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11/16/2011 08:16 PM

Where to Go for Surgery?

Don27
Posts: 13
New Member

I have been recently diagnosed with PC. I am trying to look at all my options.

One question I have is, wondering if it better to go to a "name" hospital or pick a urologist and work with him, perhaps going to a more local hospital.

I have a friend who had a radical prostetectomy and elected to go to Sloan-Kettering in Manhattan instead of going to a local hospital. Today I heard of a guy who lives in southern New Jersey and went to Johns Hopkins for his surgery. Another friend is telling me to go to NY Presbyterian because they have a great urology dept.

Any thoughts-local hospital with a doctor with whom you are familiar and comfortable with vs. a "name" hospital where you don't know any of the doctors.

Thanks.

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11/16/2011 08:38 PM
RickRed40
RickRed40Posts: 864
Member

Don,

If you were going for robotic surgery, you need to go somewhere were this procedure is performed frequently and your Surgeon has performed a minimum of 200 or so surgeries. If a local hospital has a surgeon with that much experience you are Ok to stay local.

Most states have a few treatment centers so the need to go out of state for a routine surgery is not necessary. I chose UCSF. It was 90 miles from our home. You can spend a lot of money if you go very far from home. You'll need to go for:

1. Your initial evaluation

2. Your pre surgery evaluation

3. Your Surgery

4. Your Post Surgery evaluation

5. For other treatment or follow up visits.

It is time consuming and expensive to go to a major treatment center. I'm glad I did, but I certainly wouldn't go out of state.

Post edited by: RickRed40, at: 11/16/2011 08:38 PM


11/17/2011 04:18 AM
hollywoodmark
hollywoodmarkPosts: 867
Member

I stayed "local" with my treatment, mostly 'cause I thought all the back-and-forthing to remote places would be hard on me and my wife. But if you're not far from one of the great places, and your insurance covers it, why not?

11/17/2011 10:44 AM
Pyroman
Pyroman  
Posts: 125
Member

Don, I had to go to Toledo Ohio for my surgery because our local hospital did not have a DiVinci robot, nor did they have anyone trained in it. It was a choice between Toledo and Columbus for me, so I picked the closest (60 miles away). I was glad I did, as I found a very capable doctor that done the surgery. Now our local hospital has been doing DiVinci for about 9 months now, but I still would not have went there as none of the doctors have the experience yet.

My uroligist that sent me to the big town told me that experience is a very important thing to look for. He joked with me at the last visit that I should have waited, and asked if I would have let him do the surgery, and I told him no, he had not done enough, and he told me Good Answer. My surgeon was one of the ones that helped train him this past year.

Good luck in your decision.


11/17/2011 12:37 PM
menance
Posts: 2
New Member

My urologist that diagnosed me said I should have it done by the robot. He recommended a surgeon that robotics is all he does and has been doing. Anyone over 200robotic surgeries is the ones to consider, also chose from a hospital that has the Da Vinci machine. I was lucky the surgeon he sent me also is a proctor in the field of robotic surgery and happened to be the Medical director of robotic surgery for a hospital chain.

I was surprised when I went to him for a consultation. I was told that bescause of the enlargement of my prostrate that radiation would be extremely difficult and have lasting side effects and I should rule that out. My surgeon advised that I could consider it and advised me tohave a consult before committing to the surgery. He was caring and spent more time withme than any dr i had come across before.

I decided on surgery. But before I had another hour session with him to be sure that this is what I want then he called me the night before to check on me and make sure I was ready. Then the morning of we spent some time talking and again he wanted to make sure I was fine with my decision.

Surgery went great and I was home the next day with the cather out in 5 days.

Bottom line is not only the experience of the dr but yourcomfort level with him


11/19/2011 06:42 PM
Don27
Posts: 13
New Member

Thank you all for your input. Still haven't made a decision, but need information, and this helps.

11/19/2011 11:01 PM
paperplane
 
Posts: 202
Member

Don

I read your diary, yes it is unwanted journey none of choose to have, yet here we are on the same road. You ask about active surveillance versus surgery, at 53 I choose the robotic surgery and I feel my recovery is going very well after only 7 weeks. My dad was diagnosed too late at 60 and it took him at 72. I didn't want that for my life and therefore chose to see the diagnosis as a gift for I had a choice where he didn't. Each one of us is different and the disease can progress at different rates, one of the people at work had a very aggressive version and he passed away on Halloween after being diagnosed only 2 years ago. I had my first biopsy 5 years ago when my PSA rose to over 4 in a matter of a couple years, they found nothing then in 6 samples, earlier this year they found it in 2 out of 16 samples. Think about it although the prostate is small, the % percentage they sample is very small, about 1% so in some ways you are lucky they found it on the first biopsy. At Gleson 6 you have time to study your options, but from my reading and knowledge and my experience, I would suggest dealing with it within a year rather than waiting longer. You will have to deal with it sooner or later; you are only 60 so you have a long life ahead. The younger you are the better the odds of recovery after surgery; with radiation after 3-5 years, you'll be in the same boat that we are after surgery but with less chance of improving your UI and ED. As far as local or far, I stayed with my urologist at Kaiser in CA. He had personally done over 200 and participated in over 1000. I am glad I choose him and went ahead with the surgery. I got my first blood test last week and it was < 0.1. I am on the road to recovery, I have my frustrations with some leakage and ED, but with Kegels the first is getting better and am following the rehabilitation protocol set out by my doctor which is similar to what Mulhall recommends. I see my journey now as a path to recovery.


04/21/2013 11:52 AM
spanz
 
Posts: 190
Member

There is a lot of talk, at least for davinci surgery, to go with a very experienced surgeon. That probably means at a surgical center.

Not sure how that would work out! You only stay in the hospital 1 day after the operation. Then what do you do, hop on a plane and try to make it home--I could not have done that even 1 week out. Stay in a nearby hotel for a week--not unless you have a companion there to help you! Tough choice.

You are going to be pissing like that little Italian boy statue in the fountain that you see sometimes. When you are down and out like that, it is nice to at least be at home!!!

Post edited by: spanz, at: 04/21/2013 11:53 AM


04/22/2013 02:53 PM
RickRed40
RickRed40Posts: 864
Member

Don,

If your local Urologist has performed more than 200 surgeries, than the skill level is probably there to stay locally. The best results are with SKILLED & EXPERIENCED surgeons. You can perform a da vinci surgery after a weekend of training. If your local surgeon has 200 or more surgeries performed and has confidence in his ability to perform double nerve sparing surgery stay local. If not, go to a center that does this procedure daily.

Rick


07/25/2013 08:47 AM
kapm
kapm  
Posts: 699
Member

Don,

Everyone has given great advice. Please note that these men have only spoken about their experience. None of them has pushed a particular type of treatment. They all do seem to agree that experience by the surgeon is an important issue, and something that you do need to look when you make your decision.

Making that decision can change or alter some recovery plans. If you leave your local city, then you may want to stay near the surgery site hospital for a week or so after you have the work done. Check with the hospital, sometimes they have 'agreements' with local hotels about staying for a week. Some men have looked at this recovery time as a mini vacation. You can't do a whole lot, but if you don't mind being in a wheelchair, you might be able to vist an Art Museum. You'll be getting used to the catheter, so you may not be able to do very much.

kapm

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