused, well-managed . Femoral hernias are tricky sometimes whether mesh is used or not. Bus operators. The Shouldice Clinic has demonstrated the procedure's durability and safety with 75 years of experience. And I appreciate that is frustrating when Shouldice info is hard to get but I can tell you follow up & accurate reporting of success rates for the rest of the system is just as unreliable because of useless record keeping. Toronto Transit. Its one of the great things about my job. He did get a cyst in his rear about 2 1/2 years ago, the surgeon offered to take a look. Like you, I will flying from US and I am not sure how well those stainless steel sutures behave at airport scanners or other body scanners / MRI scanners ?? He had the choice of Shouldice or a Toronto area hospital. . At Shouldice, we have one of the largest databases on hernia repair in the world. Integrate PMS with your healthcare information system. Also, you didnt say if your two hernias were repaired laproscopically or open. The first time I was sick with a high white blood cell count and they send me back home this was 5 years ago, 3 years ago I tried again and this time I had diabetes and they told me to go back home on the day of the surgery because I was coughing too much, the reason I was coughing was because of Ramipril a HBP medication. One patient told me he didnt want to go back to Shouldice with his recurrence because he couldnt afford it. Maybe if its a simple small hernia, Shouldice is a good choice, but otherwise, too clandestine for healthcare. The hypochondriac insisting on stronger pain meds and special priveleges to the I dont need pain meds tough guy. I then met the doctor who told me to lose 25 pounds and return. Here you will find current wait times for Niagara Health's Emergency Departments and Urgent Care Centres. Another confession, I alsomake money doing hernia repairs, but I dont make nearly as much as the Shouldice does off their patients. In my opinion Justin you could have got 10 opinions and with a different surgeon had the same unfortunate result. I think the most recent data is from 2012 and shows a higher failure rate at Shouldice than mesh. It is located in Toronto, Ontario, Canada north of Highway 401 on Bayview nearer . To the wife of the husband with the augurales hernia. 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. But the patient should be made clear of the longstanding post-op, well documented issues of the real probability of chronic pain. Or is it because, here it comes, that dangerous phrase Weve always done it this way? Your hernia will need to be fixed, no question. How long ago was your surgery? It went well. Do you have any other suggestions for me? We take meshes out for pain on a weekly basis. Good points John. So do you feel that in my case atleast, it might be worth giving Shouldice a first shot or is their antiquated technique simply not worth it as the hernia will in all likelihood recur and then mesh would be the only way to go? More and more often, hes having flare ups where the blood supply to his groin is being blocked. I was wondering what your thoughts were on the actual Desarda technique, not just the website. I am not going to comment on specific cases, just generalities here. Ive had mine for years (think its due to c section surgery or pregnancy) At least give your patients an informed choice based on your skill rather than your ignorance of anything other than mesh repair! Monday to Friday - 6:00 pm to 8:00 pm Saturday & Sunday - 10:00 am to 5:00 pm. 2 The Lichtenstein procedure was learned from a book, 10 instructional videos, and personal communication with Irving L. Lichtenstein, MD. 2) No tacks or staples inside the abdomen to further the chance of nerve damage. 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. I would love to see their numbers as well, but that is unlikely to happen soon. Having said that, if you have your hernia repaired without mesh (by Shouldice or anyone else), and it recurs, you can have another surgery at that point. I had an inguinal (opposite side) and umbilical hernia repairs done using mesh two years ago. Comments Off on shouldice clinic wait times; June 9, 2022; Thinking logically, implanting foreign materials in your body is a matter of concern. You are correct though, there are not good studies comparing the two methods. Tell me about it..I had an accident at work. 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. 5 weeks after surgery, my scar looks pretty much healed and I expect it will fade with time. Hi Tyler. Shouldice also claims that its model allows it to perform at a lower cost per case than public hospitals, and that wait times are a fraction of those in the public system. Im aware of the article. Ill see how it continues and report again in a month or so. Is the mesh currently being used the same product that has been on the Toronto news where they move around internally after coming loose? Overall, I am pleased with both the experience and the outcome. 