RayPat - a fairly new brother - to start his own thread

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/24/2010 8:31 AM (GMT -6)   
I don't post much but have PC. Still debating treatment but want you to know I'm praying for you.
You've had a hard road to follow but I greatly admire your strength in traveling it.
I hope I have half your courage.
 
RayPat
 
(I copied this from one of my own threads, I have asked him to give us some more details, and to make him welcomed to our family here)

RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 4/24/2010 8:44 AM (GMT -6)   
Thanks for the introduction. LOL
I've had a biopsy and the urologist said he might recommend watchful waiting if my PSA was lower but thinks I should have it treated. I'm not fond of the idea of surgery so he recommended IMRT and set an appointment for Monday with the radiologist. Not having insurance the cost is a major concern to me. Some of the things I'm wondering that you guys may be able to help me with, with what the urologist called a very small amount of cancer and the prostate isn't enlarged what would cause the frequent urination? From what I've read early stage PC usually doesn't have any symptoms. Could something else that didn't show in the urine sample be causing the elevated PSA? I had complete blood work done in January and everything was fine except the PSA. Are there other tests I should ask about before rushing into treatment and debt? How long can I take before deciding on treatment based upon what the biopsy showed? Any advice is greatly appreciated.
Age 63
Frequent urination for 10 years but never saw a doctor.
01/26/10 talked to doctor who did blood work...PSA9
Referred to urologist
Met urologist on 2/26/10....DRE normal new PSA test was 11. Taken after DRE.
Biopsy on 3/26/10. 14 samples...3 positive on right side...all 11% Gleason 3+3
Urologist said stage T-1c.
Advised treatment. Discussed surgery and set appointment with radiologist for 4/26/10


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 4/24/2010 10:06 AM (GMT -6)   
Welcome RayPat to the club. Thanks for joining us and sharing your journey.
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 10 gms., margins clear
32 Months: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4223
   Posted 4/24/2010 11:59 AM (GMT -6)   
RayPat,
You are right on the border line for Active Survelience. If cost is an issue for you, look into Brachytherapy as it is the least costly of all the procedures and has less permanent side affects than radiation. It is also more effective than regular radiation as long as you are getting 140gy and have an experienced Brachytherapyst.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/24/2010 2:11 PM (GMT -6)   
Raypat,

I tend to agree with JohnT above, your numbers put you right on the center of the fence for considering AS. If you did go on it, I doubt you would be able to safely stay on it for real long, but perhaps long enough to figure out the best way of treatment for you, and to work through the financial considerations. Seeding would be the most economic value of the standard priamary treatment options, for sure, and in most case, the least invasive.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in


RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 4/24/2010 2:26 PM (GMT -6)   
John, thanks for the information. Cost is definitely an issue. LOL
Once the initial shock of hearing the C word wore off the issue of how to pay for treatment has driven me nuts more so than having PC. In 18 months I'll be on Medicare so the idea of AS is very appealing if it's a reasonable choice. I suspect I've had this for a long time and if it's still small it may still be small in 18 months. Of course I don't know but would love to hear any opinions on what to do even though the final choice will fall on me to make.
Age 63
Frequent urination for 10 years but never saw a doctor.
01/26/10 talked to doctor who did blood work...PSA9
Referred to urologist
Met urologist on 2/26/10....DRE normal new PSA test was 11. Taken after DRE.
Biopsy on 3/26/10. 14 samples...3 positive on right side...all 11% Gleason 3+3
Urologist said stage T-1c.
Advised treatment. Discussed surgery and set appointment with radiologist for 4/26/10


RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 4/24/2010 2:31 PM (GMT -6)   
David, what do you consider "real long"? Of course if I go with AS I'd still be monitoring it with the urologist.
Age 63
Frequent urination for 10 years but never saw a doctor.
01/26/10 talked to doctor who did blood work...PSA9
Referred to urologist
Met urologist on 2/26/10....DRE normal new PSA test was 11. Taken after DRE.
Biopsy on 3/26/10. 14 samples...3 positive on right side...all 11% Gleason 3+3
Urologist said stage T-1c.
Advised treatment. Discussed surgery and set appointment with radiologist for 4/26/10


