FREE Hernia Surgery???

[Munchkin]

A great idea or a huge mistake? Opportunity or a nightmare waiting to happen?

Those who know me are aware I have a huge hernia I can't afford to get fixed until I am old enough for Medicare(3+ years). I am pretty sure it will need some kind of mesh to fix it. Anyway it does hurt off and on and it limits what I can do exercise wise. Plus I hate looking pregnant at 60+.

I passed the telephone screening this morning to participate in a paid research study that would include free hernia surgery. They are actually studying a local anesthetic for post-op pain relief, bupivacaine ( https://www.drugs.com/pro/bupivacaine.html ). The study involves 3 trips to Utah. The first trip would be to do a physical/bloodwork and finalize my participation in the study. The second trip is the surgery which is done at their facility and includes a 3 day stay. The third and last trip is a general postop surgery visit. About a month after surgery they would pay me $950. Probably about enough to cover travel expenses.

The surgeon is Allen Rappleye http://www.oldfarmobgyn.com/provider/alan-t-rappleye-md-facog

The company that provides the facility is Epic Medical Research in Murray, Utah/Salt Lake. http://epicmedicalresearch.com/current-studies/#!/study/8

And here is the clinical trial info. https://clinicaltrials.gov/ct2/show/NCT03237481?term=Heron+Therapeutics+-+HTX-011-302&rank=1

So what do you think? And yes they could still chunk me out of the study and that first trip to Utah would definitely be a leap of faith money wise because who knows what will happen. I have been on the recruiting side of studies but I have never been a victim, er, participant.

Your thoughts?

 

[southernlady]

A great idea or a huge mistake? Opportunity or a nightmare waiting to happen?

Those who know me are aware I have a huge hernia I can't afford to get fixed until I am old enough for Medicare(3+ years). I am pretty sure it will need some kind of mesh to fix it. Anyway it does hurt off and on and it limits what I can do exercise wise. Plus I hate looking pregnant at 60+.

I passed the telephone screening this morning to participate in a paid research study that would include free hernia surgery. They are actually studying a local anesthetic for post-op pain relief, bupivacaine ( https://www.drugs.com/pro/bupivacaine.html ). The study involves 3 trips to Utah. The first trip would be to do a physical/bloodwork and finalize my participation in the study. The second trip is the surgery which is done at their facility and includes a 3 day stay. The third and last trip is a general postop surgery visit. About a month after surgery they would pay me $950. Probably about enough to cover travel expenses.

The surgeon is Allen Rappleye http://www.oldfarmobgyn.com/provider/alan-t-rappleye-md-facog

The company that provides the facility is Epic Medical Research in Murray, Utah/Salt Lake. http://epicmedicalresearch.com/current-studies/#!/study/8

And here is the clinical trial info. https://clinicaltrials.gov/ct2/show/NCT03237481?term=Heron+Therapeutics+-+HTX-011-302&rank=1

So what do you think? And yes they could still chunk me out of the study and that first trip to Utah would definitely be a leap of faith money wise because who knows what will happen. I have been on the recruiting side of studies but I have never been a victim, er, participant.

Your thoughts?

If you are comfortable being a guinea pig, go for it.

I participated in a clinical study back in 1999/2000. Worth the effort.

 

[Clematis]

You're always the voice of practical reason on this board so let me throw back at you some of the rationale you have offered others...

As you always tell newbies here, pick a surgeon for his/her experience, not for their price tag. The guy's an OB/GYN so we assume he is experienced at making cesarian incisions. But what is his experience with the surgical repair -- with MESH, no less -- of a "huge" hernia? "Huge" is important. There have been some people here who have had to interview several surgeons to find one sufficiently skilled to wrangle a "huge" hernia. If he does it wrong -- and we all know sometimes it does go wrong, not death but just you still have the GD hernia -- is he going to fix it or just shrug and say a second surgery is not part of the protocol? And can you afford more travel to Utah for this to happen? If not will you then have a more difficult if not impossible second surgery to be done by a Medicare surgeon down the road?

If I didn't like the answer to any of the above questions, I'd wait 3 years to be able to chose from a list of qualified surgeons.

And oh yeah so some get the bipicavaine, others get a new drug and the third group gets what? Saline placebo? Mother of god they're gonna let that group scream in pain???

 

[DianaCox]

I've done a clinical trial - for 16 months just before my DS. It was for an obesity drug (phase III). I had to drive up to Santa Rosa once a month (100+ miles each way) for about 20 months, to pick up injectible meds that I had to inject in my abdomen every day for 16 months - 1 year blinded, second year I would definitely get the drug. I waited 4 months before concluding that I was not benefiting from it. Turned out I was on the drug the whole time, but like 70% of the participants, I made neutralizing antibodies to it. That's when I decided to have the DS.

