So Im going to outline some of my problems with the Shouldice clinic, which is held up around the world as a great Canadian healthcare success story. It was originally founded during World War 2 to allow for young men to have their hernias repaired before going off to fight. The technique was designed by Dr.Edward Earle Shouldice and became popular when he opened his hernia hospital in 1945 and his technique has attracted patients from all over the world. Thanks for your comments. Very good points Tony! Last year, it had a record year and performed nearly 7,500 operations. Don, I would recommend this approach (and frequently do) to anyone, including my patients. I have not had to take any pain medication. Besides the fact that it looks weird, my only concern is that given that Im only 42, the hernia is just going to get worse better to repair the pothole now than to wait for an emergency in the future. Thank you for this post. My recommendation for anyone 40 and under is to NOT get mesh. My pain has continued and in the last 4 months has progressively gotten worse vs getting better. Today, Shouldice Hospital performs more than 5000 . If you need help to lose weight before your operation, one of our surgeons will refer you to our diet counselling services during your initial examination or you can contact them directly at (905) 695-4914. It has lots of windows and a bunch of couches and chairs to relax in, a television and plenty of magazines and newspapers to flip thorough. What happened to good doctors? Physicians cherry pick their patients. Inguinal surgery 4 days ago at Shouldice performed by surgeon with 10,000+ hernia surgeries performed. If I was doing only one operation, the only thing I would be is bored. What would be your expectation about how the recurrence would be repaired, and the likelihood of developing chronic pain afterward? For Michael:Google search Shouldice hernia failures. Creepiest Pre Op room Ever. Open. Possibly related to how much private insurance you carry. She examined the surgery site and indicaed that my incision site was in good condition without any signs of infection. Certainly everybody who is having a hernia repaired should carefully discuss the pros and cons of using mesh- its a very individual decision and patients deserve to be well informed. I would not that in Canada most people are referred to a surgeon they do not really know for most procedures. To you doctors and surgeons; I do wonder if you feel any guilt for installing these meshs in your otherwise healthy patients I certainly couldnt do it from what I now know. By the way, my sister is an RN at HHS who recommended Shouldice from what a Doc recommended to her. The techniques used by the hernia specialists at Shouldice dramatically reduce the risk of recurrent hernias to approximately 1% over a lifetime. Shouldice, like you said, does not do that kind of thing. ( I know I already said that but they were really that bad). I had little to no pain 4 days after the surgery, and other than a small scar, my groin has been perfect. However, these hotels have NOT been inspected by the Shouldice Hospital staff. 905-695-4967 * smahdavi@shouldice.com Cindy Giroux - Business Development Manager 905-695-4908 * cgiroux@shouldice.com: The limited walk-in spaces are available on a first-come, first-served basis. Thirty five is a fair number if done completely by the surgeon in question I would think. As for tension free vs not, as I said in my blog, standard of care for most institutions is tension free (ie using mesh). It helped for about 10 days and then stopped helping. Toronto Transit. The example of my coworker is different. NURSING ANESTHESIOLOGIST Mesh does reduce the risk of recurrence but does not make it zero. This is directed towards user, Toronto: I had my inguinal hernia operated on after much internal (and external debate with various health professionals) by the Shouldice clinic. In a socialized model of healthcare, allowing some hospitals and surgeons to absolve themselves of this emergency work is unfair and leads to their claiming to have better outcomes. Snorers were a problem for one or two, so much so for one patient that he got himself moved, but most of us did not have that problem. (sorry if i made any writing mistakes, English is not my first language). Quick update from my 2017 post on my inguinal hernia repair with mesh. About a week later the pain had completely subsided and I had no further significant pain. I had a large bruise in the center of my abdomen below the belly button from the surgery and that has now gone away. NUMBER OF WALK-IN APPOINTMENTS AVAILABLE FOR THE NEXT TWO WEEKS ARE: Monday, March 6th - 0 Monday, March 13th - 12, Tuesday, March 7th - 12 Tuesday, March 14th - 12, Wednesday, March 8th - 24 Wednesday, March 15th - 12, Thursday, March 9th - 40 Thursday, March 16th - 36, Friday, March 