Looking for opinions on implant or not

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kbota
Regular Member


Date Joined Aug 2010
Total Posts : 486
   Posted 10/27/2010 7:17 PM (GMT -6)   
Here's the deal; As most of you know, I lost both nerves from the RRP. The VED works, but....well...you guys know the hassles there, and I won't repost all my stories about injections. I do think I could make the injections work out by playing a little more with the dosages (Plan to try again in the morning with .2cc....) Anyway, both my uro, and my onco have suggested that an implant will be in my future.

I met with a Dr. Wayne Hellstrom yesterday morning.

http://www.som.tulane.edu/departments/urology/faculty/hellstrom.html


AFter a few minutes of discussion and a brief exam, he felt like I was a good candidate.
Okay, here's the pros and cons of my dilemma; Since I've already past my max out of pocket for the year, my insurance co will pay 100%, as long as it's done prior to Dec 31, 2010.

I started lupron two weeks ago. I can do the implant now, save the $, and have it ready for when I complete the lupron in two + years. Or, I can simply shelve the idea, and wait until T levels recover, and then reconsider the implant. Possibly something new on the market by then..... I'm basically a cheap bast**d, and would love to save the $2k, but even if I get the thing, it will only be a play toy for the next two plus years since the lupron will soon be killing off any libido I have remaining.

I solicit your thoughts, ideas, and opinions. Both on my primary dilemma, and if anyone has heard of Dr Hellstrom.

I had a fantastic dinner with Cajun Jeff last night. He and Pat were very gracious hosts, and we had some really great conversation. Jeff; I appreciate you buddy, and look forward to the next time we can talk, and share "guy" stuff. I just don't know why Pat puts up with ya.....lol

k
Age 57 at Dx
5/09 PSA 2.26
6/2010 PSA 3.07 FPSA 18% DRE +
6/2010 Bipsy, 7 of 12+, >60%, 4+5=9
7/21/2010 - RRP
Nodes neg,Ves neg
tumor contained, still 4+5=9
pni ext.
9/3, 2010 PSA - 0.04
9/3/2010, I'm 99% continent
10/14/10, PSA still 0.04, and lupron #1, now 99.9% continent
Total ED, 3 caverject failed, pump sux
10/20/10 OD'd on trimix, after 3hrs, neo synephrine shot

Post Edited (kbota) : 10/27/2010 6:21:21 PM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 10/27/2010 7:35 PM (GMT -6)   
if you are going to be on the lupron for 2 plus years, seems it would make sense to wait till you are in a position to actually
use the new toy. just my thought
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 10/27/2010 8:39 PM (GMT -6)   
So this is a two year implant idea??? I suppose if you couldn't handle it long term it could be surgically taken out which is, that option in case of worst case scenario. I offer no advice other than question everything done to you and all the time and never get lax on such. Best to you in this.
Dx-2002 total urinary blockage, bPsa 46.6 12/12 biopsies all loaded 75-95% vol.; Gleasons scores 7,8,9's (2-sets), gland size 35, ct and bone scans look clear- ADT3 5 months prior to radiations neutron/photon 2-machines, cont'd. ADT3, quit after 2 yrs. switched to DES 1-mg, off 1+ yr., controlled well, resumed, used intermittently, resumed useage

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 10/27/2010 8:41 PM (GMT -6)   
Kbota,
Drop me an e-mail so I can get your address, or give me a call.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 10/27/2010 9:13 PM (GMT -6)   
K,
If you have no T because of the HT hen why do you need the implant? That is like having a gone without ammunition.
Age: 67 at Dx on 12/30/08 PSA 3.8
2 cores out of 12 were positive Gleason (4+4)
Davinci surgery 2/9/09 Gleason 4+4 EPE,
Margins clear, nerve bundles removed
Prostate weighed 57 grams 10-20% involved
all PSA tests since (2, 5, 8, 11, 15, 18 months) undetectable
Latest PSA test (21 months) .005

kbota
Regular Member


Date Joined Aug 2010
Total Posts : 486
   Posted 10/27/2010 9:22 PM (GMT -6)   
Purgatory: I have heard of guys who still occasionally had sex even when they were on lupron. This is all new for me, which is why I'm asking the questions. There is an advantage to doing it now, and I'm wondering if there is a good reason NOT to do it now.

