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, August 25, 1999

Hmd "Good evening, Dr. Wiseman."

Hmd "Hello, Irenee. Welcome."

Andrew "I am new here, is this a women's only discussion?"

Hmd "No, Andrew. This is for anyone who is having adhesion problems."

Andrew "great"

Hmd "Do you have some questions or concerns you would like to talk about?"

Hmd "Hi, Peggy."

Peggyk "Hello everyone."

Andrew "I recently, yesterday, surfed my way onto Dr. Wiseman's paper and felt it described many of the things I am experiencing."

Drwiseman "Hi everyone: got here at last - have had MAJOR computer problems."

Drwiseman "Sorry for the delay."

Drwiseman "Well let's get started - anyone have any adhesions questions?"

Peggyk "Dr Wiseman: I guess the official diagnosis is that I have adhesions."

Andrew "I am considering adhesiolysis and would like to get some feedback from others that might have had this procedure."

Peggyk "Last chat I was scheduled to see a GI Dr. and a Urologist and everything was fine in both these areas."

Drwiseman "Andrew: perhaps you can fill us in on your condition."

Janp2000 "Andrew, can you tell me about the adhesiolysis procedure?"

Hmd "Andrew, I had an adhesiolysis in 1997 - and within 10 days the adhesions and the chronic pain were back."

Andrew "I was shot in a car-jacking 3 years ago and underwent exploratory laparotomy with 4 resections and a punctured colon. Since then I have been experiencing chronic abdominal pain. I went through all the GI series and CAT and MRI but they showed nothing."

Andrew "diagnosis -- adhesions"

Peggyk "Andrew I also had adhesiolysis in April of this year and I am the same as Hmd - within 10 days the pain was back."

Andrew "Not exactly that fast or that simple as you all probably know by now."

Drwiseman "Did they say adhesions because that was the only thing that was left? or did they see them?"

Andrew "No, they didn't see them. Was told that I was not a candidate for scope as I have a midsection incision line."

Andrew "Was a default diagnosis."

Drwiseman "So you want to know what to do?"

Hmd "What do you mean by that fast or that simple, Andrew?"

Andrew "I want to know what to do."

Andrew "HMD: took 3 years of diagnostic testing and fighting with insurance companies."

Drwiseman "The choice is this: if you have adhesiolysis then the adhesions could come back. But you have a chance of some relief, also a diagnosis, and the chance to use an adhesion barrier, which may help."

Hmd "All adhesion sufferers want to know what to do. Many of us have resigned ourselves to being treated at Pain Clinics or with Pain Professionals."

Andrew "I am just recently out of the hospital from a second surgery that removed the bullet from my spine. Another 14" incision"

Andrew "I have gone that route with the pain center."

Andrew "I do get relief but narcotics are not what I had in mind for long duration."

Drwiseman "No one said it was going to be easy - that's why we're all here."

Hmd "I understand what you are saying, Andrew."

Andrew "When I read some of the older threads I knew you all would know."

Storms "This is my 1st time here, how does this work?"

Andrew "I started to research the adhesiolysis while I am home recovering."

Drwiseman "Andrew: what kind of response are you getting from your doctors - for many of the women with adhesions it is difficult to get a sympathetic ear."

Lrlle "Hello all. This is my first time here. I am considering having surgery for my adhesions. I know that surgery only creates more problems but I've got to do something. Have there been any new developments in the last couple of years to prevent adhesions from reforming?"

Drwiseman "Also I guess you are seeing quite a few surgeons - trauma - GI etc. - how is all this coordinated?"

Andrew "I find sympathy in the pain specialists who deal with pain, surgeons are hesitant to act because of the small success rate. GI doctor actually came up with the diagnosis but says I gotta live with it."

Drwiseman "Lrlle: to reiterate an earlier answer: adhesiolysis may give some relief, but the adhesions can recur. At least you have the chance to use an adhesion barrier."

Storms "Has anyone, or does anyone suffer from endometriosis?"

Peggyk "Dr.Wiseman right now I am seeing a pain management Dr. This has been about 5 weeks now. Right now I am at a place where I am capable of doing some of the things that I couldn't do without the aid of the medications that I am on. The only problem is that I do not want to have to live on these medications the rest of my life."

Drwiseman "There are only two at the moment: INTERCEED - by Johnson & Johnson, and Seprafilm - by Genzyme. They do not work 100% of the time but they can only be used at the time of surgery."

Janp2000 "Dr. Wiseman what are the adhesion barriers?"

Lrlle "I will be looking up adhesiolysis. Unfortunately I have a GI issue involved and right now my colon is so twisted due to adhesions that they are having trouble doing the tests they need to do. I had to have part of my colon removed when I had my last surgery."

Andrew "Are these products able to be used with a scope or do they have to be used in a more invasive way?"

Lrlle "Storm: I had endo. TAH was the result."

Storms "What did the dr tell you to do?"

Drwiseman "The two barriers are like sheets of material that dissolve in the body. They are like internal band aids that protect the cut surfaces from reattaching to something else. It is possible to put INTERCEED through a laparoscope. They can both be placed during open surgery."

Andrew "Peggy, I understand the drug thing -- what else has your pain center offered?"

Lrlle "Storm: Initially they removed just the uterus & cervix because I was so young, they didn't want to do the ovaries. 2 years later the pain was back and more intense than ever. So they went back in and did the ovaries. The adhesions were so bad that they had to remove colon."

Storms "Oh my, you are okay now, right?"

Peggyk "Andrew, so far nothing besides doing exercise which I would not be able to do without the pain medication. Walking and swimming."

