Re: DR. Reich Columbia Presbyterian Medical Center New York-Beverly

From: Christine M. Smith (
Tue Jun 8 12:47:38 1999

At Tue, 8 Jun 1999, Beverly J. Doucette wrote: >
>Dear Friends
>I am sharing my experience of surgery performed under Dr. Harry reich
>of New York as a number of you asked about it in greater detail Please
>keep in mind that this is MY surgery and that each one of us has a case
>history unique to each of us. I also am stating MY interpretation of
>how the body responds to and creates adhesions as I understand that
>physiological proccess.
>Previous to consenting to Dr. Reich's adhesional lysis procedure, I
>requested a copy of it so that I could determine for myself what was
>being done differently then other adhesional lysis I had. I also
>checked out his credentials with the AMA, all very outstanding
>recommendations. I then asked for statistics of the surgery, and even
>though he has not keep a following of his patience, he does have some
>figures on it and it looked to be the higher % of success for non
>reforming adhseions with his procedure. I also was put in contact with
>a woman who had undergone his lysis last June. We talked at great
>length ( e-mail ) and we continue to do so. She was a wealth of
>information and encouragement for me...and you can be assured that I am
>watching her case closely as it parellels my adhesional history very
>close. Dr. Reich also video tapes his entire surgery for you.
>Dr. Riechs theory to non reforming adhesions is: " The solution to
>polution is dilution! " And he stands by that phrase yet today.
>This procedure is done through minimally invasive route. One small
>incision in the naval for camera, two 1" - 2" incions on each side of
>the lower abdoman for instrument use. Dr. Reich is the only
>ambidextrious surgeon in the United States and that is a plus for us! He
>does a diagnostic look around upon entering the cavity. Looks for any
>invasive pathology aside of adhesions. Evaluates the situation and then
>determines his plan of treatment. In the event that there are dense
>adhesions, he proceeds to dissect them ( seperate. ) This isnot an easy
>process and very involved. I can understand why most DR's do NOt want
>to challenge themselves during a lysis, dangerious and tedious as you
>are working right up against and around the intestines etc....based on
>Dr. Reichs vaste experience with laporscopic
>surgery's, he has developed a technique like no other surgeon in the
>world! That is why he has the reputation as the best laporoscopic
>surgeon in the world!
>It was the clean up at the end of his surgery that impressed me the most
>and was also the reason that I chose to go to him and have this done! He
>cleans out almost EVERY peice of clotted blod that is in, around, under
>and virtually all over in the cavity following the surgery! He feels
>that it is this residuel clotted blood that the anti-bodies in an
>adhesion formers system respond to as a " foreign "y and thus creates an
>adhesion over it to protect the internal organs! Now, this is exactly
>how our bodies defense sysytem works! Think about you getting a sliver (
>externally of course ) What does our bodies defense sysytem do to that
>foreign body? Sends out the luekocytes and creates and " infection " to
>get rid of it, right? Internally, one of two types of defense systems
>kick in when there is a problem, 1) if an appendix ruptures, we get
>peritonitis ( an internal infection like pus or white blood cells that
>spill into the cavity, those white cells are responding to an
>inflamation in the appendix and built up and burst, but it WAS a defense
>mechanism as well ) That can kill us as the body has no way to rid
>itself of that infectious drainag and it infects the surrounding
>internal organs as well. In defense our body sends the luekocytes (
>white cells ) to that area of " infectious drainage " 2) Because there
>is an active infectiouse foreign body in the cavity, our bodiy will
>atepmt to " CONTAIN " that poison to protect the other internal organs
>from damage! These white cells form a material called," fibrin," ( it is
>that sticky stuff in blood by the way ) this fibrin starts to cover the
>infectious material and you have what is called an " ADHESION!" Now,
>adhesion stick together. And in a cavity filled with lots of
>organs in very close proximity of one another, what do you think will
>happen? Organs get attatched to one another...everywhere that the
>drainage touched!
>Lets look at that same reaction now using the clotted residual blood
>following your internal surgery. Blood is found througout the cavity
>from any area of surgery or ischemia ( areas scrapped or cut opening an
>area that bleeds ) In the cavity, this blood dries very fast...VERY!
>Now, 99.9% of surgeons DO NOT clean up the residual blood clots thus
>leaving that in, around and under your internal organs. Your body see
>this blood as a foriegn body and sends out the luekocytes and thus forms
>adhesions wherever these clots are. Because fibrin is sticky, these
>organs become attatched. With the peritoneum ( innermost tissue of the
>abdominal wall,) some organs become attatched to it, thus causing the
>pulling and inflamation at the attachment sites...thus PAIN, and
>eventually a decrease in our physical mobility. That pain is from the
>attatchment to the peritoneum. The other attatchment's, if any, ( organ
>to organ ) doesn't cause us pain, but it can cause bowel obstructions,
>painfull and difficult bowel movements and if some adhesions attatch the
>bowel to the vaginal wall, painful intercourse as well.
>Am I losing you? If I am, please let me know and I will be less medical.
>( I sense that you are perfectly capable of understanding every word of
>this! )
>Dr. Reich uses a procedure called " aqua " surgery. He is constantly
>flushing the cavity with ringers lactate ( a type of compatible fluid to
>the human body, like saline ) and finds the fibrin stings and removes
>them! Bit by bit...wonderfull cleanup job, on my video, if someone would
>have told me he could clean up that cavity as good as he did and I had