Zufus; No, the implant is not for two years. If I do it, it will, hopefully, be for many many years. My concern was not having much use for it while on the lupron which will be for two years.

Goodlife: email sent

Ed: I have no idea what to expect from the lupron other than what I've learned here. There is no ammo in my gun anyway, but I still like pointing and aiming the darn thing. Other guys on lupron still have sex, and still enjoy it, just not as often, and they experience much less desire for sex than before. I just have an opportunity to have it done at no cost to me, IF, I do it this year.

K
Age 57 at Dx
5/09 PSA 2.26
6/2010 PSA 3.07 FPSA 18% DRE +
6/2010 Bipsy, 7 of 12+, >60%, 4+5=9
7/21/2010 - RRP
Nodes neg,Ves neg
tumor contained, still 4+5=9
pni ext.
9/3, 2010 PSA - 0.04
9/3/2010, I'm 99% continent
10/14/10, PSA still 0.04, and lupron #1, now 99.9% continent
Total ED, 3 caverject failed, pump sux
10/20/10 OD'd on trimix, after 3hrs, neo synephrine shot

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4108
   Posted 10/27/2010 9:37 PM (GMT -6)   
Kbota it was my pleasure to have you over for that light dinner. What a joy it was for us to have you here.

You already know what I think....Go Bionic!

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4833
   Posted 10/28/2010 7:02 AM (GMT -6)   
I too am a cheap guy with better then nothing but horrible insurance. To me great news was when my deductable went from $5,000.00 to $2,500.00 ...Then up to $3,000.00 last month.
 
Guessing you have a spouse. What does she think? Does she remind you that there are many ways to skin a cat so to speak?
 
I think I'm with Ed C.:  "That is like having a gun without ammunition" and would wait.

Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 10/28/2010 8:29 AM (GMT -6)   
Since I have had wonderful success with my implant, I am most definitely bias pro implant. But I know nothing about your continuing problem.  So I'd say, if sex with your wife is possible with all of that going on, and since one with an implant pumps it up, it stays up until you're thrugh with it... I would say in order to give your wife some special attention & pleasure... go for it.  If you are not married, well that's another story in my opinion.  You know all of the "but's", so I'm sure you will do what's best.
Gene214

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7211
   Posted 10/28/2010 3:10 PM (GMT -6)   
KB:
 
If I understand what you are saying, it is unlikely that you will be uh...utilizing...the implant for 2 years. Right?
 
If so, then I would just wait. Period. A lot can happen in 2 years
 
Mel

kbota
Regular Member


Date Joined Aug 2010
Total Posts : 486
   Posted 10/28/2010 3:54 PM (GMT -6)   
Mel; I guess that's the question. I have no idea how much, how often, or even if at all I will be utilizing my new tool for the next two years. So that's an unknown.

I KNOW two things;

1. Ultimately I will need an implant no matter what, and

2. I can get it done in 2010 at no cost.

The only caveat with #1 would be if the PCa came roaring back during that two years. My uro thinks that's highly unlikely, and he also thinks that right now, I'm in the best overall health situation to recover from the implant surgery.

In two years, I'll be two years older. Duh - (I'll bet none of you thought of that huh?) And also, in two years, I plan to be 100% retired, which will mean a fixed income.

