Dr. Harry Reich, M.D. New York City
From: Beverly J. Doucette
Date: June 08, 1999 10:38 AM
A number of people have asked me go into greater detail about my experience
of having had an adhesiolysis procedure -- with Dr. Harry Reich of New
York City as my surgeon. Please keep in mind that this is MY surgery
-- and that we each have a case history which is unique. I also am
stating MY interpretation of how the body responds to and creates adhesions
-- as I understand that physiological process.
Previous to consenting to Dr. Reich's adhesiolysis procedure, I requested
a copy of it so that I could determine for myself what Dr. Reich was doing
differently from other adhesiolysis procedures, which I had had.
I also checked his credentials with the AMA -- all were very outstanding
Then I asked Dr. Reich for statistics of his adhesiolysis procedures;
and even though he has not keep a following of his patients, he did have
some figures on it. His procedures had a high percentage of success
for non-reforming adhesions.
Dr. Reich also referred me to a woman, who had undergone his adhesiolysis
procedure last June. We talked at great length by email; and we continue
to do so. She was a source of much information and much encouragement
for me; and you can be assured that I am watching her case very closely
as it parallels my adhesion history very closely. Dr. Reich also videotapes
his entire surgery for you.
Dr. Reich believes that "The solution to pollution is dilution!"
He stands by that phrase yet today! In other words: By using
copius amounts of fluid to cleanse the abdominal organs and tissues during
the surgical procedure itself; and also instilling the patient's
abdomen with ringers lactate solution, he believes these steps will prevent
adhesions from re-forming.
Dr. Reich's procedure is done through a minimally invasive route.
One small incision in the naval for the camera and two 1"- 2" incisions
on each side of the lower abdomen...for instrument use. Dr. Reich is the
only ambidextrous surgeon in the United States and that is a plus for us!
He does a diagnostic look around upon entering the cavity; and looks
for any invasive pathology other than adhesions. He then evaluates the
situation and determines his treatment plan. In the event that there
are dense adhesions, he proceeds to dissect them ( separate ). This
is not an easy process and can become very complicated.
I can understand why most Drs. DO NOT want to challenge themselves during
a adhesiolysis procedure; which is dangerous and tedious for the
surgeon as he/she is lysing adhesions next to and around the intestines
Based on Dr. Reich's vast experience with laparoscopic surgery, he has
developed a technique like no other surgeon in the world! That is
why he is recognized as being the best laparoscopic surgeon in the world!
It was the clean-up at the end of his surgery that impressed me the most;
and was also the reason that I chose to go to him and to have my surgery
done! He rinses and cleans out almost EVERY piece of clotted blood
that is in...around...under...and virtually all over the abdominal cavity
following the surgery! He believes that it is this residual clotted
blood that the anti-bodies -- in an adhesion former's system -- respond
to as a " foreign enemy"...and in its defense the anti-bodies create an
adhesion over it to protect the internal organs! Now, this is exactly
how our bodies defense system works!
Think about getting a sliver ( externally of course ). What does our
body defense system do to that foreign body? It sends out the leukocytes
and creates an "infection" to get rid of it, right? Internally, one
of two types of defense systems kick in when there is a problem:
1.) If an appendix ruptures, we get peritonitis ( an internal infection
like pus or white blood cells that spill into the body cavity. The
white cells are responding to an inflammation in the appendix...and build
up and burst. But it WAS a defense mechanism as well! This can kill
a person! Because the body has no way of ridding itself of that infectious
drainage -- which then infects the surrounding internal organs as well.
In defense our body sends the leukocytes ( white cells ) to the area of
2.) Since there is an active infectious foreign body in the cavity,
our body will attempt to "CONTAIN" that poison in order to protect the
other internal organs from damage! These white cells form a material called,
"fibrin," ( the sticky stuff from blood ). Then this fibrin begins
to cover the infectious material; and you have what is called an "ADHESION!"
Now, adhesion means "to stick together." As we know, the body cavity
is filled with many organs in very close proximity to each other. What
do you think will happen? Organs will become attached to one another
-- everywhere that was touched by the infectious drainage!
Let's look at that same reaction now -- using the clotted residual blood
-- following internal surgery. As a result of any surgical procedure,
blood is found throughout the body cavity -- in every area involved;
or from ischemia ( areas scraped or cut -- opening an area that bleeds
). In the body cavity, this blood dries very fast...VERY FAST!
Now, 99.9% of surgeons DO NOT clean up the residual blood clots -- thus
leaving the residual blood clots in and around and under all of the internal
organs. The body sees this blood as a "foreign body" and sends out
the leukocytes and thus forms adhesions wherever these clots are.
Because fibrin is a sticky substance, the organs will become attached.
