-- > -------------------------------------------------------------------------- > > -------------------------------------------------------------------------- > Dr. Harry Reich, M.D. New York > From: Beverly J. Doucette (bnb@cybrzn.com) > Tue, 8 Jun 1999 10:38:02 -0500 (CDT) > > Dear Friends, I am sharing my experience of surgery performed under Dr. > Harry Reich of New York; since 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 one of us. I also am stating MY > interpretation of how the body responds to and creates adhesions, as I > understand that physiological process. > > 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 than the other adhesional lysis, which 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 kept a following of his patients, he does have some > figures on it and it looked to be the higher % of success for non-reforming > adhesions 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 parallels my > adhesionalhistory very closely. Dr. Reich also videotapes his entire > surgery for you. > > Dr. Reich's theory regarding non-reforming adhesions is: "The solution to > pollution is dilution!" And he stands by that phrase yet today. This > procedure is done through a minimally invasive route. One small incision in > the naval for camera, two 1" to 2" incisions on each side of the lower > abdomen 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 - looking for any invasive pathology > besides adhesions. He evaluates the situation and then determines his plan > of treatment. In the event that there are dense adhesions, he proceeds to > dissect (separate) them. This is not an easy process and is very involved. > I can understand why most DRs do NOT want to challenge themselves doing a > lysis, which is dangerous and tedious - as the DR is working right up > against and around the intestines, etc. Based on Dr. Reich's vast > experience with laparoscopic surgeries, he has developed a technique like no > other surgeon in the world! That is why he has the reputation as the being > the best laparoscopic 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 piece of > clotted blood that is in, around, under, and virtually all over in the > abdominal cavity following the surgery! He feels that it is this residual > clotted blood that the anti-bodies in an adhesion former's system respond to > as "foreign" - and thus creates an adhesion over it to protect the internal > organs! Now, this is exactly how our bodies defense system works! > > Think about your getting a sliver (externally of course). What does our > body's defense system do to that foreign body? It sends out the leukocytes > and creates an "infection" to get rid of it - right? Internally, one of > two types of defense systems kick in when there is a problem: > > 1.) If our 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 inflammation in the appendix and build up and > burst; but it WAS a defense mechanism as well. Peritonitis can kill us as > the body has no way to rid itself of that infectious drainage; and it > infects the surrounding internal organs as well. In defense our body sends > the leukocytes (white cells) to the area of "infectious drainage." > > 2.) Because there is an active infectious foreign body in the abdominal > cavity, our body will attempt to "CONTAIN" that poison to protect the other > internal organs from damage! These white cells form a material > called "fibrin," which is the sticky stuff in the blood. The fibrin starts > to cover the infectious material and then you have what is called an > "ADHESION!" Now, adhesion means "to stick together." In the abdominal > cavity - filled with lots of organs in very close proximity to one another - > what do you think will happen? Abdominal organs become attached to one > another - everywhere that the infectious drainage touched! > > Lets look at that same reaction now using the clotted residual blood > following your internal surgery. Blood is found throughout the cavity from > any area of surgery or ischemia (areas scraped or cut - causing an area > that bleeds). In the cavity this blood dries very fast - VERY FAST! 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 leukocytes and thus forms adhesions > wherever these clots of blood are. Because fibrin is sticky, some of these > organs become attached to the peritoneum (innermost tissue of the abdominal > wall) causing pulling and inflammation at the attachment sites - thus > causing PAIN and eventually a decrease in our physical mobility. That pain > is from the attachment to the peritoneum. Other organ to organ > attatchments, if any, don't cause pain; but these other organ to organ > attachments can cause: > > 1. Bowel obstructions > 2. Painfull and difficult bowel movements > 3. If some adhesions attach the bowel to the vaginal wall, these can cause > painful intercourse as well. > > 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 he finds the fibrin strings and removes them - bit > by bit - a 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 will have less to react to - thus reducing, and possibly > stopping, the reformation of PAINFULL and distructive adhesions. He also > leaves 3-4 liters of ringers in the abdomen following his surgery. It takes > about 48 hours to dissipate out of the body (lots of peeing goes on). I was > not shaved, had no urinary catheter in place nor gastric nasal tube (when I > awoke in recovery) following 5 hours of surgery; and I was back in our > suite in less then 4 hours following recovery room. Sure, I had surgery > pain; but I also had both ovaries removed and two tumors! One very large > tumor had attached to the right side of my colon on the left side of my > peritoneum - my colon was totally twisted over and attached! No wonder I > hurt and couldn't have a BM on my own! > > How am I now? I'm a tiny bit sore on the lower right; but that is from an > organ removal. NO ADHESION PAIN, NO BACKACHES, NO PAIN PILLS, and a smile > on my face that only a crow bar could remove! I had been on: > > 1. Pain medication, > > 2. Anti-inflammatory medication - which you need to be on at LEAST 1500 MGS > a