Monday, March 31, 2014
The ETCA-ARD solutions Antwerp
The ETCA-ARD solutions Antwerp
How those afflicted with ARD can have hope
What are adhesions?
Adhesions are fibrous bands which connect tissues and organs that are normally separated. Generally, they occur within a week after surgery as a part of the normal healing process.
Why are they a problem?
They often reduce movement and distort internal organs. Adhesions can cause a variety of complications including infertility, pelvic pain and bowel obstruction. In a short way: they can greatly affect your daily activities.
Where do adhesions form?
As they form on tissue surface following surgery: these can be found anywhere. But there are some organs where they are more likely to form, namely: ovaries, pelvic sidewalls, fallopian tubes and bowel. These are potentially affected during gynaecological and other procedures.
What can be done?
You have to understand that you as a patient can neither cause, nor eliminate your own adhesions.
Microsurgical techniques were developed so the primary causes of trauma and inflammation are minimized and the formation of adhesions reduced.
Fortunately, the use of new adhesion barriers during the medical intervention offers great hope to prevent the formation of adhesions. It actively prevents the tissues of forming a whole during the critical week following the surgery.
How does it function?
During the abdominal, pelvic, surgery, the surgeon would apply the adhesion barrier on the surfaces who poses the biggest risk for the formation of adhesions, such as uterus, ovary, etc…. The coating prevents the tissues from gluing together and forming adhesions. When the healing process is complete, this synthetic, absorbable, adhesion barrier dissolves and is carried away from the body by the urine.
Important for yourself
The doctors you will meet understand and acknowledge that adhesions do cause pain along with a host of associated illnesses, disorders and medical problems that arise because adhesions are present.
They will do their utmost to improve your quality of life.
Why at the ETCA in Antwerp?
Here many internationally renowned Gynaecologic surgeons have formed world famous endoscopic units.
In Antwerp professor van Herendael has been involved in endoscopic surgery for more than 25 years. On a yearly basis over 200 major endoscopic surgeries are performed by professor van Herendael and his staff, all highly trained in endoscopic surgery.
He founded an endoscopic school, the ETCA, the Endoscopic Training Centre Antwerp. Over 250 endoscopic surgeons have been trained at the ETCA and some of them are now leaders in the field on their own merit.
Professor van Herendael’s accomplishments in the field of endoscopic surgery have been recognized all over the world and the Università degli studi dell’ Insubria at Varese in Italy has bestowed him the honour of a professorship in endoscopic surgery.
To accomplish as high a surgical standard as possible a partnership with industry has been made. Karl Storz Gmbh & Co (Tuttlingen Germany), one of the world leaders in manufacturing endoscopic equipment, provides the theatres with their newest instruments, video and computer equipment.
We invite you to open the PDF file for a fully documented overview of the possibility for you to have your surgery carried out in Antwerp.
Please feel free to contact us directly by mail for more information.
The information about the ETCA itself shall not be used for other purposes whatsoever, nor for any commercial action.
If you want to know more about the ETCA, please contact us directly.
Adhesions are fibrous bands which connect tissues and organs that are normally separated. Generally, they occur within a week after surgery as a part of the normal healing process.
Why are they a problem?
They often reduce movement and distort internal organs. Adhesions can cause a variety of complications including infertility, pelvic pain and bowel obstruction. In a short way: they can greatly affect your daily activities.
Where do adhesions form?
As they form on tissue surface following surgery: these can be found anywhere. But there are some organs where they are more likely to form, namely: ovaries, pelvic sidewalls, fallopian tubes and bowel. These are potentially affected during gynaecological and other procedures.
What can be done?
You have to understand that you as a patient can neither cause, nor eliminate your own adhesions.
Microsurgical techniques were developed so the primary causes of trauma and inflammation are minimized and the formation of adhesions reduced.
Fortunately, the use of new adhesion barriers during the medical intervention offers great hope to prevent the formation of adhesions. It actively prevents the tissues of forming a whole during the critical week following the surgery.
How does it function?
During the abdominal, pelvic, surgery, the surgeon would apply the adhesion barrier on the surfaces who poses the biggest risk for the formation of adhesions, such as uterus, ovary, etc…. The coating prevents the tissues from gluing together and forming adhesions. When the healing process is complete, this synthetic, absorbable, adhesion barrier dissolves and is carried away from the body by the urine.
Important for yourself
The doctors you will meet understand and acknowledge that adhesions do cause pain along with a host of associated illnesses, disorders and medical problems that arise because adhesions are present.
They will do their utmost to improve your quality of life.
Why at the ETCA in Antwerp?
Here many internationally renowned Gynaecologic surgeons have formed world famous endoscopic units.
In Antwerp professor van Herendael has been involved in endoscopic surgery for more than 25 years. On a yearly basis over 200 major endoscopic surgeries are performed by professor van Herendael and his staff, all highly trained in endoscopic surgery.
He founded an endoscopic school, the ETCA, the Endoscopic Training Centre Antwerp. Over 250 endoscopic surgeons have been trained at the ETCA and some of them are now leaders in the field on their own merit.
Professor van Herendael’s accomplishments in the field of endoscopic surgery have been recognized all over the world and the Università degli studi dell’ Insubria at Varese in Italy has bestowed him the honour of a professorship in endoscopic surgery.
To accomplish as high a surgical standard as possible a partnership with industry has been made. Karl Storz Gmbh & Co (Tuttlingen Germany), one of the world leaders in manufacturing endoscopic equipment, provides the theatres with their newest instruments, video and computer equipment.
We invite you to open the PDF file for a fully documented overview of the possibility for you to have your surgery carried out in Antwerp.
Please feel free to contact us directly by mail for more information.
The information about the ETCA itself shall not be used for other purposes whatsoever, nor for any commercial action.
If you want to know more about the ETCA, please contact us directly.
Mobilisation viscérale : lyse et prévention des adhésions péritonéales
Thérapie manuelle
Mobilisation viscérale : lyse et prévention des adhésions péritonéales
Cet article pubié en 2011 ( Bove, G.M., Chapelle, S.L., Visceral mobilization can lyse and prevent peritoneal adhesions in a rat model, Journal of Bodywork & Movement Therapies (2011), doi:10.1016/j.jbmt.2011.02.004) a pour but de vérifier par des thérapies manuelles, la prévention et le traitement des adhésions péritonéales, sources de divers problemes tels que des dysfonctions digestives, des douleurs du pelvis, des syndromes d'infertilité... Leur hypothèse, en s'aidant de rats pour modèles, était que la mobilisation viscérale, reposant sur l'anatomie, peut faciliter la mobilité physiologique abdominale, et traiter des adhésion induites par exemple après un geste chirurgical.
3 groupes de 10 rats, 1 contrôle, 1 préventif et 1 lyse.
Tous les rats ont été évalués après le 7ème jour chirurgical.
3 groupes de 10 rats, 1 contrôle, 1 préventif et 1 lyse.
Tous les rats ont été évalués après le 7ème jour chirurgical.
Lyse group: traitement avec mobilisation viscérale, palpation digitale, action ciblée de défibrosage manuel, et mobilisation des murs abdominaux et viscéraux. Evaluation des adhésions après chaque séance.
Preventive group: Traiter de la même manière mais dès le jour suivant la chirurgie.
Control group: Evaluation 7 jours après la chirurgie sans aucune mobilisation viscérale.
Résultats :
Control group: Evaluation 7 jours après la chirurgie sans aucune mobilisation viscérale.
Résultats :
Le degré de sévérité des adhésions ainsi que leur nombre étaient significativement inférieurs dans le groupe Preventiv en comparaison aux autres groupes .
Conclusions:
Ces observations initiales montrent que la mobilisation viscérale peut avoir un rôle important dans la prévention et le traitement des adhésions post-opératoires.
Ces observations initiales montrent que la mobilisation viscérale peut avoir un rôle important dans la prévention et le traitement des adhésions post-opératoires.
Poor Pup is also a Victim of adhesions
Lulu Undergoes Five-Hour Surgery at Angell Memorial Hospital
Doctors found more internal problems during Lulu's operation. She is being monitored for the next several days at Angell Memorial Hospital.
Brought to you by findmassmoney.com
Lulu. Photo credit: GoFundMe page.
Kimberly Hammond Donahue updated all of Lulu’s fans about how the German Shepherd is doing after Lulu underwent a five-hour surgery at Angell Memorial Hospitalon Monday.
On the GoFundMe fundraising pagethat Donahue created to raise funds for Lulu’s surgery, Donahue wrote on Monday:
“I am so eternally grateful for everyone that has helped me with this endeavor... I truly am and will be forever... Lulu had almost 5 hours of surgery today... She is being monitored for several days to avoid any complications, but we are not unfortunately out of the woods yet. They found so many more problems internally than originally thought... She had multiple adhesions and scar tissue internally...from who knows what... nor do I want to know. They were able to relieve a band of adhesions that were limiting and constricting her esophagus, resulting in the mega esophagus. They also discovered that one of her lungs was actually adhered to her abdominal cavity... they were able to free it and feel that they did not puncture or compromise her lung. This will be a long road of recovery and depending upon the outcome I may do more fund raising. I believe that all things happen for a reason...she came to all of us, and we have come a long way, and made tremendous strides. Please keep checking back as I want all of the prayers that can be offered... I will post updates as I know more...THANK GOD for Angell Memorial Hospital ....”
Lulu was abandoned at the Spoiled Rotten Doggy Daycare and Donahue volunteered to take her in. The dog has a medical condition called esophageal diverticulitis, which requires immediate corrective surgery to allow her to eat and not regurgitate her food. The problem hasn’t been treated for years, said Donahue.
If she didn’t get the surgery, her condition would have worsened and could have lead to a secondary condition, such as an infection in her lungs, which can be fatal.
Lulu’s story went international after Donahue started fundraising for the dog's operation last month. Money flowed it from around the world as people opened up their wallets for Lulu.
Donahue has raised nearly $18,000 for the operation and post-operation care for Lulu. Any money raised beyond that will be given to the Northeast Animal Shelter.
Saturday, March 29, 2014
Adhesions Adhesion Related Disorder Wiki
Adhesions are fibrous bands[1] that form between tissues and organs, often as a result of injury during surgery. They may be thought of as internal scar tissue that connect tissues not normally connected.
Contents
[hide]Pathophysiology[edit]
Adhesions form as a natural part of the body’s healing process after surgery in the same way that a scar forms. The term "adhesion" is applied when the scar extends from within one tissue across to another, usually across a virtual space such as the peritoneal cavity. As part of the process, the body deposits fibrin onto injured tissues. The fibrin acts like a glue to seal the injury and builds the fledgling adhesion, said at this point to be "fibrinous." In body cavities such as the peritoneal, pericardial and synovial cavities, a family of fibrinolytic enzymes may act to limit the extent of the initial fibrinous adhesion, and may even dissolve it. In many cases however the production or activity of these enzymes are compromised because of injury, and the fibrinous adhesion persists. If this is allowed to happen, tissue repair cells such as macrophages, fibroblasts and blood vessel cells, penetrate into the fibrinous adhesion, and lay down collagen and other matrix substances to form a permanent fibrous adhesion. In 2002, Giuseppe Martucciello's research group showed a possible role could be played by microscopic foreign bodies (FB) accidentally contaminating the operative field during surgery.[2] These data suggested that two different stimuli are necessary for adhesion formation: a direct lesion of the mesothelial layers and a solid substrate (FB).
While some adhesions do not cause problems, others can prevent muscle and other tissues and organs from moving freely, sometimes causing organs to become twisted or pulled from their normal positions.
Regions affected[edit]
Adhesive capsulitis[edit]
In the case of adhesive capsulitis of the shoulder (also known as frozen shoulder), adhesions grow between the shoulder joint surfaces, restricting motion.
Abdominal adhesions[edit]
Abdominal adhesions (or intra-abdominal adhesions) are most commonly caused by abdominal surgical procedures. The adhesions start to form within hours after surgery and may cause internal organs to attach to the surgical site or to other organs in the abdominal cavity. Adhesion-related twisting and pulling of internal organs can result in complications such as abdominal pain or intestinal obstruction. Small bowel obstruction (SBO) is a significant consequence of post-surgical adhesions. A SBO may be caused when an adhesion pulls or kinks the small intestine and prevents the flow of content through the digestive tract. It can occur 20 years or more after the initial surgical procedure, if a previously benign adhesion allows the small bowel to spontaneously twist around itself and obstruct. SBO is an emergent, possibly fatal condition without immediate medical attention. According to statistics provided by the National Hospital Discharge Survey approximately 2,000 people die every year in the USA from obstruction due to adhesions.[3] Depending on the severity of the obstruction, a partial obstruction may relieve itself with conservative medical intervention. However, many obstructive events require surgery to lyse the offending adhesion(s) or resect the affected small intestine.
