International Adhesions Society





Chat About Adhesions

The following chat transcript courtesy of now


Prior Chat Transcripts


Prevention of Post-Surgical Adhesions
David Wiseman, PhD
Wednesday, February 24, 1999


Drwiseman Hi everyone!

mary_s Hello Dr Wiseman!

Donna2000 Good evening Drwiseman.

Drwiseman Hi Y'all. Have we met before Donna?

Donna2000 No, first time visitor.

Drwiseman Good, well no pressure, but perhaps you would like to ask the first question?

Donna2000 I have been subscribed to several forums for a couple of weeks and saw the mention of this chat.

Donna2000 No pressure accepted. I'll go first.

Drwiseman What in particular interests you?

Donna2000 I had lap surgery in July 1997 for adhesions resulting from endo, my left ovary and what is left of my tube (tubal 4yrs ago) were adhered to my bowel. As of Christmas, I was back in constant pain and am headed back to the Dr in 2 weeks. I was told last time that I may have to have surgery each year for adhesions. That doesn't seem reasonable or a way to live.

Drwiseman No it doesn't. But many people are coping with it.

Donna2000 How? I also feel that I have a lot of hormonal imbalance happening - skin changes, moods, hot flashes.

Drwiseman A variety of ways. None is perfect but I'll give it a bash.

Drwiseman TOP 10 Ways of Coping with Adhesions:

Donna2000 Some of what I am reading, says it may be partially from the tubal?

mary_s Hi Jonesy. Welcome to the adhesions chat!

Drwiseman (The hormonal imbalances are unlikely due to adhesions) Ways of coping with adhesions:

Jonesy Hi, it's Dee, but couldn't get in with my name!

Drwiseman 1. Get more surgery. This may result in more adhesions, but with the proper use of adhesion barriers, it MAY be reduced, but not completely eliminated.

Drwiseman 2. Pain medication. This is obviously not preferred.

Donna2000 If I have another Lap, almost a certainty, what should I be asking for and what can I do to decrease adhesion problems?

Jonesy Dr. Wiseman, is Lubricoat the same thing as Intergel?

Drwiseman 3. Physiotherapy/exercise: some patients have reported benefits to having certain kinds of exercise.

Donna2000 I'm taking Indocin at the moment to function.

Drwiseman 4. (Lubricoat = INTERGEL) Have a proper diagnosis to make sure that your problem really is adhesions (sometimes other things may cause problems, they go misdiagnosed and it gets called "adhesions").

Jonesy They have checked my colon and other areas, and I have had adhesions removed 3 times already.

Drwiseman 5. Other medications: Indocin - I think that is the same as Indomethacin - that is a powerful anti-inflammatory drug. how is it working?

Donna2000 I just started it 2 weeks ago, I only take it as a last resort because of effects on my head, takes the edge off.

Drwiseman Jonesy: what kinds of problems are you experiencing?

Jonesy Extreme pain in abdomen, bloating, lots of pain upon bowel movement, pain in my back, as well as down my legs at times. Also terrible pain with intercourse. They have me on pain meds. and I was told by the Dr. you referred me to in Nashville, that I should wait for the Intergel here.

Donna2000 Ditto, here.

Drwiseman 6. Speak regularly with similarly afflicted people. Often people think that they are the only ones who suffer from this problem. Merely knowing that you're not and being able to talk to someone else takes the burden off greatly. Many times the anxiety of feeling isolated compounds the pain. Having a support network reduces this burden and eases the pain.

Donna2000 Mostly on the left side, pulling around to my back at times.

Jonesy His nurse told me that he was told today that it would probably be June or July now, but who knows?

Drwiseman Jonesy: Has anyone suggested modifying your diet to reduce solids in the bowel? This would be my number 7.

Donna2000 Down the upper part of my leg.

Jonesy Yes, it is hard for others without this problem to relate to it. Yes, he did mention that as well.

Donna2000 Sex has been non-existent around here since before Christmas, as for support, some of the message boards I've subscribed to at have been wonderful!

Drwiseman I have heard a number of things about INTERGEL: that it could be as early as June and as late as December. I don't know if they have any data on reduction in pain in these severe cases.