10th - 18 Friday, March 17th - 24, 7750 Bayview Avenue,Thornhill, Ontario,Canada L3T 4A3View Map, Tel: 905-889-1125 Fax: 905-889-4216 Canada: 1-800-291-7750 U.S./International: 1-855-328-3423 postoffice@shouldice.com, Shouldice Hospital is committed to excellence in serving all patients including people with disabilities.Learn More. I traveled from NY TRYING TO AVOID the horrors of the mesh repairs. Im traveling from the US and paying the entire bill myself (my insurance does not cover non-emergency out of country surgery). The more you weigh and the more weight you gain after hernia repair, the more your risk of recurrence rises. Shouldice Hospital is not responsible for these services. Reading your comments put some things into perspective for me. As for speed, I think they say it takes around 30 minutes to do the surgery, and they have a short wait list. At Shouldice, we have one of the largest databases on hernia repair in the world. The Shouldice Clinic outside of Toronto, Canada has demonstrated extraordinary safety and durability with their technique. Success is defined by the patient as as good as new and somewhat differently by many surgeons, who would probably view that as unrealistic I am absolutely NOT suggesting a conspiracy but why mesh can be a problem is still not well understood. Week of Surgery and Hospitalization. There is a limit of 2 visitors per patient. "In 2018, I found Dr. Samer Sbayi online. Shouldice - The best no mesh hernia repair for inguinal hernia. Same nurse. I absolutely follow up all my hernia patients. Healthcare. Have you or your staff followed up with all your patients? I was referred to a surgeon by my pcp and met with him shortly after my pcp said I had a hernia. At least give your patients an informed choice based on your skill rather than your ignorance of anything other than mesh repair! Maybe a freedom of information request needs to be filed so accurate comparisons can be made. I cannot recall a patient ever having been in hospital for 5 days after elective hernia repair. The trouble is he can barely walk with this baby between his legs. security guard 12 hour shifts aubrey pearsons oaks husband shouldice clinic wait times. The food was better than I expected. Others who have had surgery at their local small hospital and everythings good. One patient told me he didnt want to go back to Shouldice with his recurrence because he couldnt afford it. I dont know what the exact policy is on inpatient stay at Shouldice, the website said at least one day pre op, and an unspecified number post op. Theyre like impossible to find it seems these days. I seem to be a good candidate for pure tissue. I had an inguinal hernia repair at Shouldice 4 days ago. Its called cherry picking the easy cases and its exactly what Shouldice does. The recurrence rate for incisional hernia repair without mesh would approach 100 % for a large incisional hernia, so I (and most other general surgeons) would likely not recommend repair without the use of mesh. I have recently had a consult at Shouldice and had some concerns. Look for nih data. As for my health state, today is two weeks and I am still having significant pain from the muscle lump. Please mention Shouldice Hospital when you make your reservations. Drs. It was then allowed special licence by the Ministry of Health to continue operating. This is a complex technique involving multiple overlapping sutures across two layers of muscle. Now I do on call, a lot, at a smaller hospital, and it is not my practice to refuse hernia repair to overweight patients, unless it is a very large, recurrent hernia, in a very obese or frail patient, where there is little risk of bowel obstruction. I had inguinal hernia repair at Shouldice in June 2017. So far no issues at all from the surgery or related to the reasons for the surgery. [2] Contents 1 History 2 Work The short time before my surgery I couldnt find anything definitive saying mesh was good or bad. On call is hard but necessary work and I , as a Royal College trained surgeon, would not be allowed elective operating time anywhere if I did not offer on call services. Surgical Wait Times Diagnostic Imaging Wait Times (CT and MRI) Ontario Health is an institution under the Freedom of Information and Protection of Privacy Act, 1990 (FIPPA), and has policies, procedures and practices in place to ensure that its collection, use and disclosure of personal information is in accordance with FIPPA. Naturally Id like to see the same for the hospital system. I went into general surgery because its well, general. The standard of care now is to do hernia repairs with mesh, a plastic like substance which allows for less pain (if inserted properly), earlier return to work, and decreased recurrence rates. I have had one for four years and besides some soreness at the end of the day, I am not in constant terrible pain. At