In 2014 I made what I now consider one of the biggest mistakes of my life. I had a hernia repair surgery at the Shouldice clinic. Even though the consequences of that choice were obvious to me from the first few hours after the surgery I wanted to wait until a fair amount of time had passed so I could come to a definite conclusion on the impact of that operation.
Like most people out there, once I was diagnosed with an inguinal hernia I started looking at the options available to me in the US. Considering I had an inguinal hernia repair surgery(on the other side) in my teenage years with excellent results I wasn't particularly concerned. My hernia was very small and I tend to recover pretty well from surgeries and injuries without any long term pain. The one thing that I was certain about is that I did not want to have a mesh repair. The technology is great for the doctors (reduces the amount of work they have to do) so they can get it done faster and thus have a greater throughput per day which off-course results in more revenue for them. Anyway, the commoditization of medical services in the US is outside the scope of this post so I will leave it at that. In my opinion mesh hernia repair has significant risks that are only justified in the case of elderly patients 55+ and in the cases of huge hernias.
So, since I was in my early 30s a hernia repair without mesh was the best option. Unfortunately your options are very limited in the US. The majority of surgeons performing hernia repairs can only do mesh repairs. In fact, it is nearly impossible to find a doctor under 55-60 who has any experience in traditional hernia repair. Because of this fact I turned my attention to the Shouldice clinic which is one of the first results that comes up pretty much everywhere when you search for non-mesh hernia repairs.
The information on their site looked promising(very low recurrence rates and very limited post op pain). At the same time, I didn't discover anything concerning on online forums from former patients of that clinic.
Long story short after a reasonable amount of research of various doctors experienced in this type of surgery I concluded that a doctor who performs multiple of these repairs every day as is the case at Shouldice was the best choice. I therefore went ahead and scheduled my surgery.
Upon arriving at the hospital I was processed fairly quickly and once the hernia was confirmed with a physical examination I was assigned a bed and a surgeon. As far as they were concerned I was a very low risk patient. I was young, no medical issues and excellent blood work. What I didn't realized until after my surgery is that my good health was actually a big negative for me. You see, the problem with this clinic is that they have a dozen or more surgeons all of whom are performing multiple surgeries every day. The time surgeon assigned to you as well as the order in which you are operated on directly related to your level of risk.
The assignment process goes like this:
An older relatively unhealthy patient is scheduled with the best surgeon at the clinic and is operated first.
A younger and very healthy patient is assigned to the worst surgeon at the clinic and is the last one to be operated upon by that surgeon on that particular day.
So, as you might have already guessed based on what I mentioned earlier, I was assigned to the worst surgeon, Dr. Singal who at the time was probably over 75 years old. His assistant was even older (over 80). Unfortunately when I was assigned the bed and was told the doctor's name that meant nothing to me so I paid very little attention.
The day of the operation I was the 5th patient he operated on (there was only 1 more individual after me).
Since they do local anesthesia I was awake as they rolled me back to my room on a wheel chair but due to the drugs I didn't feel much pain at that point. That first evening I was in a lot of pain but I tried to brush it off by attributing that pain to the size of the incision (6 inches) and to tension in the area of the surgery.
The day after however, I started realizing what a big mistake I made by having that surgery at Shouldice. One of the very few positives of that clinic is that you get to spend 3 days with people who go through the same experience as you do. It makes the pain that comes with the experience more manageable. So, as I woke up the next day I run into a lot of people who had the surgery on the same day as I did. Some of them were almost twice my age. However the majority of them seemed to be doing great and were experiencing significantly less pain than I did. They were a lot more mobile from day one. However, everyone else who was operated by Dr. Singal was having the same experience I did. A lot of post-operative pain and as a result unable to move around as much as one would expect. Dr. Singal himself only checked on me once and very briefly on the day after the surgery. When I complained about pain to the nurses and requested another doctor to examine me I did get someone else to check the incision briefly but seemed unwilling to do anything else and just said that all looked good.
It took me 1.5 months to be able to sit for more than a few minutes. Since then, more than two years has passed. I still have a pulling pain and feel weakness in the area. A couple of attempts I made to reach out to Dr. Singal resulted in him dismissing my complaints and claiming that since I didn't have a recurrence of the hernia that the surgery was a success. Keep in mind that as I mentioned earlier I had the exact same surgery on the other side and post op pain was gone within 3 months and by the 1 year mark I didn't even remember I ever had a hernia repair surgery.
In my research after the surgery I also discovered this blog post by using my surgeon's name: http://olivia-sarrazin.blogspot.com/2010/07/shouldice-hernia-clinic-negligence-or.html
He is obviously either an incompetent doctor or simply too old to perform surgeries. Either way Dr. Singal SHOULD NOT be operating on anyone.
There is definitely some good doctors(Dr. Slater, Dr. Alexander) at Shouldice and there are some things that are positive but the process they follow to assign patients to doctors borderlines medical malpractice in my opinion and this is why I would recommend everyone to stay away unless you know in advance who will be operating on you.
I hope this post will help you avoid the mistake I made and if you are willing to go anywhere in the world to increase your odds of a successful hernia repair, I suggest you find other doctors in Canada or even better try some doctors in Europe who have more experience performing the traditional non-mesh repair.