Pelvic adhesions[edit]
Pelvic adhesions are a form of abdominal adhesions in the pelvis, typically in women affecting reproductive organs and thus of concern in reproduction or as a cause of chronic pelvic pain. Other than surgery, endometriosis, and pelvic inflammatory disease are typical causes.
Surgery inside the uterine cavity (e.g., suction D&C, myomectomy, endometrial ablation) can result in Asherman's Syndrome (also known as intrauterine adhesions), a cause of infertility.
A meta-analysis in 2012 came to the conclusion that there is only little evidence for the surgical principle that using less invasive techniques, introducing less foreign bodies or causing less ischemia reduces the extent and severity of adhesions in pelvic surgery.[4]
Pericardial adhesions[edit]
Adhesions forming after cardiac surgery between the heart and the sternum place the heart at risk of catastrophic injury during re-entry for a subsequent procedure.
Peridural adhesions[edit]
Adhesions and scarring as epidural fibrosis may occur after spinal surgery that restricts the free movement of nerve roots, causing tethering and leading to pain.
Peritendinous adhesions[edit]
Adhesions and scarring occurring around tendons after hand surgery restrict the gliding of tendons in their sheaths and compromise digital mobility.
Association with surgery[edit]
A study in Digestive Surgery showed that more than 90% of patients develop adhesions following open abdominal surgery and 55–100% of women develop adhesions following pelvic surgery.[5] Adhesions from prior abdominal or pelvic surgery can obscure visibility and access at subsequent abdominal or pelvic surgery. In a very large study (29,790 participants) published in British medical journal The Lancet, 35% of patients who underwent open abdominal or pelvic surgery were readmitted to the hospital an average of two times after their surgery due to adhesion-related or adhesion-suspected complications.[6] Over 22% of all readmissions occurred in the first year after the initial surgery.[6]Adhesion-related complexity at reoperation adds significant risk to subsequent surgical procedures.[7]
Applying adhesion barriers during surgery can help to prevent the formation of adhesions.[8] Surgical humidification therapy may also minimise the incidence of adhesion formation.[9] Laparoscopic surgery has a reduced risk for creating adhesions.[10] Steps can be taken during surgery to help prevent adhesions such as handling tissues and organs gently, using starch- and latex-free gloves, not allowing tissues to dry out, and shortening surgery time.[11]
Types[edit]
Types of adhesions:
- Fibrinous adhesions. These are causes of early postoperative obstruction which settles down within 3–5 days. The majority of fibrinous adhesions will disappear in due course of time[citation needed].
- Fibrous adhesions. If the infection is continuous or if foreign[clarification needed] is present, the fibrinous material is converted into fibrous material[citation needed].
References[edit]
- ^ "adhesion" at Dorland's Medical Dictionary
- ^ Torre M, Favre A, Pini Prato A, Brizzolara A, Martucciello G (December 2002). "Histologic study of peritoneal adhesions in children and in a rat model". Pediatr. Surg. Int. 18 (8): 673–6. doi:10.1007/s00383-002-0872-6. PMID 12598961.
- ^ See article at: www.adhesions.org/ardnewsrelease092303.pdf
- ^ Ten Broek, R. P. G.; Kok- Krant, N.; Bakkum, E. A.; Bleichrodt, R. P.; Van Goor, H. (2012). "Different surgical techniques to reduce post-operative adhesion formation: A systematic review and meta-analysis". Human Reproduction Update 19 (1): 12–25.doi:10.1093/humupd/dms032. PMID 22899657.
- ^ Liakakos, T; Thomakos, N; Fine, PM; Dervenis, C; Young, RL (2001). "Peritoneal adhesions: etiology, pathophysiology, and clinical significance. Recent advances in prevention and management". Digestive surgery 18 (4): 260–73.doi:10.1159/000050149. PMID 11528133.
- ^ a b Ellis, H.; Moran, B.; Thompson, J.; Parker, M.; Wilson, M.; Menzies, D.; McGuire, A.; Lower, A.; Hawthorn, R.; Obrien, F. (1999). "Adhesion-related hospital readmissions after abdominal and pelvic surgery: A retrospective cohort study". The Lancet 353 (9163): 1476. doi:10.1016/S0140-6736(98)09337-4.
- ^ Van Der Krabben, AA; Dijkstra, FR; Nieuwenhuijzen, M; Reijnen, MM; Schaapveld, M; Van Goor, H (2000). "Morbidity and mortality of inadvertent enterotomy during adhesiotomy". The British journal of surgery 87 (4): 467–71. doi:10.1046/j.1365-2168.2000.01394.x. PMID 10759744.
- ^ "Adhesion prevention: a standard of care". Medical Association Communications. American Society of Reproductive Medicine. February 2002.
- ^ Peng, Y; Zheng M; Ye Q; Chen X; Yu B; Liu B (2009). "Heated and humidified CO2 prevents hypothermia, peritoneal injury, and intra-abdominal adhesions during prolonged laparoscopic insufflations". J Surg Res. 151(1): 40–47.
- ^ "Adhesions". Better Health Channel. Retrieved 20 February 2014.
- ^ "Abdominal Adhesions (Scar Tissue)". Medicinenet. Retrieved 20 February 2014.
Friday, March 28, 2014
Integra Buys Covidien’s Confluent Surgical Product Lines
Integra Buys Covidien’s Confluent Surgical Product Lines
| By HospiMedica International staff writers Posted on 18 Nov 2013 |
Integra LifeSciences (Plainsboro Township, NJ, USA) is to acquire the Covidien (Dublin, Ireland) Confluent Surgical product line, including surgical sealants, adhesion barrier, and, most significantly, DuraSeal.
The DuraSeal system technology is a synthetic, absorbable, hydrogel delivered by a dual syringe applicator. When sprayed onto the dura, a strong, adherent sealing layer is produced, which effectively seals the suture line within seconds. A feature unique to DuraSeal is the blue colorant that provides the surgeon excellent visualization of coverage and thickness of the material upon application. The addition of a dural sealant technology to Integra’s current line enables the surgeon to adopt a “one stop shop” approach to closing the Dura Mater following neurosurgical procedures, complementing the company’s dural substitute, Duragen.
The other products in the Confluent Surgical product line include DuraSeal Exact/Xact, VascuSeal, and SprayShield. The products are part of the soft tissue repair category at Covidien, and generated approximately USD 65 million in sales in fiscal 2012. Under the terms of the agreement, Covidien will receive an initial cash payment of USD 235 million from Integra. Additionally, Covidien may receive up to USD 30 million, contingent upon the achievement of certain performance measures related to the transition of the Confluent Surgical business to Integra.
“The addition of the DuraSeal product lines enables our sales force and distributor partners to provide their customers with a best-in-class dural sealant as they seek to support surgeon’s efforts to minimize cerebrospinal fluid leaks upon completion of the surgical procedure,” said Robert Davis, President of Integra’s US Neurosurgery division. “Together with our broad DuraGen product line we are fortunate to have even more options to serve our customers and the individual needs of their patients.”
“This transaction allows Covidien to better focus on its global strategic priorities,” said Bryan Hanson, group president of medical devices & US at Covidien. “Based on Integra’s presence in neurosurgery and spine surgery combined with a strong portfolio of clinical evidence, we believe these products will thrive under Integra’s ownership. We express our sincere gratitude to our dedicated employees and the clinicians who have partnered with us throughout the years.”
Related Links:
Integra LifeSciences
Covidien
The DuraSeal system technology is a synthetic, absorbable, hydrogel delivered by a dual syringe applicator. When sprayed onto the dura, a strong, adherent sealing layer is produced, which effectively seals the suture line within seconds. A feature unique to DuraSeal is the blue colorant that provides the surgeon excellent visualization of coverage and thickness of the material upon application. The addition of a dural sealant technology to Integra’s current line enables the surgeon to adopt a “one stop shop” approach to closing the Dura Mater following neurosurgical procedures, complementing the company’s dural substitute, Duragen.
The other products in the Confluent Surgical product line include DuraSeal Exact/Xact, VascuSeal, and SprayShield. The products are part of the soft tissue repair category at Covidien, and generated approximately USD 65 million in sales in fiscal 2012. Under the terms of the agreement, Covidien will receive an initial cash payment of USD 235 million from Integra. Additionally, Covidien may receive up to USD 30 million, contingent upon the achievement of certain performance measures related to the transition of the Confluent Surgical business to Integra.
“The addition of the DuraSeal product lines enables our sales force and distributor partners to provide their customers with a best-in-class dural sealant as they seek to support surgeon’s efforts to minimize cerebrospinal fluid leaks upon completion of the surgical procedure,” said Robert Davis, President of Integra’s US Neurosurgery division. “Together with our broad DuraGen product line we are fortunate to have even more options to serve our customers and the individual needs of their patients.”
“This transaction allows Covidien to better focus on its global strategic priorities,” said Bryan Hanson, group president of medical devices & US at Covidien. “Based on Integra’s presence in neurosurgery and spine surgery combined with a strong portfolio of clinical evidence, we believe these products will thrive under Integra’s ownership. We express our sincere gratitude to our dedicated employees and the clinicians who have partnered with us throughout the years.”
Related Links:
Integra LifeSciences
Covidien
Thursday, March 27, 2014
How IHRT started ~ Adhesion Related Disorder International Human Rights Team.vs Endogyn Kruschinski
IHRT was founded in 2003 based on words of "Miracles" coming out of Germany.
IHRT embraces our first amendment right to free speech ~ Satire and parody have served for generations as a means of criticizing public figures, exposing political injustice, communicating social ideologies, and pursuing such artistic ends as literary criticism. Satirists usually find themselves subjected in turn to criticism, contempt and, sometimes, lawsuits.
The First Amendment protects satire and parody as a form of free speech and expression.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
In the beginning....
Saturday, May 07, 2005
Dawn Rose blows the whistle on Frankfurt……..
Dawn,
You just won't quit will you? I hope you are enjoying yourself. If anyone said anything to Daniel it was due to the fact that you and others were discrediting his work "behind the board".
I have emails to prove so. I am really tired of your game and I am sure others are as well. You hate the work we are doing because you see it as a threat to your first love: the IAS. The IAS
has been behind you and certain other people, but the IAS does not support people that have a heart to HELP the ARD patient. If they did, they would not be fighting this new work so very hard.
I never said a word about you not singing Daniel's praises, I was too busy singing my own. Dawn, I personally did not care what you were or were not doing.
Rules, rules, rules. I never read any of them. My heart is for the person begging for help. You can't even
decide WHO you are really out to attack. We are connected to Daniel, so go for it. Make a name for
yourself.
You paid money to join this club?? It did not cost me anything.
I am sure you have swam with much bigger sharks, as you seem like the type that would.
God help you, Dawn
[Edit by gingirl on Saturday, July 19, 2003 @ 05:42 AM]
----- Original Message -----
From:
To: "Dawn"
Sent: Thursday, June 12, 2003 12:14 PM
Subject: Re: Need guidance
Dear Dawn,
How are you, I hope you feel better ?
I would like to comment and to ask you if you like to continue to be on
my website as one of my patients contacts... (In your last email you wrote:
I still feel like a million buck compared to before. I have not spoken a
word of this to anyone nor will I as I get letters all the time and tell
everyone to go as you are their only hope and the relief is amazing.)
Dawn, Once I told a patient from Netherlands to go to my website and to contact one of the patients contacts and she contacted you and asked you about me. She send me your reply and it was one that directed her to another surgeon.
Today I got an email to look what advices you give on the IAS
Message board.
( Dear Elaine, Welcome, You are not crazy....if you have had prior surgeries you may indeed be suffering from ARD. A great way to check is to get your operative reports and see if adhesions were encountered during >the surgeries. If you need help locating a doctor in your area who is sympathic to the plight of the ARD sufferer, a great resource is in the support section under worldwide support listed by county and states. Hopefully you will find and IAS contact person in your area. If not you could contact Dr. Wiseman, the founder of the site. He may know of a doctor that is sympathetic to and understands ARD. He has many emails to answer and is very busy but he eventually will get back to you...he always does. An advocate should be able to help you though. Hang on, there is hope. Much love Dawn )
Dawn, I really don't believe that this kind of answers are a help for adhesion
sufferers as the exactly send them where there is NO HOPE... To
surgeons who perform surgeries after surgeries with no or only a litte
success results. Adhesion sufferers are the most complex, complicated
patients to treat. Surgeons who knows that adhesions are coming back
in a large number of theirs surgeries or that one who are gynecologic
surgeons without experience in bowel surgery, are harming the patients
knowing about alternatives. Could you explain if this is your intended purpose ? I have no problem if you continue to do so, then let me know and I will
take you out of my contact list for US.