this stage I cannot guage the quality or durability of the underlying repair. I did have some minor discomfort around the surgical sit, but nothing that I felt was an issue. They have been quite successful with it. This is why mesh is now preferred. Unfortunately I believe their actual holistic approach was outdated sometime during the cold war. Sometimes this cost is paid out by private insurance companies if the patient has a health benefits plan, or by the patients themselves. The repair is based on the Bassini repair with some modification. This makes any numbers they publish about their recurrence rates completely out of touch with the reality of what myself and other general surgeons are dealing with in our practices. Toronto is known as a wonderful getaway destination for those who enjoy world-class theatrical productions or professional sports. Its one of the great things about my job. When you come to our clinic for an examination, Shouldice staff will welcome you and arrange for a personal consultation with one of our experienced hernia surgeons. Do you know of any doctors in Ontario who will operate on overweight patients with abdominal hernias? Your post here changed my life, my plans, in a good very good way. Very interesting and enlightening article for a soon-to-be operated-on groin-hernia sufferer like me. I am of normal weight, but the physician who examined me advise me to loose weight, just because thats what he probably says automatically to all the patients. If I was doing the Shouldice repair with no mesh and keeping my patients in hospital for 5 days after hernia surgery, I would probably have my competence questioned, and with good reason. Abstract. You dont find Drs in NY doing hernia repairs without the mesh. . Your kidding yourself trying to talk anyone into not going here for a repair Both the surgeons i had had well over 10000 repairs and the first one was nearing 30000. Thanks for your comments. Though a significantly smaller hernia than the 2015 inguinal hernia the incision was two inches longer (6) and the incision was closed by puckering/pinching the skin on either side by 1/4-5/16 and secured with stainless steel staples, i.e. may be involved. 2021 Apr 1;51(4):67-69. doi: 10.1097/01.NURSE.0000736968.01359.e0. They actually recommended that my other hernia not get operated on as it was too small to be fixed (which was really impressive that they gave the correct advice, watch and wait). In our small study no patient had any pain after 6 weeks. So yes, that is you, the taxpayer, footing the bill for unnecessary care being provided by a private company. I wonder what steps should I take once Im ready to see a new surgeon in Ontario? I am now currently here in August 2016. And If I wasnt beginning to suffer the effects of cabin fever, and didnt have a life to get back to, I was almost sorry to leave to return to the UK. He had the choice of Shouldice or a Toronto area hospital. For over 75 years the Surgeons and staff of Shouldice Hospital have dedicated themselves to repairing abdominal wall hernias; it's all we do, having performed over 400,000 successful hernia repairs using our natural tissue technique without the use of surgical mesh and its serious complications. 2015 surgeries (inguinal, umbilical) performed at local Ottawa hospital by general surgeon, with some specialization in hernia repair. For over 75 years the Surgeons and staff of Shouldice Hospital have dedicated themselves to repairing abdominal wall hernias; it's all we do, having performed over 400,000 successful hernia repairs using our natural tissue technique without the use of surgical mesh and its serious complications. I honestly cannot recall the last time I admitted a patient the night before surgery, except when I was a clinical clerk, and that is going back a long time now. Also, you didnt say if your two hernias were repaired laproscopically or open. Im not happy about Shouldice being sold to a private company but I do not see that your critique of their prior history is based on any accurate or well-analysed information. Personally, I have a walnut sized umbilical hernia and am within the upper bounds of the ideal physical category. Update of previous post. Recovery done at home, pain meds prescribed, incisions very tidy, standard sutures, little to no swelling or bruising. The clinic sits on luxurious grounds and offers one thing and one thing only. Visitors will not be permitted in the patient rooms. Want fast and effectively perfect hernia repair? MeSH terms Adolescent Adult Age Factors The average North American is gaining 1-2 lbs per year, and obesity is a clear risk factor in hernia recurrence. I think is a matter of profit from this industry. We never rush you through surgery and send you home the same day; thats very stressful for both patients and their families. I live in West GTA if theres