International Adhesions Society

 

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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, December 16, 1998


Guest9 "Good Evening Dr. Wiseman!"

Drwiseman "Hi who have we here?"

Guest9 "Has anything new happened in the world of adhesions?"

Drwiseman "OK folks what do want to know about adhesions?"

Drwiseman "Guest 9: do you want to introduce yourself or to ask a question?"

Guest9 "Sorry, I'm new! ok what I would like to know is whether there are any new products re: adhesions?"

Guest9 "Dr. Wiseman, do your guests suffer from endometriosis and adhesions OR just adhesions?"

Drwiseman "Good question: Genzyme has just released a new version of their Seprafilm product in Europe, called Seprafilm 2. It won't be available in USA for some time. INTERGEL has just finished enrolment in one of their US trials but this product is not likely to be approved for another 2 years or so."

Guest9 "What is the difference between the 2 products"

Drwiseman "Our guests have adhesions due to a variety of causes, including endo"

Drwiseman "There is little difference between the products except that Seprafilm 2 is more flexible and easier for the surgeons to handle."

Guest9 "Are they gels?"

Drwiseman "They are films, rather like a dried fruit roll-up."

Guest9 "A man who has children!"

Drwiseman "Indeed: or a man with a sweet tooth!"

Guest9 "How is the efficacy of these products? Are they similar to Interceed? If not, what is the difference between all of these 3 -- or are the 3 simply from different corps?"

Doz "I had a lapo for removal of adhesions, in April, they are already back, also have adhesions from tonsillectomy"

Drwiseman "Seprafilm 1 and 2 are from the same company: Genzyme. Their efficacy should be about the same although Genzyme will need to prove that in order to gain approval. As far as their equivalency to INTERCEED, we do not have any side to side comparisons, but from animal studies they seem to be about the same."

Hoopie "I'm having a total abdominal hysterectomy on Friday and would appreciate any advice."

Drwiseman "There are some subtle differences that might make one product preferable over another in some situations."

Doz "What can I do other than more surgery, or prevent them from returning?"

Guest12 "Dr.. Wiseman - Do you know of a GOOD doc in Houston, Texas that knows about adhesions?"

Drwiseman "Doz: tonsillectomy: not much has been done to prevent adhesions here, although clearly the site is more accessible than in the abdomen."

Guest9 "Of all the products, which yields the best results -- if you are at liberty to say?"

Guest12 "Every doc I go to tells me adhesions do not cause bowel problems!! I know different!"

Doz "The adhesions on uterus and abdominal wall are the painful ones. Do you know anyone in Cleveland, OH area?"

Hoopie "So how can we prevent adhesions? I seem to get different advice from different people. Too much exercise is bad, too little is bad..."

Guest9 "Yes guys. Drs. have also told me that adhesions don't cause pain BUT nobody knows what it feels like until it happens to them!"

Drwiseman "Hoopie: I would certainly ask your doctor about adhesion formation after hysterectomy: they can certainly occur and in a small number can lead to problems. Although INTERCEED and Seprafilm should be useful in this situation but neither have been studied there. If it is a laparoscopy, seprafilm cannot be applied there (too difficult) and INTERCEED can be used although is not approved."

Hoopie "What are those, Dr.. W?"

Guest9 "Dr. W - what about the gel?"

Drwiseman "This chat is going fast and furious: who asked me about Houston and Cleveland: I know doctors in both places: please email me afterwards (synechion@aol.com) and I will give you some suggestions."

Hoopie "Are these standard treatments?"

Guest12 "That was me that asked about Houston TX"

Doz "I'm near Cleveland, thanks will email later"

Guest12 "Thanks doc David, I'll e-mail you."

Drwiseman "Which products yield best results? We don't have any head to head comparisons in humans, but INTERCEED and Seprafilm appear to be about the same with some subtle differences."

Hoopie "What are INTERCEED and Seprafilm? Are they standard treatments? My dr. is at Camb. Hospital./ Harvard MS. What should I ask her?"

