The following chat transcript courtesy of obgyn.net
Prior Chat Transcripts
Prevention of Post-Surgical Adhesions
David Wiseman, PhD
Wednesday, August 25, 1999
Hmd "Good evening, Dr. Wiseman."
Hmd "Hello, Irenee. Welcome."
Andrew "I am new here, is this a women's only
Hmd "No, Andrew. This is for anyone who is having
Hmd "Do you have some questions or concerns you
would like to talk about?"
Hmd "Hi, Peggy."
Peggyk "Hello everyone."
Andrew "I recently, yesterday, surfed my way
onto Dr. Wiseman's paper and felt it described many
of the things I am experiencing."
Drwiseman "Hi everyone: got here at last - have
had MAJOR computer problems."
Drwiseman "Sorry for the delay."
Drwiseman "Well let's get started - anyone have
any adhesions questions?"
Peggyk "Dr Wiseman: I guess the official diagnosis
is that I have adhesions."
Andrew "I am considering adhesiolysis and would
like to get some feedback from others that might have
had this procedure."
Peggyk "Last chat I was scheduled to see a GI
Dr. and a Urologist and everything was fine in both
Drwiseman "Andrew: perhaps you can fill us in
on your condition."
Janp2000 "Andrew, can you tell me about the adhesiolysis
Hmd "Andrew, I had an adhesiolysis in 1997 -
and within 10 days the adhesions and the chronic pain
Andrew "I was shot in a car-jacking 3 years ago
and underwent exploratory laparotomy with 4 resections
and a punctured colon. Since then I have been experiencing
chronic abdominal pain. I went through all the GI series
and CAT and MRI but they showed nothing."
Andrew "diagnosis -- adhesions"
Peggyk "Andrew I also had adhesiolysis in April
of this year and I am the same as Hmd - within 10 days
the pain was back."
Andrew "Not exactly that fast or that simple
as you all probably know by now."
Drwiseman "Did they say adhesions because that
was the only thing that was left? or did they see them?"
Andrew "No, they didn't see them. Was told that
I was not a candidate for scope as I have a midsection
Andrew "Was a default diagnosis."
Drwiseman "So you want to know what to do?"
Hmd "What do you mean by that fast or that simple,
Andrew "I want to know what to do."
Andrew "HMD: took 3 years of diagnostic testing
and fighting with insurance companies."
Drwiseman "The choice is this: if you have adhesiolysis
then the adhesions could come back. But you have a
chance of some relief, also a diagnosis, and the chance
to use an adhesion barrier, which may help."
Hmd "All adhesion sufferers want to know what
to do. Many of us have resigned ourselves to being
treated at Pain Clinics or with Pain Professionals."
Andrew "I am just recently out of the hospital
from a second surgery that removed the bullet from
my spine. Another 14" incision"
Andrew "I have gone that route with the pain
Andrew "I do get relief but narcotics are not
what I had in mind for long duration."
Drwiseman "No one said it was going to be easy
- that's why we're all here."
Hmd "I understand what you are saying, Andrew."
Andrew "When I read some of the older threads
I knew you all would know."
Storms "This is my 1st time here, how does this
Andrew "I started to research the adhesiolysis
while I am home recovering."
Drwiseman "Andrew: what kind of response are
you getting from your doctors - for many of the women
with adhesions it is difficult to get a sympathetic
Lrlle "Hello all. This is my first time here.
I am considering having surgery for my adhesions. I
know that surgery only creates more problems but I've
got to do something. Have there been any new developments
in the last couple of years to prevent adhesions from
Drwiseman "Also I guess you are seeing quite
a few surgeons - trauma - GI etc. - how is all this
Andrew "I find sympathy in the pain specialists
who deal with pain, surgeons are hesitant to act because
of the small success rate. GI doctor actually came
up with the diagnosis but says I gotta live with it."
