Improving patient satisfaction with wait times Nursing. I have been there two times for both right and left side repairs. It may be in part an attempt to keep a surgeon ratings list from being established, as patients are not allowed to pick a surgeon. I agree there is an absence of definitive evidence one way or the other, and that some surgeons seem to possess Olympian detachment when confronted with inconvenient statistical irregularity. Showered and dressed first thing. Do not use mesh, It can or will disintegrate in time like me and a friend too. This makes anyones numbers on hernia repair difficult to interpret, but the Shouldices number in particular should be viewed with a grain of salt. I cannot recall a patient ever having been in hospital for 5 days after elective hernia repair. He never admitted to any pain and shortly before my son was born developed an I augurales hernia. The washroom is our room was sporting a nearly unbearable urine smell. I have acknowledged in the comments above the rare but real risks of mesh insertion. 3 weeks after surgery, I was starting to return to running, but still avoided lifting anything heavy. They give you good care. I would love to see their numbers as well, but that is unlikely to happen soon. and then he has the audacity to tell me that I cant feel the mesh and that the pain is also in my head. My pain has continued and in the last 4 months has progressively gotten worse vs getting better. by | Jun 30, 2022 | zip code for princes town, trinidad | smbc leveraged finance | Jun 30, 2022 | zip code for princes town, trinidad | smbc leveraged finance I also saw the ambulance chasing lawyer ads in the US regarding mesh failures. Although operations are performed only five days a week, the remainder of the hospital is in operation continuously to attend to recovering patients. From what research Ive done some say physical therapy helps. Id stick to an open or lap repair with mesh applied externally. I despise shoultice because they refuse to operate on any patients over weight. Yes, but it will fade with time and is overly visible except when naked. How long ago was your surgery? The Shouldice Hospital in Thornhill, Ont., is world renowned for its treatment of hernias. 2016 Feb;59(1): 19-25. Your stay at Shouldice includes a number of patient services to enhance your care and comfort: Weve followed up with our patients for many decades and time has proven that the patient-focused, Shouldice approach is the key to a complete and successful recovery. Ive contacted Shouldice and would much rather prefer not having a foreign object inside of me, especially given that this is my first ever surgery. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); The problem with Shouldice or The most dangerous phrase in the English language- Weve always done it thisway., http://www.ncbi.nlm.nih.gov/m/pubmed/15243743/, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727805/, https://www.ncbi.nlm.nih.gov/pubmed/10452261, http://www.ctvnews.ca/health/growing-concerns-in-canada-over-surgical-mesh-usage-recalls-1.3372733. Im 27 and I have had three femoral hernia repairs in Nova Scotia, two open, and one (most recent) laparoscopic. Improving patient satisfaction with wait times. The repair is based on the Bassini repair with some modification. And it IS true that mesh design has improved not just materials, lighter, thinner, for instance Titanium coatings to reduce foreign body reactions, so problems 2 or 3 years ago may be referring to old technology. As for tension free vs not, as I said in my blog, standard of care for most institutions is tension free (ie using mesh). ParkingOn-site parking is available for hospital and clinic patients for a flat-rate maximum of $15 per day ($50 for the duration of an inpatient stay). Anyone can look up what a surgeon in Ontario gets paid to fix a hernia. Do your homework and make an informed decisiongood luck. may be involved. Im traveling from the US and paying the entire bill myself (my insurance does not cover non-emergency out of country surgery). Considered the same as Shouldice. Our specially trained surgical teams perform over 7, 000 hernia repairs every year, with an unparalleled track record . Most of my comments refer to groin hernia repair and as I said at the beginning, are based on my opinion as a medical expert and fixer of hernias, not on any raw data, which of course is not available. Pick a curve, any curve (say, the red one). Show More. Just returned from Shouldice. It is nice to have met your surgeon before any surgical procedure though. Shouldice Inguinal Hernia Repair Post-op Instructions Surgery You have just undergone surgery to repair an inguinal hernia. Many of these services are provided free to our patients. WOW. The place isrun a bit like a hernia boot camp, which I really had no issue with. Awake and aware during surgery, no pain but the feeling of pressure and intense tugging. mjk funeral home obituaries; san jose state university graduate programs deadlines Men umschalten. Besides, if the Shouldice process were to fail or post-op complications were to become unbearable, would it not be possible to use a mesh then? Studies show that half of all recurrent hernias develop many years after the original repair. Slight modifications were made in each procedure but the procedures were similar . Surely theres an advantage to exclusive, specialized hernia repairs that general surgery wouldnt necessarily encompass? There are days I literally cannot walk. Employees should be trained and equipped to manage waiting customers, communicate information, and resolve issues. I still feel very comfortable