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How do adhesions feel? How do adhesions feel?

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  #1  
Unread 03-27-2003, 07:16 PM
How do adhesions feel?

hi girls

I'm almost 8 months post, and I thought the recent "tugging" kind of pains in my abdomen were simply my insides still healing. I've had a great recovery period, all in all...some tenderness, and still a bit of swelly belly every now and then, but over the last couple of months the discomfort has gradually increased to Tylenol #3 level. (isn't it bizarre? I measure my pain by meds!)

But I'm not sure - I kept both of my ovaries, and the "tugging" pain isn't anything like the pains I had before surgery.

The discomfort is worse when I'm particularly active - unfortunately, my husband has been suffering from health problems too and I'm doing pretty much everything for him...this might not be helping the situation.

Any advice? experiences?

Many thanks and warm wishes,

Tess
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  #2  
Unread 03-27-2003, 07:57 PM
How do adhesions feel?

Tess,

From a long time adhesion sufferer, let me see if I can give you a little bit of my past experience with them.

Pulling is probably a very good description especially in motion like bending etc. My pain only became prominent as they became stronger(my opinion). My understanding is that they grow thicker and shorter as time passes thus pulling more on whatever they have attached to. It is not the actual adhesion that is painful but what it has attached to or bound together that causes the pain.

There is a great website www.adhesions.org that has lots of info that might shed some on the subject further. Also, the thread here on the road on adhesion info has a lot of links that SHERI provided about 3 post down.

Big s sister, that you will get some resolution to what is going on. Please do give your DR a call if you haven't already, anytime pain exceeds normal OTC pain meds or continues for a long time period it is wise to get their help and dx.

Please keep us posted, sending lots of prayers your way,
lenee
  #3  
Unread 03-27-2003, 08:06 PM
Hello ((((( Tess )))))

Sorry you are having pain...

Your description sounds familiar...

When my pain started it was like a spasming type pulling sensation in my lower pelvic area and lower back/sacrum area.
I experienced more pain during weight bearing movement, like standing & walking.

By the time I would get out of the shower in the morning I would be in excrutiating pain. It was horrible. So, I, like many of our sisters understand.

However, because we share the same type of pain doesn't mean you do have adhesions. You should call your doctor and schedule an appt to discuss it. And, as Lenee mentioned, there are links posted by Sheri in the adhesion post.

Good luck to you...

Lori
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  #4  
Unread 03-28-2003, 06:20 AM
How do adhesions feel?

((Tess))
I experience that sharp/stabbing/burning pain in my right side, cramping pains thru out my entire pelvic & abdominal area that goes thru my back & down my legs. I consulted w/ several Specialists & Surgeons who all stated that more surgery was to risky & would probably worsen the pain & damage. I do see a Pain Dr to treat my pain...


  Quote:
One cause of pain that your doctor might consider is adhesions, particularly if you have had abdominal or pelvic surgery. Adhesions are commonly associated with pelvic pain. In fact, an estimated 38 percent of women suffering from pelvic pain have adhesions. While some adhesions may be painful, most of the time they are not.

Adhesions can cause pain by binding normally separate organs and tissues together - essentially “tying them down.” The stretching and pulling of everyday movements can irritate the nerves involved. Some adhesions can cause pain during intercourse.
While pelvic pain can be an obvious symptom of adhesions, there are other serious complications of which you should be aware
http://www.ethiconinc.com/womens_hea...lvic_pain.html
  Quote:
Vascular adhesions are thick, more like string or ropes connecting two organs which are not suppose to be connected (e.g. the ovary to the bowel). This type of adhesion can cause pain. Scar tissue that forms after surgery, usually does so in the first couple of weeks. Adhesions rarely form months or years after surgery. However, this type of adhesion can become progressively shorter over time as it matures. This is the reason that the pain associated with this type of adhesion can become progressively worse months following the surgery. Dense cohesive adhesions connect two pieces of tissue together tightly, similar to gluing two pieces of wood together. There is no space in-between the two pieces of tissue. This can be the worst type of adhesions to have. This is technically the most difficult to remove and the most likely to recur after it is removed. The most common location we see this type of adhesion in gynecology is between the ovary and the pelvic sidewall. The patient may experience pain just prior to ovulation when the follicular cyst forms, tugging on the adhesion. Finally, scar tissue can be present but not connecting two body parts together. This is a tough leathery type of tissue. An example is the thick tissue that can be left after a severe burn. Inside the body this tissue can cause pain when growing on the bowel, ureter (the tube from the kidney to the bladder) and nerves. Remember scar tissue tends to shorten over time. When it is growing on tissue it will tend to restrict the normal tissue's movement or constrict the tissue ever tightening its grip. This can result in abnormal bowel motility, narrowing of the ureter (causing dilation upstream and pain, usually mid back), or pressure on a nerve resulting in pain. http://www.drcook.com/adca15.html
  Quote:
What Are the Symptoms of Adhesions?
Symptoms vary depending on the tissues involved. For example, in the gastrointestinal tract, bowel obstructions may occur. In the uterus, adhesions can cause ... In the pelvis, adhesions can cause infertility and other reproductive problems.

