Hernia Repair

Watch this week's video on YouTube (warning: contains graphic images of surgery)

Barbara Danbrook’s health story is a living testimonial to the expression, ‘adding insult to injury’. Over the past three years, she’s been diagnosed with two different types of cancer and lived through extended treatments and surgeries. Having survived all that, you would think it would be time to celebrate. But not so fast. What came next was unexpected, and crushing: a massive abdominal hernia, leading an appearance she describes as a “pregnancy which had slipped”. Not only did her physical condition make daily pleasures, like simple walking, nearly impossible, but the psychological stress of yet another health problem was heavy. “I couldn’t believe actually that after all the radiation and chemo and the two surgeries that I had to deal with something else.”

It’s a problem that’s becoming more pervasive, says Sunnybrook surgeon Dr. Fred Brenneman. More people are surviving cancer surgeries and traumas, which is wonderful. But both are also major hernia triggers. Hernias are weaknesses in the abdominal wall, and the bowel literally protrudes, often causing discomfort, fatigue and seriously hampering activities of daily living.

Hernias are often repaired using a synthetic mesh made of plastic-like material, to help contain and tuck in the bowel. But infections can happen, especially when bowel surgery is also required. That’s where a new biologic mesh, cell-free and made of human or pig skin, is much better for patients, says Dr. Brenneman. Fewer infections mean fewer surgeries for patients, and less time in the hospital. You can click on my video to see it being surgically implanted into a patient.

The trick with the biologic mesh is the cost, which is about five times more expensive that the synthetic version. Dr. Brenneman says, it’s a clear example of funding not keeping pace with innovation. Plus, he says when you factor in the cost of reduced surgeries and hospital stays, the economics equal out. Part of Sunnybrook’s role is raising awareness about this biologic mesh, and hopefully securing future funding for the growing number of patients who could benefit. In the meantime, Dr. Brenneman says, every donation counts. Click here to learn more about the mesh, and an upcoming fundraising event in October 2011.

Thankfully, Barbara’s health story may just have a happy ending yet. After her synthetic mesh developed complications, Dr. Brenneman replaced it with the biologic mesh. The difference was instant, and to date, lasting. “As far as the biologic mesh, I would say to people, do it. You’ll be so much more comfortable and you’ll feel so much better about yourself.” She hopes her story will help educate others facing a similar situation, to not settle for suffering.

It's Not Cancer...

Watch this week's video on YouTube

A few years ago, my job had me crossing paths with a woman living in Toronto. We would liaise on projects about three times a year, and this went on for nearly a decade. While we developed a very close professional bond, I was always left somewhat puzzled by her physical appearance. She had no hair, no eyebrows or eyelashes, and yet seemed otherwise well. Thoughts of cancer treatment did cross my mind, but her boundless energy and the unaltering state of her appearance year after year made that unlikely. Then one day, in an e-mail that seemed out of the blue, she kindly explained that she had alopecia. Of course, I thought. Why hadn’t I considered that? And more importantly, had I made her feel that in some way she had to explain herself?

It all goes to say, ignorance is not always bliss, so here are a few things I’ve since learned. Alopecia areata is a chronic condition that can affect anyone at anytime or age. Resulting in hair loss in small patches, the whole head or the entire body, alopecia can come and go without warning and the cause is unknown. And it’s extremely common. If you were riding the subway, let’s just say at least two people in your car would be affected.

Here at Sunnybrook, we’re lucky to have a literal hair loss guru on staff. Dr. Jeff Donovan has treated countless patients with alopecia, and he told me that personal support and appropriate treatment can make a world of difference for patients. There are a variety of options, ranging from creams to injections. And Sunnybrook is also one of the few hair loss clinics in the country to offer a topical chemical treatment called DCPC, which is about 60% effective in promoting hair growth.

It was in this clinic that I met Beverley, a patient of Dr. Donovan’s who in mid-life, started experiencing hair loss. “I thought, gee, this is odd,” she told me. “And then consistently, it just fell out. It was really hard.” Beverley now comes in for weekly DCPC treatments, which last about 5 minutes and consist of a giant Q-tip saturated in the medication being rubbed all over her scalp. While the medication does cause some temporary discomfort, Beverley described it as not too bad.

But just as important as dealing with the physical side of alopecia, she told me, was managing the psychological toll. “I think the main thing is to not lose your own personality, not to get depressed even though it’s difficult at times. You’re still the same person and you’re getting help. When you come here, you’re getting help.”

Beverley agreed to talk to me for this story to try and help other patients and to educate the public about the condition. That’s knowledge I could have used a few years ago myself. And knowing how pervasive alopecia is, hopefully this can help you, too.

For more information on the Sunnybrook Hair Loss Clinic, click here.

For additional information or support to to: The National Alopecia Areata Foundation and The Canadian Alopecia Areata Foundation.