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4223
   Posted 4/24/2010 2:46 PM (GMT -6)   
I don't think that 18 months would hurt. You have to look at your psa doubling time (the number of months it takes to double) As long as it remains above 24 months you should be ok. If it is less than a year then by all means don't delay treatment.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 4/24/2010 2:53 PM (GMT -6)   
John, thanks for that info. That's the kind of info the urologist should have discussed IMO.
I will be sure to ask about that when I talk to him again.
Age 63
Frequent urination for 10 years but never saw a doctor.
01/26/10 talked to doctor who did blood work...PSA9
Referred to urologist
Met urologist on 2/26/10....DRE normal new PSA test was 11. Taken after DRE.
Biopsy on 3/26/10. 14 samples...3 positive on right side...all 11% Gleason 3+3
Urologist said stage T-1c.
Advised treatment. Discussed surgery and set appointment with radiologist for 4/26/10


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/24/2010 2:58 PM (GMT -6)   
Ray,

Once again, I agree with John's estimate, though hopefully your urologist or any radiation oncologist you meet with, might be able to give you a clearer time frame. Unfortunately, PC is not an exact science, and its hard to predict exact paths, and outcomes in advance. You also have to consider that at best, our biopsies at time of diagnosis, are estimates, based on the cores do that come back positive. Not to cast doubt in your mind, but with some that have been through surgery, their post surgical pathology reports much more serious level of cancer involvment, once they have the entire prostate and any other surrounding tissue to examine, in that case, its not uncommon to have the Gleason number increase. On rarer occasions, the gleason number will decrease, which obviously is better news.

So, there is always an element of the unknown here, so more reason to do all you "due dilligence" at this stage, i.e. reading, studying, other professional opinions, etc. Ultimately, when you do have to make a choice, it will be, or should be, your choice alone. Then, you have to go forward, get through it, and then live with it. No matter what treatment method you use, there are no guarantees about the level and types of side effects and quality of life issue you personaly will have to deal with. Any doctor that pushes words like I guarantee you a cure, or you won't have any ED or incontinence issues, etc, should scare you. Because they can't know any of that for sure ahead of time, no matter how famous they are or how many procedures they have under your belt.

You will find with the brothers and sisters here at HW, while we have many an opinion on almost every aspect of PC, once you decide what is best for you, we will back and support you all the way. I say this line often, but I mean it, its your body, your cancer, your life. You alone, in the end, have to do or not do, what is right for you.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in


RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 4/24/2010 3:05 PM (GMT -6)   
Thanks David. Hopefully someday a cure will be found and the docs will be able to just say this is the correct treatment and not so much guess work involved. Of course that probably won't be in any of our life times.
Age 63
Frequent urination for 10 years but never saw a doctor.
01/26/10 talked to doctor who did blood work...PSA9
Referred to urologist
Met urologist on 2/26/10....DRE normal new PSA test was 11. Taken after DRE.
Biopsy on 3/26/10. 14 samples...3 positive on right side...all 11% Gleason 3+3
Urologist said stage T-1c.
Advised treatment. Discussed surgery and set appointment with radiologist for 4/26/10


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/24/2010 3:11 PM (GMT -6)   
Ray,

All of us wish for that day to come. That is where PC is more complicated than other types of cancer, it often doesnt follow logic or common sense rules. You can have 2 men, the same age, with the exact same specs, and have 2 entirely different reactions and results.

I have sons that are 26 and 32 years old, and of course, now that the old man has PC, they will be having early PSA tests done, if nothing else, to create a baseline for themselves, and to give me a peace of mind. I am hoping that anyone even in their generation, will have more accurate means of ascertaining the severity of PC if it shows up in their lives, and I pray it doesn/t.

