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Spoke with Dr Tulley today about Robitic Sugery

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Posted 8/14/2008 10:27 AM (GMT -8)
Had an appointment with Dr Tulley today about setting up the sugery for removal of the prostate.  He advised that I would have to lose about 40-60 lb.  During the sugery he is afraid that my weight would cause me some breathing problems.  He gave me a diet and I will work on that I need to lose the weight anyway.  I have been big all of my life and really not but aobut 25 lb more than I played football at in Highschool and college.  He has assured me that my cancer should not spread during this time and that it is very slow type. gleason 3+3 6 and 3 of 12 biopiseys showed cancer and those were not saturated.  He said he would feel better and that I would recover with the weight gone.

Daniel9829

Posted 8/14/2008 1:07 PM (GMT -8)
Daniel,
I know you are in the heat of the battle of the mind over this situation - everyone who has PC has gone through the same tough mental gymnastics of one sort or another. I know I was uncomfortable with what my first Urologist was advising me. It appears from your biopsy description that you do have some time to research your situation, and perhaps lose weight if that is required. PC grows slow and it appears you have caught the cancer early. I would recommend that you go to another Urologist and get a second opinion. Take your biopsy with you and any other information you have. I ended up going to 3 Urologists before I made up my mind. Each Urologist I visited had a little different view and recommendation. I learned things from all of them as well as others who had gone through similar situations, did a lot of reading on line, and communicating on this web site. The bottom line is that it is your body, your life, and you need to feel very comfortable with the person giving you advice and ultimately who will perform whatever procedure you choose.

The more information you get from searching the web, and talking with those who know, the more settled you will be in your mind about what to do, and you will be confident you made the right decision. And by the way - it will work out. Blessings. RB
___________________________________
Age 61
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA .04
Posted 8/14/2008 5:23 PM (GMT -8)
Hi Daniel

I really wanted to have robotic surgery to remove my prostate. After meeting with a Dr. everything appeared to be OK and he said my excess weight would not be a problem. But something told me I should mention that I have sleep apnea. It is not really a breathing problem but the Dr told me I was not a candidate for robotic because they sort of put your head down lower and that it can cause breating problems because it pushes your diaphram against your lungs. So I found an open surgery Dr. who was the head of the urology department and he told me I should lose about 50 pounds. I did manage to lose the weight before surgery but it was a struggle. Everything went fine and that was the end of May 2007. Things are really good and ED seems to be getting better. So losing weight should help you deal with the surgery. Good luck to you and let us know how you do with it.

Mika
Posted 8/14/2008 5:26 PM (GMT -8)
Daniel, I saw Dr. Tully for my second opinion and consultation for DaVinci. I was very impressed with him, I have been in the medical industry clinically for 30 years or so, so I am not easy to impress. I selected him for my surgeon and could not be happier. However, your decision is up to you and your loved ones. Losing weight would definitely be in your favor for all areas of your health, in addition to doing better with surgery and the post-op period. Again, my surgery will be 1 year ago on 9/5, My continence was resolved one day after the catheter was removed and erectile function has shown marked improvement in the last couple of months, am now able to achieve erection with manual stimulation only, even better response with Viagra or Cialis, haven't had to use injections for the past 3 months, so I am happy with the progress. As you have read here, everyone has a different recovery rate and your's will be no exception, just make sure you are comfortable with the treatment option you choose. Good Luck.
Randy
Posted 8/15/2008 6:35 AM (GMT -8)
Thanks for the support.  I am very comfortable with Dr Tully and I need to lose the weight.  He gave me a diet I think that I can follow (Three Day diet Plan).  I believe that I can stay on a diet for 3 days a week.  with this diet he said that I should lose a min of 40 lb by December and this would help my Type Two diabetes and over all general health.  Like another friend told me yesterday afternoon I needed a real reason to lose weight and this is it.  This was really a wake up call for me as my father died at 66 of Prostate cancer in 1991 after 6 years of dealing with it.  I spent the last 6 months of his life with him for 8-12 hours a day and do not want to walk in his shoes. 

onward and upward with the diet and excersise I have think I will fall back in the routine well since I have a sports background and am determined to hit 265 by Dec 15,2008.  this will be a streach but I think by setting this goal I will win. 

Again Thanks to all of you guys and If I can be of assistance to anyone let me know.

Daniel9829  roll

Posted 8/15/2008 7:25 AM (GMT -8)

...Good luck Daniel on the diet and work outs....remember those two-a-days' back in the day.....you've got some major motivation on your side this time around, plus, just gettin' ready for the next big game. Go for it man, you can do it....we're  all here if you need some ears......

Posted 8/15/2008 9:46 AM (GMT -8)
+1 for Dr. Tully. He was my surgeon as well. He was also my second opinion. We liked him so much, we drive from Huntsville to Birmingham for follow up appointments to this day.

