"I Decided I Can’t Live This Way"
Why should you have a colonoscopy?
“I feel like I could run a marathon…I feel great!”
“It’s Nice to Know There’s Good Care Right Here at Home”
"Thank God I Stayed Here"
"I Decided I Can’t Live This Way"
Dr. Adam Basler (left), St. James general surgeon, and Doug Hess, owner of Maple City Discount
Wine & Liquor, catch up six weeks after Doug’s successful laparoscopic colon surgery.
For Doug Hess, 57-year-old Hornell native and owner of Maple City Discount Wine & Liquor, diverticulitis had become a way of life. Diverticulitis is inflammation and infection of small pouches that develop along the walls of the intestines, which cause bloating, pain and overall discomfort.
“Twenty years ago Dr. Chaudhry, my PCP, diagnosed it and prescribed Cipro and Flagyl [antibiotics],” said Doug. This course of treatment often can help patients manage intestinal infection and inflammation brought on by diverticulitis. But for Doug it became a regular routine.
“I’d get a cramp on the right side, a light toothache type of pain,” he explained. “I’d try to stop it so it wouldn’t go any further…go on a liquid diet for three or four days, took Cipro and Flagyl. I had them on me all the time. Certain foods brought it on…if I ate a handful of popcorn, four days later I was in misery.”
The pattern of Doug’s episodes was unpredictable.
“I’d have about three bouts a year. But then sometimes I’d go six, eight months without a bout and suddenly I’d have two a month.”
The final episode that brought Doug to surgery was last November, when he and his wife Barb traveled from their Florida residence to spend Thanksgiving in Hornell.
“I was at the liquor store here,” he said. “It’s a busy holiday and we had about 600 cases come in Tuesday and I work right along with my people, so I was hauling booze all day long.”
Then he felt severe abdominal pain.
“I’d had a hernia operation about fifteen years ago,” he said, “and later that day I said to Barb, ‘I either have a real bad case of diverticulitis or I’ve ripped my hernia out.’”
Doug spent Thanksgiving with family and had planned to head back to Florida on Friday, but the pain intensified.
“I was getting worse and worse,” he said, “and at 2 a.m. the day after Thanksgiving and I had to go to the hospital. We got to St. James [emergency department] and I said just give me a pill and I’ll be fine. But the staff called Dr. Basler [St. James general surgeon], I had a CT scan, and they said it was bad…it was septic. They wanted to put me on antibiotics for 24 hours and admit me.”
Doug said Dr. Randhawa, St. James hospitalist, confirmed the seriousness of his condition.
“I asked Tariq, whom I’ve known for a long time, what do I do? He said, ‘Let’s see what tomorrow brings’ but he wouldn’t let me go home. They hooked me right up and I was out for about two days.”
On the second day Dr. Basler and Dr. Watkins [St. James general surgeon] and Dr. Randhawa visited Doug and said they thought he was out of the woods, so far…the antibiotics were doing what they’re supposed to do, but he would eventually need surgery.
Doug wasn’t convinced that surgery was necessary…after all, he’d been living with this condition for a long time.
“They left my room and I called Dr. Randhawa directly and he said, ‘These guys know what they’re doing, they have all the right equipment. With all the traveling you do back and forth, do what they say.’ I asked should I go to Rochester or Sayre or Cleveland Clinic and he said, ‘No, do it right here. I’ve got all the faith in them.’”
Although Doug was in serious condition, Drs. Basler and Watkins felt he could postpone the surgery for a later date, as long as his immediate symptoms improved.
“They wanted me to get mended up and stronger and have it electively done,” he said. “So Barb and I talked about it and set up a consult with Dr. Basler in January.”
At that appointment, Dr. Basler armed Doug with the information he needed to make an informed decision.
“The best part of my job is that I’m a guide, I’m not the driver,” said Dr. Basler. “I can help with decisions and keep my patients as informed as possible and let them know all the risks and all the benefits and what to expect. Doug presented with one of the most common reasons we do surgery…benign diverticulitis.”