KInd regards
Daniel
Daniel Kruschinski, MD EndoGyn® Institute for Endoscopic Gynecology
From Daniel
To: Dawn Rose
Date: Fri, 13 Jun 2003 19:37:07 +0200
From: Dr.Kruschinski@t-online.de
To:Dawn <>
Dear Dawn,
I got a little confused by your answers on the board and that you say, patients should ask Dr. Wiseman for further help and should search in the IAS website and so on. I mean, you should tell people to see where there are good results and help. Of course it doesn't work always but in many cases. The techniques I'm using are so extremely
important for adhesions sufferers as they show, at least in my hand,
better results than every other surgeons technique. About such
techniques it should be written and recommended to patients and not to
say them to go for gas laparoscopy with gas and no SprayGel...
I don't need everyone posting about that but it's nice that some are
doing it and patients remember to ask me and send me emails... This is
the result of Karen's and Carolyn's posting and I am able to provide much more patients with a successful adhesiolysis than ever before.
Every week there are two new victories against adhesions. And please
show me another surgeon who has the same results !!!
Why can't you all work together and keep up posting about gasless
laparoscopy and SprayGel ? Why it can't be posted about the doctor
who has till now the best tools and techniques and results for
adhesion sufferers ?
I won't be glad, if David Wiseman will stop patients posting about
this successes and then I probably will go out of the IAS.
My priority is surgery and this is what I'm living for. I don't have
any other interest in my life except surgery and changing concepts of
surgery that went wrong... I even don't have the time to deal with all
the problems, my closest family, like Shirli, my kids and some others
have... I'm a work-o-holic and yes, I'm fanatic (this is what Shirli
says) in my visions of a better surgery, to provide doctors with something that
they did a mistake in (CO2). And I will continue to provide ARD sufferers with best results. But I was counting on you as you were kind here and you spoke so
much what you wanted to do as a patients advocate, like to make fundraising and some other things... Anyway I hope you fight your pain, probably you are right with that
the ovary could be the cause of your pain... and probably it should be removed and replaced bya hormonal replacement therapy which could be controlled much better than the ovary.
Thank you
DAniel
Daniel Kruschinski, MD EndoGyn® Institute for Endoscopic Gynecology Seligenstadt(Germany)
============================================================
From Daniel
To: Dawn Rose
Dear Dawn,
I'm not angry at you. My vision is that YOU ALL cooperate together and
make my dream come through, that gasless laparoscopy is a better
tool for laparoscopic surgery.
If you send me the records I could see if I could help. But how do you
want to tell her to fly if she doesn't want and how to collect the money ?
Regards
Daniel
Daniel Kruschinski, MD
EndoGyn®
Institute for Endoscopic Gynecology
"The world is too complex for simple solutions..."
or"The world is very complex that only brilliant simple solutions will
succeed ...
----- Original Message -----
From: Karen Steward
To:
Sent: Thursday, June 26, 2003 2:10 PM
Subject: date
Hi to all,
Daniel has asked me to contact people that have had surgery with him
and request that you fill out the data form on the IAS site. I know I don't have
everyone on this list; however, will get others email addresses and send to
them also.........
Karen
From Daniel
To: Dawn Rose
----- Original Message -----
From:
To: "Dawn" <>
Sent: Monday, June 30, 2003 5:53 AM
Subject: Re: Need your advice
Hi Dawn,
This is a follow up on your surgery. As some time passed, I need
to collect some data. Please be as helpfull as possible to determine
all the issues.
Actual date:
Name:
Surgery date:
Second look date:
Average Pain score (0 - 10) before surgery:
Average Pain score (0 - 10) after surgery:
Pain medication before surgery, which and how much:
Pain medication today, which and how much:
Activity before surgery (0 - 10):
Activity after surgery (0 - 10)
Bowel movements before surgery:
Bowel movemnts after surgery:
Re-surgery becuase of adhesions ?
Bowel obstruction ?
Surgery for other indications than adhesions:
Daniel Kruschinski, MD
EndoGyn®
Institute for Endoscopic Gynecology
"The world is too complex for simple solutions..."
or "The world is very complex that only brilliant simple solutions will
succeed ..."
----- Original Message -----
From: "Dawn" <>
To: "Beverly J.Doucette" >
Sent: Thursday, July 17, 2003 11:33 AM
Subject: My PUBLIC message on Daniel site
Posted Friday, July 18, 2003 @ 00:34 AM
>
> While reviewing my operative reports that have been stowed away for some
> time I have some urgent questions that all have a right to see answered
> here.
> I feel I am pretty well educated as a lay person with ARD and I seek
> further clarification as to what happened to me.
> What do you do to acheive meticulous hemostasis? I see many blood clots
> and they are covered over in spray gel. I also see that you introduced
> gauze into my abdomin.
> I quote from my operative report"after securing hemostasis at all the
> surgery sites, Spray Gel Was applied to all the adhesiolysis areas, in
> total 6 kits of spray gel were used. After rinsing, a small amount of
> ringer fluid was left behind and an intraabdominal drainage was
> introduced into the abodomen" why did you put this drain in? I see no
> scar from it, where did you put it. Why add ringers after spray gel?
> would this not dilute it. I am seeing these blood clots covered with
> spay gel. Does not meticulous hemostasis before the introduction of
> spray gel give us the best chance? My second look op report states"
> Situs: the peritoneum all over was reddish and covered with old blood
> (reaction to the spray gel?)" Where'd all that old blood come from. Now
> I am going to tell the world I am sure I have adhesions back. I know
> what they feel like. I have written to you several times with my
> concerns and you were mad that I was not "shouting it from the rooftops"
> Your last personal email to me said " Good luck with fighting your
> pain." I am not the only one having problems either! I have remained
> silent untill now thinking I will have to return to you as you are my
> only hope. I don't think that anymore. With out valid answers to these
> questions why would your surgery be any different than the others we
> have been through? I offer my operative report to any who wish to see
> them. I am patient # 10 from the US. I urge others to break their
> silence and review their operative reports. I am happy you have this
> site Daniel but unfortunatly it's not going to be all smiley face icons
> and we have a pal for a doctor. These are matters of life and death! We
> have enough friends now lets hear from our doctor. To any who wish them
> I will email you my operative reports and the pictures so you can see
> for yourself.
> Thank you for facing these tough issues,
> Dawn
=======================================================
From Daniel
To: Dawn Rose
Posted Friday, July 18, 2003 @ 02:18 AM
From Daniel Kruschinski
to Dawn Rose, Mass.
July 2003
Hi Dawn,
I knew that some of you will cause trouble, induced by others ..
To answer your questions is very easy and I will do that, but please don't say untruth things here: First I never wrote back to you "Good luck with fighting your pain" !!!
This is what I wrotea as a part of my message to your from June 13, 2003:
"... Anyway I hope you fight your pain, probably you are right with that the
ovary could be the cause of your pain... and probably it should be
removed and replaced by hormonal replacement therapy which could
be controlled much better than the ovary.
Thank you"
This was a logical advice to your email. And it's not true that you contacted me so many times about your condition, I have nice aemails from you and even from your daughter about you joining the life now and one about that you are in pain... and I have a copy of them, so I can show it to everyone.
OK, now to your Questions:
1)To achieve hemostasis we have a wonderful instrument, the bipolar scissors, which comes from laparotomy and can be only used in gasless laparsocopy. With this instrument you can achieve a very good hemostasis.
2) Gauze is not used in the surgery, only a sponge which does help tp make the preparation very easy and doesn't cause any problems. It gives me the same tools as in laparotomy (which are anyway better than the long ones from laparoscopy where the surgeon doesn't feel what he is doing... he loses the tactile sense of his hands... so he is a surgeon without a hand ...)
3)The drain is important to recognize bleedings after surgery and by this drain the little ringer which I put inside disappears. Why I put a drain because I want to see the bleeding which can occure after every surgery, even by one who doesn't put the drain ... so in by this I can earlier plan an additional intervention if there is a bleeding...other doctors without a drain deosn't recogize e blleding at all...
4)The body / peritoneum answers to everything that is a foreign body (SpraGel is also one) with inflammation and some blood escape... individually in some patients more in others less, this blood is already without any coagulative substances so it can’t coagulate and so thus can’t cause adhesions as it doesn’t contain fibrinogen... Nothing to worry about, this is not blood that makes adhesions, this is a peritoneal fluid and is reddish and as it can’t escape while it is covered by SprayGel, it shows exactly the reaction I describe in the operative report and which shows a “healthy”, smooth and shining peritoneum with neovascularistion ! The inflammation is exactly what we want, it causes a neovascularisation (new vessels are building and bringing Oxygen and high blood supply to the wounded area which heals by this quicker... !!! And this I can say as I use very high amounts of SprayGel and have the most experience with using many kits and not only two...
Adhesions can come back after every surgery, even after mine, I never stated that we have 100% adhesions free patients... Also pain can be related to other organs or issues thany adhesions... Medicine is never 100 % as we know, so some might develop adhesion and some others not... but with the combination fo both, gasless laparoscopy and SprayGel I still have the best results...
So Dawn, you are still welcome to perform a third look as done by Lisa Graven and than we could detect if adhesions came back. This would be also good to know, as no procedure is 100 %, we are not magicians, we are humans, and we might mistake in our theories about adhesions, as adhesions are the “chameleon” of the surgical treatment and there are plenty of doctors who don’t touch this patients (as you yourself know). I’m at least trying to help and I helped many of ARD patients ... If I can heal at least one or two it is worth to work on it and to work out how and what to do better in the future, so you could help to educate my self even much more in my undertakings to fight adhesions...
Many kind regards and I’m sorry, you are trying to fight me, but I know it’s someoen else behind you... it is not you that is trying to do so... But I have the right on my side so I’m not afraid and I’m not going to remove your post like some others would do and did already on other boards... this is a free seech board and everyone can post anything, also bad things about me. This will give me the opportunity to answer officially and not get fighters behind my back ... Still your friend
Daniel
===============================================================
---- Original Message -----
From: Beverly J.Doucette
To: Dawn
Sent: Thursday, July 17, 2003 5:48 PM
Subject: RE: Your response to Daniel and Karen..
Hello Dawn,
I know your upset, and you do have a right to ask more questions as sometimes answers lead to more questions!
Here is the best way to answer Daniels email and Karen’s as well, all in one.
Stay strong, don't react, your doing what you have a right to do, if you had never met me, you would have a right to ask questions of Daniel! Remember that! Do not allow Karen to blindside you now, she is wicked with a bat, but miles away from you so your safe, her words cannot hurt unless you think they are true, and they are not.
Both Daniel and Karen are using an old psychological ploy called a, " smoke screen!"
This means that in order to avoid dealing with issues they are responsible for, they will trey to bring OTHER issues into the conversation so that your time and energy are used to deal with those lesser issues and issues with out basis so that you forget the REAL issues at hand and are more apt to focus on the crap stuff then your real concerns, thus they get out of being held accountable for what they are responsible for!
IN this case, nothing your saying is your words, thus they are not taken seriously, and Daniel uses words like "troublemeker" as it demeans you and flusters you, name calling is always a great smkoke screen! :-) Accusations will also throw the focus off the real issues as the person then spends time defending themselves and all other pertinent issues get lost in the garbage of defense.
Daniel is a pro at this stuff...and then to use medical descriptions of equipment..give me a break! And the medical physiological terms about the "body / peritoneum answers to everything that is a foreign body (SpraGel is also one) with inflammation and some blood escape... individually in some patients more in others less, this blood is already without any coagulative substances so it can’t coagulate and so thus can’t cause adhesions as it doesn’t contain fibrinogen... Nothing to worry about, this is not blood that makes adhesions, this is a peritoneal fluid and is reddish and as it can’t escape while it is covered by SprayGel, it shows exactly the reaction"
This is okay for them to do as long as you understand it..okay? Nothing to react to..unless we do it intentional, like below!
You can call me if you like...I will be sending Daniels explanations to Confluent and either Tom will get to you or he will get to me. May I give him your phone number please?
