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Posts Tagged ‘urologist’

What is happening in increasing numbers and frequency is that a patient will have his biopsy done  by his local urologist and then go about finding someone else to do the surgery. The trend has been to look for robotic surgeons and then go there for the treatment. I am Okay with that, I think it is smart to research and talk to people  and then make the informed decision that is best for the patient. The thing that prompted this post is the posts by patients on the various support sites for prostate cancer. I read time and time again about having the surgery and then returning for follow-up and seeing a physicians assistant or some other care giver rather than the surgeon. In many cases I am sure these patients have made their decision without the input of the urologist that made the diagnosis. I know this because it has happened to me. For whatever reason after the positive biopsy result, the patient does his research and goes elsewhere. When things don’t go to plan elsewhere they then feel uncomfortable coming back to the original urologist.

Here’s how you handle this: Go back to your “biopsy urologist” and listen to his input and then tell him what you have decided to do. If it is robotic then ask him who he thinks is good, if its him inquire about experience and results. If you  have decided to go elsewhere tell you urologist that and then tell him you want to follow-up with him after your treatment elsewhere. There is no reason to have your biopsy and end the relationship. In my situation, the nearest robotic surgeon with a lot of experience is 70 miles away. To continue to go there instead of here just to have PSA drawn or management of incontinence or erection issues is not time efficient.

If you have appropriately handled the situation as I have suggested, then you can easily transition back into the local and convenient follow-up of the urologist that made your diagnosis. I do this all the time. I see myself as a facilitator of your decision-making process. It matters not whether you choose me or not .I would feel most urologists feel the same way. So let’s show  the urologist that made your diagnosis (dare I say “saved your life”) some loving.

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I remember the day as if it were yesterday. I had had my surgery on my wife’s brother’s birthday, May 10th, a Thursday. On June 6th, my wife’s birthday, I called home to see if she would like me to pick something up for her birthday dinner. “I’d like Thai Dish; I really miss eating there.” There used to be a Thai restaurant near our home that she loved, but it had moved to another location about 30 minutes from our house. The new location was inconvenient, and as a result we ate there infrequently. The round trip to this restaurant from my office and then to my home I figured would be about 40 minutes, and probably a good time to try taking a sex pill to see if I could “fire this baby up.” Most of the pills have about a 30-minute window before they take effect. So as I am finishing up seeing patients for that afternoon, I get a sample pack from the drug cabinet and take one. By the time I had placed the to-go order and was in the car to pick it up, about 30 minutes had passed. Since I was still wearing a condom catheter because of the incontinence, I decided to shake the tubing that connects the bag to the condom and see if, on the way to Thai Dish, anything “perked up.” There was a fair amount of anxiety associated with this test because of the chance that the surgery had messed up the nerves responsible for erections. It was a big deal to me as it is to all men treated for prostate cancer. I determined that there was life down there. It was not much, but the fact that I had any response at all indicated to me that, at a minimum, at least some of the nerves had been spared. I pranced into and out of  Thai Dish  and played the Beatles as loud as my CD player would allow with the windows down all the way home. (I love loud music in the car with the windows down.) When I got home with the food, my wife asked, “John, did you have a good day?” “Yes,” I said, “It turned out to be a very nice day.” June 6th is historically known as D-Day, but for me it’s E-Day. In time, as the degree of my incontinence decreased and I was able to go to back to a diaper, I was very content and actually felt lucky to be “dry with a diaper, potent with a pill.”

Excerpt from ” The Decision: Your prostate biopsy shows cancer. Now what?”

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