Chat About Adhesions

The following chat transcript courtesy of obgyn.net now Medispecialty.com

Prior Chat Transcripts

Prevention of Post-Surgical Adhesions
David Wiseman, PhD
Wednesday, June 23, 1999

Drwiseman "Hi: who wants to kick off?"

Drwiseman "Any questions?"

Peggyk "Dr.Wiseman, I had e-mailed you about having a low grade temp after having Interceed applied."

Drwiseman "Oh yes: did you call J&J?"

Peggyk "I ran a low grade temp for 28 days and looking at the the Interceed product information it said that it takes 26 days for the Interceed to absorb into the body."

Peggyk "I'm sorry that was 38 days to absorb"

Peggyk "28 days"

Drwiseman "The package should say 28 days"

Peggyk "Yes it did. I made an error in saying it was 26 or 38."

Drwiseman "Any advance on 28?"

Peggyk "Any way I have little faith that the Interceed has helped me at all."

Drwiseman "26, 28, 38 ... the point is you shouldn't have a temperature."

Drwiseman "Are you in pain like before?"

Drwiseman "(was that your problem - I don't remember that part?)"

Peggyk "Yes last week was really bad for me."

Drwiseman "Has the temp subsided?"

Peggyk "I saw my Dr .and he is now sending me to a urologist, a G.I. Dr. and pain management specialist. He is afraid that he is over looking something. And yes the temp has subsided."

Irenee "Just had my 6TH surgery for adhesion removal. What can I do to prevent them from coming back so often. Last time was 2 1/2 years ago.

Peggyk "He gave me a copy of the operative report and by the sounds of all the adhesions he removed I am sure that adhesions are still my problem."

Drwiseman "Peggy: sounds like this is going to be a bit of a mystery tour. Perhaps you should ask him about pain mapping and try to see someone who does that."

Drwiseman "Even though he cut the adhesions, they may have come back. Did your pain subside immediately after the operation?"

Peggyk "Funny you should say that. We have been discussing pain mapping on the forum the past couple of days."

Drwiseman "Irenee: did the doctor use an adhesion barrier: INTERCEED or Seprafilm?"

Drwiseman "Peggy: so what about the pain?"

Peggyk "Yes. I was pain free for about 2 weeks and now the pain is back to where it was before the surgery"

Irenee "He used the 5 Step and rearranged the intestines and used an adhesion barrier."

Peggyk "It has only been 7 weeks since I had the surgery."

Drwiseman "Peggy: so the adhesions may have been the cause and they may have come back. I would think about pain mapping."

Peggyk "I will ask my Dr. about this."

Drwiseman "Irenee: what is the 5 step? Which barrier did he use: INTERCEED or Seprafilm?"

Peggyk "Which Dr. would I ask ? My gyn or a pain management specialist?"

Hmd "Dr. J. Glenn Bradley believes that second look laparoscopy - done within so many days of surgery is the easiest and best way to "sweep down" adhesions. However, not every surgeon does this procedure."

Irenee "I don't know which one . He rearranged the bowels and other organs in hope of delaying reoccurrence."

Drwiseman "Gyn I would say: although the other one should know. Go to the Pelvic pain section of obgyn.net - there are some articles there on pain mapping."

Peggyk "Thank you I will do that."

Peggyk "Dr. Wiseman, in your opinion which is the best adhesion barrier to use right at this time?"

Irenee "Is there anything I can do to help prevent adhesions from coming back? Such as not lifting, standing too long, etc.. If I hold a baby on my left side too long I go into an adhesion attack."

Drwiseman "Hmd: there is some wisdom in this."

Irenee "I have not been able to have painless sex for many years. Is this what I have to look forward to for the rest of my life (I am now 59)?"

Drwiseman "There are two barriers on the market: Interceed and Seprafilm they both have merits. A third - gel is likely to come out next year."

Hmd "I came across an article written by Dr. Bruce Downing. This article is not too long or difficult to read - and it has some excellent information in regard to Causes, Surgery to Reduce Adhesions. It was written June 2, 1999. You can find it at: www.endometriosis.org/html/article_0.html"

Peggyk "Dr. Wiseman, I'm not sure if you can answer this for me or not. Is pain management to learn how to live with the pain?"

Irenee "Any answer to my sex question? And helpful tips on what I can do to help prevent adhesions?"

Drwiseman "Sorry for the delay. Irenee: first of all some people have advocated exercises: stretching. No one really knows if this works, but I would try it."

Irenee "Does lifting cause or bring on adhesions sooner than normal?"

Drwiseman "Regarding sex. This is a question for your gynecologist. I suppose you have spoken to him/her. The best thing that is around in my estimation is pain mapping because doctors are able to precisely pinpoint the cause of pain in many cases."

Fidget "I went to a physical therapist...who was specially trained in pelvic floor rehab....I thought that helped."

Peggyk "And what happens if the pain is caused by adhesions? Do we just have to keep having surgery to lyse them?"