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 a socialized model of healthcare, allowing some hospitals and surgeons to absolve themselves of this emergency work is unfair and leads to their claiming to have better outcomes. If someone has a hernia surgery at one hospital and then develops a complication they could easily end up at the emergency department of some other hospital having the repair done by a completely different surgeon. Studies show that half of all recurrent hernias develop many years after the original repair. If hernia repair is right for you, well set a hospital admission date that is convenient for your schedule. I did read the article. The more you weigh and the more weight you gain after hernia repair, the more your risk of recurrence rises. 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. My hernias were small (umbilical and femoral) and related to pregnancies and not a previous incision. He went to a top medical school and top intern in residency program. Im 60 and 511 @ 180lbs, so not overweight and in good health. Fully sedated for duration of procedure. So one last confession. I have been wearing the orthosis for six years. 2021 Apr 1;51(4):67-69. doi: 10.1097/01.NURSE.0000736968.01359.e0. Do you know of any doctors in Ontario who will operate on overweight patients with abdominal hernias? Doctors and nurses very knowlegdeable, and covered by OHIP. The Shouldice clinic charges patients for a private room for up to 5 days (this adds up to many hundreds of dollars). 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. Any tips? I had my surgery done at Soldice 5 days ago. It was then allowed special licence by the Ministry of Health to continue operating. My email is attached here if you would like to email me! It was then allowed special licence by the Ministry of Health to continue operating. The average stay of patients is 3.2 days. I am so glad to read this. Being in hospital has its own set of complications, with hospital acquired infections, pneumonias, blood clots in the legs or the lungs, and other problems. Posted on September 8, 2011 by Ewen. I would love to see some frequency distributions for Shouldice repairs vs inpatient time and time back to work. The Shouldice Clinic is a private clinic operating in the Toronto area which has been open for decades. About a week later the pain had completely subsided and I had no further significant pain. The Shouldice clinic was purchased as an estate in the early 50's, so it definitely has that old, historic feel to it. ?Does this matter? Thanks for the comment and info. It is supposed to be better than Shouldice. I had inguinal hernia repair at Shouldice in June 2017. Hello lesmcc1. Im probably an anomaly in the hernia world, but my story is horrific and Im still passing through it. I despise shoultice because they refuse to operate on any patients over weight. 5. shouldice offers a social experience. I agree. I had little to no pain 4 days after the surgery, and other than a small scar, my groin has been perfect. He has no idea why or how it happened but didnt feel he really cared. That may sound expensive to people from Canada or anywhere else with a cost effective health care system, but keep in mind that health care in the USA is extraordinarily expensive. The amount of money being drained away by this clinic from the public system is opportunity cost, not just for hernia repairs, but all healthcare spending. or skilled? So Im going to outline some of my problems with the Shouldice clinic, which is held up around the world as a great Canadian healthcare success story. What would be your expectation about how the recurrence would be repaired, and the likelihood of developing chronic pain afterward? We now have detailed records on more than 400,000 patients and maintain one of the most comprehensive database on hernia repair in the world. Why is recurrence the worst that can happen here? My father, a neighbour, and a former co-worker have had hernia repairs in the last few years. Or it isnt the mesh itself so much as the insertion procedure? 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. Shouldice - The best no mesh hernia repair for inguinal hernia. You see the full range of personalities there. Chronic disabling pain which needs ongoing pain medication and/or other management (including mesh removal in the most severe cases) is thankfully extremely rare after groin hernia repair, be it with or without mesh. Impossible to lose the weight. I would even love to go there and observe their technique, but they are not in the business of educating surgeons, just skimming off our business. The repair is based on the Bassini repair with some modification. I will continue to recommend the Shouldice and feel it was the right choice for me. Youll be able to walk out of the operating room and, by the next morning, youll start a well-structured and supervised exercise routine. 