When the peritoneum (innermost tissue of the abdominal
wall) is involved, some organs will become attached to it -- thus causing
pulling and inflammation at the attachment sites...PAIN...and eventually
a decrease in our physical mobility. That pain is from the attachment
to the peritoneum. The other attachments, if any, (organ to organ) don't
cause pain; but can cause bowel obstructions, painful and difficult bowel
movements. If adhesions attach the bowel to the vaginal wall, painful
intercourse can result, as well. Am I losing you? If I am,
please let me know and I will be less medical. (I sense that you are perfectly
capable of understanding every word of this!)
Dr. Reich uses a procedure called "aqua" surgery. He constantly
flushes the body cavity with ringers lactate solution ( a compatible fluid
to the human body, like saline ); and he looks for the fibrin stings and
removes them...bit by bit...a wonderful clean-up job ( on my video ).
If someone would have told me he could clean up that body cavity as good
as he did -- and I HAD NOT seen him do it -- I wouldn't have believed them!
So, if you want a copy of my video, I'll send it to you!
His theory is that "if the clotted blood is cleaned from the cavity,
the body's defense system will have less to react to -- thus reducing and
possibly stopping the reformation of PAINFUL and destructive adhesions.
He also leaves 3-4 liters of ringers lactate solution in the abdomen at
the conclusion of his surgeries -- which takes about 48 hours to dissipate
from the body (lots of peeing goes on).
I was not shaved! I did not have a urinary catheter in place -- or a
gastric nasal tube when I woke in recovery. Five hours of surgery...then
to the recovery room; and in less than 4 hours, I was back in our
suite. Sure, I had surgery pain; but I also had both ovaries removed...and
two tumors removed! One very large tumor had attached the right side of
my colon to the left side of my peritoneum. My colon was totally
twisted over and attached. No wonder I hurt -- and couldn't have
a bowel movement on my own!
How am I now? I'm a tiny bit sore on the lower right; but that is from
having an organ removed. NO ADHESION PAIN! NO BACK ACHES! NO
PAIN PILLS! And a smile on my face that only a crow bar could remove!
I had been on pain medication and anti-inflammatory medication ( which
you need AT LEAST 1500mgs each day, if you're suffering from adhesion pain
) to help combat the inflammation from the pulling of the organ at the
attachment site. You can bet you have something attached to the peritoneum
at this time -- and it is pulling and doesnít like that! Anti-Acids
( from irritation of the esophagus and stomach -- from years of drugs,
sleep/pain meds at night ). And last, but not least...laxatives (
you know what that was for )..NO MORE!! I take a 500mg chewy for
calcium and Vitamin E for heart muscle; because I refuse to go on
hormone replacement therapy until I present with symptoms; and I
have none yet!
Dr. Riech will state that his procedure IS NOT a sure thing; but, statistically,
his adhesiolysis patients have shown a great reduction in reforming adhesions
following his procedure. I discussed Dr. Reichís procedure with a
local surgeon as well as a pathologist, who our son works with, before
I agreed to have it done. I also sent them my post operative reports
that defined the locations of previously lysed adhesions in both my abdomen
and pelvic cavity.
During a routine autopsy, they instilled 3-4 liters of ringers lactate
solution to raise the abdominal wall away from the intestines in order
to determine if, in fact, an adhesion from the intestine could actually
REACH and attach itself to the abdominal wall -- and reform --when that
much ringers lactate solution is in the body cavity. (That type of attachment
was the ONLY cause of MY pain.) When an organ attaches to the peritoneum,
you have pain! (I had that in both of my previous lysis.) It
did raise the abdominal wall a good 3" to 4"; and in all probability, an
adhesion WOULD NOT be able to attach.
1.) Women's Surgical Group
~ ~ ~ ~
2.) International Pelvic Pain Society
Many times a Dr. is as afraid and frustrated as we are -- as to what
to do for a person who suffers from adhesions!
Also re-evaluate your medications. You MUST be taking an analgesic
( pain med ) on a regular basis for it to be effective in combatting the
pain in your system. It is also imperative that you be taking an anti-inflammatory
Regarding an MRI, Cat Scan or any other high-tech medical test for a
person with a history of adhesions, I feel it is a waste of money and time.
A simple ultrasound and abdominal x-ray will detect any abnormal pathology
in the abdomen. If you feel that you are suffering from the same
kind of pain in the same region as with your previous adhesion problem,
then you surely don't need anymore tests...if an ultra sound proves to
be negative! All other tests will be negative too!! Your Dr.
will not be able to diagnose adhesions as the cause of your pain -- unless
he/she performs a diagnostic laparoscopic...a surgical procedure.
Your Dr. will not be able to say that your pain is caused by your adhesions
-- until he/she actually sees them. But you can be pretty much assured
the pain is from adhesions, if you have had adhesions before...and
if all of your tests are negative. You can tell your Dr. that adhesions
are causing your pain -- and not have to worry about getting sued.
BUT your Dr. can't!! He may think that adhesions are your problem; but
he really, really cannot say it until he has proven it!!
BUT...as long as all medical tests rule out abnormal pathology, you
DO have CHRONIC PELVIC PAIN; and that IS recognized as a medical condition.