I am so sorry you have to go through this with Daniel, and I am so sorry your not well, but I will try to help you as much as possible! Stay strong! Bev
=============================================================
From Dawn Rose
to Daniel Kruschinski
July 2003
Hello Daniel, (and Karen)
Daniel, you have no idea how upset and scared I am that I may have adhesions back! I have thought it for some time, and we have talked or rather communicated about that, maybe it was not as often as I stated, and maybe your words were as you said and I read them the way I saw it, remember, I am not as well as I hoped I would be, I cannot see any way I will ever be able to get back to you and who can I turn to here for help..no one! I am desperate and in pain! Then I hear you saw that yes, it could be the ovary, and I had gone all the way to Germany only to return with this message telling me I still have problems! Yes, I saw red, and I feel sick that I have problems that may need surgery, I thought I came top you for all that only to hear you tell me that the ovary might be bad....
how will I ever know as who here can do a surgery...I am sick and afraid of adhesions...and now you say I am making trouble because I need answers!
I fell like I am starting all over again here, begging to see a Dr. for what..diagnostic tests to tell me I have nothing wrong with me, start taking pain meds again.and talking to you IN Germany doesn't help me get medications here in the USA!
Others putting me up to dragging out my operatives from Germany now that you have a message board but not before that..well, if you must know why I dug them up now it is because a patient of your just returned NOT WELL at all and having a fit because I sent her over to you! She is angry and seeking answers to HER operative reports from every DR. and surgeon she can! And she blames ME for all of this and for wasting her money too! Karen, say what ever you want about me trying to make a problem, it IS a problem to be sure, and yes, someone is behind it all, but NOT who you and Daniel think it is. You want to blame Bev for everything, she says so be it, it is okay. She never mentioned anything about Daniel to me or on the IAS, always answered my concerns in private as your saying to do, and yet never putting Daniel down, even stating I might have to go back to him!! Karen you did all the public name calling and blaming..never Bev! I mentioned her name one time on the IAS, which I regret and apologized to her for doing as she had no part in it all, I did that, but she wanted no retractions at all, just to be left out of the public display!
I have talked to Bev about this recent issue with this patient because this patient didn't want to talk to Bev, she allowed me to send her operatives to Bev and asked questions. I have no idea what has transpired since then as Bev will not discuss this persons case with me and this lady is very angry at me...I dug out MY reports to show this lady that I was sorry for not being upfront with her as to how I felt and that her decision to go to Germany was based on my lies, etc...I told her I would share everything with her, I feel terrible guilt Daniel and Karen, terrible guilt for not telling her how I really felt! THIS is why I had my reports and pictures out, to send to her!
I asked Bev to look at MY reports and explain them to me in medical terminology so I would know what to say to this lady..and Bev actually said the same things that you just told me, and she pointed out that there was "old un-oxygenated blood" in the first pictures you took at the start of the initial procedure and that there were lots of adhesions, and of course that blood left in the cavity very well could cause adhesions, but to keep on mind that I did not have a barrier used here in the states so one would expect adhesions to form! Then she explained that there appeared to be blood in the cavity prior to you applying the Spraygel, but maybe you picked that out before the application of the Spraygel. (She explained that Dr. Reich picks the blood out at the end of the surgery as well as aggressive irrigation.) Then I asked her if I might have adhesion again if blood was left in and that I saw what looked like a gauze pad in two of the pictures and that gauze can cause adhesions to.
Bev, yes, Bev told me to email my questions to you, I also asked her about a drain, she told me to ask you as how could she know if I didn't remember having one and had no site where it would be how could she know. If it is in the report, then she said I had one, but to ask you as she can't know where it came out of!!
I know I come on strong and angry, but I am causing trouble because I now need answers, and now I get out my reports, it is Bev's fault? And I should tell who this person is when she asks me not to tell you yet she is screaming accusation at ME for not being honest to her and now she is WORSE then when she went over to you! This is BEV'S fault and I am making trouble induced by others!! IF only Bev would give me some time and answers, she too thinks I didn't do the right thing, yes, Karen, I too got that email!! I feel guilt, and I did wrong when this lady contacted me before going to Daniel, I WAS the cause of her wasting her money and coming back very ill! This is how I feel....and I am making trouble Daniel?
I can't afford to come back, Daniel, I am desperate and I am scared, and you don't need to tell me I don't know what I am doing and have to be "put up to it" by anyone else! I choose to say what I did to this lady, no one but me, and I did wrong. No one put me up to saying how wonderful you were when I did feel well, and even when I didn't..not even Bev put me up to that! I did it...so Daniel, give ME credit for knowing what I am doing when I write to you!
I know you can show patients emails to everyone, you did that with Lisa, remember! And Daniel, I WAS well and thought I would stay well, but now I am NOT well, so what do you ant me to do, shut up and suffer? Write happy faces all over my emails?? And I AM guilty of lying to this lady...happy faces on that too!
Your report states you achieved hemostasis, what I am asking is if that means you remove the blood clots I saw in the pictures, it doesn't matter to me the instrument, I have no idea what that even is, all I want to know is if you cleaned out the clotted blood before the application of Spraygel, that's all I am asking. I am trying to figure out if I now have adhesions..and did Spraygel make me bleed as it states in your report? If it did, how can I use it again? Why did it make me bleed?
The pictures of the blood were before the Spraygel was put on Bev said...is that true? ( And she said to ask you, she was not attacking you or anything!)
I saw a gauze pad in two pictures, that's why I asked about them. Can't I ask that without being a troublemaker?
If there is bleeding after surgery, won't adhesions form?
And I asked WHERE on my body the drain was. This lady said her drain was in her side, I didn't know I had one and told her that I didn't have one, only to read on my reports that I did, now she thinks I am lying to her again!!
Now I am confused again, inflammation causes adhesions we all have heard...and now you say I had inflammation too? I do not understand anything about the bleeding or blood part, but I asked Bev to explain it, just so you know, and she said she had to forward it to Confluent as it was all news to her and it is best someone there answers these issues, not her!
Is that blood clotting gone now do you think or did I get adhesions from them again??
Daniel, you said that each second look was 100% clear of adhesions, mine too, what does that mean then? I fear having to live with adhesions again, and I did believe that you had 100% success, maybe you did not say it but I was led to think that!! Maybe from Lisa, I don't remember! I am so afraid of having adhesions...
I don't see how I will ever get back there to you, I am so frightened, and you can keep saying someone is behind my words, Daniel, it doesn't matter, the real issues are that I think I have adhesions again, and when I got out my reports to send south, I asked Bev to read them and explain them to me. She did NOT put your surgery down, nothing like that at all, she explained what she knew, told me to email you and said I might have to go back to you too, as this other lady is supposed to do! Bev told me nothing different then you just did! But Daniel, I can't get back to there, and I do not trust anyone here! It doesn't matter what Karen says, I told this lady a lie, and that I didn't have a drain, then it is on my report...Bev told me to ask you about it, not her! I do not want Bev to dislike me, she helped me get to you...but I think she doesn't like me anymore then the others! Think what you want, Karen too, but it doesn't change my worry's and my needs!
I didn't do this behind your back and even if I asked the question in the other area to ask you stuff, everyone will see it anyway, so I wrote it here! I do NOT want to ever be accused of not being upfront again, and Karen even if you don't like that I ask Daniel questions publicly, to bad as this is how I am going to always do things, upfront and open and honest! I lied once and caused a serious problem for someone, maybe others too, but for sure one person, I will never do it aging, even if you don't like it! I am not you Karen!
Daniel, you make it sound so simple to just return as Lisa did, but I am a single parent with an ill child and no money...and how do I know it would even work a next time? Your right, nothing is 100%, but what about IF blood left in after surgery does create adhesions?? What about a drain tube creating adhesions and bleeding after surgery..creates adhesions...do I get a laporoscopic procedure done here to see if there are adhesions and not allow for any to be lysed? Is that possible to do?
Aside of all the garbage and accusations, what do I do?
You accuse me of making trouble because I ask questions, do you say that to me so I do NOT ask you questions? Why is that making trouble, Daniel? Is this why other patients don't approach you with their issues or IS everyone well except for me and this lady who just returned, and Lisa, and Sally?
I need answers for me, for me, Daniel...and if your message board can't handle truth but only smiley faces and praise..then it is not any better then any other message board that wants to be perfectly sterile and "happy" al the time, which isn't what ARD is all about all the time! To bad..you did my surgery, I have my op reports out and I need answers..and not in such a medical jabber that I cannot understand a word of, tell me in layman's terms please. That is considerate and more helpful then this email. Karen, stay out of this, YOU never had a surgery with Daniel so how can you talk to me that way..I am suffering, not you, you cannot know what I feel at all as you do not have to face this, your daughter does! It is no wonder to me she is not around to post, she got well and then ran miles away from you being overbearing in her life! Stay out of MINE!
Karen, you attacked EVERYONE on the other message boards at every post that you didn't like, now your going to start it here again?? Thats okay with me, I am going to ask my questions to Daniel as MY money was as good as anyone elses was and I deserve answers to MY questions!
( Daniel, this is part of a report I have in MY files...MY files, Karen, I can read and I understand what this says!!! Maybe it is wrong, but this is what I read.)
Cont: AETIOPATHOGENESIS OF ADHESIONS
The omentum plays a protective role in adhesion formation. Adhesive obstruction after colectomy is well known. This is because the operation involves, omentectomy and this will remove the organ that forms safe adhesions. As a result it would leave adhesiogenic areas exposed to the small bowel and will result in higher incidence of small bowel adhesions.
Another significant factor is a frequent practice to divide any adhesions that are total encountered. The division of adhesions which involves the small bowel are at a high risk of later obstruction.
PREVENTION
As yet there are no definite methods of completely preventing adhesions. The two commonly used solutions that have anti-adhesive effects in animals povidone iodine and 30% dextran 70.[13] Povidone iodine is used by surgeons more for its antimicrobial action rather than that of its anti adhesive effect.[11] Dextran is a popularly used solution in gynaecologic practice to prevent adhesions in infertility surgery.
The most important way of preventing adhesions is by meticulous technique.
The following are a few operative steps which could be undertaken to reduce the incidence of post operative adhesions.
Careful handling of the bowel to reduce serosal trauma.
Avoid rough unnecessary dissection.
Avoid contact of foreign material from the peritoneum e.g. use of absorbable material as far as possible, avoid excess use of guaze swabs, or wearing starch free gloves.
Adequate excision of ischaemic or infected debris within the peritoneum.
Preserve the omentum as far as possible. Placement of omentum around the site of surgery and run the omentum under the wound to encourage low risk adhesions to form.
Avoid dividing adhesions which do not involve the small intestines.
============================================================
From Daniel
To: Dawn Rose
----- Original Message -----
From:
To: "Dawn" <>
Sent: Sunday, July 20, 2003 3:05 PM
Subject: Re: your attacks
> Hi Dawn,
> I feel sorry for you that the drugs drives you crazy, but I would like you
> to answer my questions: Why are you doing it ? What have I done to
> you ? Why are you slandering me ? For what reasons are you lying ?
> No one of my patients was near to dy, this is really hard... to see one of
> my patients speeking such crazy things... as I am always trying to have
> avery good relationship with my patients... Why didn't you continue to
> communicate with me after June ? You stopped the communication
> after Beverly told you to do so... I really don't want why you as a adult human that I have done so much for, have to act like this... if you continue ... than I wish I would never
> have met you... if you think you can stop this mess, please come back to me.... there is nothing wrong on what I'm doing...Let's come together again, let's try at least to behave like intelliegent adult human...
> Regards
> Daniel Kruschinski, MD
> EndoGyn®
> Institute for Endoscopic Gynecology
===============================================================
Original Message -----
From: Beverly J.Doucette
To: Dr.Kruschinski@t-online.de
Sent: Sunday, July 20, 2003 9:38 PM
Subject: Re: your attacks
Dear Daniel,
What is THIS all about? My name has been tossed around the IAS and now in this email to Dawn Rose...Daniel, I have nothing to do with Dawn Rose other to tell her TO email YOU with her many questions! Dawn emailed me with her operative reports as week or so ago asking me to explain them to her as she was sending them to one of your recent patients who just returned...I answered some questions, but then told her to deal directly with you as I did not want to get into the middle of anything between Dawn and the patient!
This lady was VERY irate at Dawn and demanded that Dawn answer questions about things that Dawn told her prior to the lady coming to Frankfurt! Dawn wanted ME to speak to the lady, and I did, but only to tell her to communicate with you. This lady also said that I misrepresented Frankfurt by telling her that I would go there myself if I couldn't get Dr. Reich. This I did say to her, but that was before I found out that not everyone returning home and saying they were 100% well were actually NOT doing so well after all. I was a victim of this misinformation the same as she was! I have NOT spoken to the lady since! ( And I will not either!)
This is what Dawn explained to me prior to asking me to look at her operatives and why she asked me to do that!
This same lady called Dawn a lire and a fraud, Dawn told her she would let her see anything she wanted to see regarding Dawns operatives from Frankfurt, as Dawn felt guilty I guess...Dawn told this lady something about her ( Dawn) NOT having a drain tube post surgically, and then when Dawn found her operatives, it stated she did in fact have a drain, so the lady once again called her a lier and said Dawn scammed her for "pushing" Frankfurt!