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. Thanks. But to watch how efficient and careful the surgeon was, isolating nerves to make sure they werent damaged, reconstructing the inguinal ring, and the detailed suturing technique, I am very satisfied with the result. I higly recommend Shouldice Hospital. Mesh does reduce the risk of recurrence but does not make it zero. Shouldice also does not require a doctors referral to see patients and bill the Ontario health care system. I have had this happen once. You are correct, we should have much better reporting systems than we do. 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. Discover the Shouldice Experience We offer a complete and holistic recovery program that promotes healing and a rapid return to normal activities. But the reality is that in Ontario anyway, major hospitals are getting as bad as any private clinic in letting cost considerations trump quality of patient care, but thats a whole other topic. My biggest concern is chronic pain, and of course it will be quite some time before I know if thats going to be an issue. http://www.ncbi.nlm.nih.gov/m/pubmed/15243743/ The limited walk-in spaces are available on a first-come, first-served basis. They dont call it the Shouldice Experience for nothing. For personal comparisons I am a 50+ year old male in average/above average health. I had two hernias repaired in November last year. I know 2 other people who have gone up for repair both of which are now well over 30 years on the repair without issue also.. Take care safe travels. The nursing staff was a mixed bag, as would be expected anywhere. I have constant pain of some kind from stabbing to just dull along with foreign body sensation. over 30 years and thousands of repairs we have redone 3 for pain The last was 2 weeks ago and already he is pain free. I still feel very comfortable with my decision to use the Shouldice clinic. I would not that in Canada most people are referred to a surgeon they do not really know for most procedures. Standard and mandatory wake up is 0530 for all. A skim off of the healthy and the wealthy to the private system, leaving the public system to deal with the emergency, unhealthy, and poorer patients. This is critical, because one of the patients greatest fears is an obdurate, shrugging surgeon suggesting post op that there are no guarantees in life and this is all in your head. On call is hard but necessary work and I , as a Royal College trained surgeon, would not be allowed elective operating time anywhere if I did not offer on call services. Would you please share with me what kind of hernia you had. Designed exclusively to meet the needs of hernia patients, Shouldice is a fully licensed, 89-bed surgical hospital. 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. The sheet says this ridge will last for several months (oh joy). shouldice clinic wait times. 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. Often times it is our expectations that get us in trouble. I live in Montreal, soon to be living in Ontario. Have no perceptible issues with umbilical repair but under strain do feel some discomfort at the lower end of inguinal repair. Healthcare. Just returned to UK after Shouldice and its specifically mentioned in the folder. In fact, I believe in less than a decade the medical profession will be inundated with increasing problems from meshes installed in patients 20+ years pervious and will be forced to go back to training their surgeons to the standard they were at pre-1990s, before mesh became mainstream, when hernias were repaired the way they should still be getting repaired today suturing. There is nothing spectacular about this facility. Thanks for your blog. Is this because Shouldice thinks this is good care? 2. shouldice offers low cost. Update to the above. Anyhow, one piece of overwhelming evidence in support of going to Shouldice that I found is in the Can. Most of us felt it was an efficient operation and we could see why they do things that way it was logical. Therefore, it would be more destructive to attempt to accommodate greater numbers of patients at the expense of the quality of either care or facilities. Critiques are always welcome because it can make people think out of the box. . They can walk in, and be called in to be seen by the doctor without having to wait for long. 2015 surgeries (inguinal, umbilical) performed at local Ottawa hospital by general surgeon, with some specialization in hernia repair. While my knowledge of Shouldice is not direct, it is close to home, and entirely contrary to what you have said. Showered and dressed first thing. I have a consultation in 6 months to decide if I am eligible for surgery (I can tell you now I am) at a local hospital. Mesh or the Shouldice method? Now I do on call, a lot, at a smaller hospital, and it is not my practice to refuse hernia repair to overweight patients, unless it is a very large, recurrent hernia, in a very obese or frail patient, where there is little risk of bowel obstruction. Usually, the time only varies by a minute per day but some days will have the same time for multiple days consecutively. Your kidding yourself trying to talk anyone into not going here for a repair Both the surgeons i had had well over 10000 repairs and the first one was nearing 30000. I can accept that this is work that should perhaps be compensated at a different level because of its extra demands. We regret that we cannot make reservations on your behalf. 