Since my surgery in January 2002, I continue to be free of the pain caused by adhesions!! However, it is still too early for me to know for sure. Dr. Wiseman has commented that adhesions can return years later; and after reading some of the messages on the IAS MB, I am beginning to believe he may be right.
I have learned that adhesions begin to form as soon as 3 hours after surgery!! How do I know this? I have read about surgeons, who have performed lengthy (more than 3 hours - to as many as 10 hours) adhesiolysis procedures -and have actually seen the formation of adhesions in places where they had already lysed adhesions!!
After a surgical procedure, if any adhesions are going to re-form - or if any new adhesions (de novo) are going to form -they will continue to form for up to 7 days following the surgical procedure!! After 7 days adhesions - left within the abdominal/pelvic cavity - will begin to mature. As adhesions mature, they shrink (shorten) and become toughened; and as a result, it won't be long before its victim, the adhesion-sufferer, experiences and has to deal with chronic pain again!!
I am free of the pain of adhesions!! I wish I could tell you that I'm free of pain - but I can't. I was hoping Dr. Korell would be able to resect the painful scar tissue that resulted from a laparotomy I had in 1970. This scar tissue is located at the lowest point of the laparotomy incisional scar (just above the pubic bone) - but deep within the sutured tissues.
The day before my January 2002 surgery, Dr. Korell explained to me what happens when a surgical incision is made. As I understood him to say: When the surgeon makes an incision with a scalpel, he/she has to cut through several layers of tissue, etc. Unfortunately, in the process of making an incision, nerves are also severed (cut)!!
At the conclusion of the surgical procedure, the surgeon then sutures each layer of tissue together. The scar tissue - that forms along the severed edge of each layer of tissue - forms a barrier that prevents the severed nerves from penetrating through the scar tissue and prevents the nerves from reconnecting to their former nerve pathway. The result? The severed nerves become trapped!! Since the nerves cannot penetrate the scar tissue, the nerves begin to and continue to " mis-fire." It is the trapped nerves that cause unrelenting pain
Dr. Korell has had some success with freeing up trapped nerves - via an abdominal revision procedure. Since I was desperate for relief from pain, I was willing to try anything that might help - in spite of Dr. Korell's explanation about scar tissue causing nerves to be trapped. Had I not been so deperate and filled with hope, I might have used my analytical brain and realized (since the odds of a successful abdominal revision are unpredictable) that my hope for success and pain relief was also unpredictable.
When I had surgery in January 2002, I decided to take a chance by having an abdominal revision (like a bikini cut) in addition to an adhesiolysis. Dr. Korell applied both SprayGel and Intergel to the areas 1.) where adhesions had attachd my bowel to the peritoneum in the RLQ; and 2.) where adhesions had attached my omentum to the abdominal wall.
In spite of Dr. Korell's very careful and skillful surgical expertise, the abdominal revision was unsuccessful in eliminating the pain I continue to experience. The recovery from the abdominal revision has been a very painful experience!!
I can best describe the pain of trapped nerves as being a constant burning, knife-like pain that radiates throughout my lower pelvis and out to both of my hips. Sitting exacerbates the pain; however, I don't let the pain prevent me from sitting. I rely on the psychological technique of distraction to keep my mind so busy that pain messages lose their impact. Distraction has worked very well for me for most of my life!!
Scar tissue is NOT the same as adhesions!! To recapitulate: The scar tissue - I am referring to - is the scar tissue that forms within the tissues as a result of the incision made at the time of the surgery. As the tissues heal, scar tissue forms - creating a barrier that the severed nerves are unable to penetrate!!. Consequently, the nerves begin to "misfire" - and that's what causes the pain!! I'm not sure if my description of inter-tissual scarring is completely acurate; but I think you will get the picture.
Beverly Doucette was invited by Dr. Harry Reich to attend the International Society of Gynecologic Endoscopy (ISGE) Congress at Berlin in late April 2002. During a break Bev found the opportunity to open a discussion about laparotomy procedures and inter-tissual scarring. In a matter of a few minutes, Bev attacted about a dozen surgeons, who also entered into the discussion. Bev used my experience with inter-tissual scarring - from a laparotomy in 1970 - as the topic for discussion.
These highly educated and very experienced laparoscopic surgeons had NO idea that scarring from a laparotomy incision would cause debilitating pain!! Now they do know - including Dr. Reich. Dr. Reich told Bev that he plans to write a paper about inter-tissual scarring!!
According to Bev, there isn't anything surgeons can do to "fix" inter-tissual scarring!! Once nerves have been severed, nothing can be done surgically to restore the nerves to their former nerve pathways!!
Medical research has not found a way to prevent the human body from forming adhesions - as the body heals and protects itself. That is the reality!! Medicine is still in the "Dark Ages" regarding the formation of adhesions and inter-tissual scarring!! Hopefully, someday soon medical research will discover "the key" that will provide surgeons with a barrier that actually will help to prevent adhesions.
As of 2002, Confluent Surgical's SprayGel adhesion barrier is showing real promise; but will SprayGel continue to show promise in the long term? That's the million/billion dollar question. I sure hope so!!!