Drwiseman I'm glad the message board thing is useful.

Jonesy When INTERGEL is available here, then will the Drs. know the data?

Donna2000 It's a help, my husband is wonderful and patient, but he has a hard time relating to "female problems".

Jonesy Ditto!!!!!!!! Donna!

Donna2000 The hard part is that with this go round, I seem to have some depression, crying spells or on the verge of tears, and rage spells at times. That is hard on the family. I'm not sleeping well, and that is not helping.

Jonesy Donna, probably part of it is the fact it IS so depressing, at least I think so.

Drwiseman I should imagine that Ethicon/Lifecore will make all the INTERGEL data available at that time. I am not aware however that the studies that were done, were done in these type of patients.

Donna2000 To make matters worse, my gyn, who I've been going to for 12+ years has herself in over her head and cannot take an emergency, so I've had to find a new gyn. I've been told he is very conservative, I'll see week after next.

Jonesy Because ours is severe, you mean?

Donna2000 My PCP has tried to do what he can, but admits that endo is not "his thing". He gave me the Indocin to try instead of the Anaprox which wasn't doing much of anything. The only thing I've noticed out of the indocin, is that I started it just before this period, and although it didn't help the heaviness, etc, it lengthened it, we are at 12 days and counting. Down to a light flow at the moment.

Jonesy Drwiseman, I don't like to take the pain medication, but it is the only thing to ease the pain at all. I have been taking it for a couple months now.

Drwiseman Does it help?

Jonesy How bad is it to be taking pain meds. for this long, and to continue until the Intergel arrives?

Donna2000 Dee, what are you taking?

Jonesy Lortab 7.5

Donna2000 I haven't heard of that.

Jonesy I kind of alternate the two, Lortab, and Darvocet. It does ease the pain. But I wonder in the long run what kind of price I'll pay for having to take it so long.

Donna2000 I get tired of feeling like a pelvic cripple.

Jonesy Amen!

Donna2000 I want to be me again.

Drwiseman Lortab is hydrocodone. People can stay on these drugs for a LONG time. If you have real pain you should not become dependent. These drugs may have an effect on the bowel causing constipation.

Donna2000 I'd like just to have sex again!

Jonesy Yeah, my son cried, the other night, saying he wished I could be "me' again.

Jonesy That is good to hear , Drwiseman - the part about not becoming dependent.

Drwiseman Regarding INTERGEL although the data may be good (I haven't seen a great deal) it may still not be the answer. If surgery is necessary at that time and INTERGEL can be used then great, but, as with any other treatment I do not want you to feel that this will be the end.

Drwiseman It may not be.

Barbaran I would like to take a moment of everyone's time to make an announcement. is getting ready tolaunch it's newest Special Section, Chronic Pelvic Pain. Adhesions will be a part of this section AND Dr. Wiseman is on the Editorial Advisory Board!!!!!!

Jonesy My dr. said he could not guarantee, of course, but said that he felt, that this was my best alternative.

Drwiseman Regarding sex, unfortunately I can't help there, other than to say that YOU are not alone and if you feel isolated, then you are not.

Donna2000 I've read that it just seems some people will form adhesions whatever is done.

Donna2000 Thanks for the info, Barbara. Will it be posted on the obgyn boards when available?

Jonesy Drwiseman, I think my Dr. was saying that INTERGEL had iron in it, or something, that was more helpful, than some of the others, does that sound right?

Drwiseman Most people in fact do form adhesions. The issue is which ones will develop problems.

Donna2000 What are your 8,9, & 10 suggestions, Drwiseman?

Amylynn Dr Wiseman, What do you know about Metformin and insulin levels. Is there a national standard for insulin levels. I was just curious how the RE's and OBGYNs are diagnosing Insulin Resistance.

Drwiseman About INTERGEL and Iron. I don't believe that the iron has any medical effect. It basically acts to delay the disappearance of the gel in the abdominal cavity. The longer it is there (in theory), the more chance it will have of working. The iron holds the gel molecules

Jonesy Drwiseman, you seem to "sound" very skeptical about this...

Amylynn Dr Wiseman, my other question is what is the safest surgical method to treat PCO? without creating anyfurther trouble.