Dawn feels terrible, she asked me to look at the operatives, and I did, she asked where a drain would have been if she had one, which she says she doesn't remember, that is when I told her to discuss her issues with you as I do NOT want to remain involved with anything to do with Frankfurt, and I told that to Dawn well over a week ago! I do commend Dawn for trying to make amends with this lady by trying to be honest with her now....
This same lady also says that Lisa Graven scammed her after I referred her to talk to Lisa about Frankfurt, so it was MY fault again! I want no part of any of this, Daniel!
And to see my name used in this manner here when I have neither posted anything negative about you or your procedure on the IAS or anywhere else...what some of your patients did was wrong Daniel, whether you like it or not, they were not sharing current information about their current health, be it adhesions or not, and people felt that they were not hearing the truth prior to going over to see you! I emailed my issues to YOU and to the women who reported that they were well, when in fact they reported elsewhere that they were NOT well!
False reports posted public for all to see and to use in making a decision as to where to seek a surgery, is not something that I want to see happen to victims of ARD, and I don't think you did either! It is always best to report how a person is feeling and living after ANY adhesiolysis so that others do not have false expectations when they elect to go to a certain surgeon!
NOT one time did I ever mention anything about your surgery, Daniel and never did I ever go public with this issue, the other ladies did that! I never saw your procedure or skill or compassion as being anything but that it is, decent and offering a good chance of improvements from ARD symptoms! What I take issue to, was the women not sharing the truth! A simple as that! You can look back many months in the IAS archives and you will have seen me post maybe two times in that year..and it was never to put down or slander you or your procedure, Daniel!
Daniel, If anyone wanted to see Frankfurt go, who do you think that would be??? Perhaps me a little bit, I was the one who introduced Frankfurt..of course I want to see it be productive, but only with honesty and respect, and some of those you choose to speak on your behalf, well, they remain less then of moral charachter! Not just MY thinking, Daniel, they were caught in dishonest behavior, and now they are very unhappy with me for asking them to be honest to thier fellow ARD sufferers and speak the truth, and they all did, but they also all left the IAS for some reason, shame I am guessing, and then stating that they were thrown off by Davie, that is not truth again, and people can see that...and it was again, from thier own mouths, Daniel, not mine!
I don't think you want to secure patients by former patients not being honest with them, Daniel, and that is what happened, and that is what is behind the issues with Dawn, I am sure! ( At least what I knew, this other stuff I have no idea about !!and I don't want to know either..leave me out of all this stuff, all of it looks CRAZY to me!)
I have not posted on the IAS for ages, and I do not plan to start now! I do not need nor want anyone to post for me, in fact, Dawn Rose DID post something about me in response to someone calling me a lier etc, etc..and I emailed Dawn to never use my name again unless she has permission from me, which she did not have! I don't care what any thinks I am doing or did, that is the least of anything that bothers me, because it is said doesn't make it fact, and your words here are far from being fact, Daniel, as why would I care if Dawn Rose emails you?? I hardly know her! I'm going to take MY time to deal with her issues and the other ladies issues?? Why would I do that? Remember, I also sent that email about not being honest to Dawn as well as the others, and she wasn't honest, non of them were, so why in the world would I NOW deal with her?
My God, Daniel, I have no idea what all that stuff is that your saying in this email!! About someone dying??? Who is sandering you, it isn't me!! I haven't emailed you sice that issue with some not telling the truth..and that was NOT you, it was them! How is that slandering you, Daniel??
I am not aware at all about any contacts Dawn had with you at anytime...now or before June! She doesn't email me Daniel...only to see her operatives and to tell me she was trying to be honest with this lady now! I am NOT interested in her trying to be honest now, or any of the ladies, they did share the truth, and it has offered and allowed prospective patients to ask more questions of them and hopefully you, so that when anyone comes to Frankfurt, they are prepared fully as to what to expect..and it is NOT all" miracles" as these ladies were saying over and over and over Daniel..it simply wasn't! Maybe you didn't know that these particular ladies ( Karen, Sally, Dawn. Lisa, & Carolyn) where telling people that there were 100% success's coming our of Frankfurt, and that they were all well..given Karen speaking for her daughter, then I hear that this is NOT the fact, and emailed you and them to begin to share the truth so others who elect to go to you will not have unrealistic expectations, as this lady now states she had because these same ladies, and ME included, falsified information about Frankfurt!
Daniel, I have not dealt with anyone or anything to do with Frankfurt since my email to you and to ONE time look at Dawn Rise's operatives, and tell her to go to you with her issues! I want out of ALL ARD issues...not because of you, David Wiseman or anyone else, but this lady is going to cause some trouble, Dawn should worry, as should the rest of those women she talked to or who posted false information, if this lady and her husband decide that they were frauded by them ...they are all in deep trouble! Not you, Daniel, as you did not make the statements that everything was 100% success's, and neither did I as I was advocate for Harry only!
I will also share that I was saddened when Karen would attack anyone who talked about any other surgeon or surgery or that they could not get funds to go to Frankfurt, she hurt so many innocent people who are the victims living with ARD, she doesn't live with that pain and suffering the same as the victims do, yet she was unmerciful in her behaviors to them! This was sad as you were trying so hard to open the doors in Frankfurt...and that type of behavior was only serving to close them! I am not sure if you know this or not, but their appreciation of your skill, went to far and they became dishonest backers of you...not it is difficult even for me to get excited for Helen surgery with you, as I wonder if the second looks really were all 100% free of adhesions, and once I found out that a number of your patients were not well after some months, be it adhesions or not, I will wait and hold my breath as time goes by for Helen...praying and hoping that she will be one of the fortunate ones who had your adhesiolsysi, many are well, ( I THINK!!) and may Helen be among them, Daniel! I know you did your best with her, and God, I pray she will have success to a great %!
I cannot be to optimistic since the ladies didn't tell the truth, I too feel like a victim of their over zealous words....but this is NOT your fault Daniel, as I have no doubt that you did not know they were saying such things!
I cannot stop anyone from using my name or placing suspician on me for things..but that doesn't cause me to do anything different as I am not doing any of it anyway! Maybe you would be best served to look at issues as if that patient or person or whomever you think is not acting on their own, as Daniel, in the case of Dawn Rose, it is not me, so deal with her and hold her accountable for whatever it is she is doing....and use me if you want to, but you will never be able to deal with the reality of the issues as she states them or does them, as she is doing them, not me, and it seems you have some issues here...I wouldn't touch this with a ten foot pole! You know, I am NOT even curious as to what the hell this is all about, my name in it or not, I don't want to even know about it!!
Good Luck Daniel, and unless you have proof I am doing something, Daniel, keep me out of it. Beverly
----- Original Message -----
> From: "Dawn" <>
> To: "Beverly J.Doucette" <>
> Sent: Sunday, July 20, 2003 6:01 PM
> Subject: Need assistance or the shot heard round the world.
>
Holy crap Beverly.......it is the shot heard round the world...leaves me
> > all a bit nausoues....but anyhow I am done with the posting
> > part........and ......um I think David is going to be pissed at me as
> > Karen came gunning for me over on the IAS...well I guess you'll see....I
> > am a bit ashamed I was so nasty but whats done is done........I think
> > the message got out to more that I ever imagined.
> > What I need help with is......well.......maybe David might not want to
> > hear my voice right now as Karen is all over him demanding I be banned
> > from IAS as well. I need my second look pics and as best I know, David
> > has the only copy.......it is probably sitting unopened in a pile some
> > where.....but Jo and I are going to compare pics of our adhesiolysis...I
> > think they should have this as they are concerned and "got it"....I am
> > sure that David would not go out of his way for Jo....but they are our
> > sister too.
Thank you again so much.... Thank you, Love, Dawn
Original Message -----
From: "Beverly J.Doucette" <>
To: "Dawn" <>
Sent: Monday, July 21, 2003 9:55 AM
Subject: Re: Need assistance or the shot heard round the world.
I see my email got to you to late, not that it is my business to tell you
> what to do, but I was out of town and got home very late last night to
> respond to your email.
>
> I see that you already posted..as did dear Karen...and I am not sure what
> you mean about Jo...xxxxxxxx perhaps?
>
> Please do NOT post anything that will open a door for Karen as she is
> spiteful and will hurt anyone who so much as gets in her way! So many who
> post and are attacked by her are innocent..posting anything that will elicit
> a response from her is not worth it. It is nauseating to be sure, Dawn.
> please do not post anything about Frankfurt, dear, speak to David about
> things before you post as if you feel your not getting answers from Daniel,
> perhaps David can answer them as well!!
>
> Like I said before, Dawn, please do not get caught up in any battles on the
> IAS as it only hurts us all. Perceived involvement or not, when our names
> are brought up like that, it hinders anything we might want to do or say to
> support other victims of ARD.
>
> These posts are said and done now...but try to think about not responding no
> matter how frustrated you are or if the issues are about Frankfurt and
> Daniel, take them to his site if nothing else. I cannot tell you what to
> do, and I did mention before not do anything on the IAS board that is
> negative, but now I am begging you not to keep it going, dear, please?
>
> I am not sure what you mean by got out to more then you thought?? I, this
> morning, got hate mail in my private email, and I had nothing to do with any
> of this. My involvement is perceived, even by Daniel mentioning my name all
> the time, so there is nothing I am going to do about it, but walk away from
> ARD issues, which is fine with me actually.
>
> But please Dawn, don't post negative things on the IAS, your a valuable
> asset to the IAS, try to talk to David about things before you post, if you
> will. One day someone will need your advice and you want to be there for
> them, and NOT be perceived as "reactive" shall I say.
I don't know what you and Jo will find, but if it is an issue for Daniel,
> take it to Daniel, I am not sure how, but you might want to talk to David
> first, he is really a wonderful person and will NOT be angry, he will help
> resolve your issues and he will want to do that before posts start a
> controversy on the IAS. I mentioned that before...and I will mention it
> again, please, I really, really beg you, Dawn, not to respond to anymore of
> anyone's ( Karen) posts on the IAS that elicit negative issues.
> Your message is well taken by those who see it, as long as you want to share
> what your story out of Frankfurt is, offer to do it in a private
> email...that is much better for both you and who ever requests any
> information about Frankfurt. It serves everyone better, my dear..okay?
>
> I don't know what to say, other then to ask again not to post about
> Frankfurt on the IAS, I have no right to ask that of you or anyone, but we
> have talked about it, and you know where I sit as to that issue, bickering
> on the IAS serves no useful purpose, and Dawn, you can avoid it and be just
> as effective in getting your message shared by using email, in fact, it will
> be taken more seriously then if seeing it posted in a public way, don't you
> think so? This makes me so sad, sick as you put it....it is past, but now
> you can stop it in it's tracks by letting it all fade away, at least on the
> IAS if you want to deal with Daniel and issues of his making, but you can
> let it fade away on the IAS, dear, please think about this. You probably
> feel worse now then before you posted on the IAS, and if that is so, then
> try not to keep it going.
>
> I have heard no more from XXXXXX, so maybe she is okay. I did put her in
> touch with a surgeon who she can ask questions of, nothing more either of us
> can do. You are free of her, Dawn....!
>
Take care now, I will help you too! Bev
You just won't quit will you? I hope you are enjoying yourself. If anyone said anything to Daniel it was due to the fact that you and others were discrediting his work "behind the board".
I have emails to prove so. I am really tired of your game and I am sure others are as well. You hate the work we are doing because you see it as a threat to your first love: the IAS. The IAS
has been behind you and certain other people, but the IAS does not support people that have a heart to HELP the ARD patient. If they did, they would not be fighting this new work so very hard.
I never said a word about you not singing Daniel's praises, I was too busy singing my own. Dawn, I personally did not care what you were or were not doing.
Rules, rules, rules. I never read any of them. My heart is for the person begging for help. You can't even
decide WHO you are really out to attack. We are connected to Daniel, so go for it. Make a name for
yourself.
You paid money to join this club?? It did not cost me anything.
I am sure you have swam with much bigger sharks, as you seem like the type that would.
God help you, Dawn
[Edit by gingirl on Saturday, July 19, 2003 @ 05:42 AM]
----- Original Message -----
From:
To: "Dawn"
Sent: Thursday, June 12, 2003 12:14 PM
Subject: Re: Need guidance
Dear Dawn,
How are you, I hope you feel better ?
I would like to comment and to ask you if you like to continue to be on
my website as one of my patients contacts... (In your last email you wrote:
I still feel like a million buck compared to before. I have not spoken a
word of this to anyone nor will I as I get letters all the time and tell
everyone to go as you are their only hope and the relief is amazing.)