Dr. Basler told Doug and Barb that surgery was probably the best long-term option.
“Doug unfortunately was dealing with it for over two decades and never got completely better,” he said. “The whole point of surgery is to take out the diseased segment and try to remove all the diverticuli or ‘out pouches’ of the colon, to prevent any chance of recurrence.”
Dr. Basler stressed that patients and their families ultimately are the decision makers.
“I sometimes have an opinion and will share my opinion if asked, but I want my patients to be the ones who are truly making the decision. What I think is, ‘If this was me what would I want to have done?’ I can tell you I don’t want to be on antibiotics the rest of my life and I don’t want to keep coming back to the hospital.
In many cases patients can think about it.
“If they’re not ready for surgery yet and they want to come back and talk to me later, or if they get admitted into the hospital for diverticulitis, we’ll have this conversation again,” said Dr. Basler. “This is always a patient-centered decision.”
Doug asked where he should have his surgery done.
“Dr. Basler said we’ve purchased new equipment [at St. James], and you’re not in any danger of needing an ICU, so you’re ok to do it here. And I said that’s good as it’s more convenient for my wife, so we scheduled it.”
This was to be one of the first laparoscopic colon surgeries done at St. James Hospital. Twenty years ago this wouldn’t have been available as the standard of care, said Dr. Basler.
“These days doing the minimally invasive approach – or at least attempting it – is the standard of care,” said Dr. Basler. “Some patients still need the open procedure because we cannot proceed safely laparoscopically, but most of the time this is done safely laparoscopically.”
He explained that surgery for diverticulitis is not what is once was.
“We’re not doing this through big, midline incisions. We make three to four small incisions, using small instruments and a camera. We inflate the abdomen with CO2 so that we can see everything in its entirety. Then we remove the portion of the colon that’s diseased and then use a special stapling device to attach the two healthy portions.”
The current standard of care also includes a thorough pre-op process.
“Before we even get to the OR we need to do a workup,” said Dr. Basler. “The patient is likely to have had a CT scan (imaging of the abdomen) to be sure it really is diverticulitis if there is a stricture. After that, we do a colonoscopy to be sure this is a benign condition, because certain cancers can behave like diverticulitis.
After all that is done, the procedure gets scheduled.
“We also want to be sure patients are eating appropriately before surgery so that their nourishment needs are met, especially protein,” said Dr. Basler.
Doug did the workup and reported for surgery on April 24. The whole procedure took about ninety minutes.
“We removed approximately 25cm [slightly less than 1 foot] of Doug’s colon,” said Dr. Basler. “His condition was fortunately confined to one place in the colon and there weren’t adhesions on other organs. Any kind of infection causes inflammatory response, which causes scar tissue, where organs can get ‘stuck’ to each other or the abdominal sidewall.” Dr. Basler also straightened a ‘kink’ in Doug’s colon.
That evening Doug was already up and about.
“By 10pm I was walking the halls,” he said. “The nurses said the more I walked the better I’d be. I had the surgery on Wednesday and I was out of the hospital on Friday at noon. I got home, and once the surgery pain wore off and everything got working again, each day I got better.”
The typical patient stays in the hospital three to five days, but Doug was able to go home in two days.
“That has nothing to do with how we do the surgery, but what we’ve learned about enhanced recovery,” said Dr. Basler. “For example, we let patients eat right away after surgery instead of ‘starving’ them until they move their bowels, like we did in the past.
With the minimally invasive procedure there usually is less of a need to use narcotics for pain control.
“This helps get everything working the way it’s supposed to much earlier,” said Dr. Basler, “as well as decreases medication side effects, and ultimately gets patients out of the hospital a lot sooner.”
Dr. Basler compared minimally invasive with traditional “open” procedures.
“With minimally invasive surgery, you’re not going to have the chronic abdominal pain,” he said. “You feel more like yourself if you don’t have to spend a week in the hospital. Midline [open] incisions hurt, and it takes a long time for that to get better, so the recovery time for laparoscopic is a lot faster. “
Even though it was major surgery, Doug had very little post-op discomfort.