We talk about this often here, we need a test, that can positively tell the difference between an indolent cancer, that is never going to grow or hurt you in your lifetime, from what that seems low level, and then suddenly takes an agressive turn. This is why any Gleason 7 case is hard to deal with. They can indolent or very dangerous, and its a thin, hidden line to know the difference. With Gleason 8 and above cases, you pretty well know what you will be dealing with.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in


RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 4/26/2010 11:28 AM (GMT -6)   
I met with the radiologist this morning. Other than a thorough DRE is was a great meeting. He confirmed the opinion of the urologist that he felt it was confined to the gland and that either Brachetherapy or IMRT would be effective treatments. Talked for over an hour about the two procedures and his estimate of the costs. He's going to have the head of the finance department at the hospital call me to discuss actual cost and payment plans. If the radiologist is right about the costs I'll be having seeds since I can afford to pay for that out of savings. Anyway, for the first time in two months I feel great. I had worried myself sick over all this but now that I feel comfortable with the treatment choice I'm ready to move forward and start the road to recovery.
Age 63
Frequent urination for 10 years but never saw a doctor.
01/26/10 talked to doctor who did blood work...PSA9
Referred to urologist
Met urologist on 2/26/10....DRE normal new PSA test was 11. Taken after DRE.
Biopsy on 3/26/10. 14 samples...3 positive on right side...all 11% Gleason 3+3
Urologist said stage T-1c.
Advised treatment. Discussed surgery and set appointment with radiologist for 4/26/10


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 4/26/2010 11:34 AM (GMT -6)   
RayPat, that's great news, I'm sure it took a big load off your mind to finally get some concrete answers and get some action going....Keep us informed..
James C. Age 63
Gonna Make Myself A Better Man www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07: PSA 7.6, Recheck after 4 weeks Cipro-6.7
7/07 Biopsy: 3 of 16 PCa, 5% invloved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, 110gms, Path Report- Stg. pT2c, 10 gms., margins clear
32 Months: PSA's .04 each test since surgery, ED continues: Bimix- .3ml PRN, Trimix- .15ml PRN


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/26/2010 1:10 PM (GMT -6)   
Good news, Raypat, I hope this comes to be for you, and that it will be in a range that won't send you to the poor house.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in


RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 4/26/2010 1:21 PM (GMT -6)   
James, I was amazed at how much light this guy shed on my situation compared to the urologist.
Urologist basically told me the facts of my biopsy and the three treatment choices and told me to let him know.
This guy took the time to explain in detail the pros and cons of all three and then listened to my questions and addressed them all straightforward. I've got a lot of confidence in him and feel good about him doing the Brachetherapy. Also explained that my frequent urination was not because of the PC but probably just a function of getting older or even though my prostate doesn't feel enlarged it could be if I naturally have a small prostrate. Also told me that the Flomax dose could be doubled if needed. Time will tell if I'm making the right decision but for now it's taken the stress off so I can hopefully enjoy a meal and get a good night's sleep for a change.
Age 63
Frequent urination for 10 years but never saw a doctor.
01/26/10 talked to doctor who did blood work...PSA9
Referred to urologist
Met urologist on 2/26/10....DRE normal new PSA test was 11. Taken after DRE.
Biopsy on 3/26/10. 14 samples...3 positive on right side...all 11% Gleason 3+3
Urologist said stage T-1c.
Advised treatment. Discussed surgery and set appointment with radiologist for 4/26/10


RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 4/26/2010 1:29 PM (GMT -6)   
David, I was amazed that the Brachetherapy was as cheap as he quoted. Of course when the dust settles I'm sure it'll be more but if he's any where close I can handle it and not be living on the street. LOL
Age 63
Frequent urination for 10 years but never saw a doctor.
01/26/10 talked to doctor who did blood work...PSA9
Referred to urologist
Met urologist on 2/26/10....DRE normal new PSA test was 11. Taken after DRE.
Biopsy on 3/26/10. 14 samples...3 positive on right side...all 11% Gleason 3+3
Urologist said stage T-1c.
Advised treatment. Discussed surgery and set appointment with radiologist for 4/26/10


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/26/2010 2:05 PM (GMT -6)   
That's real good, RayPat, regular radiation and/or salvage radiation can be incredibly expensive, my salvage radiation was over 200K before adjusted for insurance, and my surgery/hospital time was a good 80K. I was fortunate to have good insurance even though I was out of work.

JohnT and Tudpock have both done well so far with their "seeding", and I am sure will both be glad to continue to guide you through the process. I had wanted that as my first choice, but unfortantely, my specs and numbers didn't allow it as an option.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in

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