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. Best of luck. Its called cherry picking the easy cases and its exactly what Shouldice does. The washroom is our room was sporting a nearly unbearable urine smell. Too risky. [2] Contents 1 History 2 Work I am scheduled to have a right side repair done at Shouldice next week. RobthinksIm going to Shouldice in 2 weeks. 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. Ten days after surgery I taught a two week long course requiring standing for 10-12 hours per day and golfed the day after the course. I am debating on having surgery on my right inguinal hernia and whether to do it at Shouldice or at my local hospital. Poor nights sleep (roommate having pain, snoring, up through the night for pain meds, temperature check by nurse at some point, etc). 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. I tend to agree more than disagree with the surgeons comments about Shouldice with regards to their capitalistic method. Yes, but it was over quickly, and I felt my recovery was extremely successful with minimal time off work. Do not use mesh, It can or will disintegrate in time like me and a friend too. At this stage I cannot guage the quality or durability of the underlying repair. I have recently had a consult at Shouldice and had some concerns. Thanks for sharing your experience, Kram. There is a specialty clinic in Toronto, Canada called Shouldice Hospital. When staring down the prospect of putting a foreign substance in your body, as a patient you need to be treated with respect and provide knowledge and experience when asked. The cost of more comprehensive programs is covered by most insurance plans. The short time before my surgery I couldnt find anything definitive saying mesh was good or bad. Hello Justin. Id stick to an open or lap repair with mesh applied externally. ParkingOn-site parking is available for hospital and clinic patients for a flat-rate maximum of $15 per day ($50 for the duration of an inpatient stay). .One year after this major Shouldice surgery in MAJOR pain EVERY day and night I NOW look like a fucking mutant due to their amazing technique over there at Shouldice and to no email at least 15 trips back there and numerous emergency visits and NO family doctor. I do have recurrences, about 1 per year but I find since I have warned the patients about this they are usually pretty accepting of it and happy to come back to me for another repair. The biggest problem with the Shouldice hospital is you cannot choose your surgeon and like anywhere there are good ones and bad ones. The other thing about hernia repairs is that recurrence rates have always been very hard to measure. Naturally I did not wait and had a laparoscopic mesh insertion operation in November in one of the major hospitals around the GTA. Monday - Friday: 9 a.m. - 7:30 p.m. Saturday & Sunday: 8 a.m. - 5:30 p.m. Closed: most major holidays . When you come to our clinic for an examination, Shouldice staff will welcome you and arrange for a personal consultation with one of our experienced hernia surgeons. Sharing the experience with a bunch of other patients was a big plus in my opinion. I agree that the beds are uncomfortable and some of their routine seems a bit military and dated, but I was very confident in their abilities and a few days of discomfort at a hospital is nothing compared to the long term results. Well that was 2 years ago, he did lose 45 lbs and the doctor still refused to do the operation siting that he had no place to put what was in his testicle area! Safe for airport scanners AND MRI. To do less would be to jeopardize the positive end result. My biggest concern is chronic pain, and the medical papers I have found do not give the Shouldice method the best score. However, these hotels have NOT been inspected by the Shouldice Hospital staff. We have a big number here, dont you think? This was a very informative post. Having said that, the risk of recurrence is much higher with umbilical and epigastric hernias in pregnancy than with groin hernias. . Hard to be critical regarding matters of efficiency without data descends into rhetoric pretty quickly. Care and service do not stop once you leave Shouldice Hospital. Sheraton Parkway600 Highway 7Richmond Hill, Ontario905-881-21211-800-668-0101Call hotel for special Shouldice rate.2.5 miles from the hospital. 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?
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