AMS 800 Urinary Control System

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DrJohn
New Member


Date Joined May 2009
Total Posts : 12
   Posted 5/15/2009 11:30 AM (GMT -6)   
I completed the urodynamics test today and my doctor confirmed that my sphincter is not functioning properly. My original surgery was 13 months ago and he said that my incontinence is unlikely to improve without intervention. He recommended the AMS 800 Urinary Control System because he didn't think that the sling would solve the problem. It's another major surgery but I'm very uncomfortable in my current state. It seems like a cumbersome device to use but I thought that I would check to see if anyone "out there" in this Forum has any experience with the system. I'm booked for surgery in late June but I'm still searching for information.

John

RHC Jr.
Regular Member


Date Joined Feb 2009
Total Posts : 39
   Posted 5/15/2009 12:41 PM (GMT -6)   

Dr. J:

I suggest that you look for postings from Gene 214, KW, CowboyBob, Divo, Berb, jerryv, and Salty Clark on this subject.  In particular, KW's journals are quite detailed, and I've found to be helpful.

In an earlier post, I believe that you said that you were down to 2 pads per day.  With that low level, I'm surprised (and dismayed) that it was determined that you were not a candidate for the Advance Male Sling.

RHC Jr.
Last PSA prior to biopsy  -  11.9
Biopsy  -  8/7/2008
Cancer findings at left lateral and left medial apex of prostate
Gleason score  -  3+3 = 6
Staging  -  T1c
Prostate size/weight  -  128 cc./ 99 grams
Bone and CT scans  -  9/12/2008  -  both clear
Age at biopsy  -  65         Health  -  Excellent (other PCa)  (Lift weights, play golf & tennis (incl. singles))
da Vinci RP surgery  -  12/15/2008 at Naples Hosp.
Surgeon  -  Dr. Wm. Figlesthaler
Hosp. Stay  -  1 night
Catheter removed  -  12/23/2008
Post-Op blood tests  -  2/2/2009 & 3/27/2009                     PSA  -  undetectable
Scheduled 12 weeks biofeedback, coupled with electrical stimulation  (started 3/3/2009)
 


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 5/18/2009 6:55 PM (GMT -6)   

    John, how much are you leaking? Heavy pads or light pads? Soaked or just damp?  I would like to hear some details so we all know exactly what you are dealing with.  IF you are using two pads a day you should be able to get good results with the sling.  Look forward to hearing more about your story.

    KW


    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second Opinion Consultation for Incontinance at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.
    March 27th, 2008 - Sling not working, Little or no improvement.
    April 18, 2008 - Collagen injection.  Back to using 4-6 full pads a day within a week.
    May 14, 2008 - Another collagen injection to try to Band-Aid the leaking for our June cruise.  Will start making conusultation appiontments for AUS after we return.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    July 30, PSA 0.00.
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
    Oct. 6th, 2008 - AUS Activation by Dr. Morey.  Working Great, only light drips and dribbles.
    Jan, 31st, 2009 - PSA 0.00  Next test in July, 2009  
 
 
 
 
 
 
 
 
   
 
   
     


DrJohn
New Member


Date Joined May 2009
Total Posts : 12
   Posted 5/18/2009 8:07 PM (GMT -6)   
Hey KW, I'm going through 1-2 pads per day and about 150-200 ml of leakage. It's the usual leakage triggers of coughing, sneezing, lifting or just plain gravity! I don't even know that it's happening most of the time. My abs are strong and I did the kegels but to no avail. It really seems like a sphincter problem and the sling's success with that issue are not well documented. I spoke with a few guys who have the AMS 800 and they swear that it changed their lives but having to depend on a device to urinate is something I'm still getting my head around. But, on the other hand, I don't want to go through my next 3-4 decades with a raw and uncomfortable undercarriage. Also, the waiting time for the sling procedure here in Canada is 9-12 months. Any ideas?

Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 5/20/2009 12:47 PM (GMT -6)   
John,
 
I too am surprised the doctor suggested the sling is not an option for you... at such a rather small amount of leakage.  But I can affirm that the AMS 800 works very good for me... and it's not comberson at all, now that I am used to it.  But after all, I was goingl through lots and lots of pad each day.  I was not able to retain one drop of urine in my blatter.  As it went in, it leaked out.  If it is the 800 for you, be assured that from the experience of many guys, it will work good.  But...
 
One more thing you should be aware of.  The AUS is not perfect.  I wear a small pantiliner each day to catch the tiny drips, but one application in my briefs per day is all that's needed to catch the miniscule drips.
 
And just a p.s. -- It takes how long in Canada?  And we (present administration) are wishing that for our healthcare system?  I think I prefer what we already have, which works pretty good, in my opinion. 
 