any way for you to recommend me to be looked at by either yourself or a trusted colleague. If this is an arguement that many surgeons feel should be addressed then of course I would be open to hearing the arguments for it but I believe our health care system should have a structure thats based on requirements necessary for delivering good outcomes for patients at the best cost. I agree that the beds are uncomfortable and some of their routine seems a bit military and dated, but I was very confident in their abilities and a few days of discomfort at a hospital is nothing compared to the long term results. Please call 905-695-4911 to book a time. I tend to agree more than disagree with the surgeons comments about Shouldice with regards to their capitalistic method. Update to the above. We know that asking patients about their satisfaction with their care has nothing to do with the quality of care provided. We use this information to refine our surgical techniques and document the success of our hernia repairs. My husband went in, doctor said lose weight and i will do it. 2 The Lichtenstein procedure was learned from a book, 10 instructional videos, and personal communication with Irving L. Lichtenstein, MD. ParkingOn-site parking is available for hospital and clinic patients for a flat-rate maximum of $15 per day ($50 for the duration of an inpatient stay). [1] The hospital specializes in hernia care. But ask yourselves this: is it really that important a year later if you slept in an uncomfortable bed for a few days if you have no chronic pain or ever have to worry about developing it? I have constant pain of some kind from stabbing to just dull along with foreign body sensation. Shouldice also does not require a doctors referral to see patients and bill the Ontario health care system. Finally, I am sorry you are experiencing problems and I sincerely hope they are at the lower end of the spectrum. Your stay at Shouldice includes a number of patient services to enhance your care and comfort: Weve followed up with our patients for many decades and time has proven that the patient-focused, Shouldice approach is the key to a complete and successful recovery. No my Dr was not willing to help much other than referring me to pain management which doesnt help solve the underlying issue and seemed baffled that these issues were continuing. That is tough. Surely theres an advantage to exclusive, specialized hernia repairs that general surgery wouldnt necessarily encompass? Shouldice Hospital (formerly Shouldice Hernia Centre) is a private hospital at 7750 Bayview Avenue in Thornhill, Ontario, Canada. Im probably an anomaly in the hernia world, but my story is horrific and Im still passing through it. I find this mind boggling- this approach was abandoned in the rest of medicine decades ago. Do you yourself know how many of your hernia surgeries fail? And yes, Shouldice cherrypicks their cases, perhaps because they can. If that is the case, I would rather stay in NYC but I guess I will have to make the trip to find out. Shouldice Hospital was established in 1945 by Dr. Edward Earle Shouldice (1890-1965), inventor of the Shouldice repair. Hernia repairs at the Shouldice are done with local anesthetic, no mesh insertion, and with a long stay in their hospital to recover. Should I wait or should I see a surgeon right away? To increase the text size, press and hold down the command key on a Mac or the windows key on PC, then press the plus (+) key. The typical Shouldice patient only experience s 5 days of required recovery time after their surgery, while hernia patients from other institutions typically experience 10 days of recovery time. So do you feel that in my case atleast, it might be worth giving Shouldice a first shot or is their antiquated technique simply not worth it as the hernia will in all likelihood recur and then mesh would be the only way to go? Employee Training Those who are picked to be on the front-line, are the ones who can help create a great customer experience. The Bassini repair, named after Dr. Edoardo Bassini who developed it in the 1880s, was the first efficient repair for inguinal hernia. My hernia is very small and only appears after I have been working-out or stand for a long period of time however I have a constant dull pain in the groin area/lower abdomen area (heaviness feeling) My fianc and I also love to travel and travel insurance seems to be an issue. Our first available appointment is in July of 2023. 