“I quickly weaned myself off the pain pills,” he said. “They gave me about a week’s supply and I was on it a day and a half…and then was on ibuprofen for about two weeks and I was fine.”
Doug’s overall recovery progressed smoothly.
“I saw Dr. Basler the following Wednesday and we flew back to Florida that Friday. I stopped in to see him a month ago [May] and he said, ‘You’re fine…I’ll see you in a month.’
Rather than pain, Doug’s main complaint was post-op fatigue.
“The fatigue is caused by your body healing,” said Dr. Basler. “Although on the outside your small incisions look fine and are healed, inside your body is still healing, as that’s a lot of trauma to remove part of an organ. It takes time because it’s a big surgery. But recovery doesn’t have to be in a hospital…you can get your energy back at home.”
Dr. Basler said some patients take longer to recover.
“You have to take what you’re working with,” he said. “Patients who are older or have decreased functional status won’t bounce back as quickly as Doug did, but in general, doing it this way you’re going to bounce back a lot quicker with less complications…and get back to being yourself. “
Dr. Basler also explained how overall bowel function improves after surgery.
“The colon learns to adapt to the changes,” he said. “It can continue to function normally, which is mostly to reabsorb water. Most people feel better because they’ve had a stricture or chronic disease there and haven’t been able to move their bowels appropriately. Patients don’t even know this, because this is a smoldering process that’s happens over time, where things become more narrow.”
At the time of this interview, Doug was six weeks post-op and was feeling great.
“I had a bowl of popcorn two weeks ago and thought I had died and went to heaven! We went to the movies and ordered popcorn with double butter and felt like a kid in a candy store! You don’t realize what you adjust yourself to. I’m sure there plusses and minuses and people who have had problems [with the surgery], but mine, thank God, worked out perfect.”
Doug has nothing but praise for his St. James surgical team.
“It was a great experience,” he said. “Both Dr. Basler and Watkins came in, they both tag-teamed me, and one is as good as the other…but this Basler, he’s a peach…he’s a good guy. [Afterward] he knew I was going to be home and he stopped in to check on me, numerous emails back and forth…that was nice. Just a great guy…wonderful guy…I would recommend him to anybody.”
Doug has talked about his experience with others facing the same problem.
“I’d recommend it 100%...don’t wait. Matter of fact I’ve talked with three or four people at the store, and I’ve told them you’ve got to go see these people and have this done and don’t live with it any longer.”
He continued, “I probably wouldn’t have had it done, but you’ve got that security that this guy really knows what he’s doing and there was no second guessing. I did a little homework on him – both of them – and got nothing but great reviews all the way around. But up ‘til almost a year ago I probably wouldn’t have considered it. With that last bout I got scared, and I decided I can’t live this way.”
Dr. Basler recommends people take their condition seriously, but don’t assume that surgery is the only option.
“Diverticulitis is more common than people realize,” he said. “I think a lot of people are living with something like this and don’t even know it…they’re just used to ‘my left side hurts every so often and I just don’t feel good but then it goes away.’”
He said there are levels of diverticulitis, from just inflammation of the colon to having a large perforation that’s going to require emergent surgery.
“Some people have one or two bouts and it may never happen again…those people I don’t take to the operating room.”
Doug was happy with his whole experience.
“I have all the confidence in them and in the facility too. I can’t say enough about the facility…the nurses you have there and the staff, both in November and this last time…unbelievable. They’re good people. We’re so lucky in Hornell to have people like this…I hope we can keep the momentum up and great things will keep happening at the hospital.”
Dr. Basler or Dr. Watkins are available to talk with anyone suffering from chronic diverticulitis and similar conditions. Call (607) 385-3820 to schedule a consult.
Why should you have a colonoscopy? Tracey Ellis says, “Do it, because if there is something wrong it’s going to save your life.”
Tracey Ellis of Canisteo, NY is an active 51-year-old whose passion is her “second career” as a stay-at-home grandma.