Drwiseman "Regarding the positions that elicit an adhesion attack there is not much I can say other than avoid them. It's easier said than done. I am trying to find physiotherapists who have some knowledge of this stuff. I have heard about one and am trying to get some info from her."

Drwiseman "Fidget: where is your therapist? Can you email me the name and phone? synechion@aol.com"

Peggyk "It is very discouraging to know that there is no cure for us."

Fidget "Sure...in a suburb of Kansas City, Kansas....was referred to her by a KC doc who I found via the International Pelvic Pain Society."

Irenee "Has anyone that has had the amount of surgeries that I have had (6) applied for disability?"

Fidget not familiar with disability laws

Peggyk "Irenee, have you been on the adhesion forum? There are a few ladies that have tried to get disability and they may be able to give you some info."

Fidget "What about medication? I have been getting some relief with elavil...50-75 mg a day."

Irenee "PeggyK - where can I find the adhesion forum?"

Drwiseman "Peggy: q about adhesions and pain. If adhesions are the cause of pain the only think that can be done is to cut them. An adhesion barrier must be used to lessen the chances of them coming back."

Drwiseman "Irenee: I know of people who have had 20 surgeries. I know of some people who are on disability. Email me afterwards and I will pass you onto someone who has experience with that type of thing."

Drwiseman "The adhesion forum is at http://www.obgyn.net/adhesions.asp"

Fidget had two surgeries....Interceed was used...but I am probably worst than I was before the surgeries....does that mean I am at the "have to live with it stage"?

Peggyk "I have gotten a lot of support from everyone on the forum as I am sure you would."

Drwiseman "Peggy pain management is a term that encompasses drug and physical therapy treatment of the pain. It could include coping skills also i.e. learning to live with it. That of course is not a very good answer but in some cases that is all we have."

Drwiseman "Fidgit: perhaps you can email me the name and number of that person."

Peggyk "That is what I am afraid of - having to have to live with the pain."

Fidget "I will doc...but not sure it will be today...I am at the office...and that info is at home...will email you tomorrow night."

Drwiseman "Fidgit: "live with it" no, it doesn't. I wouldn't give up. Interceed although useful in some cases is not our only "answer" there will be other things that are better. Also I think with pain mapping we have improved the way diagnoses are made."

Fidget had pain mapping too

Fidget "lol...at least I feel like I have done the right things so far."

Drwiseman "Have I answered everyone's questions (or attempted to)?"

Irenee "I intend to write to Oprah and try to get a story about adhesions out to the public. Anyone willing to discuss contact me at irenee3@aol.com"

Peggyk "I totally regret having my hysterectomy because I feel that this is what caused all my problems. With having an infection after the hyster."

Fidget has found huge help this week by altering something simple....taking the steps like a child would

Fidget "one at a time"

Fidget "and making a conscious effort to walk and move in a way that doesn't twist my left side"

Drwiseman "Let me stress that there are many people working on the treatment of adhesions. We are also trying to make a difference by offering support on our forum. We will also be conducting our own research but this will take time."

Drwiseman "Good advice Fidgit."

Drwiseman "I would like to take down everyone's email to add them to our mailing list so we can keep you informed. I have Helen and Peggy. Is that OK Irenne and Fidgit?"

Peggyk "Thank you Dr. Wiseman, but it is very frustrating."

Fidget "Thanks much for this work....we may get pretty whiny about where we are....but are so appreciative of the people working on this on our behalf."

Drwiseman "Actually I have you all down"

Peggyk "Dr. Wiseman. I would like to thank you for the forum. I don't know where I would be without it."

Drwiseman "The purpose of this chat is to answer questions live. You can also email me directly as you all have done."

Fidget just had a thought...may have that pt name address here doc...will send it on tonight if I can figure out our email here..

Hmd "There is some excellent information at the adhesions forum http://www.obgyn.net/adhesions.asp."

Peggyk "It is really difficult when your family doesn't understand what you are going through. And to have all those wonderful people on the forum is a godsend."

Drwiseman "Any more questions? Let me ask if anyone is interested in attending a conference on adhesions in October in Florida?"

Fidget "Sure! ....let's at least get a vacation outta this!"

Peggyk "I wish I could but it would not be possible for me Thank you anyway."

Hmd "Bev has been giving all of us a good pep talk on the importance of educating yourself about your medical situation."

Fidget "Anyone familiar with the International Pelvic Pain Society?"

Fidget found a knowledgeable ob/gyn there

Peggyk "Yes I have been to that site."

Fidget "No easy answers though."

Hmd "Be sure to check out the newsletters and resources for women at the International Pelvic Pain Society web site: http://www.pelvicpain.org/"

Peggyk "Thank you Helen I will."

Fidget "Are you the HelenD from the forum, Helen?"

Hmd "I will send you some information on how to help your loved ones - they are hurting too."

Fidget has enjoyed reading your posts

Peggyk "I would appreciate any information."

Hmd "I lost my anonymity a long time ago!"

Fidget "They kinda jump out at you as...hmmmm....wise...if that's not too strong of word."

Peggyk "Well I have to go. It was nice chatting with everyone."

Peggyk "Goodnight to all."

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.

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