Dawn, Once I told a patient from Netherlands to go to my website and to contact one of the patients contacts and she contacted you and asked you about me. She send me your reply and it was one that directed her to another surgeon.
Today I got an email to look what advices you give on the IAS
Message board.
( Dear Elaine, Welcome, You are not crazy....if you have had prior surgeries you may indeed be suffering from ARD. A great way to check is to get your operative reports and see if adhesions were encountered during >the surgeries. If you need help locating a doctor in your area who is sympathic to the plight of the ARD sufferer, a great resource is in the support section under worldwide support listed by county and states. Hopefully you will find and IAS contact person in your area. If not you could contact Dr. Wiseman, the founder of the site. He may know of a doctor that is sympathetic to and understands ARD. He has many emails to answer and is very busy but he eventually will get back to you...he always does. An advocate should be able to help you though. Hang on, there is hope. Much love Dawn )
Dawn, I really don't believe that this kind of answers are a help for adhesion
sufferers as the exactly send them where there is NO HOPE... To
surgeons who perform surgeries after surgeries with no or only a litte
success results. Adhesion sufferers are the most complex, complicated
patients to treat. Surgeons who knows that adhesions are coming back
in a large number of theirs surgeries or that one who are gynecologic
surgeons without experience in bowel surgery, are harming the patients
knowing about alternatives. Could you explain if this is your intended purpose ? I have no problem if you continue to do so, then let me know and I will
take you out of my contact list for US.
KInd regards
Daniel
Daniel Kruschinski, MD EndoGyn® Institute for Endoscopic Gynecology
From Daniel
To: Dawn Rose
Date: Fri, 13 Jun 2003 19:37:07 +0200
From: Dr.Kruschinski@t-online.de
To:Dawn <>
Dear Dawn,
I got a little confused by your answers on the board and that you say, patients should ask Dr. Wiseman for further help and should search in the IAS website and so on. I mean, you should tell people to see where there are good results and help. Of course it doesn't work always but in many cases. The techniques I'm using are so extremely
important for adhesions sufferers as they show, at least in my hand,
better results than every other surgeons technique. About such
techniques it should be written and recommended to patients and not to
say them to go for gas laparoscopy with gas and no SprayGel...
I don't need everyone posting about that but it's nice that some are
doing it and patients remember to ask me and send me emails... This is
the result of Karen's and Carolyn's posting and I am able to provide much more patients with a successful adhesiolysis than ever before.
Every week there are two new victories against adhesions. And please
show me another surgeon who has the same results !!!
Why can't you all work together and keep up posting about gasless
laparoscopy and SprayGel ? Why it can't be posted about the doctor
who has till now the best tools and techniques and results for
adhesion sufferers ?
I won't be glad, if David Wiseman will stop patients posting about
this successes and then I probably will go out of the IAS.
My priority is surgery and this is what I'm living for. I don't have
any other interest in my life except surgery and changing concepts of
surgery that went wrong... I even don't have the time to deal with all
the problems, my closest family, like Shirli, my kids and some others
have... I'm a work-o-holic and yes, I'm fanatic (this is what Shirli
says) in my visions of a better surgery, to provide doctors with something that
they did a mistake in (CO2). And I will continue to provide ARD sufferers with best results. But I was counting on you as you were kind here and you spoke so
much what you wanted to do as a patients advocate, like to make fundraising and some other things... Anyway I hope you fight your pain, probably you are right with that
the ovary could be the cause of your pain... and probably it should be removed and replaced bya hormonal replacement therapy which could be controlled much better than the ovary.
Thank you
DAniel
Daniel Kruschinski, MD EndoGyn® Institute for Endoscopic Gynecology Seligenstadt(Germany)
============================================================
From Daniel
To: Dawn Rose
Dear Dawn,
I'm not angry at you. My vision is that YOU ALL cooperate together and
make my dream come through, that gasless laparoscopy is a better
tool for laparoscopic surgery.
If you send me the records I could see if I could help. But how do you
want to tell her to fly if she doesn't want and how to collect the money ?
Regards
Daniel
Daniel Kruschinski, MD
EndoGyn®
Institute for Endoscopic Gynecology
"The world is too complex for simple solutions..."
or"The world is very complex that only brilliant simple solutions will
succeed ...
----- Original Message -----
From: Karen Steward
To:
Sent: Thursday, June 26, 2003 2:10 PM
Subject: date
Hi to all,
Daniel has asked me to contact people that have had surgery with him
and request that you fill out the data form on the IAS site. I know I don't have
everyone on this list; however, will get others email addresses and send to
them also.........
Karen
From Daniel
To: Dawn Rose
----- Original Message -----
From:
To: "Dawn" <>
Sent: Monday, June 30, 2003 5:53 AM
Subject: Re: Need your advice
Hi Dawn,
This is a follow up on your surgery. As some time passed, I need
to collect some data. Please be as helpfull as possible to determine
all the issues.
Actual date:
Name:
Surgery date:
Second look date:
Average Pain score (0 - 10) before surgery:
Average Pain score (0 - 10) after surgery:
Pain medication before surgery, which and how much:
Pain medication today, which and how much:
Activity before surgery (0 - 10):
Activity after surgery (0 - 10)
Bowel movements before surgery:
Bowel movemnts after surgery:
Re-surgery becuase of adhesions ?
Bowel obstruction ?
Surgery for other indications than adhesions:
Daniel Kruschinski, MD
EndoGyn®
Institute for Endoscopic Gynecology
"The world is too complex for simple solutions..."
or "The world is very complex that only brilliant simple solutions will
succeed ..."
----- Original Message -----
From: "Dawn" <>
To: "Beverly J.Doucette" >
Sent: Thursday, July 17, 2003 11:33 AM
Subject: My PUBLIC message on Daniel site
Posted Friday, July 18, 2003 @ 00:34 AM
>
> While reviewing my operative reports that have been stowed away for some
> time I have some urgent questions that all have a right to see answered
> here.
> I feel I am pretty well educated as a lay person with ARD and I seek
> further clarification as to what happened to me.
> What do you do to acheive meticulous hemostasis? I see many blood clots
> and they are covered over in spray gel. I also see that you introduced
> gauze into my abdomin.
> I quote from my operative report"after securing hemostasis at all the
> surgery sites, Spray Gel Was applied to all the adhesiolysis areas, in
> total 6 kits of spray gel were used. After rinsing, a small amount of
> ringer fluid was left behind and an intraabdominal drainage was
> introduced into the abodomen" why did you put this drain in? I see no
> scar from it, where did you put it. Why add ringers after spray gel?
> would this not dilute it. I am seeing these blood clots covered with
> spay gel. Does not meticulous hemostasis before the introduction of
> spray gel give us the best chance? My second look op report states"
> Situs: the peritoneum all over was reddish and covered with old blood
> (reaction to the spray gel?)" Where'd all that old blood come from. Now
> I am going to tell the world I am sure I have adhesions back. I know
> what they feel like. I have written to you several times with my
> concerns and you were mad that I was not "shouting it from the rooftops"
> Your last personal email to me said " Good luck with fighting your
> pain." I am not the only one having problems either! I have remained
> silent untill now thinking I will have to return to you as you are my
> only hope. I don't think that anymore. With out valid answers to these
> questions why would your surgery be any different than the others we
> have been through? I offer my operative report to any who wish to see
> them. I am patient # 10 from the US. I urge others to break their
> silence and review their operative reports. I am happy you have this
> site Daniel but unfortunatly it's not going to be all smiley face icons
> and we have a pal for a doctor. These are matters of life and death! We
> have enough friends now lets hear from our doctor. To any who wish them
> I will email you my operative reports and the pictures so you can see
> for yourself.
> Thank you for facing these tough issues,
> Dawn
=======================================================
From Daniel
To: Dawn Rose
Posted Friday, July 18, 2003 @ 02:18 AM
From Daniel Kruschinski
to Dawn Rose, Mass.
July 2003
Hi Dawn,
I knew that some of you will cause trouble, induced by others ..
To answer your questions is very easy and I will do that, but please don't say untruth things here: First I never wrote back to you "Good luck with fighting your pain" !!!
This is what I wrotea as a part of my message to your from June 13, 2003:
"... Anyway I hope you fight your pain, probably you are right with that the
ovary could be the cause of your pain... and probably it should be
removed and replaced by hormonal replacement therapy which could
be controlled much better than the ovary.
Thank you"
This was a logical advice to your email. And it's not true that you contacted me so many times about your condition, I have nice aemails from you and even from your daughter about you joining the life now and one about that you are in pain... and I have a copy of them, so I can show it to everyone.
OK, now to your Questions:
1)To achieve hemostasis we have a wonderful instrument, the bipolar scissors, which comes from laparotomy and can be only used in gasless laparsocopy. With this instrument you can achieve a very good hemostasis.
2) Gauze is not used in the surgery, only a sponge which does help tp make the preparation very easy and doesn't cause any problems. It gives me the same tools as in laparotomy (which are anyway better than the long ones from laparoscopy where the surgeon doesn't feel what he is doing... he loses the tactile sense of his hands... so he is a surgeon without a hand ...)
3)The drain is important to recognize bleedings after surgery and by this drain the little ringer which I put inside disappears. Why I put a drain because I want to see the bleeding which can occure after every surgery, even by one who doesn't put the drain ... so in by this I can earlier plan an additional intervention if there is a bleeding...other doctors without a drain deosn't recogize e blleding at all...
4)The body / peritoneum answers to everything that is a foreign body (SpraGel is also one) with inflammation and some blood escape... individually in some patients more in others less, this blood is already without any coagulative substances so it can’t coagulate and so thus can’t cause adhesions as it doesn’t contain fibrinogen... Nothing to worry about, this is not blood that makes adhesions, this is a peritoneal fluid and is reddish and as it can’t escape while it is covered by SprayGel, it shows exactly the reaction I describe in the operative report and which shows a “healthy”, smooth and shining peritoneum with neovascularistion ! The inflammation is exactly what we want, it causes a neovascularisation (new vessels are building and bringing Oxygen and high blood supply to the wounded area which heals by this quicker... !!! And this I can say as I use very high amounts of SprayGel and have the most experience with using many kits and not only two...
Adhesions can come back after every surgery, even after mine, I never stated that we have 100% adhesions free patients... Also pain can be related to other organs or issues thany adhesions... Medicine is never 100 % as we know, so some might develop adhesion and some others not... but with the combination fo both, gasless laparoscopy and SprayGel I still have the best results...
So Dawn, you are still welcome to perform a third look as done by Lisa Graven and than we could detect if adhesions came back. This would be also good to know, as no procedure is 100 %, we are not magicians, we are humans, and we might mistake in our theories about adhesions, as adhesions are the “chameleon” of the surgical treatment and there are plenty of doctors who don’t touch this patients (as you yourself know). I’m at least trying to help and I helped many of ARD patients ... If I can heal at least one or two it is worth to work on it and to work out how and what to do better in the future, so you could help to educate my self even much more in my undertakings to fight adhesions...
Many kind regards and I’m sorry, you are trying to fight me, but I know it’s someoen else behind you... it is not you that is trying to do so... But I have the right on my side so I’m not afraid and I’m not going to remove your post like some others would do and did already on other boards... this is a free seech board and everyone can post anything, also bad things about me. This will give me the opportunity to answer officially and not get fighters behind my back ... Still your friend
Daniel
===============================================================
---- Original Message -----
From: Beverly J.Doucette
To: Dawn
Sent: Thursday, July 17, 2003 5:48 PM
Subject: RE: Your response to Daniel and Karen..
Hello Dawn,
I know your upset, and you do have a right to ask more questions as sometimes answers lead to more questions!
Here is the best way to answer Daniels email and Karen’s as well, all in one.
Stay strong, don't react, your doing what you have a right to do, if you had never met me, you would have a right to ask questions of Daniel! Remember that! Do not allow Karen to blindside you now, she is wicked with a bat, but miles away from you so your safe, her words cannot hurt unless you think they are true, and they are not.
Both Daniel and Karen are using an old psychological ploy called a, " smoke screen!"
This means that in order to avoid dealing with issues they are responsible for, they will trey to bring OTHER issues into the conversation so that your time and energy are used to deal with those lesser issues and issues with out basis so that you forget the REAL issues at hand and are more apt to focus on the crap stuff then your real concerns, thus they get out of being held accountable for what they are responsible for!
IN this case, nothing your saying is your words, thus they are not taken seriously, and Daniel uses words like "troublemeker" as it demeans you and flusters you, name calling is always a great smkoke screen! :-) Accusations will also throw the focus off the real issues as the person then spends time defending themselves and all other pertinent issues get lost in the garbage of defense.