with my decision to use the Shouldice clinic. I was suprised by your posting. Ill take my chances with mesh next time all day long. We know that people often find it challenging to manage their weight, especially when they have a hernia that restricts their ability to exercise. I traveled from NY TRYING TO AVOID the horrors of the mesh repairs. I agree with Toronto that it is hard to find any real data on the Shouldice clinic. I know 2 other people who have gone up for repair both of which are now well over 30 years on the repair without issue also.. Take care safe travels. The short time before my surgery I couldnt find anything definitive saying mesh was good or bad. Toronto Transit. My concern is with the use of mesh on a growing teenage boy. Impossible to lose the weight. Lastly, I really feel strongly that clinics and surgeons which do not do emergency on call work should not be allowed to operate on an elective basis. Thanks for the comment and info. A skim off of the healthy and the wealthy to the private system, leaving the public system to deal with the emergency, unhealthy, and poorer patients. Taxi from Toronto to Shouldice Hernia Centre. Several day stats are not the norm at other hospitals, party due to the higher risk of hospital borne infections and partly to be able to service a large group of people with varying needs. The surgeon indicated that when they went in to operate they discovered I actually had two hernias (one direct and one indirect) and he repaired both. If you dont have a very classic bulging abdominal or groin hernia, they are not going to operate. Dr. Yunis and staff accommodated my physical disability, handicap. Shouldice.com A pioneer among for-profit surgery clinics in Canada has been sold to a private health corporation for $14-million, ending a family-owned dynasty that played a unique role in the. This is part of the problem with our record keeping. The surgery at Shouldice reportedly costs in the neighborhood of $5,000 to $8,000, less than a similar surgery in the U.S. that 90% of the time uses polypropylene mesh. They say Im an unusual case, but 2 years after having an inguinal hernia repaired at Shouldice I am still suffering from nerves entangled in scar tissue. He has no idea why or how it happened but didnt feel he really cared. Unfortunately it did not adequately control for risk factors known to be associated with recurrence, including obesity. The Shouldice Clinic is a private clinic operating in the Toronto area which has been open for decades. Anecdotal reports from those who have had this problem make it sound like a real living hell. Which method is the best option considering I want to get pregnant? I did read the article. Thank you. Sadly once you get the mesh and have issues with it the medical community doesnt know what to do. I got three different answers from Shouldice on how long I should wait to try and conceive after surgery (4 weeks, 3 months and 1 year). Its not much. As a specialist, I am not allowed tobill OHIP to seepatients without a referral from another doctor, and so we see the double standard growing. It is virtually impossible to find any real data on Shouldice. Ive tried to get surgery twice. When staring down the prospect of putting a foreign substance in your body, as a patient you need to be treated with respect and provide knowledge and experience when asked. The general surgeon I seen advised 6 weeks. Your comment/reply from January 25, 2016 AT 11:14 PM says: for the vast majority of patients they will be aware if their repair, or have to take medications for it., I am guessing that you probably meant:they will NOT be aware OF their repair, or have to take medications for it.. I can NOT for the life of me understand the following: Im looking forward to lesmcc1s response. But the reality is that in Ontario anyway, major hospitals are getting as bad as any private clinic in letting cost considerations trump quality of patient care, but thats a whole other topic. 2) No tacks or staples inside the abdomen to further the chance of nerve damage. Lets start with the Pros This is so helpful! Ive tried this though for me personally, it made it worse for me so they are leaning towards it rubbing on my nerves. The more you weigh and the more weight you gain after hernia repair, the more your risk of recurrence rises. And yes, Shouldice cherrypicks their cases, perhaps because they can. So one last confession. Surgeons need to do emergency work or perforated appendicitis, gangrenous gallbladders, and blocked bowels (sometimes stuck in hernias) would not be dealt with, and patients would die. I am of normal weight, but the physician who examined me advise me to loose weight, just because thats what he probably says automatically to all the patients. shouldice clinic wait times. I think 3 or 4 tomorrow in fact. We provide a lifetime of support to all our patients through our annual follow-up program. At least give your patients an informed choice based on your skill rather than your ignorance of anything other than mesh repair! What would be your expectation about how the recurrence would be repaired, and the likelihood of developing chronic pain afterward? Placed in a room with patient who had surgery the day prior. I would love to see some frequency distributions for Shouldice repairs vs inpatient time and time back to work. The office staff takes care of business very nicely, very personable, walking you through every step of the way. It is a small hospital dedicated only to hernia repair. I am also not a fan of the idea of Centres of Excellence. The idea that high volumes of doing one thing only makes you