Gene214
PC diagnosed 12-06 @ age 63
Radical open removal 2-14-07, Gleason 3+3=6
Removal of stricture 6-07, incontinence continues
Scheduled for AUS & IPP 05-08
Surgeon cancelled one day pre-surgery, due to cardiac concerns
Nuclear stress 5/13/08
3 stents 5/27
AUS, IPP implanted 07-16-08
AUS, IPP was activated on 08-18-08.  They both work!
10-20-08 went back to surgeon for a follow-up.  Both devices are working very good and surgeon was very pleased that I am very pleased.
 


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 5/26/2009 8:31 PM (GMT -6)   
I second what Gene said. The AUS is easy to use and will become second nature in no time. But like Gene, I also wear a light panty liner every day for drips and dribbles. I do have to wear a regular Depends Guard to play golf. But one pad last easily all day long.
I do not know about the Canadian health care rules, but I would do some more lookin regarding the sling with your ammount of leaking.
Good Luck,
KW
    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second Opinion Consultation for Incontinance at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.
    March 27th, 2008 - Sling not working, Little or no improvement.
    April 18, 2008 - Collagen injection.  Back to using 4-6 full pads a day within a week.
    May 14, 2008 - Another collagen injection to try to Band-Aid the leaking for our June cruise.  Will start making conusultation appiontments for AUS after we return.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    July 30, PSA 0.00.
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
    Oct. 6th, 2008 - AUS Activation by Dr. Morey.  Working Great, only light drips and dribbles.
    Jan, 31st, 2009 - PSA 0.00  Next test in July, 2009  
 
 
 
 
 
 
 
 
   
 
   
     


DrJohn
New Member


Date Joined May 2009
Total Posts : 12
   Posted 6/2/2009 8:54 AM (GMT -6)   
Thanks for the feedback on the AMS800! I had my pre-op meeting yesterday but, unfortunately, the surgeon was unavailable to discuss the device functionality. For instance, if he doesn't activate the 800 for about six weeks, does that mean that I have no bladder control for that period? I'm just considering my lifestyle limitations during recovery. I had a meeting with the surgeon who does the sling here in Toronto and he said that when the sphincter is not functioning and the bladder is spasmodic (like mine), the sling has only limited success. I don't like single option situations so I'm pretty anxious about my decision to go forward with the surgery next week. However, changing pads every few hours is no longer viable, either! AND, if one more person says that I should feel lucky that the cancer is gone, I think I'll hurl . Seriously, I know that I'm lucky to be here and I'm just trying to keep my emotional bearings; it will be great to have some sense of normalcy.

Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 6/2/2009 3:08 PM (GMT -6)   
Dr. John,
 
Until the Artificial Urininary Ssphincter is activated, it is as if you do not have the device implanted.  I can only presume that you would maintain the same amount of leakage as before.  At least that's the way it was with me and every other implantee I know and/or have talked to, that is the way it was with them too.  But your body needs that time to heal.  As soon the the device is activated, it will begin to function the way it is designed to do.   
The six weeks passes rather quickly when you compare it to the time you have put up with leaking.
 
Gene214
PC diagnosed 12-06 @ age 63
Radical open removal 2-14-07, Gleason 3+3=6
Removal of stricture 6-07, incontinence continues
Scheduled for AUS & IPP 05-08
Surgeon cancelled one day pre-surgery, due to cardiac concerns
Nuclear stress 5/13/08
3 stents 5/27
AUS, IPP implanted 07-16-08
AUS, IPP was activated on 08-18-08.  They both work!
10-20-08 went back to surgeon for a follow-up.  Both devices are working very good and surgeon was very pleased that I am very pleased.
 


Salty_clark
Regular Member


Date Joined Apr 2008
Total Posts : 95
   Posted 6/2/2009 8:21 PM (GMT -6)   
John...As another implantee of the AMS 800 I can unqualifiedly recommend its use as an effective remedy for one who suffers Intrinsic Sphnicter Deficiency (ISD).  My surgery was in Jan 09 with activation in Mar 09.  Since the activation I have been dry...whether I am just sitting and relaxing or doing some sort of strenuous activity.  The sphnicter holds!  The button and tubes implanted in the scrotum are hardley noticiable and have become as much a part of me as its two next-door cousins.  The other intruder, the pump that activates my 77 year-old privates into that of a much younger man is much more intrusive and requires some getting used to before one can feel comfortable.  Bionically speaking, the two implants are wonderful inventions that has given me my life back after my cancer journey.
 
John...having said all that, I am a bit hesitant in your case and hope you are not going for over-kill.  To be honest if I had only been leaking enough for two pad changes per day I probably wouldn't have had the implant.  I was leaking in all positions, night and day, just a continuous flow.  It was an easy decision for me.  In your case, I think I would try another doctor and another opinion before proceding.  But in the giant scheme of things life sometimes is just a roll of the dice...The numbers definitely are in your favor with the AMS 800 but there are also the possibility of snake-eyes.
Good Luck to you. 
 