Drwiseman Amylynn: Diabetes. I am not up on the latest in all that sort of thing. I am not an MD (medical doctor) and cannot give you medical advice.

Drwiseman Skeptical: about the mechanism of action of INTERGEL: no certainly not - I led the group that did the initial preclinical studies. I have seen it work in animals. If you mean about my comments on what to except, I am not skeptical, just cautious - I have seen too many people put their hopes on one thing.

Jonesy I understand .

Donna2000 Fair enough.

Drwiseman PCO: there are several ways of treating PCO and several beliefs about what is the best treatment. I'm afraid that beyond that I can't comment except you will need to canvas a number of GYN's who deal with it. Barbara: don't we have some kind of forum or group for that on

Amylynn Dr Wiseman I am the host of the PCO Chat! I am just trying to get some additional information on it. I have a notebook with about 250 pages of information, I am just trying to get info on what the most effective surgery would be.

Drwiseman I knew that (wink). I can say that the adhesion formation after PCOD surgery appears to differ from that which occurs after other surgery, e.g. endo, adhesiolysis etc.

Jonesy Drwiseman, were you saying that it might not work, in cases like mine, because it is so severe?

Drwiseman 8. Make sure you get a good doctor: I would say that you need a doctor who a) understands that adhesions can be a problem, b) who knows that some things can and should be done (not always) c) who has access to other specialists (GYN, general surgeon, pain specialist, physiotherapist etc.).

Amylynn What do you all think could cause the least problems? Ovarian drilling or wedge resection?

Donna2000 My Pcp is quick to pull out a medical book if I ask a question that stumps him, or he calls a specialist, not afraid to say I don't know. That seems to be rare these days.

Drwiseman You mean INTERGEL: I don't want to pre-empt the data because I haven't seen it. But my understanding of the way most of these studies have been performed (INTERCEED, INTERGEL, Seprafilm etc.) is that they have not included patients with this severity of disease. I may be wrong in the case of INTERGEL and for this reason we need to see the data that is presented. At the same time I have told a number of companies that they need to start studies in patients with severe disease.

Drwiseman Donna: you are lucky to have this type of doctor. Although there are of course many good ones out there, you need to hunt them down. Although it is a question of finding one that you are suited to. That is personal and does not reflect the doctor him/herself.

Jonesy No wonder they call you Drwiseman! (wink) Thank you so much for helping me find a good Dr.

Drwiseman Jonesy: I just reviewed my email from you. The doctor I told you about is highly respected, for obviously good reason.

Jonesy Yes, he really seems to know what he is talking about. And better, yet, he knows what I'm talking about!

Donna2000 My Pcp just feels bad because there isn't anything more he can do till I get in to the gyn. He did a pelvic and a bunch of tests so the results would be ready when I get there.

Drwiseman 9. Be prepared to be in this for the long run. Be persistent and don't give up.

Donna2000 Pain doesn't let you give up.......I just can't let it get the better of me.

Drwiseman I guess one of the most important things a doctor can do is not dismiss you like you are crazy. That is not to say that in some patients, there is not a large psychological element. But I guess the presumption should be that the patient is another human being with real feelings, pain and fears.

Drwiseman What is number 10? Any suggestions?

Donna2000 Keep talking in chat rooms??? number 10

Drwiseman That's it.

Donna2000 :) :)

Jonesy Good job, Donna! : )

Drwiseman Which brings us nicely to a close. Any more last comments or questions?

Donna2000 Thanks

Amylynn Thanks for your help!

Jonesy Thank you ,Drwiseman for all you've done to help us.

Amylynn Join us for a PCO chat on Monday evenings if you can.

Donna2000 Thanks for your help, I'm sure I'll be back....have a wonderful evening. Nite all!

Amylynn Nite!

Drwiseman Thanks everyone for your comments and remember...stay in there. Mary will also get this transcript cleaned up and posted in the next week or so so you can review this chat. Good night everyone.

mary_s Goodnight and thank you Dr. Wiseman. I will have this log up tomorrow.

Jonesy Good night, to all of you.

Drwiseman logging off. Goodnight..


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