day if you are suffering adhesion pain. This medication is to help combat > the inflammation from the pulling of the organ at the attachment site. You > can bet you have something attached to the peritoneum at this time - and it > is pulling and doesn't like that! > > 3. Antacids - from irritation of the esophagus and stomach from years of > drugs. > > 4. Sleep/pain meds at night and last but not least... > > 5. Laxatives - and you know what that was for!! > > NO MORE!! I take a 500 mg chewy for calcium and Vitamin E for heart > muscle - as I refuse to go on hormone replacement until I present with > symptoms...and I have not yet! > > Dr. Reich 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. Reich's 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 previously 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 attach itself from > the intestine - when there is that much ringers lactate in the cavity (that > type of attachment was the ONLY cause of my pain) - and when organ > attachment 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 attach. > > In the event you are interested in contacting Dr. Reich, let me know and I > will assist you 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 > crook....like 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: > bnb@cybrzn.com . 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 areas of adhesion disorder. Take him information from Dr. > Wiseman, the Women's 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 to what to do for you! Also re-evaluate > your medications - you MUST be taking an analgesic (pain med) > on a consistent basis for it to be effective in your system to combat the > pain. It is also imperative that you have an anti-inflammatory. > > 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 ultrasound and abdominal x-ray will detect any abnormal pathology in > the abdomen. If you feel that you are suffering 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 ultrasound proves negative! Everything > else will be negative too; and your DR. STILL cannot diagnose your > adhesions as the cause of your pain - unless a diagnostic laparoscopic > surgery is performed. > > Your Dr. cannot say that your pain is caused by your adhesions until he sees > them; but you can pretty much be assured that the pain is from adhesions - > if you had adhesions before - if your tests show negative. > > You 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 until proven! BUT, as long as all medical tests rule > out abnormal pathology, you DO have CHRONIC PELVIC PAIN and that IS > recognized as a medical condition; so get on a pain management routine and > take it from there! A DR. HAS TO respond to your request for that! > There also is NOT any other effective pain management for adhesions: no > massage (the adhesions are located too deep within the cavity for "breaking > down," etc..) and no type of linaments or balms which will neither reach nor > penetrate the peritoneum. The peritoneum tissue is there to PROTECT against > invasion of infectious and foreign matter. 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, massage, and such WILL help relax the adhesion sufferer - and > there is something to be said for treating the emotional as well as the > psychological self. In fact, it is imperative to do that!! And therapy > for family members - support, education, and ideas as to how to live with > one who is suffering this very painfull and debilitating disorder. The > impact that "Adhesion Disorder" places on a family is no different than a > diagnosis of cancer, Muscular Dystrophy, Multiple Sclerosis, or any other > debilitating disorder - only that our disorder is just beginning to be > focused on. How much focus it gets is up to each one of us! So learn about > it!! Educate your DR.s about it!! Don't be afraid of it; because it can > be effectively lived with...and, most of all, there is HOPE !!! > > If a medical facility DID NOT perform medical tests on a patient, who > presented with complaints of pain - and just assumed that their symptoms of > pain WERE due to adhesions (because the patient has a history of > adhesions) - what would you do if you DID have a tumor or cancer and it went > undetected because of a DR. writing your pain off as due to adhesions > without checking into it? I'd be pretty miffed! My recent contacts with > the Mayo Clinic indicated to me that a number of the DR.s DID in fact feel > that adhesions in and of themselves caused pain. Like almost everywhere > else though, they have not come up with a practical treatment or surgical > procedure that would benefit an adhesion former. Mayo Clinic DR.s will work > with an adhesion patient through pain management. I did start my pain > management through them. (I cannot see a basis for an "investigation" into > the Mayo Clinic or any other medical facility because they perform medical > tests on those of us who have a history of adhesions.) I was found to have > TWO tumors - and that was only through an adhesional lysis that I elected to > have done in New York City under Dr. Reich! If he had not found them, who > knows what might have happend to me. I would not allow any local DR.s to > perform anymore tests on me as I was convinced that ALL MY pain was from > adhesions and that there was no valid reason to put myself through > testing that would have negative results for abnormal pathology - let alone > pay for tests over and over again. Boy was I wrong!!! So I have to advise > all, for what it's worth, that testing is necessary and could save your > life! If all tests have negative results for abnormal pathology, then it is > probably your adhesions. It is then up to you to determine the next step - > surgery for them or live with them and try pain management. > > I do believe that the more educated one becomes to their own disorder, the > better equiped they are to discuss treatment with a DR - even down to what > needs to be done in a surgery, if you elect that route! I also feel that > adhesional lysis, performed in a certain way, CAN reduce the amount of > reformed adhesions; and, in all