better at it. Thanks for sharing your positive experience Kram. 905-695-4967 * smahdavi@shouldice.com Cindy Giroux - Business Development Manager 905-695-4908 * cgiroux@shouldice.com: He takes the time to explain everything to you, during the consultation, before the surgery, and after the surgery. One patient told me he didnt want to go back to Shouldice with his recurrence because he couldnt afford it. I had little to no pain 4 days after the surgery, and other than a small scar, my groin has been perfect. My first week after surgery at Shouldice wasnt too bad. Beds and pillows are absolute garbage ( bring yourself a sleeping bag for the floor for a more comfortable sleep) Reilly's, a disused bar, was barricaded up by the rebels, and it . Thanks for your blog. Recovery done at home, pain meds prescribed, incisions very tidy, standard sutures, little to no swelling or bruising. I would imagine a lot of people wouldnt go back to someone who wasnt successful with their surgery the first time unless it was very minor surgery. Mesh or the Shouldice method? If I was doing only one operation, the only thing I would be is bored. Why is recurrence the worst that can happen here? But the patient should be made clear of the longstanding post-op, well documented issues of the real probability of chronic pain. Given the heightened concerns with the transmissibility of COVID-19 and the pressures on our Emergency Departments, we ask that you consider your healthcare options before visiting the hospital for non-emergency concerns. We have a big number here, dont you think? By the way, my sister is an RN at HHS who recommended Shouldice from what a Doc recommended to her. Same in the US. [2] Contents 1 History 2 Work Sounds like he needs a repair, although you dont need to worry about blood supply usually. I have a consultation in 6 months to decide if I am eligible for surgery (I can tell you now I am) at a local hospital. Its certainly an interesting place. She suggested that the nerve fibre regrowth in the skin layers around the surgical site may be causing the sensitivity. Im about 2hrs from Shouldice. Mesh does reduce the risk of recurrence but does not make it zero. From the group I saw (30 of us), virtually everyone was doing much better after the surgery. I will miss the black squirrels. I went for a long walk after the surgery. I am debating on having surgery on my right inguinal hernia and whether to do it at Shouldice or at my local hospital. 4) Shouldice ONLY carry out this operation, meaning they are presumably highly skilled and also experienced in avoiding nerves during suturing, thus improving chances of post-op pain free life. Another confession, I alsomake money doing hernia repairs, but I dont make nearly as much as the Shouldice does off their patients. That is, to avoid mesh and avoid any of the potential complications from mesh (primary fear usually is chronic pain in the groin, mesh migration, foreign body sensation from mesh, etc). Hopefully you find an answer. As I said at the beginning, this blog is my opinion and I have a conflict of interest BUT evidence based medicine would say you need to be doing hernia repairs with mesh. The standard of care when the Shouldice was formed was a primary (suture) repair and lots of days in hospital recovering from the pain of having your own tissues reamed together to repair the hernia. Most patients I know of that go to Shouldice go there specifically for the expert all-tissue repair, the classic old fashioned hernia repair sutured with their own tissues. To decrease the text size, press and hold down the command key on a Mac or the windows key on PC, then press the minus (-) key. I find this mind boggling- this approach was abandoned in the rest of medicine decades ago. Ive read of issues with all repair methods except for TAPP laproscopic have you heard of it? I imagine quite a few would turn tail and run, but listen: I was NEVER in pain and it only lasted 5 days and it had to be done. Hilton Garden Inn300 Commerce Valley DriveThornhill, ON L3T 7X3905-709-60083 miles from the hospitalTo receive a 10% discounted Shouldice rate click here. You . Personally, I have a walnut sized umbilical hernia and am within the upper bounds of the ideal physical category. This is so important, but our electronic medical records do not allow that to happen at this point in time. Others who have had surgery at their local small hospital and everythings good. Posted on September 8, 2011 by Ewen. You are correct, we should have much better reporting systems than we do. Myself, and others who are wary of mesh, are reacting to the very real possibility of chronic severe pain, and other complications like erosion, migration, and neuroma that can come from mesh. I have had a similar issue with the mesh (surgery May 2017) and tried a nerve block. To see how we do a Modified Shouldice visit http://www.herniaoperation.co.uk I have only good things to say about the Shouldice! Toronto is known as a wonderful getaway destination for those who enjoy world-class theatrical productions or professional sports. If I had an unhappy patient who did not want to have surgery with me again, I would refer them on for a second opinion. The whole experience was quite pleasant, and Sarasota, Florida is a beautiful, wonderful place to visit. Should I wait or should I see a surgeon right away? . My husband got discouraged and gained even more weight. (LogOut/ No referral is required. In addition to issues of capacity and organizational analysis, describes a well-focused, well-managed . We've found that this peer-to-peer mentoring is important. A very hard ridge is forming under