Drwiseman "Peggy - I am interested in what the pain folks have done for you - is this drugs? or something else?"

Lrlle "Storm: Unfortunately other issues have come up now. And so, in addition to having severe pain from adhesions, I'm now dealing with colon problems. They're still trying to diagnose it though. I keep an upbeat attitude."

Peggyk "Dr Wise man - it is drugs. Right now I am taking Methadone, Klonopin and Arthrotec."

Storms "Did you have it so bad that you got constipated alot?"

Lrlle "I never really had any problems in that area. However, I don't normally go very often. Once or twice a week is normal for me. Only when I was pregnant was constipation a problem."

Andrew "Peggy - do they have any biofeedback pros or psychs to talk to at this center?"

Lrlle "Storm, I agree with you. If I hadn't been finished with having children, I would never have consented to the hysto. I would have just continued going in every so often and having the endo burned out."

Hmd "Some of you are taking part in the adhesions forum at: http://www.obgyn.net/adhesions.asp This is an excellent place to exchange information about adhesions and chronic pain."

Peggyk "Not as far as I know."

Drwiseman "Any one have any ideas about diet?"

Storms "Well mine is from my last c-section with my daughter. I had a miscarriage b/c of it."

Andrew "The clinics I have been to do offer that and it helps tremendously."

Peggyk "There is only one Dr. It is not a pain center The Dr. is specialized in pain management."

Drwiseman "What about physical therapy?"

Lrlle "Storm: I'm sorry to hear about your daughter. Perhaps you can find someone in your area that specializes in high risk pregnancies."

Peggyk "No, nothing other than walking and swimming."

Andrew "Is the bloating feeling a constant for those with adhesions?"

Drwiseman "Many people report bloating and say they need to keep off foods with fibre."

Drwiseman "I have been told by one lady that fortified flax helps, but this is just one person."

Andrew "I did have a PT that did what is called myofacial Release massage over the scars left after the surgery and felt it was a great relief although only lasted a day or so."

Drwiseman "It's probably like stretching a rubber band - they can only stay stretched for a while - if they don't break - they'll be back in place."

Andrew "That is exactly what it is like."

Janp2000 "Dr Wiseman I would love to find out if there is a certain diet that would ease the cramping, pain etc. or do you know of any herbal remedies or vitamins?"

Storms "Lrlle- when I was pregnant with my daughter, I had to have a c-section, and because of the c-section, I have endo. I recently had a miscarriage because of it. So I'm looking for anything to help, so we can try again."

Drwiseman "While I have you all here - I want to restate Helen's plug for our web site at http://www.obgyn.net/adhesions.asp

Hmd "I am being treated on an ongoing basis since January 1997 by a psychiatrist who specializes in pain management and a psychologist who helps me to express my feelings and just plain talk about how chronic pain is affecting my life. I am taking 600mg of carbamazepine during the day and 100mg of amitriptyline at bedtime. Amitriptyline is an antidepressant and it also helps to relieve pain. I have been taking amitriptyline since 1975 and it has really made a difference in my life."

Andrew "Dr Wiseman--an earlier thread mentioned a convention in Miami? What is it?"

Drwiseman "We are trying to put together a small meeting for adhesions people in Ft. Lauderdale - do you have any interest in attending?"

Andrew "Yes I live just north of Ft Lauderdale."

Hmd "Andrew, if you want more information about adhesions and chronic pain, please email me at: olddad66@runestone.net."

Peggyk "Well I'm gonna say good night. This is the biggest problem with the meds that I am on. I cannot stay awake."

Drwiseman "I am trying to put together a small agenda: an OBGYN to speak about adhesions and pain, and a general surgeon to speak about adhesions and bowel problems: we would then follow with a general discussion about clinical problems and then have some sort of business meeting to get the INTERNATIONAL Adhesions Soc. organized. It would probably last about 3 hours - what do you think?"

Hmd "I have read that a low-residue diet is indicated for people with bowel problems. This is not my problem - so I have not tested this."

Andrew "I am a sponge when it comes to getting information on adhesions. I also have problems finding doctors that are sympathetic to adhesions and pain."

Lrlle "Does anyone know of any support groups in the Washington, DC metropolitan area?"

Andrew "I am interested in the meeting --any info I need?"

Andrew "Hmd--thanks I will email you to get the info you have."

Andrew "What is a low residue diet?"

Drwiseman "Andrew - the best thing to do is to go to http://www.obgyn.net/adhesions.asp and fill out the form - I will put you on the mailing list. Since you are local perhaps you might want to help organize it."

Drwiseman "Low residue means that there is little poop (technical term)."

Hmd "Andrew you will find information about doctors who are sympathetic to adhesions and chronic pain in the websites I gave you earlier."

Drwiseman "There are no support groups anywhere as far as I know other than our International Adhesions Society."

Drwiseman "I will have to leave you all in a few minutes - any final questions?"

Hmd "Remember to check out: http://www.obgyn.net/adhesions.asp on a daily basis."

Storms "Lrlle-Thanks for talking to me, I wish I could help you. I'll keep you in my prayers. Bye."

Hmd "There were others who would have liked to be here tonight, but were unable to figure out how to download. Every time a change is made, it becomes more complicated."

Hmd "Thank you, Dr. Wiseman, for giving us a place to share!!"

Hmd "Andrew: Just write to me at: olddad66@runestone.net"

Andrew "Thanks"

Drwiseman "Sorry to have to leave you all: please contact me if you have any questions: synechion@aol.com"

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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