“I’ve been taking care of my granddaughter Kaya almost four years now and I really love that,” she said. “It still means getting up at 5:00 every morning and getting everything going and running…it’s just like a regular job. I’m very active and very healthy…my granddaughter keeps me really busy!”
Upon turning 50, Tracey’s PCP recommended she get a screening colonoscopy. Given her busy schedule and anxiety with doctors, a colonoscopy wasn’t exactly on her bucket list.
“Well, I didn’t decide it…my doctor did when I turned that golden age of 50,” she said. “It’s just one of those health things you do to keep up with your body. It’s no different than a mammogram…keeping up with yourself and check-and-balance. After sitting with Dr. Ashdown and Marietta Goodliff [UR Primary Care Hornell], we came up with a referral and that’s how I got started.”
Tracey was sent to Dr. Adam Basler, general surgeon at St. James Hospital, and she was happy with her referral from the very start.
“I’m not good with doctors…I have white coat syndrome, so it took a lot to build myself up to get myself going to do it. When I went in [to Dr. Basler’s office] they explained everything to me…from what was going to happen, what to expect, how to cleanse myself, absolutely everything.”
Setting up a date for her procedure was quick and easy.
“They [Dr. Basler’s staff] were real quick about it…there was no lingering and I was glad for that,” said Tracey. “They then called in my prescription for the supplies and boom, boom, boom. It all happened real quick…they don’t let you sit around and think about it...for me it’s a really good thing.”
The pre-op nurse at St. James gave Tracey some tips on how to do the cleansing prep, which is generally the most unpleasant part of a colonoscopy.
“The nurse had ideas on how to get the drink down and that was so helpful,” said Tracey. “She suggested drinking it fast through a straw as I was walking around so I’m not getting filled up. I took half of it the night before and the other half five hours before the procedure...I got up at 2am to ‘dust it off’ and start over again, but it was fine. I was tired, but the whole cleansing was not bad at all…it really wasn’t.”
The day of Tracey’s procedure went extremely well and she was grateful for all of the extra TLC from the St. James staff.
“I was at the hospital by 7 a.m. When I came in everybody was so good to me. The lady at registration could tell I was nervous and she said, ‘It’s ok, I just had mine [colonoscopy] done and it was fine.’ The nurse brought me right in, took me into the cubicle and put my IV in…she got it first poke with absolutely nothing. Every few minutes I had someone coming in taking my blood pressure and checking on me. One of the nurses asked what I’d like to eat and drink after the procedure.”
Then her surgeon, Dr. Basler, came in.
“Dr. Basler is the greatest guy…I just love him. His bedside manner is great. He could tell I was really nervous, and he just kept smiling at me and said it’s ok. He went over everything he was going to do, what to expect, and just reassured me I was in good hands. He has this smile and charisma about him that just calms you.”
Tracey’s anesthesiologist was also very reassuring.
“She explained everything to me and said, ‘I’m going to be right beside you…my job is to watch over you, watch your breathing, blood pressure, everything. It’s going to be ok.’ [During the procedure] I was out but I not ‘out out’…I was just in a deep fog. The next think I know she’s waking me up and the girls were unhooking me and wheeling me back.”
While in the recovery area Tracey got her results. Dr. Basler found and removed one small benign polyp but otherwise everything was clear, and he said he’ll see her again in five years.
“What makes me feel so grateful for everyone is when I was done with my snack, the whole team that did the procedure with Dr. Basler came in. While he was telling me my results they all stood with him, and they all wished me well. It wasn’t just Dr. Basler, it was the whole team. That really, truly impressed me. Even my husband Mike, who has had two colonoscopies [elsewhere] said ‘I didn’t get that kind of treatment.’ They made my husband feel so comfortable and brought him coffee and everything.”
It was a quick transition from start to finish and Tracey was home by 9:30 a.m.
“I felt fantastic honestly! But I did come home and take a nap…they suggest you rest for a little while, take it easy and relax. The next day everything was pretty much back to normal.”
The follow up communication was thorough as well.