the incision, which the patient discharge sheet says should be expected. Meaning the hernia comes back, requiring a second repair. I dont want to come off too confrontational but I am going to be blunt. Like you, I will flying from US and I am not sure how well those stainless steel sutures behave at airport scanners or other body scanners / MRI scanners ?? Shouldice is the gold standard of no-mesh hernia repair. Secondly, I have not heard of desarda method. Is the mesh currently being used the same product that has been on the Toronto news where they move around internally after coming loose? The issue is really about the size of the facial defect vs the risk of recurrence with and without mesh. 80%| 10. Shouldice would take me again, the surgeon Im scheduled with said ideal patient, all these things mean is low risk for the actual surgery, doesnt mean itll work or not give you issues down the road. They dont call it the Shouldice Experience for nothing. The Shouldice procedure was learned from personal observation at the Shouldice Clinic, a book, 9 and instructional articles. In my opinion Justin you could have got 10 opinions and with a different surgeon had the same unfortunate result. I hear that the wait time is up to a few years for the surgery itself. It's nice and bright! 2 The Lichtenstein procedure was learned from a book, 10 instructional videos, and personal communication with Irving L. Lichtenstein, MD. Train operators. The Hospital was founded in 1945 and performs over 7000 hernia repair operations a year. Shouldice Hospital recommends a healthy diet for hernia repair, and one that focuses on achieving an acceptable body weight. Having said that, if you have your hernia repaired without mesh (by Shouldice or anyone else), and it recurs, you can have another surgery at that point. I cant get a job people think Im pregnant or will need a leave of absence. Which must annoy surgeons who use only mesh). Care and service do not stop once you leave Shouldice Hospital. I did have some minor discomfort around the surgical sit, but nothing that I felt was an issue. Thank you for putting so much valuable information over here. In thinking Doctors are same as a lot of other industries. Do you yourself know how many of your hernia surgeries fail? Over the past two decades this small 90-bed hospital has averaged 7,000 operations annually. Shouldice Hospital is a bit of curious place. Hi thanks for your article. 5 weeks after surgery, my scar looks pretty much healed and I expect it will fade with time. On rare occasions Ill have a minor sensation in the area but that may just be from something Ive done and all in my mind that its related to the op. Cataract implants, joint implants, tubal ligation clips are all examples of other extremely safe foreign materials we implant in patients for their benefit. Certainly not brochure material. It was then allowed special licence by the Ministry of Health to continue operating. It is very painful to walk, stand, cough, sneeze, laugh, use the washroom in any capacity and expect from the bruising that this will carry on for atleast another week. The limited walk-in spaces are available on a first-come, first-served basis. I have constant pain of some kind from stabbing to just dull along with foreign body sensation. There is some evidence that using generalistsis a cheaper, better way to run a health care system and I believe that. You, and others like you, in other words. First scheduled patients moved to pre-surgery prep. Shouldice prepares you for your hernia operation and recovery. Pain is tolerable(sensation of burning/stabbing in groin) that subsides quickly with reduction of effort/strain. Im left asking the question do I fix it now or after pregnancy? I dont know what the exact policy is on inpatient stay at Shouldice, the website said at least one day pre op, and an unspecified number post op. Employee Training Those who are picked to be on the front-line, are the ones who can help create a great customer experience. From a patient and voter point of view, I dont see why all surgeons need to do emergency or on-call work. Any advice would be appreciated, I am athletic, non-smoker, late 20s. Realistically, I am 50, 57 and 163 pounds, am I really going to lose 30 pounds and keep it off for the rest of my life? Leave jewellery and other valuables at home. This is why they went to Shouldice in the first place, in the Toronto area it has a kind of mythical acclaim. 3. shouldice provides hernia repair with a short hospital stay. They told me they were being charged much less at Shouldice than they would have paid out of insurance in the US. My biggest concern with the Shouldice clinic is that you might get a very experienced surgeon, or you might get a surgeon that is quite inexperienced (relative to the rest of the staff). When I went for my pre-op. There are some awful stories out there. 