Daniel is a pro at this stuff...and then to use medical descriptions of equipment..give me a break! And the medical physiological terms about the "body / peritoneum answers to everything that is a foreign body (SpraGel is also one) with inflammation and some blood escape... individually in some patients more in others less, this blood is already without any coagulative substances so it can’t coagulate and so thus can’t cause adhesions as it doesn’t contain fibrinogen... Nothing to worry about, this is not blood that makes adhesions, this is a peritoneal fluid and is reddish and as it can’t escape while it is covered by SprayGel, it shows exactly the reaction"
This is okay for them to do as long as you understand it..okay? Nothing to react to..unless we do it intentional, like below!
You can call me if you like...I will be sending Daniels explanations to Confluent and either Tom will get to you or he will get to me. May I give him your phone number please?
I am so sorry you have to go through this with Daniel, and I am so sorry your not well, but I will try to help you as much as possible! Stay strong! Bev
=============================================================
From Dawn Rose
to Daniel Kruschinski
July 2003
Hello Daniel, (and Karen)
Daniel, you have no idea how upset and scared I am that I may have adhesions back! I have thought it for some time, and we have talked or rather communicated about that, maybe it was not as often as I stated, and maybe your words were as you said and I read them the way I saw it, remember, I am not as well as I hoped I would be, I cannot see any way I will ever be able to get back to you and who can I turn to here for help..no one! I am desperate and in pain! Then I hear you saw that yes, it could be the ovary, and I had gone all the way to Germany only to return with this message telling me I still have problems! Yes, I saw red, and I feel sick that I have problems that may need surgery, I thought I came top you for all that only to hear you tell me that the ovary might be bad....
how will I ever know as who here can do a surgery...I am sick and afraid of adhesions...and now you say I am making trouble because I need answers!
I fell like I am starting all over again here, begging to see a Dr. for what..diagnostic tests to tell me I have nothing wrong with me, start taking pain meds again.and talking to you IN Germany doesn't help me get medications here in the USA!
Others putting me up to dragging out my operatives from Germany now that you have a message board but not before that..well, if you must know why I dug them up now it is because a patient of your just returned NOT WELL at all and having a fit because I sent her over to you! She is angry and seeking answers to HER operative reports from every DR. and surgeon she can! And she blames ME for all of this and for wasting her money too! Karen, say what ever you want about me trying to make a problem, it IS a problem to be sure, and yes, someone is behind it all, but NOT who you and Daniel think it is. You want to blame Bev for everything, she says so be it, it is okay. She never mentioned anything about Daniel to me or on the IAS, always answered my concerns in private as your saying to do, and yet never putting Daniel down, even stating I might have to go back to him!! Karen you did all the public name calling and blaming..never Bev! I mentioned her name one time on the IAS, which I regret and apologized to her for doing as she had no part in it all, I did that, but she wanted no retractions at all, just to be left out of the public display!
I have talked to Bev about this recent issue with this patient because this patient didn't want to talk to Bev, she allowed me to send her operatives to Bev and asked questions. I have no idea what has transpired since then as Bev will not discuss this persons case with me and this lady is very angry at me...I dug out MY reports to show this lady that I was sorry for not being upfront with her as to how I felt and that her decision to go to Germany was based on my lies, etc...I told her I would share everything with her, I feel terrible guilt Daniel and Karen, terrible guilt for not telling her how I really felt! THIS is why I had my reports and pictures out, to send to her!
I asked Bev to look at MY reports and explain them to me in medical terminology so I would know what to say to this lady..and Bev actually said the same things that you just told me, and she pointed out that there was "old un-oxygenated blood" in the first pictures you took at the start of the initial procedure and that there were lots of adhesions, and of course that blood left in the cavity very well could cause adhesions, but to keep on mind that I did not have a barrier used here in the states so one would expect adhesions to form! Then she explained that there appeared to be blood in the cavity prior to you applying the Spraygel, but maybe you picked that out before the application of the Spraygel. (She explained that Dr. Reich picks the blood out at the end of the surgery as well as aggressive irrigation.) Then I asked her if I might have adhesion again if blood was left in and that I saw what looked like a gauze pad in two of the pictures and that gauze can cause adhesions to.
Bev, yes, Bev told me to email my questions to you, I also asked her about a drain, she told me to ask you as how could she know if I didn't remember having one and had no site where it would be how could she know. If it is in the report, then she said I had one, but to ask you as she can't know where it came out of!!
I know I come on strong and angry, but I am causing trouble because I now need answers, and now I get out my reports, it is Bev's fault? And I should tell who this person is when she asks me not to tell you yet she is screaming accusation at ME for not being honest to her and now she is WORSE then when she went over to you! This is BEV'S fault and I am making trouble induced by others!! IF only Bev would give me some time and answers, she too thinks I didn't do the right thing, yes, Karen, I too got that email!! I feel guilt, and I did wrong when this lady contacted me before going to Daniel, I WAS the cause of her wasting her money and coming back very ill! This is how I feel....and I am making trouble Daniel?
I can't afford to come back, Daniel, I am desperate and I am scared, and you don't need to tell me I don't know what I am doing and have to be "put up to it" by anyone else! I choose to say what I did to this lady, no one but me, and I did wrong. No one put me up to saying how wonderful you were when I did feel well, and even when I didn't..not even Bev put me up to that! I did it...so Daniel, give ME credit for knowing what I am doing when I write to you!
I know you can show patients emails to everyone, you did that with Lisa, remember! And Daniel, I WAS well and thought I would stay well, but now I am NOT well, so what do you ant me to do, shut up and suffer? Write happy faces all over my emails?? And I AM guilty of lying to this lady...happy faces on that too!
Your report states you achieved hemostasis, what I am asking is if that means you remove the blood clots I saw in the pictures, it doesn't matter to me the instrument, I have no idea what that even is, all I want to know is if you cleaned out the clotted blood before the application of Spraygel, that's all I am asking. I am trying to figure out if I now have adhesions..and did Spraygel make me bleed as it states in your report? If it did, how can I use it again? Why did it make me bleed?
The pictures of the blood were before the Spraygel was put on Bev said...is that true? ( And she said to ask you, she was not attacking you or anything!)
I saw a gauze pad in two pictures, that's why I asked about them. Can't I ask that without being a troublemaker?
If there is bleeding after surgery, won't adhesions form?
And I asked WHERE on my body the drain was. This lady said her drain was in her side, I didn't know I had one and told her that I didn't have one, only to read on my reports that I did, now she thinks I am lying to her again!!
Now I am confused again, inflammation causes adhesions we all have heard...and now you say I had inflammation too? I do not understand anything about the bleeding or blood part, but I asked Bev to explain it, just so you know, and she said she had to forward it to Confluent as it was all news to her and it is best someone there answers these issues, not her!
Is that blood clotting gone now do you think or did I get adhesions from them again??
Daniel, you said that each second look was 100% clear of adhesions, mine too, what does that mean then? I fear having to live with adhesions again, and I did believe that you had 100% success, maybe you did not say it but I was led to think that!! Maybe from Lisa, I don't remember! I am so afraid of having adhesions...
I don't see how I will ever get back there to you, I am so frightened, and you can keep saying someone is behind my words, Daniel, it doesn't matter, the real issues are that I think I have adhesions again, and when I got out my reports to send south, I asked Bev to read them and explain them to me. She did NOT put your surgery down, nothing like that at all, she explained what she knew, told me to email you and said I might have to go back to you too, as this other lady is supposed to do! Bev told me nothing different then you just did! But Daniel, I can't get back to there, and I do not trust anyone here! It doesn't matter what Karen says, I told this lady a lie, and that I didn't have a drain, then it is on my report...Bev told me to ask you about it, not her! I do not want Bev to dislike me, she helped me get to you...but I think she doesn't like me anymore then the others! Think what you want, Karen too, but it doesn't change my worry's and my needs!
I didn't do this behind your back and even if I asked the question in the other area to ask you stuff, everyone will see it anyway, so I wrote it here! I do NOT want to ever be accused of not being upfront again, and Karen even if you don't like that I ask Daniel questions publicly, to bad as this is how I am going to always do things, upfront and open and honest! I lied once and caused a serious problem for someone, maybe others too, but for sure one person, I will never do it aging, even if you don't like it! I am not you Karen!
Daniel, you make it sound so simple to just return as Lisa did, but I am a single parent with an ill child and no money...and how do I know it would even work a next time? Your right, nothing is 100%, but what about IF blood left in after surgery does create adhesions?? What about a drain tube creating adhesions and bleeding after surgery..creates adhesions...do I get a laporoscopic procedure done here to see if there are adhesions and not allow for any to be lysed? Is that possible to do?
Aside of all the garbage and accusations, what do I do?
You accuse me of making trouble because I ask questions, do you say that to me so I do NOT ask you questions? Why is that making trouble, Daniel? Is this why other patients don't approach you with their issues or IS everyone well except for me and this lady who just returned, and Lisa, and Sally?
I need answers for me, for me, Daniel...and if your message board can't handle truth but only smiley faces and praise..then it is not any better then any other message board that wants to be perfectly sterile and "happy" al the time, which isn't what ARD is all about all the time! To bad..you did my surgery, I have my op reports out and I need answers..and not in such a medical jabber that I cannot understand a word of, tell me in layman's terms please. That is considerate and more helpful then this email. Karen, stay out of this, YOU never had a surgery with Daniel so how can you talk to me that way..I am suffering, not you, you cannot know what I feel at all as you do not have to face this, your daughter does! It is no wonder to me she is not around to post, she got well and then ran miles away from you being overbearing in her life! Stay out of MINE!
Karen, you attacked EVERYONE on the other message boards at every post that you didn't like, now your going to start it here again?? Thats okay with me, I am going to ask my questions to Daniel as MY money was as good as anyone elses was and I deserve answers to MY questions!
( Daniel, this is part of a report I have in MY files...MY files, Karen, I can read and I understand what this says!!! Maybe it is wrong, but this is what I read.)
Cont: AETIOPATHOGENESIS OF ADHESIONS
The omentum plays a protective role in adhesion formation. Adhesive obstruction after colectomy is well known. This is because the operation involves, omentectomy and this will remove the organ that forms safe adhesions. As a result it would leave adhesiogenic areas exposed to the small bowel and will result in higher incidence of small bowel adhesions.
Another significant factor is a frequent practice to divide any adhesions that are total encountered. The division of adhesions which involves the small bowel are at a high risk of later obstruction.
PREVENTION
As yet there are no definite methods of completely preventing adhesions. The two commonly used solutions that have anti-adhesive effects in animals povidone iodine and 30% dextran 70.[13] Povidone iodine is used by surgeons more for its antimicrobial action rather than that of its anti adhesive effect.[11] Dextran is a popularly used solution in gynaecologic practice to prevent adhesions in infertility surgery.
The most important way of preventing adhesions is by meticulous technique.
The following are a few operative steps which could be undertaken to reduce the incidence of post operative adhesions.
Careful handling of the bowel to reduce serosal trauma.
Avoid rough unnecessary dissection.
Avoid contact of foreign material from the peritoneum e.g. use of absorbable material as far as possible, avoid excess use of guaze swabs, or wearing starch free gloves.
Adequate excision of ischaemic or infected debris within the peritoneum.
Preserve the omentum as far as possible. Placement of omentum around the site of surgery and run the omentum under the wound to encourage low risk adhesions to form.
Avoid dividing adhesions which do not involve the small intestines.
============================================================
From Daniel
To: Dawn Rose
----- Original Message -----
From:
To: "Dawn" <>
Sent: Sunday, July 20, 2003 3:05 PM
Subject: Re: your attacks
> Hi Dawn,
> I feel sorry for you that the drugs drives you crazy, but I would like you
> to answer my questions: Why are you doing it ? What have I done to
> you ? Why are you slandering me ? For what reasons are you lying ?
> No one of my patients was near to dy, this is really hard... to see one of
> my patients speeking such crazy things... as I am always trying to have
> avery good relationship with my patients... Why didn't you continue to
> communicate with me after June ? You stopped the communication
> after Beverly told you to do so... I really don't want why you as a adult human that I have done so much for, have to act like this... if you continue ... than I wish I would never
> have met you... if you think you can stop this mess, please come back to me.... there is nothing wrong on what I'm doing...Let's come together again, let's try at least to behave like intelliegent adult human...