So make sure that you get on a pain management routine; and take it from
there! A Dr. HAS TO respond to your request for that!! There ARE
NO other effective ways to manage chronic pain ( when adhesions are the
cause ). Massage is ineffective; because adhesions are located
too deep within the body cavity to be massaged. There are NO linaments
or balms that will reach or penetrate the peritoneum; because the peritoneum
tissue is there to PROTECT against invasion...and that IS OUR problem to
So please be careful folks with spending money for things that sound
good...but which WILL NOT work for adhesions! Relaxation, massages
and such WILL HELP relax the adhesion sufferer; and there is something
to be said for treating the emotional as well as the psychological self.
In fact, it is imperative to do that; and include therapy for family
members...support...education...and ideas as to how to live with one who
is suffering this very painful and debilitating disorder. The impact
that adhesion-related disease places on a family is no different from a
diagnosis of Cancer, Muscular Dystrophy, Multiple Sclerosis, or any other
debilitating disorder. Except that the focus is just beginning to
be on adhesion-related disease!! And how much focus it gets, is up to each
one of us!! So learn about it and educate your spouse. Don't
be afraid of it because it is possible to live effectively with it...and
THERE IS HOPE!!
If a Dr. DID NOT perform medical tests on a patient presenting with
complaints of pain -- and assumed that the patient's symptoms WERE due
to adhesions ( because the patient had a history of adhesions ), what would
happen if the patient DID actually have a tumor or cancer -- and it went
undetected because a Dr. wrote the patient's symptom of pain off as due
to adhesions without checking into it? I'd be pretty miffed!
My recent contacts with the Mayo Clinic indicated to me that a number
of the Drs. DID ,in fact, feel that adhesions do cause pain. Like
almost everywhere else though, the Mayo Clinic has not come up with a treatment
or surgical procedure that would benefit an adhesion-former. The Mayo Clinic
will work with an adhesion patient through pain management. I started
my pain management through them. I cannot see a basis for an "investigation"
into the Mayo Clinic or any other medical facility because they perform
medical tests on those of us who have a history of adhesions.
TWO tumors were found as a result of the adhesiolysis, which I elected
to have done in New York City with Dr. Reich as my surgeon! If he
not found them, who knows what might have happened to me. At that time
I would not allow any local Drs. to perform anymore tests on me -- as I
was convinced that ALL of MY pain was from adhesions -- and that there
was NO valid reason to put myself through testing that would have negative
results for abnormal pathology...let alone have to pay for tests over and
over again. Boy was I wrong!!!
So, I have to advise all of you, for what it's worth, that testing is
necessary and could save your life! If all tests have negative results
for abnormal pathology, then it is probably adhesions. It is then
up to you to determine the next step...surgery or try pain management and
live with them.
I believe that the more educated one becomes about their medical condition
(such as adhesions, for example), the better prepared you will be to discuss
treatment with a Dr. -- including even what needs to be done in a surgery,
if you elect that route! I also believe that an adhesiolysis performed
in a certain way, CAN reduce the amount of reformed adhesions -- and in
all probability decrease the formation of DeNovo (new adhesions )adhesions.
I firmly believe that there are NO barriers that will be effective in
dealing with adhesions...and I mean NONE! Once you learn what type
of procedure is best for an adhesiolysis, you can discuss it with your
surgeon. You can even dictate how and what you wish to have done
for you and this disorder!
Remember these words: "YOU ARE NOT ALONE!" If anyone thinks that adhesion
disorder can't kill, ask Dr. Wiseman who the second victim of Dr. Kavorkian
(Dr. Death) was. Well, I'll tell you...it was a 56 year old woman, who
suffered chronic pelvic pain!!! Our disorder...OURS!!!
I suffered and still suffer from this disorder...surgery or not.
At this time I am addicted to pain meds and am withdrawing from them.
I am scared to death every time I eat because I think I'll get constipated
and I will suffer such horrible pain BEFORE, DURING and AFTER I defecate.
Yes, have a bowel movement. Yes, I live with fear that I'll start to pee
my pants again like I did for 10 years...and I am ONLY 48 years old ( I
was 38 years old when this nightmare with adhesions began.)!! Disease
respects NO age, trust me on that! Every little pain I get in my
abdomen fills me with fear that the adhesions are back; but then
I talk to myself and review what I have learned about OUR disorder and
I settle myself down and I am better...better for awhile.
Because I have educated MYSELF about adhesion disorder, I will make
it through this part of it as well; but I will always live with the fear
of them reforming. It is ever present in the back of my mind; and
I find myself feeling anxious at times to live every minute that I have
right now...and I will! I share only from experience and what I have
learned as a result of living with the pain of adhesions. I don't
know anything any better than the rest of you -- maybe just from a different
perspective, thatís all. I need to hear your perspectives also.
NO not for personal gains, not for any study, not really for any other
reason than the fact that you have what I have; and I am so grateful for
the sharing on the International Adhesions Society Message Board because
that to me IS a way for me to educate myself on all of this new information.