3. shouldice provides hernia repair with a short hospital stay. I do everything I want without restricting myself. I just want the best treatment possible with the lowest chronic pain! I can accept that this is work that should perhaps be compensated at a different level because of its extra demands. According to another surgeon I saw mesh isnt likely to cause all of the issues it does in other portions of the body (erosion mainly) and said in his experience 1 year isnt that uncommon to feel mostly back to normal. I honestly cannot think of anything much to criticise beyond, just possibly, the tendency for some staff to be satisfied with your progress in their own minds, but could convey this rather better to the patient my equipment turned black and trebled in size so I had to get a specific answer to my question: is this normal? 6 Strategies for Managing Customer Wait Times 1. He also reiterated that he also only does mesh unless of some other medical reason. I had a double inguinal done at Shouldice 10 weeks ago and was in a fair bit of discomfort for the first 8 weeks but am feeling much better now and am thankful I have no mesh to disrupt things down the road. Following this summers logging and landscape work I will report the status of all three repaired hernias. The general surgeon I seen advised 6 weeks. I can still thankfully work but havent been able to exercise without being in major groin pain. I would also, I hope, be getting angry calls from our hospitals administrators asking what the hell I was doing keeping patients in hospital for so long after such a simple procedure. So why would you do so for an inguinal hernia repair, a surgery that is far from simple and fraught with potential serious complications, mesh or no mesh. Or that you are cynically making a play for a vast damages pay out. Shouldice also claims that its model allows it to perform at a lower cost per case than public hospitals, and that wait times are a fraction of those in the public system. First scheduled patients moved to pre-surgery prep. Standard rubberized hospital bed and pillow. I have acknowledged in the comments above the rare but real risks of mesh insertion. Whether that fear of mesh is warranted, I do not know. Day surgeries admitted in the morning released that afternoon. Safe for airport scanners AND MRI. I think it depends on the surgeon involved and what your expectations are around the surgery. They are not sure what the issue for me is caused by. On what basis do you make the claim that the media over-represents the risk? The average stay of patients is 3.2 days. In thinking Doctors are same as a lot of other industries. I was wondering what your thoughts were on the actual Desarda technique, not just the website. I generally will do any umbilical hernia under 1 cm in size without mesh, but that is not an absolute and depends on a lot of factors, including my discussion with the patient. I am still avoiding heavy lifting, but everyday lifting activities (groceries, young children, etc) arent causing any issues. Also, they dont just do simple hernia surgeries on skinny people. Shouldice also offers a variety of services to help you prepare for your hernia operation and improve your recovery. Here in the United States physicians can opt out of the Medicare system (for elderly) and refuse to treat medicare patients. I asked for a copy and watched my surgery during recovery. Now I have chronic pain and wondering if I should of stuck out the pain another week or two to find another Dr. for another opinion. We go to physicians expecting a solution to a problem, expecting, sometimes, an unreasonable outcome, expecting physicians to be more than human, expecting them to always do the right thing. I did not get a reply what so ever until September 2014 advising me that they can operate on me. They dont call it the Shouldice Experience for nothing. Very interesting. Thanks for sharing your positive experience Kram. Its not hard to understand whats happening here. Hard to be critical regarding matters of efficiency without data descends into rhetoric pretty quickly. It is a small hospital dedicated only to hernia repair. The Shouldice procedure was learned from personal observation at the Shouldice Clinic, a book, 9 and instructional articles. The recurrence rate with Shouldice techniques was higher than mesh techniques (OR 3.80, 95% CI 1.99 to 7.26) but lower than non-mesh techniques (OR 0.62, 95% CI 0.45 to 0.85). I dont want to come off too confrontational but I am going to be blunt. I am very happy with the outcome and am glad I didnt go for a mesh repair. Which must annoy surgeons who use only mesh). Thanks Kram. We know that people often find it challenging to manage their weight, especially when they have a hernia that restricts their ability to exercise. Thanks. I went for consultation at Shouldice in October 2013 for consultation regarding an umbilical hernia repair. I know 2 other people who have gone up for repair both of which are now well over 30 years on the repair without issue also.. Take care safe travels. I agree. Hopefully you find an answer. We regret that we cannot make reservations on your behalf.
Jack Weston Cause Of Death,
The Lord Will Perfect That Which Concerns Me Sermon,
Articles S