3) Shouldice use sutures only, minimising foreign material being implanted into body, hence minimising most of afore mentioned risks associated with nerve damage. We are currently accepting patients in our Examination Clinic by appointment or limited walk-ins on a first-come, first-served basis. Pure tissue technique, according to yourself and other general surgeons, has the risk of recurrence. The biggest problem with the Shouldice hospital is you cannot choose your surgeon and like anywhere there are good ones and bad ones. In order to lose the proper amount hed need to eat saw dust and exercise. Change). I have had a right side inguinal hernia for 1.5 yrs and am scheduled for mesh repair locally end of May (bumped from mid-May). I would also, I hope, be getting angry calls from our hospitals administrators asking what the hell I was doing keeping patients in hospital for so long after such a simple procedure. I did not get a reply what so ever until September 2014 advising me that they can operate on me. mjk funeral home obituaries; san jose state university graduate programs deadlines Men umschalten. There is a small hard spot just under the belly button but it is slowly shrinking, I was told this could take some time. Absolutely not. This is why mesh is now preferred. Please call 905-695-4911 to book a time. (2) do you know of the desarda method of no mesh surgery? He is based in New York and covered by my insurance. in sum, shouldiced uses high value, low cost strategy. I was extremely excited to not have to wait a long time to get in for an operation as the hernia was making it almost impossible to drive. Dr. Shouldice graduated from the Univ of Ottawa Fac of Med,Univ of Ottawa Fac of Med in 1979. I do not feel Shouldice does an honest job of their success rate, but they are not the only place or surgeon to do that for sure. My biggest concern is chronic pain and it seems there is a lack of research reporting on chronic pain and pregnancy. A: The Shouldice repair is named after Dr. Edward Earle Shouldice (1890-1965), the Canadian surgeon who invented the technique in the 1940s. Affiliation 1 Anna Bradshaw is an FNP student at . In general looking forward to a day when performance stats for regulated professionals and their related clinics/practices will be available for scrutiny then we can all make decisions based on merit rather than hearsay or fuzzy notions of reputation etc. But Im glad you had a good experience and outcome. The 3 scars have pretty much healed up. Our clinic offers hernia examinations by appointment or on a limited walk-in basis. (thats gotta mean something!). On call is hard but necessary work and I , as a Royal College trained surgeon, would not be allowed elective operating time anywhere if I did not offer on call services. Im probably an anomaly in the hernia world, but my story is horrific and Im still passing through it. I am quite disappointed in myself for not having done a thorough investigation prior to my Shouldice fix. Are you willing to be more specific about the nature of your problems post op? And if not, would I need further surgery in my 60s if I gain a few pounds. Change), You are commenting using your Twitter account. We encourage you to take advantage of these beneficial patient programs. Following this summers logging and landscape work I will report the status of all three repaired hernias. Shouldice is licensed by the Ontario Ministry of Health, which covers the entire cost to Ontario residents of hernia operations there under OHIP, the. I would like to see much more transparent reporting and rating of all surgeons & hospitals & clinics. I wonder what steps should I take once Im ready to see a new surgeon in Ontario? Thanks Kram. I just want the best treatment possible with the lowest chronic pain! The doctor in Quebec told him to lose 30lbs and he did but while waiting his hernia became even larger. The first consultation is walk in which for me meant a 3 hour wait in a run down old estate living room. in the area have been giving me the run around on who to see so now looking to go where there is someone more specialized. I just had my inguinal hernia repaired at Shouldice. The typical Shouldice patient only experience s 5 days of required recovery time after their surgery, while hernia patients from other institutions typically experience 10 days of recovery time. We are committed to recruiting and retaining the most talented people and are focussed on creating a workplace where people enjoy the challenge of their career, create and engage in best practices, and are treated with respect. Theyre like impossible to find it seems these days. I briefly looked at the website, and I would have the same concerns as with the Shouldice, namely that recurrence rates for hernia repairs without mesh would be unacceptably high unless in a highly selected (skinny) population in North America. 0. Shouldice of course sends most of the patients it sees back to where they came from, and does not have to worry about complications or ongoing issues from their repairs. Also, I doubt if any teaching staff in state/public schools has many good things to say about private education, the reasons only too obvious. I since switched meds and lost a bit of weight but Its so difficult to even move with a cantaloupe sized abdominal hernia. Well keep in touch every year and offer you an opportunity to have your hernia repair checked and monitored by our surgeons. We take meshes out for pain on a weekly basis. To you doctors and surgeons; I do wonder if you feel any guilt for installing these meshs in your otherwise healthy patients I certainly couldnt do it from what I now know. The day after and two days after the operation I walked around the Shouldice property which helped with circulation and recovery. .1st operation to save my life. Certainly everybody who is having a hernia repaired should carefully discuss the pros and cons of using mesh- its a very individual decision and patients deserve to be well informed. In fact, after asking permission and explaining the purpose, they live-streamed my operation to a Surgeons conference in Victoria, BC. Did I have any discomfort during recovery? I really dont want to get into a lot of detail about the complex world of hernia repair here, but the world surgical community has moved on from primary repair with lots of inpatient days and the Shouldice has not.