Some interesting differences in treatment in Germany and the US

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AndrewJ
Regular Member


Date Joined Jul 2007
Total Posts : 25
   Posted 8/5/2007 2:05 PM (GMT -7)   
As you can see in my profile, I’m an Australian living in Germany, now 6 weeks post-op and doing very well. I only found this site after my surgery, but it has been very interesting and helpful. I thought long and hard about whether to set out my success in my profile as I know a lot of guys are suffering out there and I want to be sensitive to that, but I genuinely hope that my story gives hope, especially to younger guys terrified of the surgery and what it will do to their “quality of life”.

I’m still planning to write my experience in detail, but there is one issue I want to address in this topic: the apparent differences between treatment here in Germany and in the US. Of course, I only have anecdotal information to go on (the few dozen stories I’ve heard here in Germany and the cases I’ve read here), so this isn’t a scientific comparison, but there do seem to be a couple of significant differences in the treatment regime.

I was in hospital for 9 days – 1 night before the surgery, the day of the surgery and 7 days post-op. They generally keep you in hospital here as long as the catheter is in, give you the colored-dye test on day 7 and remove the catheter and release you the next day. The hospital system here is very well funded and there is no pressure to get out quickly. I hear stories on this site about leaving hospital after a couple of days and I really couldn’t imagine it given my energy levels and need for nursing attention in the first week, but I guess you adapt to the reality of the system you are in and there are pros and cons both ways. Being in hospital for so long was a pain, but I could really rest and concentrate on getting well. Having catheter removal as the pre-requisite for leaving hospital here means that there is some pressure from patient and hospital for this to happen as soon as possible (usually Day 7 or 8). I read some stories on this site about people having the catheter for up to 2 weeks or longer, which seems a very different approach not to say a nightmare. I can’t help wondering as a lay person whether getting the tube out a bit earlier helps things like continency and potency on the basis that the systems spend less time in an unusual state and might kick back in faster … Just my 2c worth.

The other major difference I see is the “preventative” treatment for ED. Maybe I am missing something from the posts, but it seems to me that a lot of members on the board start work on the ED issues some months down the track, perhaps once continency issues are improving. I read some cases where the patient had to ask their urologist for Viagra/Levitra/Cialis some months after surgery. Here, the so-called “Kiel Method” (small doses of the drugs each day in the 3 months immediately following surgery or until natural erections kick in) is well-known by urologists and widely practiced. As they said to me, this is keeping the tracks in order even though the trains aren’t running at the moment! I got my first Levitra with my pre-op meds and then it arrived every day with my evening meal in hospital and taking it was the highlight of my day! (I woke on the first night after removal of the catheter with the painful beginnings of an erection and had to get out of bed to make it go away, but I was the happiest man on earth. And satisfying sex was possible less than 3 weeks post-op. I'm relatively young and both nerves were spared, so maybe I would have had the same result without the early meds-intervention, but hey it can't have hurt.)

I realize that my basis for comparison of the 2 approaches is very narrow and maybe I have got my facts wrong about what is normal over there across the Atlantic. Sorry for the long post and please understand that I am not saying one approach is better or worse, just that there are interesting differences which some members here might like to debate.
45 years old, Australian living in Germany
PSA: started around 3.5 in 2005, 6.1 at time of surgery
Biopsy: nothing found in 2006, 3 May 2007 3 of 24 cores positive, Gleason 3+3 or 3+4 depending on pathologist
RPE in Munich, Germany on 22 June 2007
Post surgery pathology: organ confined but less than 1mm from margins, Gleason 3+3, pT2c, Lymph nodes removed and clear
First post-surgery PSA 31 July 2007: 0.01 Yippee!
Fully continent immediately after removal of catheter on Day 8. Double yippee!!
No potency issues & looking at discontinuing daily small doses of Levitra. Triple yippee!
This man knows he has been VERY lucky.


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 8/5/2007 3:26 PM (GMT -7)   

Hi ~  AndrewJ & Loved Ones,

 

                Welcome to…

                                      HealingWell

                                                                                 and

 

                  A   Special   Warm Welcome  to  You!

 

KNOWLEDGE    IS    POWER  ...  and  POWER conquers  fear

 

 

We are so thankful you shared your journey…. Long post!!!???  Could it have been shorter??…. No way… Not if we were to get the full picture….  Welcome!!!! 

 

Partial quote….from AndrewJ from above:

                       I’m still planning to write my experience in detail

 

Good for you….We truly look forward to having you share it here.  You will learn that this forum is very powerful… Why ~ because we share everything…. Good/Bad and/or Ugly….  Life is not always good but we learn from each other how to make it better by sharing our experiences…..What a powerful gift! 

 

So ~ take your time getting your thoughts together….. and we look forward to having your very own “Personal Journey”…added to our forum.

 

Partial quote….from AndrewJ from above:

                       First post-surgery PSA 31 July 2007: 0.01 Yippee!

 

  tongue      1st    PSA…   !!!~~~>>>  Woo~Hoo  <<<~~~!!! Undetectable

 

Cause  for   celebration!!!!!  Definitely!!!     

What a wonderful day it is ~ each and every-day….   

Enjoy it to the fullest. 

Yippeeeee!!!!!! From  Lee & Buddy

*     *     *     *     *     *

The ultimate “goal”… we all strive for… Thank you for sharing ~ that your goal has been met….

It is very important to “all ”of us!  This is a way of positive feedback…

A way of showing others Hope… and a way of Sharing.  

J  Caring is Sharing ~  Thank You for Sharing  J

 

Our thoughts and prayers are with you as you continue to move forward…

In Friendship ~ Lee & Buddy


mama bluebird - Lee & Buddy… from North Carolina

J  We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)

 


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 664
   Posted 8/9/2007 5:38 PM (GMT -7)   

Hi Andrew

I just noticed your post, it seems to have slipped down a bit.  You bring several very interesting ideas that I think deserve comment. In the good old USA we have been told for the past several decades or so, that it is good to get out of the hospital quickly and on our own so we can really recover. I think we all know that that thinking has been promoted by the greedy American insurance companies and their Republican law maker stooges. It also might be right.

I must admit, that I screamed and clawed to get out of the hospital at the earliest possible time.  However, I think there is something about being "taken care of" that might be better for all of us. It would be interesting to explore the difference between being booted out in 24 hours to being taken care of for a week.

The fact that you are apparently suffering few of the continence and sexual side effects of prostate surgery should at least suggest that we examine the difference.

Thanks for your post


 
Biopsy 10/16/06
T2A,  PSA 4.7
Gleason 4+4=8 right side
adrenocarcinoma of prostate
DaVinci Surgery 01/16/07
Post op report,confirms Gleason4+4=8
no extra extension/invasion identified
age 65
Back on the golf course...
90 day PSA  less than 0.01 (undetectable)
Six Month PSA still undetectable
Beginning injection therapy for ed (08/07/07)
 

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