What I've learned about Adhesions Related Disorder (ARD)...

From: Helen Dynda (olddad66@runestone.net)
Thu Feb 6 16:16:38 2003

I'm not a medical professional; but I can share what I've learned about Adhesions Related Disorder (ARD) with you. Based on my experience of having lived with chronic pain for more than 32 years, it was my constant search for information that eventually led me to a medical professional, who listened to me, believed me and offered me a diagnostic laparoscopy - as the way to determine the cause of my pain. Based on my symptoms, he told me he thought my symptoms sounded more like adhesions than endometriosis. ADHESIONS!! I had never heard of adhesions before!!

I agreed to have a diagnostic laparoscopy; and as a result I learned for the very first time that I had developed massive adhesions following a laparotomy I had in 1970. The massive adhesions had attached my omentum to my abdominal wall as if these surfaces had been bonded or glued tightly together. You may find it hard to believe; but it had taken me 27 years to finally learn the true cause of the chronic pain that had dominated my life. I can't stress enough how important it is to learn as much as you possibly can about the symptoms that are affecting your life - physically, emotionally and psychologically.

If you are suffering from chronic pain - and all of your diagnostic tests have been negative or normal for abnormal pathology - it is quite possible you may be suffering from adhesions. A diagnostic laparoscopy is the only way that both adhesions and endometriosis can be diagnosed!! If you've been diagnosed as having adhesions or endometriosis (or both), it's very important to start learning as much as much as you can. ARD is so poorly understood by the medical profession; and there are far too many doctors who don't believe - or won't admit - that adhesions can cause pain!! With the knowledge you gain, you will be able to recognize if your doctor has the same understanding about ARD as you do. If he/she doesn't, then it's time to look for a doctor who does!!

" Knowledge gives you strength. Knowledge gives you courage. Without courage there can be no progress. Without progress there is no solution."

ARD is not recognized by the medical profession as being either a disease or disorder!! As a result, surgeons are very poorly reimbursed - by health insurance programs and government insurance programs (Medicare and Medicaid) - for the time required for a skilled laparoscopic surgeon to complete a lengthy, very difficult and risky adhesiolysis procedure. Consequently, very few surgeons are willing to perform adhesiolysis procedures!! However, if the patient is experiencing a complete bowel obstruction, this becomes an emergency situation - and the surgeon has no choice but to operate!!

You will learn that there are three adhesion barriers currently available in the United States: Interceed, Seprafilm and Intergel. The FDA has approved the use of these adhesion barriers for open abdominal procedures (laparotomy) only!!! Only an informed doctor would know that adhesion barriers are available. A doctor, who is not aware of adhesion barriers, will not have the skill and experience needed to apply these adhesion barriers correctly.

Unfortunately, none of these adhesion barriers is 100% effective. Each barrier has its own problems. Seprafilm is brittle and is difficult for the surgeon to use. When moistened, Seprafilm becomes sticky and very difficult for the surgeon to apply. Interceed will not be effective if any blood is left in the abdominal/pelvic cavity. Intergel was approved by the FDA in 2001 - for use in open abdominal (laparotomy) procedures only. Since none of these barriers is consistently effective, many of the best surgeons do not apply an adhesion barrier at the conclusion of a surgical procedure!!

In November 2001 the Confluent SprayGel adhesion barrier was approved by the European Union for use in laparoscopic surgical procedures in Europe. June 2002 SprayGel clinical trials began at several locations in the United States. tt may take a couple of years before Confluent Surgical will be ready to present the result of the SprayGel clinical trials to the FDA for their approval. Currently, SprayGel is being used in Australia, Europe and the United Kingdom - with encouraging results!!

The purpose of an adhesion barrier is to prevent the formation of adhesions. Adhesions are known to form within three hours following a surgical procedure. This completely natural and normal process is how the human body tries to heal and protect itself following a surgical procedure!! Adhesions will continue forming for up to 7 days!! After 7 days - and as the adhesions mature - adhesions gradually begin to shrink and become more dense.

If adhesions have attached any of the internal organs to the peritoneum, this will cause pain!! For example: If the adhesions have attached the bowel to the peritoneum, the peristalsis of the bowel will pull or cause a twisting action on the peritoneum. The peritoneum has a rich supply of nerve endings; and the continual peristalsis action of the bowel on the peritoneum will cause these nerves to become irritated and inflamed. This constant irritation and inflammation on the peritoneum will cause PAIN!!

What you don't know can hurt you. Knowledge is power in a doctor/patient relationship


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