Salty

Age 75 at DX 76 on 9 May 08
DRE positive with nodule 15 Jan 08
PSA 3.8 18 Jan 08
Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.
Bone scan and CT scan Negative 12 Mar 08
Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.
- - - - - - - -
da Vinci successfully completed by Dr Fagin as scheduled.
Path Report:
Gleason downgraded to 3+4=7
Tumors confined to the prostate.
Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.
Margins Negative.
Extraprostatic Extension Negative
Seminal Vesicle Invasion Negative
Stage pT2c
As far as it goes between you, me and the fence post I am cured. 
06-24-08 <0.1 Undetectable.
09-23-08 <0.1 Undetectable.
01-10-09 <0.01 Undetectable. 
04-17-09 <0.1 Undetectable.
AUS/IPP installed by Dr Morey 1/21/09 Activation 03/09/09 successfully completed by Dr Morey...All Systems GO!  99.9% continent.


DrJohn
New Member


Date Joined May 2009
Total Posts : 12
   Posted 6/3/2009 6:39 AM (GMT -6)   
Thanks, Salty! I sincerely appreciate your caution and I have reviewed my decision to proceed with the AMS800 many times and with another doctor when I discussed the sling option. I'm still very active in sports and in my profession (presentations, travel, etc.) and I just need a reliable solution plus I'm raw from the urine and that creates low level pain and itching that is distracting to say the least. Your comments about the device are encouraging, though, and thanks again for weighing in...it helps a lot!

Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 6/3/2009 10:39 AM (GMT -6)   
Salty, glad to know you're still around.  I lost your numbers, etc. and was wondering how you were doing.  Glad you're part of our "club" now.
 
Gene214
PC diagnosed 12-06 @ age 63
Radical open removal 2-14-07, Gleason 3+3=6
Removal of stricture 6-07, incontinence continues
Scheduled for AUS & IPP 05-08
Surgeon cancelled one day pre-surgery, due to cardiac concerns
Nuclear stress 5/13/08
3 stents 5/27
AUS, IPP implanted 07-16-08
AUS, IPP was activated on 08-18-08.  They both work!
10-20-08 went back to surgeon for a follow-up.  Both devices are working very good and surgeon was very pleased that I am very pleased.
 


Salty_clark
Regular Member


Date Joined Apr 2008
Total Posts : 95
   Posted 6/3/2009 2:17 PM (GMT -6)   
John...So be it...I am one of those type of guys too that when I have made a decision I stick to it...and it has proven out very good for me in my life so far.  A little tidbit for you...I experienced similar problems from the urine contact on the skin..no matter how hard I tried I got little rashes or chaffed skin in the nether regions.  My doc said it was caused from a fungus and gave me a prescription for Nystatin creme...a topical dressing and it kept the problem at bay and gave me relief until I was completely dry.  You may need something like that prior to activation.
 
Gene...Greetings and salutations.  I am still kicking around...I have a plan to live to be 102 years of age before I kick the bucket.  After two wars and numerous skirmishes I retired from the Army when I was 42.  After all the problems I have faced over the years, in and out of service, I made a vow that ole' Uncle Sam was going to have to pay me my retirement pay for 60 years...still got 25 years to go so you guys are gonna have to put up with me for a heck of lot of years yet.
 
Good luck to all
 
Happy Trails
 
Salty

Age 75 at DX 76 on 9 May 08
DRE positive with nodule 15 Jan 08
PSA 3.8 18 Jan 08
Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.
Bone scan and CT scan Negative 12 Mar 08
Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.
- - - - - - - -
da Vinci successfully completed by Dr Fagin as scheduled.
Path Report:
Gleason downgraded to 3+4=7
Tumors confined to the prostate.
Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.
Margins Negative.
Extraprostatic Extension Negative
Seminal Vesicle Invasion Negative
Stage pT2c
As far as it goes between you, me and the fence post I am cured. 
06-24-08 <0.1 Undetectable.
09-23-08 <0.1 Undetectable.
01-10-09 <0.01 Undetectable. 
04-17-09 <0.1 Undetectable.
AUS/IPP installed by Dr Morey 1/21/09 Activation 03/09/09 successfully completed by Dr Morey...All Systems GO!  99.9% continent.