“Afterward I got two phone calls…one from the hospital to make sure I was ok and one from Dr. Basler’s office asking if I was ok, do I have any pains, the same questions plus more. They reassured me if I have any questions, nothing’s too small and don’t hesitate to call. From start to finish they don’t give up on you. They’re right there every step of the way.”
Tracey has important advice for anyone who’s been told they should have a colonoscopy or is considering it.
“Do it, because if there is something wrong it’s going to save your life. If they don’t find something, it’s peace of mind, knowing that that part of your body is as healthy as the rest of you. Having the experience that I did, with all the great people, that’s all I talk about now! I know that sounds silly, but I met so many great people and they truly care.”
Tracey is on a mission to be sure people get their colonoscopy to take care of any little problems before they become serious.
“It’s better off if they find a problem and take care of it, because for me, that little girl [Kaya] is my world. I want to see her graduate, I want to see her get married…and if you don’t do these things, you just never know. Some people say, ‘I don’t want to go through that’ and I keep telling them there’s nothing to it…it’s easy peasy and if I can do it, anybody can do it!”
For more info about colonoscopies or to schedule your appointment, call St. James Hospital’s surgical team at (607) 385-3820.
“I feel like I could run a marathon…I feel great!”
Read Stacey Heary’s story on her surgical experience with Dr. Brian Watkins.
Stacey Heary catches up with her surgeon, Dr. Brian Watkins.
Six years ago Stacey Heary, 56, of Friendship, NY began having episodes of abdominal and back pain that her primary care physician diagnosed as diverticulitis. She’s a healthy, active person who works for Literacy West/CORE and serves as assistant director at an after-school program at Belfast Central School.
“At first the attacks were spaced apart,” said Stacey, “but then they got more frequent and each time I was in bed for a week. We couldn’t figure out what triggered them. When I’d get an attack, I’d say here we go again.”
Diverticulitis is inflammation or infection of small pouches that develop along the walls of the intestines. It may involve anything from a small abscess in one or more of the pouches to a massive infection or perforation of the bowel. The pouches can develop anywhere on the digestive tract, but most commonly form at the end of the descending and sigmoid colons located on the left side of the abdomen. Along with the pain, diverticulitis can cause abdominal bloating, diarrhea, chills and a low-grade fever. For some people it’s an unpredictable and debilitating condition.
The normal treatment is antibiotics which Dr. Ashdown, Stacey’s primary care physician, prescribed to help her through the episodes. But as time went on the attacks started coming more frequently, until they affected Stacey’s ability to work, travel and generally enjoy life.
“We got to the point where enough is enough,” she said.
In September 2018, Dr. Ashdown referred Stacey to Dr. Brian Watkins, a general surgeon who had joined St. James Hospital in August.
“I hadn’t heard of Dr. Watkins and of course I Google everything. I looked at his education and at everything. I trust Dr. Ashdown…if that’s who he’s sending me to then he’s got to be good.”
Her first appointment with Dr. Watkins was an evaluation of her condition.
“He wanted to discuss my original diagnosis from the CT scan, and about every attack I had…and he explained to me in full detail everything that was causing this and what could be done to repair it,” she said.
Dr. Watkins explained, “Diverticulitis is a very common problem that can be treated with medication, but for someone like Stacey who has recurring episodes that impact her quality of life, surgery is an option.”
Dr. Watkins recommended doing a laparoscopic sigmoid colon resection, also known as “minimally invasive” laparoscopic colon surgery, to remove the diseased portion of Stacey’s colon. In this procedure, the surgeon operates through 4 or 5 small openings (each about a quarter inch long) while watching an enlarged image of the patient’s internal organs on a television monitor. The diseased portion is removed, and the remaining healthy colon is reconnected to provide normal bowel function.
“Stacey’s surgery was to be the first laparoscopic colon resection done by a Hornell surgeon, and one of the very few that have been done in the region,” said Dr. Watkins. “It’s a standard procedure in many areas, but not as standard in rural hospitals. The traditional ‘open’ procedure is typically done, instead of making small incisions with a camera.”
The benefits of this type of procedure are many.