>NOT seen him do it, I wouldn't believe them! So, if you want a copy of
>my video, I'll send it to you!
>His theory is that if the cavity is cleaned of the clotted blood, the
>body's defense system wil have less to react to thus reducing and
>possibly stopping reformation of PAINFULL and distructive adhesions. He
>also leaves 3-4 liters of ringers in the abdoman following his surgery.
>Takes about 48 hours to dissipate out of the body. ( Lots of peaing
>goes on..:-) )
>I was not shaved, no urinary cathiter in place or gastric nasal tube
>when i woke in recovery. 5 hours of surgery and I was back in our suite
>in less then 4 hoursfollwing recovery room. Sure, I had surgery pain.
>but I also had both ovary's removed and two tumors! Surprise the
>Dr.! One very large and had attatched the right side of my colon to the
>left side of my peritoneum...colon was totally twisted over and
> wonder I hurt and couldn't have a BM on my own!
>How am I now, a tiny bit sore on the lower right, but that is from an
>smile on my face that only a crow bar could remove!
>I had been on pain medication, anti-inflamitory's ( which you need to be
>on at LEAST 1500 MGS of a day if you are suffering adhesion pain, that
>is to combat the inflamation from the pulling of the organ attatchment
>site, you can bet you have something attatched to the peritoneum at this
>time and it is pulling and doesnt like that! ) anti- acids ( from
>irritation of the esophogus and stomach from years of drugs, slepp/pain
>meds at night and last but not least...laxatives! ( and you know what
>that was for! ) NO MORE....I take a 500 MG chewy for calcium and Vit. E
>for heart muscle as I refuse to go on hormone replacement untill I
>present with symptoms...and I have not yet!
>Dr. Riech will state that his procedure is NOT a sure thing, but
>statistically, his lysis patients have shown a great reduction in
>reforming adhesions following his lysis.
>I discussed Dr. Reichs procedure with a local surgeon as well as a
>pathologist who our son works with, before I agreed to have it done. I
>also sent them my post operative reports that defined the locations of
>previuosly lysed adhesions in both my abdoman and pelvic cavity. During
>a routine autopsy, they instilled 3-4 liters of ringers lactate to raise
>the abdominal wall away from the intestines to determine if in fact an
>adhesion could reform and REACH the abdominal wall to attatch itself
>from the intestine when there is that much ringers in the cavity. (
>that type of attatchment was the ONLY cause of my pain and when organ
>attatchment involves the peritoneum you have pain! I had that in both
>previous lysis.) It did raise the abdominal wall a good 3-4" and in all
>probability, an adhesion would NOT be able to attatch.
>In the event you are interested in contacting Dr. reich, let me know
>and I will assist with that as well. I also can give some pretty fresh
>ideas in planning a trip to New York. ( without getting hit by a street
>selling someone I know did! )
>I hope this synopsis provides you with the information you asked me for.
>If there is anything else I can do for you, please feel free to e-mail
>me at:
>Please educate yourselves to all that you can about adhesion disorder
>and then call for a SIT DOWN consultation with your DR. to discuss all
>area of adhesion disorder. take him informatuon from Dr. Wiseman, the
>woman surgical group and even from the International Pelvic Pain Society
>under the direction of Dr. Perry. Many times the DR. is as scared and
>frustrated as we are as what to do for you!
>Also re evaluate your MUST be atking an analgesic (
>pain med ) on a constistent basis for it to be effective in your system
>to combat the pain. It is also imparative you have an anti-inflamitory.
>As for an MRI, Cat Scan or any other high tech medical test for a person
>with a history of adhesions, I feel it is a waste of money and time. A
>simple ultra sound and abdominal x-ray will detect any abnormal
>pathology in the abdoman. If you feel that you are sufferring from the
>same type of pain in the same region as with your previous adhesion
>problem, then you sure don't need anymore tests if an ultra sound proves
>negative! Evrything else will too and your DR. STiLL cannot diagnose
>your adhesions as the cause of your pain unless a diagnostic paoroscopic
>surgery is performed. Your Dr. cannot say that your pain is caused by
>your adhesions untill he sees them, but you can pretty much be assured
>the apin is from your adhesions if you had that before and if your tests
>show can say it is your adhesions and not have to worry
>about getting sued...your DR. can't! He sure might think it is from
>them, but he really, really cannot say it untill proven! long
>as all medical tests rule out abnormal DO have CHRONIC
>PELVIC PAIN and that IS recognized as a medical get on a
>pain management routine and take it from there! A DR. HAS TOO respond
>to your request for that!
>There is also NOT any other effetive pain management for
>message( the adhesions are located to deep within the cavity for "
>breaking down etc..) and no type of linamints or balms will reach, nor
>can they penetrate the peritoneum as that tissue is there to PROTECT
>against invasion os things....that IS OUR problem to begin with! ) so
>please be carefull folks with paying out bucks for things that sound
>good...but WILL not work on the adhesions! Relaxation, messages and such
>WILL help relax the adhesion sufferer and there is something to be said
>for treating theemitional as well as the pschological self ..... in
>fact it is imparative to do that! And therepy for the family
>, education and ideas as to how to live with one who is
>sufferring this very painfull and debilitating disorder. The impact
>that " Adhesion Disorder " places on a family is no different then a
>diagnosis of cancer, Muscular Distophy, Multiple Sclerosis or any other
>debilitating disorder....only ourdisorder is just begginning to be
>focused on...and how much focus it gets is up to each one of
>learn about it, educate your DR.'s...don't be afraid of it as it can be
>effectivly lived with...and there is HOPE..!