Clinically, adhesions present as fever, chronic or acute abdominal, pelvic or chest pain, partial or complete mechanical bowel obstruction, and infertility. Mechanical small bowel obstruction after previous surgery can be the most severe effect of adhesions.

Adhesions may be responsible for chronic persistent abdominal pain without associated pelvic pathology. Clinically, adhesions present as chronic or acute abdominal or pelvic pain, partial or complete mechanical bowel obstruction, and infertility. Though adhesions probably cause pain by entrapment of expansile viscera, the relationship of adhesions to abdominal pain is still controversial. In contrast, mechanical small bowel obstruction after previous surgery demonstrates unequivocally the most severe effect of adhesions.

Patients with chronic or recurrent abdominal pain and a history of numerous abdominal surgical procedures are often denied treatment if they are not obstructed or symptomatic of intermittent bowel obstruction. This may be because, from the surgeon’s viewpoint, adhesiolysis is associated with low reimbursement for long operations with high medicolegal risk. Also, adhesions may recur, and the risk of enterotomy (a hole in the bowel) during surgery is very high.

While surgical therapy is withheld, multiple abdominal diagnostic procedures including abdominal CT scan are frequently ordered. The patients are then sent to chronic pain clinics for evaluation. Though few studies exist, a recent report suggests that women with severe, dense vascularized bowel adhesions have a significant reduction in pain after adhesiolysis.

Extensive small bowel adhesions are not a frequent finding at laparoscopy for pelvic pain or infertility. In these cases, either the tube is stuck to the ovary or the ovary is adhered to the pelvic sidewall. The rectosigmoid (the rectum and sigmoid colon) may cover both. Rarely, the omentum (a fold of peritoneum extending from the stomach to adjacent organs in the abdominal cavity) and small bowel are involved.
http://www.adlap.com/adhesions.htm#Symptoms?
  Quote:
Although these bands may involve any organ in the abdomen, the type of adhesions most likely to cause problems are those affecting the small intestine. Adhesions can cause an external obstruction of the small intestine by crossing over a loop of intestine and preventing intestinal contents from passing through. In fact, the most common cause of obstruction of the small intestines is adhesion formation. Patients who develop obstruction complain of a crampy, abdominal pain, often accompanied by nausea, vomiting and abdominal distention. An X-ray of the abdomen provides information to make the diagnosis.

Patients with obstruction often improve spontaneously after treatment in the hospital with IV fluids and nutrition. However, in some cases, the obstruction is complete or persistent, resulting in "strangulation" of the bowel. These cases may require emergency surgery to remove the adhesions.
http://www.ivillagehealth.com/expert...1560-2,00.html
  Quote:
You may have found this site because you are experiencing the symptoms of pelvic pain or infertility. Or, you may have already seen a doctor, and you are now preparing for gynecologic surgery. In either case, you should talk to your doctor about adhesions – both treatment and prevention. Remember, your doctor won’t necessarily bring up every adhesion treatment or prevention method available. It’s up to you to be proactive and encourage a frank discussion about the options available to you. You may have found this site because you are experiencing the symptoms of pelvic pain or infertility. Or, you may have already seen a doctor, and you are now preparing for gynecologic surgery. In either case, you should talk to your doctor about adhesions – both treatment and prevention. Remember, your doctor won’t necessarily bring up every adhesion treatment or prevention method available. It’s up to you to be proactive and encourage a frank discussion about the options available to you.
To determine whether adhesions are the cause of symptoms such as pelvic pain or infertility, your doctor may perform an exploratory procedure using a laparoscope (a narrow lighted tube inserted through a small incision in the abdominal area) to inspect the abdominal cavity and pelvic structures. Laparoscopy has become a standard method for diagnosing various gynecologic disorders.
http://www.ethiconinc.com/womens_hea.../talk_doc.html
  Quote:

What Should I Ask My Doctor About Adhesions?
Because adhesions are quite common following surgery, and potentially can result in serious complications, it’s very important to discuss them prior to any abdominal or pelvic operation. Learn all you can about what your surgeon plans to do to to help prevent adhesions.
It may be helpful to be prepared with the following questions:
  • How likely is it that adhesions will form as a result of this procedure?

    What will be done during the procedure to help prevent adhesions from forming?

    Is the use of a barrier method of adhesion prevention right for me?

    Are there symptoms of adhesions that I should watch for as I recover from surgery?