I would be concerned about having a surgery out of state, but then you are already more comfortable with that than I am. And cosmetically, they are not going to really care (but you might not care as much about that as to be fixed ASAP and at low cost).

Keep in mind that you may not have access to any other sort of pain relief if the drug doesn't work ...

 

[Munchkin]

I am busy doing my research and so far I can't find ANY malpractice on the doc and that's odd. He is most likely a few years older than me and it looks like he has never had a malpractice claim against him. But I will keep on looking. The only negative review I have found so far was from a woman whose child has cerebral palsy. Has privileges and operates at multiple hospitals. Has done research projects/received funding for research in the past. Does a lot of gyn type surgeries as well as some general but still mostly on women. He is also DaVinci and LAP certified and in MD world some certs mean nothing and others are work.

 

[Munchkin]

I've done a clinical trial - for 16 months just before my DS. It was for an obesity drug (phase III). I had to drive up to Santa Rosa once a month (100+ miles each way) for about 20 months, to pick up injectible meds that I had to inject in my abdomen every day for 16 months - 1 year blinded, second year I would definitely get the drug. I waited 4 months before concluding that I was not benefiting from it. Turned out I was on the drug the whole time, but like 70% of the participants, I made neutralizing antibodies to it. That's when I decided to have the DS.

I would be concerned about having a surgery out of state, but then you are already more comfortable with that than I am. And cosmetically, they are not going to really care (but you might not care as much about that as to be fixed ASAP and at low cost).

Keep in mind that you may not have access to any other sort of pain relief if the drug doesn't work ...

The no other drugs scares me for sure. I could give Jeff the good drugs and I would for sure bring something worth taking for the trip home! The plan is LAP so how bad could those scars be? Can't think of anything that would be worse than my open DS, scar-wise.

 

[Munchkin]

You're always the voice of practical reason on this board so let me throw back at you some of the rationale you have offered others...

As you always tell newbies here, pick a surgeon for his/her experience, not for their price tag. The guy's an OB/GYN so we assume he is experienced at making cesarian incisions. But what is his experience with the surgical repair -- with MESH, no less -- of a "huge" hernia? "Huge" is important. There have been some people here who have had to interview several surgeons to find one sufficiently skilled to wrangle a "huge" hernia. If he does it wrong -- and we all know sometimes it does go wrong, not death but just you still have the GD hernia -- is he going to fix it or just shrug and say a second surgery is not part of the protocol? And can you afford more travel to Utah for this to happen? If not will you then have a more difficult if not impossible second surgery to be done by a Medicare surgeon down the road?

If I didn't like the answer to any of the above questions, I'd wait 3 years to be able to chose from a list of qualified surgeons.

And oh yeah so some get the bipicavaine, others get a new drug and the third group gets what? Saline placebo? Mother of god they're gonna let that group scream in pain???

My understanding is they are trying incisional pain relief to look for ways to cut back on opioids. I have heard of a few DSers who had some kind of pain relief directly into their incisions and it was effective. And yes, I want to know what they will be using for pain. I will just assume I would get saline!

Fast forward 3 years to Medicare and I would probably have a choice of several general surgeons. But no guarantees they would be better than this guy. And it's almost a sure thing I wouldn't be able to get a hernia expert. The part about waking up and still having the hernia is possible. Or re-herniating myself could happen too. With ANY doc. They don't give guarantees on anything! And you are right, I could croak! What's good about the freebie is that it's not drive thru surgery, they keep me there for the pain study 3 full days. That pretty well covers any likely postop issues.

The reason it's so attractive to me to do it now rather than continue to wait is a quality of life issue. I am really tired of not being able to do things I want to do. A secondary concern is waiting for Medicare makes me 3 years older heading in to surgery.

What I really want is the hernia with muscle repair and the complete tummy tuck. Yes, I know. Wish in 1 hand and poop in the other. Which one gets filled up first? Sigh!

I have lots of questions and you added to the list.

 

[Spiky Bugger]

I had the (related?) On-Q local anesthetic for my panniculectomy. It worked well. I still needed opioid pain meds, but not for three days.


I found this...which suggests that they only let the placebo participants suffer for an hour?

Liposomal bupivacaine is a unique and novel product giving clinicians a longer-acting alternative to bupivacaine HCl for local analgesia. As a single-dose local injection into the surgical site, liposomal bupivacaine can produce postsurgical analgesia for up to 72 hours as compared with approximately 7 hours with standard bupivacaine. This prolonged analgesic effect can delay, decrease, or eliminate the use of postsurgical opioid therapy for many patients. In a soft-tissue surgical model (hemorrhoidectomy), patients treated with liposomal bupivacaine requested their first opioid approximately 14 hours after surgery (compared with 1 hour in the placebo group) and had 45% lower total consumption of opioids during the first 72 hours postsurgery as compared with placebo recipients; almost 28% of patients used no opioids at all after surgery. In addition, patients treated with liposomal bupivacaine had a lower incidence of ORAEs compared with the placebo group.