probability, decrease the formation of > DeNovo adhesions. I firmly believe that there are NO adhesion barriers > created today that will be effective in dealing with adhesions - and I mean > NONE! Once you learn what type of procedure is best for an adhesional > lysis, you can discuss it with your surgeon - even dictate how and what you > wish to have done for you and this disorder! Thanks! > > Beverly > > ---------------------------------------------------------------------------- > -------------------------------------------------------------------------- > > -------------------------------------------------------------------------- > Remember these words..."YOU ARE NOT ALONE!" I stated the other day that if > anyone thought that adhesion disorder can't kill...ask Dr. Wiseman who the > second victim of Dr. Kavorkian (Dr. Death) was...well I'll tell > you...it was a 56 year old woman who suffered chronic pelvic pain! Our > disorder...OURS!!! I suffered and still suffer from this disorder, surgery > or not...I am addicted to pain meds and am withdrawing from them at this > time. I am scared to death every time I eat as I think I'll get constipated > and will suffer such horrible pain...BEFORE, DURING and AFTER I > defecate..yes, have a bowel movement. I live with the fear that I'll start > to pee my pants again as I did for 10 years...and I am ONLY 48 years old > now...so that put me at 38 years old living liked that! Every little pain I > get in my abdomen fills me with fear that the adhesions are back...but then > I talk to myself and run through what I have learned about OUR disoder and I > settle myself down and I am better ...better for awhile. > > Because I have educated MYSELF about adhesion disorder I will make it > through this part of it as well, but I will always live with that fear of > them reforming...it is ever present in the back of my mind and I find myself > feeling anxious at times to live every minute that I have now...and I will! > I share only from experience and what I have learned living with this...I > don't know anything any better then the rest of you, maybe just from a > different perspective, thats all. I need to hear your perspectives also, no > not for personal gains, not for any study, not really for any other reason > than the fact that you have what I have; and I am so grateful for the > sharing as that to me IS educating myself yet on all this new stuff. > Thank-you Helen, Anne, Chris, Michele, everyone who has the courage to reach > out to touch the lives of fellow sufferers like me..a.lets build this > thing...and let's pray for strength and progress...as folks....I WAS dying > as I lay on my couch not being able to eat, vomited all the > time...had become intolerant to ALL my medications lastSeptember...couldn't > have a regular BM without laxatives, and I couldn't sit for over 10 minutes > with out excruciating pain...went outside only 2 times in April 1999...that > was to make the trip to New York for surgery...2 times. > > I went from my bed to my couch...took pills, waited, oh god how I waited for > 7pm so that I could take my heavy dose of sleep and pain pills and go to bed > again! I remember looking outside and my husband asking if I > wanted to try to take a walk...I was too weak and he knew that, but I said > no as it looked like it was going to rain, it looked cloudy and not real > inviting to me...you know what, friends, my husband said the sun WAS > shining and there wasn't a cloud in the sky! But, by the grace of GOD, it > looked uninviting to ME..and I didn't have to suffer the reality that I was > just to ill to even take a walk outside. What a good GOD I have...didn't > want to tempt me, I guess..but I really think he didn't want to hurt me even > more! Social life...nope, not interested...couldn't eat or sit > anyway...hadn't sat at my own kitchen table in two years...if and when I > ate, it was reclining on the couch! I loved my husband and 3 children so > much...but I was ready to go as I was just so tired...so tired, not unhappy, > not unloved...just ready to sleep forever and not lay and watch life go by, > even that didn't matter anymore...I was just so tired! The thought ofdying > wasn't scary...wasn't depressing, it wasn't really anything as I was just > too tired to want to keep laying around vomiting and in pain so that > everyone else was at peace knowing that I was still around or something...I > WAS DYING! > > What IS life if it isn't living? What is the highest quality of life for > me? To just be able to get up in the morning and move about...no vomiting, > not a lot of pills, to be able to eat. I pretty much still live on egg > custard and yogart, some scrambled eggs. NO CHEESE as cheese is so > constipating that I will forever be afraid of it..and I live in the dairy > state WISCONSIN, so I won't be doing any commercials I suppose! I mentioned > to my husband the other day how bright the sun was shining as we were > preparing to take a drive...with ME sitting up in the FRONT seat, not laying > in the back with pillows...WOW...now that IS life!!! I notice all the > little things now...but to me they are the big things...I went and grocery > shopped last week...alone! Two weeks ago my husband said he was getting > tired and was going up to bed...I said, "Ok, honey, I'll be up in a bit when > I finish puttsing here." He stopped and looked at me...it was 10pm!! He > was looking at the clock, so I did too...we both started to > laugh. HE was going to bed and I was staying up! Then we just hugged and I > started to cry...I mean REALLY cry... you see I WAS STAYING UP!!! That's > all...just something so simple; but to me it meant LIFE....I can't > continue sharing right now. I'm sorry, but all this reflection causes me to > have to deal with this and I can't...I > just want to enjoy the time I've been given....please offer support, > education, your stories...anything that will reach out and give hope and a > chance for life for all adhesion sufferers...all who suffer pain for > whatever reason...for GOD sakes...if for no other reason...for yourselves! > > GOD BLESS EACH OF YOU! > > Bev >