“Doing laparoscopic surgery for this condition affords less pain, quicker recovery, smaller incisions, and less chance of infection and hernias,” said Dr. Watkins. “It’s a huge benefit to the patient. A lot of procedures can now be done laparoscopically. Doing this procedure traditionally [open] would mean a week in the hospital and more discomfort. That’s why a lot of patients have gone to a bigger medical center for [this type of] surgery, because there are more options available.”
Dr. Watkins does most of his surgeries at St. James Hospital but Stacey requested to have her procedure at Noyes Hospital, nearer to family. Dr. Watkins is part of the team of surgeons that serves Noyes, Jones and St. James hospitals.
“I had been at Noyes with my niece and it is closer to my son, and since I didn’t know how long I was going to be there, it was more convenient,” she said.
Stacey’s surgery was scheduled for mid-December and went off without a hitch.
“I checked in for surgery on a Thursday morning,” she said. “Dr. Watkins and his assisting surgeon, Dr. Basler, both came in to talk to me while they were prepping me. I had the surgery, went back to my room after recovery, got up that night and started walking the halls. The nurses were a little shocked, because people usually don’t get out of bed until the next morning.”
Depending on the type of laparoscopic bowel procedure, patients often leave the hospital in a few days and return to normal activities more quickly than patients recovering from open surgery.
“I was projected to be in [the hospital] 3 to 7 days, depending on how I recovered,” said Stacey. “My surgical site looked wonderful and I felt great. Two days later I was ready to go home. I wasn’t taking any of the pain medicine – any narcotics – even when I went home – I just needed ibuprofen.”
Stacey was amazed at how quickly she bounced back from major surgery.
“I had it done on Thursday and went home two days later. I even went to our work Christmas party the following Thursday, which included an all-day staff meeting,” she said. “It could have been 4 to 6 weeks for recovery, but Dr. Watkins didn’t project it to be that long. I did exactly what he told me to do…he said your body will tell you what you can do. I ate soft foods at first and about a week later I was able to eat everything…and I’ve not had one issue.”
Stacey said this has been a life-changing event.
“I used to wake up every morning with a stomach ache…not any more. For six years my stomach was always upset. To wake up in the morning and feel this good all the time is amazing. I feel like I could run a marathon…I feel great!”
She is now back to doing the things she loves and making up for lost time.
“We have a motorhome and like to travel…now I can plan on going somewhere and not have to worry. Before if I started to have a stomach ache we decided we probably shouldn’t go…what if we were 500 miles from home and I get ill and need the medication right away, what would we do? I also had to be careful with certain foods. I also like to exercise but had to stop because I was afraid I was going to exert or damage something. It’s nice…I don’t have to worry about that anymore.”
Stacey has words of encouragement for people who are suffering as she did.
“I would tell someone if it has ever been suggested that they have a colon resection, do it, because it really is a total life changer. When Dr. Watkins got in there he discovered my colon had an abscess that we weren’t aware of before. He took out the damaged part, and voila!”
During those years of pain and discomfort and countless episodes, Stacey thought her options were limited.
“One thing I find interesting, is that I never would have known about the colon resection if I hadn’t come to Dr. Watkins. Dr. Ashdown sent me to him because he knew something needed to be done. There may be a lot of people out there who are going through this and have no idea that they can have this done and feel fantastic.”
Stacey has nothing but high praise for her surgeon’s capabilities and approach.
“Dr. Watkins has the best bedside manner, ever. I asked the nurses at the hospital about him…they said he’s awesome. He’s just the nicest guy. He talks to you like a regular person. If you meet him you’ll love him.”
Likewise, Dr. Watkins is pleased with Stacey’s happy ending.
“That’s what it’s all about…taking care of folks and having good outcomes. It’s very gratifying.”
“It’s Nice to Know There’s Good Care Right Here at Home”
Read Jay Dreyer's Story on his surgical experiences at St. James.
Jay Dreyer (left) converses with his surgeon, Dr. Brian Watkins.
Jay Dreyer, 64, is a Canisteo resident and regional mortgage lender for Community Bank in Elmira, as well as a jogger and an active, do-it-yourself guy.