Learning all you can, and having an open discussion with your doctor about adhesion prevention is the way to help ensure the best surgical outcome possible.
http://www.ethiconinc.com/womens_hea...questions.html
I hope this was of some help Good Luck w/ finding some answers & relief Pls keep us posted....(((hugs)))

PS~Here is some info on Adhesion Prevention:

http://www.ethiconinc.com/page/patient/index.html
http://www.drdaiter.com/hyst_ecto/hyst3.html

2nd look Lap:
http://www.reproductivecenter.com/m...aparoscopy.html

Can Adhesions be prevented?
  Quote:
The only way to treat adhesions is to remove or separate them surgically. This procedure is called adhesiolysis. Studies have shown that patients with pelvic pain and severe adhesions can experience a marked reduction in symptoms after adhesiolysis.

However, even following adhesiolysis, adhesions reform more than 70 percent of the time. That’s why adhesion prevention is so important.

Meticulous surgical technique – Careful surgical technique can help minimize trauma, minimize the interference with the blood supply, prevent the introduction of foreign bodies, minimize bleeding, lessen the incidence of raw surfaces and decrease the incidence of infection - all of which help reduce adhesion formation.

Although adhesions often form after gynecologic surgery, they are not inevitable. And, even if adhesions do form, they usually don’t cause pain or other problems.

Although there is no way to eliminate the risk of adhesions completely, there are steps your surgeon can take to reduce the likelihood of adhesion formation. The most effective methods of adhesion prevention involve meticulous surgical technique and the use of a physical barrier to separate tissue surfaces while they heal.

Surgeons have developed minimally invasive techniques such as the laparoscopy, that are designed to minimize trauma, blood loss, infection, and the introduction of foreign bodies, all of which can lead to inflammation and adhesion formation. Good surgical technique involves minimizing tissue handling, using delicate instruments, and keeping the tissues moist when they are exposed to the air.

While good surgical technique is important, it is often not sufficient to prevent adhesions. There are also other preventive steps that can be taken:

http://www.ethiconinc.com/womens_hea...oduct/faq.html
  Quote:
"If the adhesions are extensive, and the patient has undergone previous adhesion surgery that failed, I have taken an unorthodox approach to such individuals. Because adhesions begin to form almost immediately, along with the healing process involving the raw anterior abdominal wall, I have in special situations recommended a repeat laparoscopy in one week. At this point, the "new" adhesions are flimsy, soft, do not contain a blood supply, and can be swept away with minimal tissue injury, compared to a conventional adhesiolysis (freeing the adhesions surgically) of old adhesions that are dense, very adherent, and bloody. This is performed in an outpatient setting, and usually takes but a few minutes, compared to the time involved dealing with extensive, dense old adhesions." http://medseek.com/glennbradley/newsdetail.cfm?ref=264
Adhesion Prevention Home Page:
http://www.adhesions.com/welcome_main.html

Proven Adhesion Prevention:
http://www.genzymebiosurgery.com/opa...vel=2&opage=66

Welcome to SPRAYGEL :: Adhesion Barrier: http://www.confluentsurgical.com/spraygel/usa_home.htmA Meta-analysis of Interceed Barrier Safety/Efficacy:
http://www.adhesions.com/clinical_studies.html

Interceed:
http://www.ethiconinc.com/womens_hea...interceed.html

Contemporary Adhesion Prevention:
http://www.centerforendo.com/news/ad.../adhesions.htm

GYNECARE INTERGEL® Adhesion Prevention Solution:
http://www.fda.gov/cdrh/pdf/p990015.html

Seprafilm surgical intestinal adhesion prevention: http://www.gbcrs.org/seprafi.html

CO2 laser, Harmonic Scalpel, Electrosurgery, LAP Surgery:ADHESIOLYSIS:
http://www.endogyn.com/en/endogyn-en.htm

ANTI-Adhesion treatment for Gynecologic surgery:
http://www.fda.gov/bbs/topics/ANSWER.../ANS01117.html

Gynecare Intergel:
http://www.ethiconinc.com/womens_hea.../intergel.html
  #5  
Unread 03-28-2003, 09:29 AM
How do adhesions feel?

Hi Tess!!

Well, it looks as though you have received an enormous amount of adhesion info C/O SHeri. She is the info QUEEN!!

I have read alot of the info she provided and I think that adhesions are PART of my problem. :cry:

I hope you can get in to see your Gyn to discuss your pain with him or her. Everyone heals at a different rate and it MAY be just the healing process, but then again you can never be too safe by consulting your Dr about it..

I hope you are feeling better!!

PS... I replied to your PM you sent me, I hope you got it, let me know if I can help in any way!!



Pam
  #6  
Unread 03-28-2003, 10:22 AM
Adhesions

Hi Tess,
Your symptoms sound remarkably like mine. Mine started at 5 months after surgery and became progressively worse. I too measure my pain by medication needed!! My pain level went from Tylenol once a day to Vicodin twice a day.
It was a pulling pain, stabbing at times.
I had lap. surgery on the 17th of this month--multiple adhesions were found, removed and a barrier (Interceed) applied.
I'm not saying this is your problem, but anything causing you that much pain needs to be addressed with your doctor.
Best of luck to you,
Kristy
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