Drwiseman "Lrlle: to reiterate an earlier answer:
adhesiolysis may give some relief, but the adhesions
can recur. At least you have the chance to use an adhesion
Storms "Has anyone, or does anyone suffer from
Peggyk "Dr.Wiseman right now I am seeing a pain
management Dr. This has been about 5 weeks now. Right
now I am at a place where I am capable of doing some
of the things that I couldn't do without the aid of
the medications that I am on. The only problem is that
I do not want to have to live on these medications
the rest of my life."
Drwiseman "There are only two at the moment:
INTERCEED - by Johnson & Johnson, and Seprafilm
- by Genzyme. They do not work 100% of the time but
they can only be used at the time of surgery."
Janp2000 "Dr. Wiseman what are the adhesion barriers?"
Lrlle "I will be looking up adhesiolysis. Unfortunately
I have a GI issue involved and right now my colon is
so twisted due to adhesions that they are having trouble
doing the tests they need to do. I had to have part
of my colon removed when I had my last surgery."
Andrew "Are these products able to be used with
a scope or do they have to be used in a more invasive
Lrlle "Storm: I had endo. TAH was the result."
Storms "What did the dr tell you to do?"
Drwiseman "The two barriers are like sheets of
material that dissolve in the body. They are like internal
band aids that protect the cut surfaces from reattaching
to something else. It is possible to put INTERCEED
through a laparoscope. They can both be placed during
Andrew "Peggy, I understand the drug thing --
what else has your pain center offered?"
Lrlle "Storm: Initially they removed just the
uterus & cervix because I was so young, they didn't
want to do the ovaries. 2 years later the pain was
back and more intense than ever. So they went back
in and did the ovaries. The adhesions were so bad that
they had to remove colon."
Storms "Oh my, you are okay now, right?"
Peggyk "Andrew, so far nothing besides doing
exercise which I would not be able to do without the
pain medication. Walking and swimming."
Drwiseman "Peggy - I am interested in what the
pain folks have done for you - is this drugs? or something
Lrlle "Storm: Unfortunately other issues have
come up now. And so, in addition to having severe pain
from adhesions, I'm now dealing with colon problems.
They're still trying to diagnose it though. I keep
an upbeat attitude."
Peggyk "Dr Wise man - it is drugs. Right now
I am taking Methadone, Klonopin and Arthrotec."
Storms "Did you have it so bad that you got constipated
Lrlle "I never really had any problems in that
area. However, I don't normally go very often. Once
or twice a week is normal for me. Only when I was pregnant
was constipation a problem."
Andrew "Peggy - do they have any biofeedback
pros or psychs to talk to at this center?"
Lrlle "Storm, I agree with you. If I hadn't been
finished with having children, I would never have consented
to the hysto. I would have just continued going in
every so often and having the endo burned out."
Hmd "Some of you are taking part in the adhesions
forum at: http://www.obgyn.net/adhesions.asp This is
an excellent place to exchange information about adhesions
and chronic pain."
Peggyk "Not as far as I know."
Drwiseman "Any one have any ideas about diet?"
Storms "Well mine is from my last c-section with
my daughter. I had a miscarriage b/c of it."
Andrew "The clinics I have been to do offer that
and it helps tremendously."
Peggyk "There is only one Dr. It is not a pain
center The Dr. is specialized in pain management."
Drwiseman "What about physical therapy?"
Lrlle "Storm: I'm sorry to hear about your daughter.
Perhaps you can find someone in your area that specializes
in high risk pregnancies."
Peggyk "No, nothing other than walking and swimming."
Andrew "Is the bloating feeling a constant for
those with adhesions?"
Drwiseman "Many people report bloating and say
they need to keep off foods with fibre."
Drwiseman "I have been told by one lady that
fortified flax helps, but this is just one person."
Andrew "I did have a PT that did what is called
myofacial Release massage over the scars left after
the surgery and felt it was a great relief although
only lasted a day or so."
