My Dog Calendar for 2012 Don’t buy it…just click the preview button. I bet you’ll see a dog or two you recognize.
Since my book has been written I see a lot of patients who show up for a second opinion. I get to hear first hand the impressions made by the original urologist. Sometimes it’s good but more often it is bad.
Anyway this week a guy shows up for the second opinion discussion and in about three minutes it was clear that this patient’s biggest concern in the world was continence.
Here’s the thing…no urologist in the world and I even mean Dr. Walsh himself can tell a patient he will not be incontinent if he has his prostate removed. Nobody. It is something we just don’t understand. We can give percentages, but not assure continence. I knew that going in for myself.
So my job was easy. Radiation whether external beam or seeds will not cause incontinence. Maybe urgency and some incontinence as a result of urgency but not just leaking.
“Based on what you’ve told me I think that radiation is a reasonable option and I’d recommend a consultation with a radiation oncologist. I’d ask him very specific questions about the risks and benefits and in particular continence questions.”
When a patient clearly tells you what is most important to him in the decision-making process it is like a slow curve ball that doesn’t curve. I’ll knock it out of the park every time.