Well, the placebo group REQUESTED pain meds...no mention of their having received them?



And this? So maybe not perfect for shoulders? Or just ambulance chasers?

https://bernllp.com/shoulder-pain-pump-lawsuit/

 

[Spiky Bugger]

However, remember that if you get a hernia repair with mesh NOW, you may be making additional surgeries in that area far more difficult.

 

[Munchkin]

I had the (related?) On-Q local anesthetic for my panniculectomy. It worked well. I still needed opioid pain meds, but not for three days.


I found this...which suggests that they only let the placebo participants suffer for an hour?

Liposomal bupivacaine is a unique and novel product giving clinicians a longer-acting alternative to bupivacaine HCl for local analgesia. As a single-dose local injection into the surgical site, liposomal bupivacaine can produce postsurgical analgesia for up to 72 hours as compared with approximately 7 hours with standard bupivacaine. This prolonged analgesic effect can delay, decrease, or eliminate the use of postsurgical opioid therapy for many patients. In a soft-tissue surgical model (hemorrhoidectomy), patients treated with liposomal bupivacaine requested their first opioid approximately 14 hours after surgery (compared with 1 hour in the placebo group) and had 45% lower total consumption of opioids during the first 72 hours postsurgery as compared with placebo recipients; almost 28% of patients used no opioids at all after surgery. In addition, patients treated with liposomal bupivacaine had a lower incidence of ORAEs compared with the placebo group.

Well, the placebo group REQUESTED pain meds...no mention of their having received them?



And this? So maybe not perfect for shoulders? Or just ambulance chasers?

https://bernllp.com/shoulder-pain-pump-lawsuit/

Yikes on the shoulder pain pump! I had a pain pump with my DS and it was the worst possible scenario. I never could get enough to just go to sleep. Just enough to take the edge off. And if you were lucky enough to get to sleep you had to wake up every 10 minutes to push the damn button. The first time I actually got to relax and sleep was about a half hour after taking my first vicodin at home. It helped me tremendously. I would have been much more recovered if I had had vicodin in the hospital instead of that damn pump!

Actually that liposomal bupivacaine sounds pretty good. ALONG WITH A BIG DOSE OF OXY!

One of the things that helps patients recover postop is moving around. And when you are in pain, you don't move. And you don't sleep well. I have always believed in using good drugs after surgery. I have had opioids prescribed to me multiple times over the years and I have yet to become addicted. I still have a few vikes left over from my DS. Now they are acting like you are addicted for life if you even get to see hydrocodone. Much less sniff or actually take one!

More than a year ago I had some serious dental work done and they absolutely refused me pain meds. Told me to take freaking tylenol. Made me glad I was a medication hoarder and never got rid of any decent pain meds. I needed the good stuff for a couple days then I was fine. Ridiculous!

 

[Susan in Tennessee]

Is this still on the table? I am really hoping it turns out to be a golden opportunity for you!

 

[JackieOnLine]

More than a year ago I had some serious dental work done and they absolutely refused me pain meds. Told me to take freaking tylenol. Made me glad I was a medication hoarder and never got rid of any decent pain meds. I needed the good stuff for a couple days then I was fine. Ridiculous!

that is just terrible - what is wrong with this stupid country?

 

[Spiky Bugger]

Is this still on the table? I am really hoping it turns out to be a golden opportunity for you!

What she said.

 

[DianaCox]

<= Leftover narco pain med hoarder too. You never know when you might need them for something - an emergency (when my son broke his arm, I gave him a Tylenol#3 before taking him to the ER, because I KNEW he wouldn't get anything for hours); when there might be a disaster and you can't get to a doctor (an earthquake or WWIII for example); or the ability for the ultimate checkout.

 

[Clematis]

CAUTION: I too hoard opiates b/c of my kidney stones but I never take one if I plan on going to the ER. If you don't come in with blood gushing or a compound fracture, many if not most ERs will run a drug screen to see if you are a drug seeker before they will administer morphine. If opiates turn up in your blood test, they will send you on your way with a Tylenol. I've been to ERs all over the world for kidney stones. They ALL make me wait moaning and vomiting for 3-4 hours until the blood test results come back before giving me morphine. (Although they never say this.) The only exception is when I go to my closest ER as they are used to my stones and have access to the history of tests to prove I have them.