“Last summer I decided to pour my own sidewalk, carrying 80# bags of cement,” he said. “I felt a pain in my side, and thought I had pulled a muscle. I later went to my PCP who ordered an ultrasound, but nothing [definitive] showed."
The abdominal pain persisted and got worse as the months wore on. “In November I got a cold with a cough and my side was really sore…I knew something was wrong.”
Jay’s primary care physician suspected a hernia and suggested he set up an appointment with a surgeon.
“I wanted to stay local,” Jay said, so he scheduled a consult with Dr. Brian Watkins, a new general surgeon who joined St. James Hospital in summer 2018.
Dr. Watkins confirmed the PCP’s suspicion. “99% of the time you know it’s a hernia, and surgery is the best course of treatment,” he said. “It’s a common procedure but located in a dynamic area, where the torso and legs come together. Although it’s a simple procedure, it should not be taken lightly.”
“Dr. Watkins was pretty frank and said it’s not a difficult surgery but there are different levels of recovery,” said Jay. “He made me feel completely comfortable. I didn’t think about pain being an issue…I wanted to get in and out and have it done.”
Jay scheduled his procedure for late November at St. James. “I was completely comfortable in the hospital…all the staff were smiling, and my nurse took the time to explain everything that was going to happen. I felt like I was among family and friends.”
That day Dr. Watkins did an “open” procedure to fix Jay’s hernia.
“People think laparoscopy [minimally invasive surgery] is better than an open procedure,” said Dr. Watkins. “But in my opinion, the open procedure is a better repair for a first-time hernia because it doesn’t require going inside the abdominal cavity [with a laparoscope] to fix it. We can use mild sedation rather than general, and place the mesh into the ‘open’ space, below and above the tear. That makes the abdominal wall stronger than it was before.”
Hernia patients who have the “open” procedure usually experience less pain and a quicker recovery, according to Dr. Watkins.
“This is a safer, less invasive, and a better repair for first-time hernias, with little chance of complications,” he said.
To help minimize post-operative pain, Dr. Watkins put Jay on a drip novocaine system, which involves inserting a tiny tube that connects to a ball filled with novocaine. After surgery, the patient carries the ball around in a pouch. This pain-release system releases long-acting novocaine at a slow rate directly to the surgical site, thus minimizing the need for narcotics.
“The most uncomfortable part of that was carrying the pouch,” said Jay. “I didn’t need supplemental drugs, and after four days I pulled the tube out myself,” as directed by Dr. Watkins.
Jay recovered very quickly.
“I had my surgery on Friday and was back to work on Tuesday…amazing. My recovery was exactly as Dr. Watkins told me and I was virtually pain-free. It only felt like there was a ‘Sharpie’ in my side, which got better over time. It was absolutely pain-free except the feeling like a cut that’s healing. And I was back to exercise in ten days.”
The surgery left Jay feeling renewed. “Since the operation I can’t tell you how good I feel. I’m so relieved. I can now sit comfortably…that’s the biggest thing.”
When asked what he would recommend to others facing hernia surgery, Jay had only words of encouragement.
“It was such a non-event and I have complete confidence in Dr. Watkins. You really shouldn’t have any fears. I was completely satisfied.”
Dr. Watkins affirmed Jay’s opinion.
“We want people to know that we can do most surgical things here,” he said. “A hernia can be such an easy operation, there’s no reason to travel out of town. That’s why I’m here.”
As Jay reflected on his surgery, he was grateful to have stayed local. “I just wanted good quality care right here…it was a tremendous experience. It’s nice to know there’s good care right here at home, and it doesn’t get any better than that.”
"Thank God I Stayed Here"
Read Jack Grillo's story on his surgical experience at St. James.
Jack Grillo (left) catches up with his surgeon, Dr. Brian Watkins.
Meet Jack Grillo, 55, a Hornell native who works in data entry at Alstom. A physically active guy, Jack didn’t think twice on Father’s Day 2018 when he decided to try to move a large log in his yard by himself.
