This is where Brian Gerhard spends his mornings in the gym. >>I really enjoy the way I feel doing the
exercise and I've gotten used to it and I enjoy it. <<Brian does some of these exercises with great
ease. But that wasn't the case for many years. As a child, Brian was diagnosed with cancer. >>I was
diagnosed with a type of cancer called a Wilms tumor and it's basically a large mass that grows
on the kidney. At age four, they discovered this large mass, essentially the size of a grapefruit
on my right kidney. >>Initially, doctors removed the tumor and his right kidney. But more treatment was
needed. >>I had multiple rounds of radiation, multiple rounds of chemo, multiple abdominal
surgeries to correct bowl obstructions, um, caused by the radiation. I think I wound up in 13
different surgeries, all due to the initial cancer treatment. >>Treatment that cured the cancer but left
other problems for Brian, he developed a small hernia, which wasn't too much of an issue until
one day. >>I was playing with one of my Children. The other child wanted to play, jumped on top of me
and put their elbow into that nickel sized hernia and basically tore the muscles to the size of an
orange. >>Surgery was needed Immediately. >>What ended up happening is a surgeon had to put in a mesh,
um, kind of like patching the knee of jeans or pants. Watching a hole in in cloth,
they put a mesh over top of it. Uh, and stitch that, that patch in place. >>A repair that really
didn't solve Brian's other internal issues. >>There was still other small hernias. There was still
other other tares and the abdominal wall. So it didn't it didn't change a whole lot as far as day
to day life. Um It just literally patched that one spot. >>Over time, Brian's hernias created some
unexpected problems. >>I thought I just pulled a muscle or I twisted something um You know because
of the number of holes and tears in my abdominal wall. I honestly didn't think anything of it.
And I just I kept getting sicker and sicker and ultimately wound up in the emergency room.
>>What we found was that the mesh that was placed for a very legitimate good reason
had ultimately led to a complication and a meshing section. >>Penn State Health's minimally invasive and
bariatric surgery team put together a plan. >>He did kind of brace us. He said you know I
you're in bad shape, I said okay, thank you. He said that basically you know we can't
unbreak you and then fix you all in the same operation. So he he kind of braced us for two
operations. The first operation that we do is designed to fix the infectious problems. Okay.
And so that includes removing any infected tissue, removing anything that's permanent that we can
find. So old mesh, old suture, old tax and then removing the section or sections of intestine
that have been damaged or are involved in the infection in the erosion. >>After you've
healed for an extended period of time. Then you'll you'll come back in for another surgery and will
basically rebuild your entire abdominal wall. >>A stage two surgery for Brian was an open what
we call abdominal wall reconstruction where we basically separate the abdominal wall into layers
and then we put the patient back layer by layer. We put a layer of the patient back together. First
we then put a brand new piece of mesh in two widely cover the areas where the abdominal wall
has had hernias or defects or gaps before. And we take the muscles that are apart and we close
them back over the top. >>Complex surgeries that Brian healed from fairly quickly.
>>I feel great. I have more energy honestly I feel better about myself. >>And Brian has a message for
Dr. Pauli I and his team. >>Thank you for having the knowledge and the skill to be able to do this and
just for really changing the trajectory of my life. >>And Brian really does feel amazing after all of
the surgeries he had as a child. He says he always had pain in his stomach area but not anymore.
And joining us right now is Dr. Eric Pauli, chief of the division of minimally invasive
and bariatric surgery at Penn State Health and also Brian's surgeon. Thanks for being with us.
>>Thanks for having me. >>Really, what an amazing story. Brian is doing so well. How does it feel to know
that you have made his life so much better? >>Yeah, I mean it's this is the most meaningful part of
the job. I mean we are trained to take care of people but seeing people in this, you know, kind of
context where they're at home and living their lives and doing the things they want to
do. We don't get to see it all the time. But when we do it's part of what keeps us going and makes
us willing and eager to take care of people with complex medical and surgical problems. >>And when
you say about complex really, how do you approach some of these complex cases and really work with
the patient. I know that Brian said you did sort of walk him through the process. How do you
prepare them? >>Yeah, I mean that first clinic visit is really about sort of setting the expectations
and the goals for how the next operation or operations are going to work. We spend time
talking with patients about the reasons that their previous surgeries may not have worked. We talk
about medical problems they have that need to be addressed like diabetes, smoking or issues with
weight and we work with them to fix those problems before we had often do another hernia surgery.