Guest12 "I need to hear at least "ONE" doctor say I'm not crazy". Adhesion do cause bowel blockages! Am I right?"

Drwiseman "G12 first: I'm not a doctor (MD) at least, but you are definitely NOT crazy"

Guest9 "Guest 12, I believe you"

Hoopie "Dr.. W, do you do medical research on adhesions?"

Guest9 "Drs. often think we're crazy unless they can "see" the problem."

Guest12 "Can you have adhesions around your heart? Sometimes I feel I'm having a heart attack - such pain."

Drwiseman "Hoopie: INTERCEED and Seprafilm are both barriers that are placed at the site of surgery in order to prevent scarring (adhesions). You should ask your doctor about adhesions and what s/he uses to prevent them. Yes, I do research on adhesions."

Guest9 "Dr. W, what about the gels?"

Drwiseman "You should also ready the article I have on adhesions A Patient's Guide to Adhesions and Related Pain

Hoopie "Are they standard treatments?"

Hoopie "i.e., are they commonly used at major hospitals?"

Barbaran "Guest 12: Why not contact Joseph Feste, MD? He's at Methodist, in the Fanin Bld. His CV is on OBGYN.net. Do a search with his name."

Drwiseman "They are standard treatments in some hospitals only, not everywhere. Some major hospitals use them and some do not. Some have never heard of them and some do not think they work."

Guest12 "By the way doc, I read your article and I found it to be very informative. Thanks.."

Drwiseman "Guest9: Gels: there are 3 main gels under development: INTERGEL: Sepragel and Flogel. None of them are approved yet. INTERGEL ins approved in Europe"

Drwiseman "Guest12: many thanks"

Drwiseman "Houston: There are several doctors who know lots about adhesions: Drs. Feste, Randy Dunn, Robert Franklin (all at Fannin) and Russel Malinak at Baylor."

Guest9 "Dr. W, Ditto Guest12 on your article. Are these 3 gels from separate companies? Are they all equally good? If not, which is best? Or does it all go back to Drs. skills and inflammatory events in our bodies?"

Drwiseman "Gels: we don't yet have a good handle on how well these gels work alone or against each other. There are no data available except for a little on INTERGEL, which is really too little to draw any major conclusions."

Guest12 "From Houston - thanks I will check them out....I have been (I thought) to every doc on Fannin and Main St.....they are the ones that told me they don't cause bowel obstruction!!! I'll check them out...thanks.."

Drwiseman "Adhesions around the heart: Yes, adhesions do form around the heart after heart surgery, but they should not cause pain. If you are experiencing "heart attack" pain then you MUST see your doctor immediately."

Hoopie "How about Harvard MS? used here? Also, is the research just on the gels, or other factors related to developing adhesions, risk factors, etc."

Mary_s "Dr. Wiseman, it's too bad something couldn't be created in a spray form to coat the organs and prevent adhesion formation. I know this sounds kind of crude...but something like Pam spray."

Hoopie "actually, maybe I'll try to access the site, read the article, and then ask questions"

Drwiseman "Harvard: I don't know anyone from there off the top of my head."

Mary_s "Coat the organs yet not interfere with their function."

Drwiseman "PAM spray: there are people working on that."

Mary_s "Really?"

Drwiseman "YUP: a little more viscous perhaps, but that kind of idea."

Guest12 "From Houston - He did check my heart out. All he found was a prolapse. I have had the pain for approx. 8mos now."

Guest12 "Sometimes the pain shoots under my arm."

Drwiseman "Guest12: Better safe than sorry. I'm not an MD, but it sounds like you need to see a cardiologist."

Hoopie "At what hospital do you do your research, Dr.. W?"

Guest12 "That was a cardiologist!"

Guest12 "Doc Wiseman, I have to pick up my son from church. I'll e-mail for more info. Thanks for being here. I REALLY appreciate you! :)"

Drwiseman "I have my own company and I work with a number of companies on developing anti-adhesion products."

