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Abdominal Adhesions
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Abdominal Adhesions

I had laproscopic lysis of adhesions, my adhesions were 15 years old. My doctor did not tell me the pain could get worse with the removal and said I could go back to work in 3 days. I could not do much the 1st day due to anesthesia and could not have sex or use tampons for 2 weeks.
Is this normal with this surgery? I am in excruciating pain since the surgery. What are the normal post-op instructions for such a procedure?
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Welcome to the gastroenterology community!  Where were the adhesions located?  What type of surgery did you have?
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My adhesions were between my uterus and my abdomen, from when I had a c-section. I was originally scheduled for a diagnostic laproscopy, but, I think she forgot to change the post-op directions when she did the lysis of the adhesions??? They were not blocking any organs and my "baby" is 6 foot tall 180lbs, not trying to have any more.
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Oh okay, I don't know much about that type of adhesions, sorry.  I hope someone else will come along and answer your question.  Or you can try posting in another community.
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Avatar_f_tn
I know that if adhesions are not removed correctly, they will just return and usually come back worse than before. From what I've read, lysing them is not the best way to do it- they should be cut and removed. This needs to bo done by a surgeon who is very experienced with adhesions and unfortunately they are difficult to come by. I have also read that using an adhesion barrier is a MUST if there is to be any chance of success-i.e., no reformation of adhesions. Several adhesion barriers have come and gone off the market but I assume that there must be at least one available at any given time.

I have also read about a few surgeons who do what they call 2nd or even 3rd-look laparoscopy. This is where, within a week or so of the original surgery, they go back in and remove any new adhesions that have begun to form. Supposedly, these new adhesions are softer and easier to remove than the original ones, and removing them early is thought to leave behind less damage which hopefully will prevent the return of tougher, more problematic adhesions. But I assume that this is very rare and since insurance is loathe to cover adhesiolysis in general I doubt that this would be standard practice anytime soon. From what I understand, the surgery has to be coded as being done for a different reason than removing adhesions, and then adhesions can be removed if 'incidentally' found if there is to be any insurance coverage.

I'm going to be seeing a new gastro this week- haven't been to one for quite awhile because I got tired of being thrown under the IBS bus. I'm over 50 so assume he'll want to do a colonoscopy. If so, I will have to mention adhesions (I have had a few surgeries- hysterectomy, etc.) because they can make scope tests painful and/or difficult. My last test was a sigmoidoscopy 12 years ago and the scope caused very intense pain at certain points- and the doctor giving the test knew it but just kept going-but I got no follow-up discussion opportunity- just a letter telling me the test was negative for polyps, etc. Even if anesthesia is given I know there can be pain and if it's like the last time the pain lasted for several weeks after the procedure and I remember swearing that I'd never have another scope test again.

I think the biggest problem with adhesions is the lack of awareness and publicity- like I said, it almost seems like there is a gag order going on. By not talking about them, I feel that it might be a factor as far as research to find effective ways of treating them. I have read about companies trying to develop effective barriers so there is work being done. There is also an author/patient advocate named Karen Steward who blogs about adhesions at karensteward.com.

I myself have been dealing with adhesions for close to 28 years but only learned of them from physical therapists in the past few years. They tried to lossen the adhesions and gave me postural exercises but they didn't help. I also go to a medically-oriented massage therapist  every few weeks but that's not enough either.

I have yet to find a physician who will even discuss the topic of adhesions- it's as though there is a gag order. They all insist I have IBS but that does not explain the tight, painful tethered-down and wrap-around feelings that I have throughout my abdomen and pelvis. They are essentially 'frozen' just like you have with frozen shoulder. My organs feel like they are adhered to my abdominal wall- not slippery but more like a dry sandpaper feeling. Very frustrating when you know what the problem is but can't even have a conversation with a doctor about it!
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Avatar_f_tn
Avocado1, was your PT trained in the techniques of visceral manipulation as taught by J.-P. Barral? If not, you might want to contact one who has gone though the muti-part course dealing with organ movement and adhesions. When done correctly by someone very experienced in the techniques it can be very helpful and cut one heck of a lot of discomfort.
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The medically-oriented massage therapist that I go to every 5-6 weeks is trained in the Barral method of visceral manipulation. She also is constantly training on more things- she just started craniosacral therapy.

The sessions- usually 90 minutes- do feel pretty good but unfortunately the tight, tethering and wraparound feelings from the adhesions are still there. They cause digestion issues, sciatica and vulvodynia on the back left side of my leg. Might also be causing low blood pressure and heart palpitations. Pretty much my whole abdomen and pelvis are frozen and maybe because I've had them for so long and been through a few surgeries they are just too tough. I also tried stretching exercises from a book called 'Heal Pelvic Pain'. Even on the rare occasion when I sense any loosening effects it seems like it doesn't last and everything quickly becomes very tight again

Thanks for your response..
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Avatar_f_tn
Avocado, something sounds a bit 'off.' If tissues are being stretched properly, it's going to provide a template for subsequent replacement of existing tissues with a 'longer' tissue length. I don't mean to question the skill level of your therapist, but I know and use this modality in a medical setting and have for many years. Even adhesions of 'long-standing' loosen.

Problems are found when other confounding factors are present such as celiac disease. Conditions such as that - constant 'poisoning' of the tissues with specific food substances - end up giving the tissues the feeling of 'old tires.' When you work with a person with adhesions and a whole body feel that's tight and unyielding, an underlying cause such as food intolerances needs to be investigated. With underlying causes present, you can 'pull and tug' forever and make very little change and it's frustrating for everyone.
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