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 6/5/2009 8:05 AM (GMT -6)   
John, depending on what sports and activities you are in you could still have a fair ammount of leaking during those activies even after the AUS. I golf and the stress of the swing will cause enough leaking to need a regular Depends Male pad. I know bike riding and other sports that are hard on the perneal area not really advised after the AUS. You may want to make sure your doctor knows what your lifestyle is and your concerns about how the AUS will tolerate those activities.
KW
    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second Opinion Consultation for Incontinance at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.
    March 27th, 2008 - Sling not working, Little or no improvement.
    April 18, 2008 - Collagen injection.  Back to using 4-6 full pads a day within a week.
    May 14, 2008 - Another collagen injection to try to Band-Aid the leaking for our June cruise.  Will start making conusultation appiontments for AUS after we return.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    July 30, PSA 0.00.
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
    Oct. 6th, 2008 - AUS Activation by Dr. Morey.  Working Great, only light drips and dribbles.
    Jan, 31st, 2009 - PSA 0.00  Next test in July, 2009  
  
 
 
      


DrJohn
New Member


Date Joined May 2009
Total Posts : 12
   Posted 6/5/2009 10:37 AM (GMT -6)   
That makes sense, KW. I went over my notes from my last visit with my surgeon and he said that the collar on the AMS may need replacing in 4-5 years. Have you had that experience? Just keyhole surgery to make the upgrade but I really was looking for a one time fix. Also, I took Salty's advice and asked my doctor for some anti-fungal cream (Lamisil) and the problem of chafing was resolved immediately...thanks!

Salty_clark
Regular Member


Date Joined Apr 2008
Total Posts : 95
   Posted 6/5/2009 1:06 PM (GMT -6)   
John...KW makes a very valid point...I have experienced a squirt when some sort of pressure is appied to the perioneal area where the cuff is located such as when I sit down on the leading edge of a hard chair and pressure is exerted on the cuff.  The leak or squirt doesn't appear simultaneously but does happen upon arising from that position and the pressure is released on the cuff.  Its annoying but not a big problem for me as I am learning to accomodate by initially sitting further into the chair and then its no problem.  Some sporting activities might be a problem for you...such as biking.  The human being normally sets upon the two hip bones and surrounding muscle and there are no problems when doing that.  Placement of the cuff is very important for a successful outcome.  My doctor told me that he was able to get the cuff in the very best possible position around the bulbo...but the result is that I must accomodate a bit.  Having a generous supply of surrounding muscle would certainly help...of which, I am seriously lacking...an added component of older age for which I am severely afflicted.
 
Salutaions KW...I hope at some future time we have the opportunity to meet.  I have followed your journey and it has been of great assistance to me in my travels as well.
 
Good Luck
 
Salty

Age 75 at DX 76 on 9 May 08
DRE positive with nodule 15 Jan 08
PSA 3.8 18 Jan 08
Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.
Bone scan and CT scan Negative 12 Mar 08
Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.
- - - - - - - -
da Vinci successfully completed by Dr Fagin as scheduled.
Path Report:
Gleason downgraded to 3+4=7
Tumors confined to the prostate.
Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.
Margins Negative.
Extraprostatic Extension Negative
Seminal Vesicle Invasion Negative
Stage pT2c
As far as it goes between you, me and the fence post I am cured. 
06-24-08 <0.1 Undetectable.
09-23-08 <0.1 Undetectable.
01-10-09 <0.01 Undetectable. 
04-17-09 <0.1 Undetectable.
AUS/IPP installed by Dr Morey 1/21/09 Activation 03/09/09 successfully completed by Dr Morey...All Systems GO!  99.9% continent.


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 661
   Posted 6/5/2009 9:11 PM (GMT -6)   
Gene214 said...
John,
 
 
 
 
And just a p.s. -- It takes how long in Canada?  And we (present administration) are wishing that for our healthcare system?  I think I prefer what we already have, which works pretty good, in my opinion. 
 
Gene214

  Hey Gene214
Sorry to go off topic, but your comment about health care caught my attention.   I must DISAGREE with you about 200%.  There is much misunderstanding about health care reform.  President Obama is NOT proposing a system like that in Canada.  He is talking about a system somewhat like Medicare, which in my case is great...a godsend...I would be a homeless street person without it.
 
The special interest and big insurance guys are trying to kill a government insurance program that is fair and equitable.  That is what we need and that is what the President has proposed.  The special interest insurance Giants want to continue to extort their pound of flesh.  We cannot tolerate that any longer.
 
Did you know that almost 70% SEVENTY PER CENT  of all personal bankruptcies are caused by Medical bills...not retail debt or home foreclosures.  The culprits are many, but one thing that will help is a fair medical insurance plan offered by the US government.
 
By the way, I agree that a government run medical "system" is not the way to go.  That is not what President Obama is talking about.
 
