The following chat transcript courtesy of obgyn.net
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
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
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
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
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
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
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
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
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? email@example.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
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
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 firstname.lastname@example.org"
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
Peggyk "Thank you Dr. Wiseman, but it is very
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
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
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
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
Peggyk "Goodnight to all."
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with the International Adhesions Society, is not intended
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nor does it substitute for professional medical advice.
Always seek the advice of your physician or other qualified
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or regarding a medical condition or its current treatment.