Does that change anyones opinion?

k
Age 57 at Dx
5/09 PSA 2.26
6/2010 PSA 3.07 FPSA 18% DRE +
6/2010 Bipsy, 7 of 12+, >60%, 4+5=9
7/21/2010 - RRP
Nodes neg,Ves neg
tumor contained, still 4+5=9
pni ext.
9/3, 2010 PSA - 0.04
9/3/2010, I'm 99% continent
10/14/10, PSA still 0.04, and lupron #1, now 99.9% continent
Total ED, 3 caverject failed, pump sux
10/20/10 OD'd on trimix, after 3hrs, neo synephrine shot

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 10/28/2010 4:39 PM (GMT -6)   
kbota,

aren't you kind of answering your own question? sounds like your mind is made up 100%, and that is cool, but why solicit opinions?
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 654
   Posted 10/28/2010 5:25 PM (GMT -6)   
I just yesterday met with  Dr. Larry Lipshultz ,Houston, and made the decision to go ahead with the IPP. For me the question was more than just having an errection. Some people can and have successfully introduced the VED into their relationship with their wife but after about 10 years using one, it has not worked well to maintain the overall experience of intimacy with my wife. Too much focus on the equpment and errection, if, and how long it will last. My wife and I never liked the VED. I think the IPP might bring my relationship back to as normal it can be. This is big decision and for me it was relatively sudden, like you, but for different reasons. I wanted to combine the IPP with the AUS that I just found out that I will need. Anyway, one of the things that might be a factor is weather to have the IPP before SRT. I would guess that might be preferable? Maybe  SRT  might cause some damage and complicate the later implantation? Added to that, you might be able continue your relationship in the comming two years whereas without  it would there be any chance of that and as you say you will need it anyway unless you try and are sucessful with injections and how long will that work.
It is a big leap, but think about it a few days ( that's how long it took me) and the issues may become clearer.
Whatever you decide, I hope you can get some peace and steady nerves for the next few years.
Ron.
06-08 1st biopsy neg psa 4
10-09 psa 5.5 2nd biopsy 1/12 pos. 10%, G(4+3) age 65
12-15-09 RRP Tulane NOLA Dr Lee
Path, 1%, clr marg, no EPE, no SVI, nodes cl, G(4+3)
100% incontinent after 3 mo. PT
ED, pre-op severe, post op total , considering IPP
10/10 Dr Boone, Baylor recomended AUS
post op psa's 0.04,<0.1,<0.1

kbota
Regular Member


Date Joined Aug 2010
Total Posts : 486
   Posted 10/28/2010 6:33 PM (GMT -6)   
Purgatory said...
kbota,

aren't you kind of answering your own question? sounds like your mind is made up 100%, and that is cool, but why solicit opinions?


I suppose that's a fair question.

Although I may sound like it, I'm not committed 100%. I'm sort of on the fence, and yet, I can think of good reasons TO, and good reasons NOT to do it now. I'm just soliciting opinions from those of you more experienced than I. The wisdom on this forum is staggering, and I find it very valuable.

I just like to get as many facts on the table as possible prior to committing. You guys help me to accomplish that.

For example, Ron just brought up the SRT issue. I'm a G9, and yet, I had not thought of the real possibility of radiation somewhere in my future. "IF" I had to do SRT before the IPP, then what complications does that bring to the IPP surgery?

That's the input I'm looking for, and that's why I'm asking.

k
Age 57 at Dx
5/09 PSA 2.26
6/2010 PSA 3.07 FPSA 18% DRE +
6/2010 Bipsy, 7 of 12+, >60%, 4+5=9
7/21/2010 - RRP
Nodes neg,Ves neg
tumor contained, still 4+5=9
pni ext.
9/3, 2010 PSA - 0.04
9/3/2010, I'm 99% continent
10/14/10, PSA still 0.04, and lupron #1, now 99.9% continent
Total ED, 3 caverject failed, pump sux
10/20/10 OD'd on trimix, after 3hrs, neo synephrine shot

lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 681
   Posted 10/28/2010 9:33 PM (GMT -6)   
Sometimes we make stupid decisions for the wrong reason ...I know I have done that in the past. smhair
 
So let me get this right 1) You have post surgery erectile problems 2) You are beginning a two year lupron therapy 3) Lupron therapy has a history of decreasing sexual urge  4) You are considering a penile implant so you can have intercourse that you probably will not have because of the lupron. 5) You are doing this to save a relatively small amount of money.6) Implant surgery is painful and messy, though the results are often good.  Hey you are just messing with us...right?
 