We can discuss this more on a new thread if people are interested.
PSA up to 4.7 July 2006 , nodule noted during DRE
Biopsy 10/16/06 ,stageT2A
Very Aggressive Gleason 4+4=8  right side
DaVinci Surgery  January 2007
Post op confirms gleason 4+4=8 with no extension or invasion
no long term continence problems
Post surgery PSA continues to be "undetectable"
One side nerves spared
Bi-Mix for ED 
born in 1941


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 6/6/2009 7:32 AM (GMT -6)   
I am 7 weeks post-op, so I am a new-comer to incontinence. But, it only took me 2 day s to realize that I could not tolerate a wet undercarriage, or a urine soaked pad weighing down my underpants.

I went to the medical supply store and got a Zimmerman clamp. I know, they are not recommended by most people, but for me, my mental state change was night and day. I have it adjusted so that it only lightly clamps, probably looser than the AUS, but it is very effective.

I have an active work life, which may find me climbing ladders, or being on machinery of different sorts. The change in my attitude has been night and day for me.

Meanwhile, I continue to do kegals, and srengthen my pelvic muscles. I am dry at night, and am able to walk to the bathroom at night with minimum leakage. I believe that I will be ready for longer periods during the day within a week or so, and hopefully quit using the Zimmerman within 2 or 3 weeks.
Age 58
PSA 4.47
Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09
Nerves spared
0/23 lymph nodes involved
pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.
Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Thankful for early diagnosis, and U.S. healthcare
Living the Good Life, cancer free
6 week PSA undetectable. 


DrJohn
New Member


Date Joined May 2009
Total Posts : 12
   Posted 6/6/2009 8:39 AM (GMT -6)   
I am Canadian but I earned my PhD at Duke. I have lived and worked throughout the United States although I currently reside in Toronto. Let me address your comments about the differences in our healthcare systems in two ways: 1) functionality and 2) values. The Canadian healthcare industry is world class when it comes to dealing with emergencies and urgent care. Elective surgery is treated in that way, i.e. it can wait but, even then, the time period is acceptable to most Canadians. In fact, my AMS surgery is technically elective since some urologists want to observe changes over 24 months post-surgery. Once I made the decision, surgery was scheduled for three weeks later. Our cancer research leads the world, as well, with Princess Margaret Hospital in Toronto hosting more dedicated cancer scientists than anywhere else. We can choose any doctor we want, including specialists, and the medical system provides incentives for doctors to practice in communities with low populations (we currently have a shortage of General Practitioners). Please note, 75% of our 34 million people live within 75 miles of the 49th parallel border with the U.S. so we have very small communities throughout the second largest (geographically) country in the world. For perspective, California has about 37 million people.

The American media has tried to make our medical system "wrong" for years but when Natasha Richardson bumped her head on a ski slope in Quebec and subsequently died, the media suggested that she was not airlifted from the resort because of our antiquated system. The facts: following the incident, Richardson and her friends/family refused to be taken to the hospital that was a 3-hour ambulance ride away in Montreal; she died many hours after that point. Our medical system works well most of the time and it is undergoing a massive overhaul to improve service, reduce cost and digitize records using a new Microsoft program designed for that purpose.

The Canadian system has worked for over 50 years when a Conservative government decided that it was every Canadian's right to have access to "free" medical services. It certainly helped that Prime Minister Diefenbaker's mother was in palliative care at the time! That's my segue to values. It's estimated that between 40-50 million Americans have no medical coverage and, perhaps, just as many are under-insured. American politicians, medical industry lobbyists and, indeed, the media have conspired to demonize the Canadian system as expensive and socialist. It's expensive but totally manageable when you have the government negotiating on behalf of every Canadian. Our taxes are generally about the same as America with a few exceptions at the upper end and I can speak directly to that issue having paid taxes on both sides of the border. Americans need to get beyond the labels and negative connotations of "socialism", "government run", etc. and demonstrate that no American should be left behind when it comes to healthcare. It's unconscionable that a country that spent trillions of dollars on the war of choice in Iraq and bailing out the auto industry and Wall Street cannot seem to make healthcare part of its value set. Medical care should be a right for all Americans not the cause of bankruptcy and a life of misery. The high quality of healthcare in the United States is unquestionable but it should not be based on capitalistic, market principles. Americans should also be better informed about alternative systems before politicizing the options. Even Michael Moore's movie, Sicko, although flawed factually in some parts gives a fairly good overview of the comparative differences.

Frankly, I think that Obama is flip flopping on the healthcare issue. The closest he has come to making healthcare a "right" for Americans is to say that "healthcare should be affordable for all Americans". I don't know if that is the same thing.

On a personal note, Ron Taylor (http://en.wikipedia.org/wiki/Ron_Taylor_(baseball)) is my GP and he likes to say that when it comes to making money, he was too early for baseball and too late for socialized medicine in Canada. Our doctors make decent coin but they are not making as much as they could in the United States and, yet, we still seem to be able to recruit doctors to our country.

