iThyroid.com

HERNIA

February 22, 2002

(I thought today would be a good day to write out this information, while I still feel  the pain from my latest hernia surgery.)

My belief is that hernias are the result of nutritional deficiencies, as opposed to the common theory that they result from heavy lifting. Copper deficiency is most likely the key deficiency which causes hernias.

Copper is essential for collagen production and when copper gets deficient, then the collagen fibers get weak. Collagen provides the structure which holds the muscle fibers together, so this weakening can result in a separation of the muscle fibers, allowing the inner tissues to protrude.

There are many types of hernias and these can occur in persons of any age, including newborns. I have had two inguinal hernias: the right side in 1993 and the left side in 1997. Each was repaired using a polypropylene mesh (brand name Marlex) as a reinforcing material.

My surgeon told me that hernias repaired without a mesh have about a 16% chance of  recurring, while those with the mesh repair recur only about 2% of the time. I was concerned about the possibility of having some reaction to the mesh, but he informed me that there was nothing to worry about. 

The hernia repair I had done on the right side in 1993 went well and I never had another problem with it. I had waited about 7 years (not a typo!) from the time I first developed the hernia to the time when I had it repaired. Interestingly, I developed the hernia during one of my fasts. I was fasting because I wasn't feeling well. Most likely I had a copper deficiency and should have been supplementing with copper rather than fasting! I tried many suggested therapies to correct the hernia naturally, but none of them worked. I managed to get along by not eating before any physical activity. If my colon contents were minimal, I was usually able to play basketball or hike without problems. However, if I had eaten I'd have to constantly push the hernia back in. 

The hernia repair I had done in 1997 went smoothly also. I didn't wait very long to have this one repaired, since I had success with the previous repair. However, this repair came back to haunt me four years later. Also, of note: this hernia repair was performed just a few weeks before I started developing hyperthyroidism. I don't think there was a causal effect from the operation or the mesh, but who knows. Most likely I had a copper deficiency which was the major factor in both the hernia development and in the hyperthyroidism.

In late June, 2001, I started getting a soreness in the left groin area. Right where the diagonal scar from the '97 hernia surgery was, it started to swell, get sore, and turn red. Within two weeks the sore opened and started draining. This is when I started doing research about mesh rejection.

Apparently there is a problem with mesh rejection since it's in the medical literature. Various studies have shown that between 1 and 4 people per thousand will reject the mesh. The standard medical treatment for mesh rejection is surgical removal of the mesh.

At first I thought, "What luck...I was that one in a thousand....", but the more I thought about the rejection problem, the more I realized that I'd be the person to get it. I have never been the type who has allergies or other problems like that, so I didn't think that it was because my body was too weak to tolerate the foreign object in my body. My thinking was that it was the opposite: my body was very strong and well nourished and had the energy to push out any foreign object.

What I have done with my nutrition since developing this hernia is quite different from what most people do. Supplementing with copper and other nutrients that support  thyroid and collagen health has significantly changed my body chemistry. Most people don't do this.

By supplementing with copper, my body now has the capacity to rebuild the tissue where the hernia occurred. This means that as it rebuilds the tissue, it gradually pushes the mesh out. 

With this theory in mind, I decided to wait as long as I could before getting the mesh taken out. I was actually hoping that my body would push the mesh fully out of my body so I could avoid surgery. I would have to change the bandage twice a day and the gauze would be covered with greenish fluid. I thought that this fluid was the mass of dead cells that died on one side of the mesh, while new cells were being generated on the other side, a process which gradually moves the mesh toward the skin surface.

However, after eight months the sore hadn't made any progress. Also, I had a trip to the tropics coming up in a couple weeks and I didn't like the idea of going to a place where germs proliferate like crazy when I had an open wound. 

I had a problem finding a surgeon. The problem is that most of them have never dealt with this type of problem and the few that have done so have only seen one case. I finally found someone who seemed competent, but he hadn't done a mesh removal since he was a resident, 30 years ago. 