"I should have used a tractor or gotten one of my neighbors to help," he said. Jack heard a "pop" and shortly thereafter noticed a bulge on the left side of his groin area. He went to his PCP who wanted to refer him a surgeon in Corning.
"My wife [who works at St. James Hospital] knew about the two new surgeons at St. James and suggested I give them a try."
So he made an appointment with Dr. Brian Watkins, general surgeon, who joined St. James last summer.
"Dr. Watkins said I had a large [inguinal] hernia, and suggested surgery to fix it," said Jack.
"A hernia is a hernia," said Dr. Watkins. "Anyone can get one, even if you have a sedentary lifestyle or job. I don’t believe active patients get hernias any more frequently than sedentary people."
Surgically repairing a hernia usually the best course of action, and Jack scheduled his surgery for Sept. 10 at St. James Hospital.
Often a hernia is just under the surface of the skin. When that’s the case, Dr. Watkins recommends doing an "open" procedure rather than laparoscopy (minimally invasive) for first-time hernias, unless a patient is coming back to fix a previous hernia repair.
"In my opinion, the open procedure is a better repair for a first-time hernia," Dr. Watkins explained. "Doing laparoscopy can be more invasive because you have to go inside the abdominal cavity, and it also requires general anesthesia. A hernia repair often doesn’t have to be done inside the abdomen, and most patients can have the procedure under mild sedation."
Many people think laparoscopic surgery means less pain and a quicker recover.
"That’s not necessarily the case for a hernia. Doing laparoscopy for hernias can actually be more painful and require a longer recovery," said Dr. Watkins. "The mesh that I put in goes into the [open] space is like a ‘2-in-1 repair’, below and above the tear. Above and below makes mechanical sense, and the abdominal wall is stronger now than before."
He asserts that the open technique for hernias is safer, less invasive, and a better repair with less pain. What’s more, patients recover quickly and have little chance of complications.
"The way I perform this repair has the lowest recurrence rate in the literature," said Dr. Watkins. "The literature says 0.5% recurrence with this open procedure – it’s the best repair you can get for a first-time hernia. That’s how I’d have my hernia fixed."
Jack said his recovery was quick and relatively painless, and no narcotics were needed for pain control.
"I was up and walking around the day after, and recovered after three weeks. Plus, I was the ‘test dummy' for the no cocaine ball."
Dr. Watkins explained "The on-Q pain system [aka novocaine ball) is a non-narcotic pain control method for post-operative recovery – an alternative way of dealing with pain directly at the site."
During surgery, the surgeon places a tiny tube that connects to a balloon-like ball typically filled with novocaine. After surgery, the patient carries the stretchy plastic ball around in a pouch. This pain-release system releases long-acting novocaine at a slow rate directly to the surgical site.
"This device put the medication where the nerves are in the abdominal wall," said Dr. Watkins. "It’s quite effective and there is a low risk of problems. Most importantly, there is less use of narcotics [with this method] for pain control. I generally don’t prescribe narcotic meds, or at least tell my patients not to pick up the prescription unless needed. It’s great that we have different things to utilize [for pain control]. Because of [potential problems with] narcotics we need different ways."
Once the patient no longer needs pain control, the tiny novocaine tube can be easily removed at home or in the doctor’s office.
"Following the instructions Dr. Watkins provided, I pulled it out myself without any problem," said Jack.
In addition to the quick and relative pain-free recovery, Jack he had a good experience with the surgical team at St. James Hospital. "The care was really good – I was impressed. I was in and out quickly and home by 10:30 or 11:00 that morning. It was a pleasant experience."
Jack has high praise for Dr. Watkins and his work.
"He was really thorough, the healing process was great, and the scar is very unnoticeable," said Jack. "I would recommend his procedure. In fact, I have a hernia on the other side and I’ll end up coming to Dr. Watkins for that. It was a phenomenal experience…I’d recommend him to anyone…give him a shot."
Jack is especially grateful to have stayed close to home for his surgical care.
"I’m glad I did it here instead of driving all the way to Corning…it was local, right here, and I’m totally satisfied. Thank God I stayed here."