Drwiseman "It's probably like stretching a rubber
band - they can only stay stretched for a while - if
they don't break - they'll be back in place."
Andrew "That is exactly what it is like."
Janp2000 "Dr Wiseman I would love to find out
if there is a certain diet that would ease the cramping,
pain etc. or do you know of any herbal remedies or
Storms "Lrlle- when I was pregnant with my daughter,
I had to have a c-section, and because of the c-section,
I have endo. I recently had a miscarriage because of
it. So I'm looking for anything to help, so we can
Drwiseman "While I have you all here - I want
to restate Helen's plug for our web site at http://www.obgyn.net/adhesions.asp
Hmd "I am being treated on an ongoing basis since
January 1997 by a psychiatrist who specializes in pain
management and a psychologist who helps me to express
my feelings and just plain talk about how chronic pain
is affecting my life. I am taking 600mg of carbamazepine
during the day and 100mg of amitriptyline at bedtime.
Amitriptyline is an antidepressant and it also helps
to relieve pain. I have been taking amitriptyline since
1975 and it has really made a difference in my life."
Andrew "Dr Wiseman--an earlier thread mentioned
a convention in Miami? What is it?"
Drwiseman "We are trying to put together a small
meeting for adhesions people in Ft. Lauderdale - do
you have any interest in attending?"
Andrew "Yes I live just north of Ft Lauderdale."
Hmd "Andrew, if you want more information about
adhesions and chronic pain, please email me at: email@example.com."
Peggyk "Well I'm gonna say good night. This is
the biggest problem with the meds that I am on. I cannot
Drwiseman "I am trying to put together a small
agenda: an OBGYN to speak about adhesions and pain,
and a general surgeon to speak about adhesions and
bowel problems: we would then follow with a general
discussion about clinical problems and then have some
sort of business meeting to get the INTERNATIONAL Adhesions
Soc. organized. It would probably last about 3 hours
- what do you think?"
Hmd "I have read that a low-residue diet is indicated
for people with bowel problems. This is not my problem
- so I have not tested this."
Andrew "I am a sponge when it comes to getting
information on adhesions. I also have problems finding
doctors that are sympathetic to adhesions and pain."
Lrlle "Does anyone know of any support groups
in the Washington, DC metropolitan area?"
Andrew "I am interested in the meeting --any
info I need?"
Andrew "Hmd--thanks I will email you to get the
info you have."
Andrew "What is a low residue diet?"
Drwiseman "Andrew - the best thing to do is to
go to http://www.obgyn.net/adhesions.asp and fill out
the form - I will put you on the mailing list. Since
you are local perhaps you might want to help organize
Drwiseman "Low residue means that there is little
poop (technical term)."
Hmd "Andrew you will find information about doctors
who are sympathetic to adhesions and chronic pain in
the websites I gave you earlier."
Drwiseman "There are no support groups anywhere
as far as I know other than our International Adhesions
Drwiseman "I will have to leave you all in a
few minutes - any final questions?"
Hmd "Remember to check out: http://www.obgyn.net/adhesions.asp
on a daily basis."
Storms "Lrlle-Thanks for talking to me, I wish
I could help you. I'll keep you in my prayers. Bye."
Hmd "There were others who would have liked to
be here tonight, but were unable to figure out how
to download. Every time a change is made, it becomes
Hmd "Thank you, Dr. Wiseman, for giving us a
place to share!!"
Hmd "Andrew: Just write to me at: firstname.lastname@example.org"
Drwiseman "Sorry to have to leave you all: please
contact me if you have any questions: email@example.com"
DISCLAIMER: Please note that all information
provided on this web site, or in response to any communication
with the International Adhesions Society, is not intended
nor is implied to constitute professional medical advice
nor does it substitute for professional medical advice.
Always seek the advice of your physician or other qualified
health provider prior to starting any new treatment
or regarding a medical condition or its current treatment.