This doctor told me that he thought that is was unlikely that my body would be able to eject the mesh. The mesh used is roughly an oval with a slit cut to the center from one edge. This slit enables the patch to be placed around the seminal

About a week ago, the area became increasingly sore and it seemed that a change was occurring. I thought that the mesh had been migrated sufficiently so that it was pulling on the seminal vesicle and this tension was causing the increase in pain. This worried me.

Yesterday I had the mesh removed in an out patient surgery center. Everything went great and now, barely 24 hours after the surgery I'm feeling quite well.

The surgeon told me that he was very surprised because everything inside looked much better than he had expected. The mesh was not attached at the center and barely attached around the edges. It was quite easy to get it out. He told me that the original hernia hole was nearly all filled in with new tissue and that it just took a couple sutures to close the small hole that remained. While before the operation, he warned me that there was probably about a 20% chance of needing a subsequent hernia repair, after the operation he told me that this was extremely unlikely and that everything should be fine.

Of further interest he told me that the mesh was not attached to the seminal vesicle and that it eventually would have been pushed out of my body. So what I originally hoped for so many months ago, would have happened if I'd had just a little more patience.

However, right now, I'm glad I got it taken out. It was another great medical experiment on myself, and I really believe that my waiting all that time gave my body the time to close the original hernia.

Of course, I'm very happy that I discovered copper and its critical function in collagen formation. Without that, I might not have had a mesh rejection, but then I wouldn't be as healthy as I am now. Hopefully going through this ordeal will yield information that will help others with similar problems.

Here is what I'd recommend:

1. Make sure you have adequate copper to make sure you don't get a hernia. Routine hair analyses are the only way to determine your copper status. Blood analysis won't show it.
2. If you get a hernia, take copper and the assisting nutrients (follow the supplement information for hypers). You might want to wait to see if the hernia will repair itself, if this is not a danger to your health. I now believe that it's possible the body can repair this problem if you give it the nutrients it needs.
3. If you elect to get the hernia repaired surgically, you'll need to decide if you want the mesh or not. Some doctors don't use the mesh so you'll want to find one of these. If you get the mesh put in, be aware of a possible mesh rejection if you are supplementing copper and other nutrients that assist collagen formation. If mesh rejection does occur, I'd suggest following the path that I took. Wait as long as you can for your body to repair.
4. If you get a hernia, find a good surgeon and use his expertise to avoid getting yourself into trouble. They are usually able to tell you if you are at any risk of complications if you delay surgery. Get multiple opinions.
5. Remember if your parent had a  hernia (like my father), or you are tall, you might be at greater risk of developing a hernia. Also, if you have had a hernia, your children are probably also at risk of a copper deficiency.  Supplement with copper if you have determined that you might be deficient.

I hope all this information helps you. Please email me at BU007@aol.com or post on the bulletin board if you have any relevant stories. Then I can post them below. Thanks, John

Studies:

This one is interesting, but I don't understand the implications.

Hum Pathol 1985 Nov;16(11):1141-6
Crystalline foreign particulate material in hernia sacs.

Pratt PC, George MH, Mastin JP, Roggli VL.

The subserosal stroma of hernia sacs consistently contains birefringent particulate material, in amounts greater than those observed in other intra-abdominal organs. The major component of this material was shown in the present study to be talc; thus, it cannot be of endogenous origin. Cellular response to this foreign material is remarkably slight. Possible sources of the material and mechanisms of access to the hernia sac were examined in a search of the available literature. It is proposed that the probable source is ingestion with food or, more likely, medications and that the particles reach the peritoneal cavity by migration through the intact intestinal wall. They probably reach the hernia by sedimentation in peritoneal fluid and subsequently migrate into the subserosa. The virtual absence of response to the particles is attributed to their composition (silicate) and their relatively small size (up to about 10 microns) compared with the particles in talc granulomas (up to at least 50 microns).