Hi Beverly, I realized that you might think that I think you are saying that ultrasound is useful for diagnosis of adhesions, while other more expensive, high tech tests such as MRI are not. I realize this is not what you mean, since you also say that laparoscopy is the only way to diagnose adhesions. What I differed with is that you stated these other high tech tests were useless once a diagnosis of adhesions is made. I don't believe this is true. I have said this many times but I don't think you can say pain is the same thing just because it feels like it did when you had the adhesions. I have given my reasons in previous posts. An ultrasound as a *followup* to adhesiolysis is probably as useless as it is in initial diagnosis.

you mentioned that you will not take hormone replacement until you show signs of deficiency. If you have had your ovaries removed and do not have ovarian remnants left behind then you are estrogen deficient. If a blood test does not confirm this, then there is estrogen producing tissue somewhere. As far as physical symptoms go I was told by my gyn that many women have no subjective symptoms of menopause AT ALL. This sounds kind of unbelievable but it comes from some one who has worked with a great many women. Also, I'm sure everyone has heard women say they never knew they were in menopause except for lack of periods. So if you base your decision on whether or not to take hormone replacement on subjective symptoms then you are ignoring the risk to your bones and cardiovascular system. I do realize there are reasons why women sometimes hold off on replacement hormone, such as having had the surgery for endometriosis or a family or personal history of breast cancer and this is why the take substitutes such as you are doing, calcium and vitamin E.

Chris S.

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