Sorry for the long note but I enjoy debating and with only four days to go before my surgery, I prefer to think that our system is working just fine!

lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 661
   Posted 6/6/2009 9:03 AM (GMT -6)   
DrJohn said...
I am Canadian but I earned my PhD at Duke. I have lived and worked throughout the United States although I currently reside in Toronto. Let me address your comments about the differences in our healthcare systems in two ways: 1) functionality and 2) values. The Canadian healthcare industry is world class when it comes to dealing with emergencies and urgent care. Elective surgery is treated in that way, i.e. it can wait but, even then, the time period is acceptable to most Canadians. In fact, my AMS surgery is technically elective since some urologists want to observe changes over 24 months post-surgery. Once I made the decision, surgery was scheduled for three weeks later. Our cancer research leads the world, as well, with Princess Margaret Hospital in Toronto hosting more dedicated cancer scientists than anywhere else. We can choose any doctor we want, including specialists, and the medical system provides incentives for doctors to practice in communities with low populations (we currently have a shortage of General Practitioners). Please note, 75% of our 34 million people live within 75 miles of the 49th parallel border with the U.S. so we have very small communities throughout the second largest (geographically) country in the world. For perspective, California has about 37 million people.

The American media has tried to make our medical system "wrong" for years but when Natasha Richardson bumped her head on a ski slope in Quebec and subsequently died, the media suggested that she was not airlifted from the resort because of our antiquated system. The facts: following the incident, Richardson and her friends/family refused to be taken to the hospital that was a 3-hour ambulance ride away in Montreal; she died many hours after that point. Our medical system works well most of the time and it is undergoing a massive overhaul to improve service, reduce cost and digitize records using a new Microsoft program designed for that purpose.

The Canadian system has worked for over 50 years when a Conservative government decided that it was every Canadian's right to have access to "free" medical services. It certainly helped that Prime Minister Diefenbaker's mother was in palliative care at the time! That's my segue to values. It's estimated that between 40-50 million Americans have no medical coverage and, perhaps, just as many are under-insured. American politicians, medical industry lobbyists and, indeed, the media have conspired to demonize the Canadian system as expensive and socialist. It's expensive but totally manageable when you have the government negotiating on behalf of every Canadian. Our taxes are generally about the same as America with a few exceptions at the upper end and I can speak directly to that issue having paid taxes on both sides of the border. Americans need to get beyond the labels and negative connotations of "socialism", "government run", etc. and demonstrate that no American should be left behind when it comes to healthcare. It's unconscionable that a country that spent trillions of dollars on the war of choice in Iraq and bailing out the auto industry and Wall Street cannot seem to make healthcare part of its value set. Medical care should be a right for all Americans not the cause of bankruptcy and a life of misery. The high quality of healthcare in the United States is unquestionable but it should not be based on capitalistic, market principles. Americans should also be better informed about alternative systems before politicizing the options. Even Michael Moore's movie, Sicko, although flawed factually in some parts gives a fairly good overview of the comparative differences.

Frankly, I think that Obama is flip flopping on the healthcare issue. The closest he has come to making healthcare a "right" for Americans is to say that "healthcare should be affordable for all Americans". I don't know if that is the same thing.

On a personal note, Ron Taylor (http://en.wikipedia.org/wiki/Ron_Taylor_(baseball)) is my GP and he likes to say that when it comes to making money, he was too early for baseball and too late for socialized medicine in Canada. Our doctors make decent coin but they are not making as much as they could in the United States and, yet, we still seem to be able to recruit doctors to our country.

Sorry for the long note but I enjoy debating and with only four days to go before my surgery, I prefer to think that our system is working just fine!
DrJohn .....Great comments.  Maybe one of our forum moderators can take your post and mine above regarding the need for medical reform and start a new thread.  This is a very important subject that needs critical attention. idea
Thanks
PSA up to 4.7 July 2006 , nodule noted during DRE
Biopsy 10/16/06 ,stageT2A
Very Aggressive Gleason 4+4=8  right side
DaVinci Surgery  January 2007
Post op confirms gleason 4+4=8 with no extension or invasion
no long term continence problems
Post surgery PSA continues to be "undetectable"
One side nerves spared
Bi-Mix for ED 
born in 1941


Salty_clark
Regular Member


Date Joined Apr 2008
Total Posts : 95
   Posted 6/6/2009 10:02 AM (GMT -6)   
John...I wish you well on your upcoming surgery and hope you are able to attain all the benefits you have outlined in your posting.  But John...your politics are showing.  Whatever your particular political leanings are this forum is not the place for expressing them.  The hair on the back of my neck rises when I hear phrases such as "war of choice in Iraq" and other such present government tidbits scattered throughout your rant.  As I recall we were being shot at in the skies over Iraq while we were enforcing a U. N. mandate.  I don't see "choice" entering into the discussion at all when considering whether we fight someone who is shooting at us.  This is not a philosophical question like most academians love to assert when in front of an audience of like-minded shallow-thinking people who lean toward a socialistic system where "government can take care of everything."  I can blow holes in most things in your rant but I will leave it at that and just let you know that words have meanings based on your frame of reference and I know definitely where you are coming from.
 