Drwiseman "Guest12: nice to chat with you. Good luck"

Hoopie "Thanks for the info. I will read your article"

Drwiseman "Thank you. By the way please email me so I can add you to our adhesions mailing list. We are getting ready to launch the "International Adhesions Society""

Drwiseman "OK, who is keeping track of the questions: which questions did we not answer yet?"

Drwiseman "Hi Guest 16: how are you?"

Guest16 "good...although experiencing problems with the computer"

Drwiseman "It seems that everyone is today"

Guest9 "Gee, I was away for a few minutes and now I missed the mystery guest 12! I experience the same symptoms re heart and underarm shooting pains. some of the girls on the endo net experience the same. we thought it was perhaps endo related since so many of us have had this since endo problem"

Guest16 "How is the adhesions society coming along? By the way, this is Karen in AZ"

Drwiseman "Hi Karen: our star web designer!! I have called almost everyone - still a few people to go and I think I have someone to do almost everything we need. I hope to finish this up over the holidays"

Drwiseman "Guest9: did you have heart surgery before?"

Guest9 "Dr. W,, do you ever publish updates on your site or is that what the chat is for?"

Drwiseman "I have not made an update to the main adhesions article yet, but we hope to have an International Adhesions Society Page up and running in a few months where we will have updates."

Guest9 "Heart surgery! No way. I did have a scary experience in May where I felt severe tightness in the chest, nausea, dizzy, numb arm - went to emergency and the doc said I had esophageal spasm but that I should check up with cardio doc just to confirm heart is ok."

Drwiseman "We will also have a page at OBGYN.net where more frequent news will be posted."

Drwiseman "Guest9: well any kind of chest pain should be checked out properly: again I am not an MD, but you need to see one if necessary"

Drwiseman "Any more questions?"

Guest9 "Laparoscopically, are you saying that we have to wait for the gels?"

Guest9 "I mean for the pelvic region"

Drwiseman "You must wait for the gels for laparoscopy and laparotomy."

Guest9 "Not what I wanted to hear!"

Drwiseman "Pelvic and other kinds of surgery"

Guest9 "Which gel does your company produce?"

Guest16 "What happens over time, say 20 years, to adhesions (severe adhesions) that are left in place...and by this I mean of the troublesome type that cause a lot of pain"

Barbaran "OK gals I didn't want to announce it but, OBGYN.net's new Special Section will be Chronic Pelvic Pain and we will be including Adhesions, Endo and anything else that causes it. I do know there will be some Big Names in these areas of medicine on the Editorial Advisory Board. Watch for the announcement the first of the year."

Guest9 "Yeah"

Drwiseman "I do not produce any gel: I collaborate with people who do. The companies that are in development with gels are: Sepragel (Genzyme), INTERGEL (Eticon'Lifecore biomedical) and Flogel (Alliance). Gliatech have a liquid called ADCON P which looks promising. There is a version of this called ADCON L which is used to prevent spinal adhesions."

Guest9 "Dr. W will you participate in this new section? Do you collaborate with all of these companies?"

Drwiseman "What happens in time?: adhesions just stay there: they may grow thicker. sometimes people have adhesions for many years before a problem arises."

Drwiseman "I believe that I will participate in this section. And yes I collaborate with some of these companies."

Mary_s "Are there any other adhesion questions this evening for Dr.. Wiseman?"

Mary_s "Thank you for hosting tonight, Dr.. Wiseman!"

Guest9 "Thank you Dr. W for your time this evening"

Guest16 "Thank you Dr.. W."

Drwiseman "Thanks everyone. Have a nice holiday."

Barbaran "Dr.. Wiseman has been invited by OBGYN.net to join the Editorial Advisory Board for Pelvic Pain and I "think" he just gave me his Yes.......... Tell him He Needs to be on the board!"

Mary_s "Goodnight everyone, we'll see you next month here. Have a nice holiday."

Guest16 "Yes, I believe he does!!"

Guest9 "And thank you for dr. recommendations which you made to me in the past. You have helped me more than you will ever know!"

 

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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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