> Regards
> Daniel Kruschinski, MD
> EndoGyn®
> Institute for Endoscopic Gynecology
===============================================================
Original Message -----
From: Beverly J.Doucette
To: Dr.Kruschinski@t-online.de
Sent: Sunday, July 20, 2003 9:38 PM
Subject: Re: your attacks
Dear Daniel,
What is THIS all about? My name has been tossed around the IAS and now in this email to Dawn Rose...Daniel, I have nothing to do with Dawn Rose other to tell her TO email YOU with her many questions! Dawn emailed me with her operative reports as week or so ago asking me to explain them to her as she was sending them to one of your recent patients who just returned...I answered some questions, but then told her to deal directly with you as I did not want to get into the middle of anything between Dawn and the patient!
This lady was VERY irate at Dawn and demanded that Dawn answer questions about things that Dawn told her prior to the lady coming to Frankfurt! Dawn wanted ME to speak to the lady, and I did, but only to tell her to communicate with you. This lady also said that I misrepresented Frankfurt by telling her that I would go there myself if I couldn't get Dr. Reich. This I did say to her, but that was before I found out that not everyone returning home and saying they were 100% well were actually NOT doing so well after all. I was a victim of this misinformation the same as she was! I have NOT spoken to the lady since! ( And I will not either!)
This is what Dawn explained to me prior to asking me to look at her operatives and why she asked me to do that!
This same lady called Dawn a lire and a fraud, Dawn told her she would let her see anything she wanted to see regarding Dawns operatives from Frankfurt, as Dawn felt guilty I guess...Dawn told this lady something about her ( Dawn) NOT having a drain tube post surgically, and then when Dawn found her operatives, it stated she did in fact have a drain, so the lady once again called her a lier and said Dawn scammed her for "pushing" Frankfurt!
Dawn feels terrible, she asked me to look at the operatives, and I did, she asked where a drain would have been if she had one, which she says she doesn't remember, that is when I told her to discuss her issues with you as I do NOT want to remain involved with anything to do with Frankfurt, and I told that to Dawn well over a week ago! I do commend Dawn for trying to make amends with this lady by trying to be honest with her now....
This same lady also says that Lisa Graven scammed her after I referred her to talk to Lisa about Frankfurt, so it was MY fault again! I want no part of any of this, Daniel!
And to see my name used in this manner here when I have neither posted anything negative about you or your procedure on the IAS or anywhere else...what some of your patients did was wrong Daniel, whether you like it or not, they were not sharing current information about their current health, be it adhesions or not, and people felt that they were not hearing the truth prior to going over to see you! I emailed my issues to YOU and to the women who reported that they were well, when in fact they reported elsewhere that they were NOT well!
False reports posted public for all to see and to use in making a decision as to where to seek a surgery, is not something that I want to see happen to victims of ARD, and I don't think you did either! It is always best to report how a person is feeling and living after ANY adhesiolysis so that others do not have false expectations when they elect to go to a certain surgeon!
NOT one time did I ever mention anything about your surgery, Daniel and never did I ever go public with this issue, the other ladies did that! I never saw your procedure or skill or compassion as being anything but that it is, decent and offering a good chance of improvements from ARD symptoms! What I take issue to, was the women not sharing the truth! A simple as that! You can look back many months in the IAS archives and you will have seen me post maybe two times in that year..and it was never to put down or slander you or your procedure, Daniel!
Daniel, If anyone wanted to see Frankfurt go, who do you think that would be??? Perhaps me a little bit, I was the one who introduced Frankfurt..of course I want to see it be productive, but only with honesty and respect, and some of those you choose to speak on your behalf, well, they remain less then of moral charachter! Not just MY thinking, Daniel, they were caught in dishonest behavior, and now they are very unhappy with me for asking them to be honest to thier fellow ARD sufferers and speak the truth, and they all did, but they also all left the IAS for some reason, shame I am guessing, and then stating that they were thrown off by Davie, that is not truth again, and people can see that...and it was again, from thier own mouths, Daniel, not mine!
I don't think you want to secure patients by former patients not being honest with them, Daniel, and that is what happened, and that is what is behind the issues with Dawn, I am sure! ( At least what I knew, this other stuff I have no idea about !!and I don't want to know either..leave me out of all this stuff, all of it looks CRAZY to me!)
I have not posted on the IAS for ages, and I do not plan to start now! I do not need nor want anyone to post for me, in fact, Dawn Rose DID post something about me in response to someone calling me a lier etc, etc..and I emailed Dawn to never use my name again unless she has permission from me, which she did not have! I don't care what any thinks I am doing or did, that is the least of anything that bothers me, because it is said doesn't make it fact, and your words here are far from being fact, Daniel, as why would I care if Dawn Rose emails you?? I hardly know her! I'm going to take MY time to deal with her issues and the other ladies issues?? Why would I do that? Remember, I also sent that email about not being honest to Dawn as well as the others, and she wasn't honest, non of them were, so why in the world would I NOW deal with her?
My God, Daniel, I have no idea what all that stuff is that your saying in this email!! About someone dying??? Who is sandering you, it isn't me!! I haven't emailed you sice that issue with some not telling the truth..and that was NOT you, it was them! How is that slandering you, Daniel??
I am not aware at all about any contacts Dawn had with you at anytime...now or before June! She doesn't email me Daniel...only to see her operatives and to tell me she was trying to be honest with this lady now! I am NOT interested in her trying to be honest now, or any of the ladies, they did share the truth, and it has offered and allowed prospective patients to ask more questions of them and hopefully you, so that when anyone comes to Frankfurt, they are prepared fully as to what to expect..and it is NOT all" miracles" as these ladies were saying over and over and over Daniel..it simply wasn't! Maybe you didn't know that these particular ladies ( Karen, Sally, Dawn. Lisa, & Carolyn) where telling people that there were 100% success's coming our of Frankfurt, and that they were all well..given Karen speaking for her daughter, then I hear that this is NOT the fact, and emailed you and them to begin to share the truth so others who elect to go to you will not have unrealistic expectations, as this lady now states she had because these same ladies, and ME included, falsified information about Frankfurt!
Daniel, I have not dealt with anyone or anything to do with Frankfurt since my email to you and to ONE time look at Dawn Rise's operatives, and tell her to go to you with her issues! I want out of ALL ARD issues...not because of you, David Wiseman or anyone else, but this lady is going to cause some trouble, Dawn should worry, as should the rest of those women she talked to or who posted false information, if this lady and her husband decide that they were frauded by them ...they are all in deep trouble! Not you, Daniel, as you did not make the statements that everything was 100% success's, and neither did I as I was advocate for Harry only!
I will also share that I was saddened when Karen would attack anyone who talked about any other surgeon or surgery or that they could not get funds to go to Frankfurt, she hurt so many innocent people who are the victims living with ARD, she doesn't live with that pain and suffering the same as the victims do, yet she was unmerciful in her behaviors to them! This was sad as you were trying so hard to open the doors in Frankfurt...and that type of behavior was only serving to close them! I am not sure if you know this or not, but their appreciation of your skill, went to far and they became dishonest backers of you...not it is difficult even for me to get excited for Helen surgery with you, as I wonder if the second looks really were all 100% free of adhesions, and once I found out that a number of your patients were not well after some months, be it adhesions or not, I will wait and hold my breath as time goes by for Helen...praying and hoping that she will be one of the fortunate ones who had your adhesiolsysi, many are well, ( I THINK!!) and may Helen be among them, Daniel! I know you did your best with her, and God, I pray she will have success to a great %!
I cannot be to optimistic since the ladies didn't tell the truth, I too feel like a victim of their over zealous words....but this is NOT your fault Daniel, as I have no doubt that you did not know they were saying such things!
I cannot stop anyone from using my name or placing suspician on me for things..but that doesn't cause me to do anything different as I am not doing any of it anyway! Maybe you would be best served to look at issues as if that patient or person or whomever you think is not acting on their own, as Daniel, in the case of Dawn Rose, it is not me, so deal with her and hold her accountable for whatever it is she is doing....and use me if you want to, but you will never be able to deal with the reality of the issues as she states them or does them, as she is doing them, not me, and it seems you have some issues here...I wouldn't touch this with a ten foot pole! You know, I am NOT even curious as to what the hell this is all about, my name in it or not, I don't want to even know about it!!
Good Luck Daniel, and unless you have proof I am doing something, Daniel, keep me out of it. Beverly
----- Original Message -----
> From: "Dawn" <>
> To: "Beverly J.Doucette" <>
> Sent: Sunday, July 20, 2003 6:01 PM
> Subject: Need assistance or the shot heard round the world.
>
Holy crap Beverly.......it is the shot heard round the world...leaves me
> > all a bit nausoues....but anyhow I am done with the posting
> > part........and ......um I think David is going to be pissed at me as
> > Karen came gunning for me over on the IAS...well I guess you'll see....I
> > am a bit ashamed I was so nasty but whats done is done........I think
> > the message got out to more that I ever imagined.
> > What I need help with is......well.......maybe David might not want to
> > hear my voice right now as Karen is all over him demanding I be banned
> > from IAS as well. I need my second look pics and as best I know, David
> > has the only copy.......it is probably sitting unopened in a pile some
> > where.....but Jo and I are going to compare pics of our adhesiolysis...I
> > think they should have this as they are concerned and "got it"....I am
> > sure that David would not go out of his way for Jo....but they are our
> > sister too.
Thank you again so much.... Thank you, Love, Dawn
Original Message -----
From: "Beverly J.Doucette" <>
To: "Dawn" <>
Sent: Monday, July 21, 2003 9:55 AM
Subject: Re: Need assistance or the shot heard round the world.
I see my email got to you to late, not that it is my business to tell you
> what to do, but I was out of town and got home very late last night to
> respond to your email.
>
> I see that you already posted..as did dear Karen...and I am not sure what
> you mean about Jo...xxxxxxxx perhaps?
>
> Please do NOT post anything that will open a door for Karen as she is
> spiteful and will hurt anyone who so much as gets in her way! So many who
> post and are attacked by her are innocent..posting anything that will elicit
> a response from her is not worth it. It is nauseating to be sure, Dawn.
> please do not post anything about Frankfurt, dear, speak to David about
> things before you post as if you feel your not getting answers from Daniel,
> perhaps David can answer them as well!!
>
> Like I said before, Dawn, please do not get caught up in any battles on the
> IAS as it only hurts us all. Perceived involvement or not, when our names
> are brought up like that, it hinders anything we might want to do or say to
> support other victims of ARD.
>
> These posts are said and done now...but try to think about not responding no
> matter how frustrated you are or if the issues are about Frankfurt and
> Daniel, take them to his site if nothing else. I cannot tell you what to
> do, and I did mention before not do anything on the IAS board that is
> negative, but now I am begging you not to keep it going, dear, please?
>
> I am not sure what you mean by got out to more then you thought?? I, this
> morning, got hate mail in my private email, and I had nothing to do with any
> of this. My involvement is perceived, even by Daniel mentioning my name all
> the time, so there is nothing I am going to do about it, but walk away from
> ARD issues, which is fine with me actually.
>
> But please Dawn, don't post negative things on the IAS, your a valuable
> asset to the IAS, try to talk to David about things before you post, if you
> will. One day someone will need your advice and you want to be there for
> them, and NOT be perceived as "reactive" shall I say.
I don't know what you and Jo will find, but if it is an issue for Daniel,
> take it to Daniel, I am not sure how, but you might want to talk to David
> first, he is really a wonderful person and will NOT be angry, he will help
> resolve your issues and he will want to do that before posts start a
> controversy on the IAS. I mentioned that before...and I will mention it
> again, please, I really, really beg you, Dawn, not to respond to anymore of
> anyone's ( Karen) posts on the IAS that elicit negative issues.
> Your message is well taken by those who see it, as long as you want to share
> what your story out of Frankfurt is, offer to do it in a private
> email...that is much better for both you and who ever requests any
> information about Frankfurt. It serves everyone better, my dear..okay?
>
> I don't know what to say, other then to ask again not to post about
> Frankfurt on the IAS, I have no right to ask that of you or anyone, but we
> have talked about it, and you know where I sit as to that issue, bickering
> on the IAS serves no useful purpose, and Dawn, you can avoid it and be just
> as effective in getting your message shared by using email, in fact, it will
> be taken more seriously then if seeing it posted in a public way, don't you
> think so? This makes me so sad, sick as you put it....it is past, but now
> you can stop it in it's tracks by letting it all fade away, at least on the
> IAS if you want to deal with Daniel and issues of his making, but you can
> let it fade away on the IAS, dear, please think about this. You probably
> feel worse now then before you posted on the IAS, and if that is so, then
> try not to keep it going.
>
> I have heard no more from XXXXXX, so maybe she is okay. I did put her in
> touch with a surgeon who she can ask questions of, nothing more either of us
> can do. You are free of her, Dawn....!
>
Take care now, I will help you too! Bev
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