Salty

Age 75 at DX 76 on 9 May 08
DRE positive with nodule 15 Jan 08
PSA 3.8 18 Jan 08
Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.
Bone scan and CT scan Negative 12 Mar 08
Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.
- - - - - - - -
da Vinci successfully completed by Dr Fagin as scheduled.
Path Report:
Gleason downgraded to 3+4=7
Tumors confined to the prostate.
Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.
Margins Negative.
Extraprostatic Extension Negative
Seminal Vesicle Invasion Negative
Stage pT2c
As far as it goes between you, me and the fence post I am cured. 
06-24-08 <0.1 Undetectable.
09-23-08 <0.1 Undetectable.
01-10-09 <0.01 Undetectable. 
04-17-09 <0.1 Undetectable.
AUS/IPP installed by Dr Morey 1/21/09 Activation 03/09/09 successfully completed by Dr Morey...All Systems GO!  99.9% continent.


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 661
   Posted 6/6/2009 12:31 PM (GMT -6)   
Salty_clark said...
John...I wish you well on your upcoming surgery and hope you are able to attain all the benefits you have outlined in your posting.  But John...your politics are showing.  Whatever your particular political leanings are this forum is not the place for expressing them.  The hair on the back of my neck rises when I hear phrases such as "war of choice in Iraq" and other such present government tidbits scattered throughout your rant.  As I recall we were being shot at in the skies over Iraq while we were enforcing a U. N. mandate.  I don't see "choice" entering into the discussion at all when considering whether we fight someone who is shooting at us.  This is not a philosophical question like most academians love to assert when in front of an audience of like-minded shallow-thinking people who lean toward a socialistic system where "government can take care of everything."  I can blow holes in most things in your rant but I will leave it at that and just let you know that words have meanings based on your frame of reference and I know definitely where you are coming from.
 
Salty

Whoops Salty ...  Speaking of rants, your radicalism is showing.  I would hate for you to shoot holes in this "shallow minded thinker". 
 Who said anything about socialistic?  We have a medical coverage crises in this country.  Just because you (and I) are old enough for Medicare doesn't mean that the Fifty Million Americans without medical coverage should be left to shift in the wind. Outside of the indefensible trillions spent on war that should have been better spent protecting American's health, no one argued about war.
 
My comments were about medical care and medical coverage.  It needs fixing in a big way.

DrJohn
New Member


Date Joined May 2009
Total Posts : 12
   Posted 6/6/2009 2:47 PM (GMT -6)   
Wow, I didn't expect that kind of blowback but I sincerely appreciate your time responding; you are likely right that this is not the forum for political posturing (even if unintended) so this will be my final comment. Actually, my politics are right of center in most situations and I have more Ayn Rand in me than I like to admit. I have a lot of faults but I have never been accused of being shallow-thinking, Salty. I will let that one go because I obviously hit a raw nerve with my comments and I deeply honor your past service to the United States. I'm sorry if I was disrespectful. I was just responding to some comments about the Canadian healthcare system and I'm a little fatigued at people commenting about a system that they don't understand and never experienced. I admit that my Iraq comment could appear to be out of context when talking about healthcare but cost is often the excuse used by politicians and lobbyists when it comes to considering universal healthcare for Americans. Healthcare is an issue of values and choices, not political ideology.

Salty_clark
Regular Member


Date Joined Apr 2008
Total Posts : 95
   Posted 6/6/2009 4:24 PM (GMT -6)   
lifeguyd said...
Salty_clark said...
John...I wish you well on your upcoming surgery and hope you are able to attain all the benefits you have outlined in your posting.  But John...your politics are showing.  Whatever your particular political leanings are this forum is not the place for expressing them.  The hair on the back of my neck rises when I hear phrases such as "war of choice in Iraq" and other such present government tidbits scattered throughout your rant.  As I recall we were being shot at in the skies over Iraq while we were enforcing a U. N. mandate.  I don't see "choice" entering into the discussion at all when considering whether we fight someone who is shooting at us.  This is not a philosophical question like most academians love to assert when in front of an audience of like-minded shallow-thinking people who lean toward a socialistic system where "government can take care of everything."  I can blow holes in most things in your rant but I will leave it at that and just let you know that words have meanings based on your frame of reference and I know definitely where you are coming from.
 