Posted 8/15/2008 11:59 AM (GMT -8)
Hey Daniel good luck with your surgery! I pushed my surgery out a few months so I could get into better shape. I got a personal trainer and amped up my running schedule and ate very healthy. I lost inches and pounds and I really think that it made all of the difference in the world for my recovery. Especially doing core strength training. Everyone recovers differently, but for me having the extra strength in my arms and hamstrings really helped from stressing out my ab muscles when I had to push myself out of bed or in and out of chairs. As I recover I have started to jog after 2 weeks and did a little strength training just yesterday. You would be amazed at what you can do for yourself in just a few months time.
Posted 8/15/2008 4:06 PM (GMT -8)
I'll tell you one thing my doc (robotic) said about losing weight pre-surgery. When you lose the fatty tissue, your skin etc. takes much longer to shrink and tighten up (especially at our age smilewinkgrin). The benefit is that the gas blows you up better (think balloon) giving the surgeon better and clearer access to your innards.
Bill
Posted 8/18/2008 2:19 PM (GMT -8)
 

  guys  thanks for thefrank discussion...probably very politically incorrect, but wondering how much you guys weighed when you went for initial consultations...

I am wondering if I am wasting my time..

Age 60, 320 pounds, diagnosed a bout 6 years ago with sleep apnea and after four or five weeks of trying to sleep with the machine (IPAP? cpac? whatever?) I tossed it and figured it is probably better to croak in your snoring sleep than wrassle with  the machine all night long...

My initial consultation for da Vinci is next Tuesday at Sloan Kettering, and I am just wondering if with all good intentions I am kidding myself that obesity risks trump modern science....I foolishly thought that an active lifestyle, living and working vigorously at 9,000 ft altitude, and eating to excess whenever I pleased made me "relatively" healthy until by PC diagnosis a month ago....

I guess any positive reinforcement is appreciated.

Mbshine

Psa FROM 0.08 TO 4.6 IN 7 YEARS, DOUBLING IN PAST THREE YEARS

NEEDLE BIOPSY POSITIVE IN 3 of 11 samples

gleasons 6, 6 and 7

local urologist recommended soonas possible daVinci

 

Posted 8/18/2008 3:57 PM (GMT -8)
I (5'9") weighed in at 107kg (236lb) just before the time of diagnosis, I too was in excellent general health. Knowing I was due for the biopsy (under mild anesthesia) I set about losing weight. I had a little used treadmill that I began to use (slow build up of distance and speed over about 8 weeks) and followed a pretty strict diet (no red meat. no pastries etc.....very little chicken, a little fish.........lots of veg and fruit. Diet and exercise meant that by the time of the op ( 6 weeks after biopsy) I had lost 6 kg (14 lbs). I have continued with the diet and exercise and over the 14 months I now come in at 90 kg. (total loss of 17kg....38lbs) A long, slow, steady process but well worth the effort. The difference can really be felt both with energy levels and sense of well being.
Bill
Posted 8/19/2008 5:22 AM (GMT -8)
I am 5'9" 180lbs prior to surgery and am still weighing approximately the same. I had within the last year weighed as much as 200lbs (before I knew I had PC) but went on an Atkins type diet for a while and loss the excess. I found that kind of diet easy to handle and recommend it should you want to lose some weight. I don't have a large frame and I think that matters with regard to weight. I have a friend who weighs significantly more than I (somewhere near 300lbs) who had DiVinci at the same doc as myself in February this year and has done fine. I am sure each person's situation is a little different.

The good thing for you is that you caught the PC early and you have some time to research and make adjustments. Keep your chin up. RB

Age 61
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA .04
Posted 8/19/2008 5:12 PM (GMT -8)
RB-Billy Mac

you guys are great..giving me confidence!
mbshine
Posted 8/20/2008 6:11 PM (GMT -8)
Daniel,

Dr Tully removed my prostate March 5th. It been just over 5 months. Dr. Tully has performed around 1100 or more Di Vinci Robotic surgeries. There are not many Urologist with this level of experience. I know it is very hard to wait but Dr Tully may be worth the time it takes to lose the weight. Dr Bugg is very good too. Losing the weigth will give Dr Tully the ability to do his best. Good luck

Posted 8/27/2008 1:26 PM (GMT -8)
Just a brief note re my exam and consult with
Dr. Bernard Guillonneau at Memorial Sloan Kettering

I had a nice intake session with his senior research fellow, who administered a Digital Rectal Exam and said there was no abnormality felt.

Then my wife and I met with Dr. Guillonneau who was friendly but frank. He did not seem to have known that my wife and I traveled more than 4,000 miles roundtrip (and spent more than $2,000 for the NY trip to see him) and asked if I was local, from New York. He seemed to have little sympathy or empathy for my situation, since my obesity of my own making, and of course he was correct.

His view is that because of my obesity and thus morbidity risks including sleep apnea
and related post-surgery complications, in his opinion I am not a candidate for
any surgery, open, laparoscopic, daVinci etc, nor am I a candidate for radiation or seed
therapy. He also thought bariatric surgery means nothing but complications without committed, sincere, and dedicated lifestyle changes.


the MSK lab had not yet reviewed my biopsy to confirm at least one Gleason 7 score, and he suggested that since I will likely die of something related to heart disease, diabetes, or stroke before dying from prostate cancer, I attempt to lose as much weight as possible and have a new PSA and new biopsy in December.

My local urologist does not seem pleased with the candor of the world's leading authority in New York and wants to consider hormonal therapy or cryo/freezing procedures...

It is tough to remain optimistic especially when one knows Dr. G is 100 per cent correct, and a life of gluttony and healthcare neglect catches up with everyone..

So, that's the update I promised you....thank you all for your support and concern.

Mbshine
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