 It's like 'I am having headaches and my neuro surgeon has a special on brain surgery, but only for the next 90 days.  He says if I will sign up for a lobotomy by January he will give me a 35% discount.  So I can save $32000 dollars but he needs to drill a hole in my head which I may or may not need.
 
Duh ... Patience is not what a doctor treats.  So show a little patience and do one thing at a time.  Get your follow up treatment and then see what you need to do to regain your sexual health. yeah
 

kbota
Regular Member


Date Joined Aug 2010
Total Posts : 486
   Posted 10/28/2010 9:51 PM (GMT -6)   
lifeguyd said...
Sometimes we make stupid decisions for the wrong reason ...I know I have done that in the past. [img]/community/emoticons/smhair.gif[/img]



So let me get this right
1) You have post surgery erectile problems yup
2) You are beginning a two year lupron therapy yup
3) Lupron therapy has a history of decreasing sexual urge yup
4) You are considering a penile implant so you can have intercourse that you probably will not have because of the lupron....key word "probably"
5) You are doing this to save a relatively small amount of money uhm, yup
6) Implant surgery is painful and messy, though the results are often good. I dunno, never did it before
Hey you are just messing with us...right? nope



It's like 'I am having headaches and my neuro surgeon has a special on brain surgery, but only for the next 90 days. He says if I will sign up for a lobotomy by January he will give me a 35% discount. So I can save $32000 dollars but he needs to drill a hole in my head which I may or may not need.

You really think this is a meaningful comparison? Your analogy is meaningless, because it's so "off the chart" stupid.



Duh ... Patience is not what a doctor treats. So show a little patience and do one thing at a time. Get your follow up treatment and then see what you need to do to regain your sexual health. [img]/community/emoticons/yeah.gif[/img]




But, thanks for your opinion. And, have a nice weekend.

k
Age 57 at Dx
5/09 PSA 2.26
6/2010 PSA 3.07 FPSA 18% DRE +
6/2010 Bipsy, 7 of 12+, >60%, 4+5=9
7/21/2010 - RRP
Nodes neg,Ves neg
tumor contained, still 4+5=9
pni ext.
9/3, 2010 PSA - 0.04
9/3/2010, I'm 99% continent
10/14/10, PSA still 0.04, and lupron #1, now 99.9% continent
Total ED, 3 caverject failed, pump sux
10/20/10 OD'd on trimix, after 3hrs, neo synephrine shot

Post Edited (kbota) : 10/28/2010 8:57:54 PM (GMT-6)


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 681
   Posted 10/28/2010 9:59 PM (GMT -6)   
Sorry I thought I was writing in the same 'joking style' that your posts seem to contain.  At the same time, I was suggesting that saving some money was not a good reason to rush important decisions.
PSA July 2006 4.7 , Nodule found
biopsy 10/06 very agressive gleason4+4=8 identified
DaVinci surgery, January 2007
Post Ob confirms, gleason 4+4=8 with no extension or invasion
no long term continence problems
post surgery PSA continues to be undetectable at 3 years
ED continues, using bimix
born 1941

Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 10/29/2010 4:42 PM (GMT -6)   
Let me add my voice to the "don't do it" chorus:

  • A prosthesis is never as good as the real thing.
  • There is no going back.
  • There is a risk -- this is serious surgery.
  • You will be seriously inconvenienced for two weeks with lesser inconvenience for two months. Compare with the minor inconvenience of a jab or pump, once a month, week, or day -- insert your timeframe here :-)
  • The implant will not last for ever, and you may be faced with doing the same thing over again in ten years.

As you are starting to get good results with Trimix, and as you are embarking on Lupron, I think is is way too soon to have an implant. I see an implant as a last-resort option when there is otherwise no prospect of usable erections. Your Trimix experience indicates that apart from nerves, your equipment is still in good working order, and I expect with more practice you will see further improvement. So don't wreck it now!

<Chorus> Don't do it Kbota, don't do it! <chorus>
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