Salty

Whoops Salty ...  Speaking of rants, your radicalism is showing.  I would hate for you to shoot holes in this "shallow minded thinker". 
 Who said anything about socialistic?  We have a medical coverage crises in this country.  Just because you (and I) are old enough for Medicare doesn't mean that the Fifty Million Americans without medical coverage should be left to shift in the wind. Outside of the indefensible trillions spent on war that should have been better spent protecting American's health, no one argued about war.
 
My comments were about medical care and medical coverage.  It needs fixing in a big way.

"Whoops Salty ...  Speaking of rants, your radicalism is showing." 

Yeah I guess I am a radical and you know something...I am proud of it.  A Radical American...has a nice ring to it, doesn't it!

During the Depression I grew up in a small town in Oklahoma.  Each man stood on his own two feet taking care of his family as best he could.  Acceptance of assistance was frowned upon generally and rejected by most except that given by the nearest of friends or relatives or good church people in the direst of times.  The values of that time were transferred to me.  We had a mistrust of governmental handouts and the strings attached.

It is always interesting that, when one espouses American ideals of working hard, taking care of your family and not expecting government handouts, it is a "radical" view in some eyes.  I am called a radical when I say that Americans are a unique people that want the government to do what the Constitution calls for and no more than that.  Our present government is rapidly moving toward "cradle to grave" care for everyone in all aspects of our lives.  And this includes health care.  I can empathize with those who beseech the government to do more and more but carefull what you wish for...it will be too late after its in place.  Whether one likes to call it by other names or use pleasant sounding words socialism has begun in America with the takeover of the finance system and the auto industry.  A socialized form of federal health care for all is coming and with that will be a general detirioration of the system. 

Why is it that everytime the liberals want to get some of their programs passed regardless of the consequences they say we are in the midst of a  "crisis".  And who said anything about forgetting about the 40 to 50 million Americans who reportedly have no insurance coverage.  There are ways to solve that without coverting over to socialism such as, for example, qualifying each one of these non-covered people with a wage-means testing and the government pay their insurance.  Taxes will go up on all working people and income-producing people.  There would be relatively little affect on the remaining covered people and our traditional health delivery system...the best in the world...will remain intact for all to enjoy.

Now, the meat...you need to go back and read carefully my comment regarding the war in Iraq.  I made reference to "choice" of war in Iraq as if we elected on our own to go to war without any consideration for all the events involving Saddam that led up to our involvement.  The present government likes to make it appear that we just arbitrarily put on our field packs, shouldered our weapons and marched off to conquer foreign lands.  Nothing could be further from the truth.  Lies and damm lies have a way of clouding the issues and historical fact.  Another reason for my lack of trust in the present government to get it right in an issue as important as health care.

And, finally, a personal note.  When I was 18 I signed a contract with the U.S.Army that I would render such services as they desired and they would provide me with reportedly the best medical care for the totality of my life.  I am technically still in the Army at the age of 77...They chose to transfer me to the Retired Rolls.  My contract with them is for life but, technically, I could be activated at any time should the need arise.  So, do not under any circumstance think that I am on the dole or receiving handouts from the government.  It is earned in blood.


Age 75 at DX 76 on 9 May 08
DRE positive with nodule 15 Jan 08
PSA 3.8 18 Jan 08
Biopsy 11 Mar 08 Gleason 8 (4+4) on the right 3 out of 12 positive <5%. Gleason 7 (4+3) on the left 1 out of 11 positive <5%.
Bone scan and CT scan Negative 12 Mar 08
Robot Assisted da Vinci prostectomy with Dr Fagin in Austin scheduled for 30 April 08.
- - - - - - - -
da Vinci successfully completed by Dr Fagin as scheduled.
Path Report:
Gleason downgraded to 3+4=7
Tumors confined to the prostate.
Bilateral tumor on right side 5 of 10 levels and on left side tumor present in 9 of 10 levels.
Margins Negative.
Extraprostatic Extension Negative
Seminal Vesicle Invasion Negative
Stage pT2c
As far as it goes between you, me and the fence post I am cured. 
06-24-08 <0.1 Undetectable.
09-23-08 <0.1 Undetectable.
01-10-09 <0.01 Undetectable. 
04-17-09 <0.1 Undetectable.
AUS/IPP installed by Dr Morey 1/21/09 Activation 03/09/09 successfully completed by Dr Morey...All Systems GO!  99.9% continent.


DrJohn
New Member


Date Joined May 2009
Total Posts : 12
   Posted 6/6/2009 4:41 PM (GMT -6)   
Salty, you fought for the right for all of us to express our point of view and I am grateful and thankful for your sacrifice. On the medical front, you have been very helpful (with great detail) in your support while I go through this process to get back to some semblance of normalcy. I would really enjoy continuing a dialogue on the other subjects. If you feel the same, I can be reached at jwhitesell@orgcode.com.
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