Need info for a friend

Could someone please give me an objective listing of the pro's and
con's of traditional, open prostatectomy (sp?) as compared to
laparoscopic surgery? This is for someone we know; the doctor has told
him that laparoscopic is better because they can use a camera to look
around inside, whereas in open surgery, it is all done blindly by feel.

The issue also is that the laparascopic would have to be done far away,
whereas the open could be done close to home.

I presume you still have the misery of the catheter in both cases, and
I know my hubby said that was the worst part anyway.

Also - if the biopsy showed a Gleason 6, and cancer in only 5% of one
sample, why would the PSA be 10?

Thanks for any help I can pass on.

Linda
Pennsylvania

<Love2camp5@cs.com> wrote in message
news:1162912813.059064.210840@k70g2000cwa.googlegr oups.com...
> Could someone please give me an objective listing of the pro's and
> con's of traditional, open prostatectomy (sp?) as compared to
> laparoscopic surgery? This is for someone we know; the doctor has told
> him that laparoscopic is better because they can use a camera to look
> around inside, whereas in open surgery, it is all done blindly by feel.

WHAT?

Not according to our surgeon, he took a careful look at everything :-)

Mary
>

As for the PSA of 10 and only one positive sample, there are lots of
reasons. One being there is more cancer in the prostate than the
biopsy was able to sample. It's kind of like poking raisin bread with
straws looking for the raisins. You can miss a whole lot of raisins,
in fact you sometimes miss them all and get a negative biopsy when
there is indeed cancer there.

As for the differences between lap and regular, it's true you see
better with lap, you feel things better with open. You recover quicker
with lap than with open. Each one has its proponents and if you do a
search on this newsgroup you'll find all the arguments pro and con for
each. I believe it's a tossup as to outcome which is what's most
important. The skill of the surgeon is far and away the most important
consideration your friend has to make. Good luck to him.
Dave Perry
Love2camp5@cs.com wrote:
> Could someone please give me an objective listing of the pro's and
> con's of traditional, open prostatectomy (sp?) as compared to
> laparoscopic surgery? This is for someone we know; the doctor has told
> him that laparoscopic is better because they can use a camera to look
> around inside, whereas in open surgery, it is all done blindly by feel.
>
> The issue also is that the laparascopic would have to be done far away,
> whereas the open could be done close to home.
>
> I presume you still have the misery of the catheter in both cases, and
> I know my hubby said that was the worst part anyway.
>
> Also - if the biopsy showed a Gleason 6, and cancer in only 5% of one
> sample, why would the PSA be 10?
>
> Thanks for any help I can pass on.
>
> Linda
> Pennsylvania

Love2camp5@cs.com wrote...snip...
> Could someone please give me an objective listing of the pro's and
> con's of traditional, open prostatectomy (sp?) as compared to
> laparoscopic surgery?

I think that if you are in good physical shape and the LRP and "open"
docs are good ones, then the differences betwen the two are minimal.
In both cases you can be out of the hospital in 2 days and back at work
in 2 weeks. If you're not in such good shap, then I think the LRP is
easier to tolerate (smaller incisions, but still the length of all LRP
incisions is pretty close to the length of the "open" incision). With
a good doc, blood loss is about the same (minimal) with the two
procedures, so vision is comparable as well (the "open" docs use
magnifcation too). The ability to "feel" the tissue, which some docs
say is important in some situations, is lost in the LRP. Usually the
catheter comes out sooner with the LRP. There are no studies showing
that the recurrence rates from an LRP are better, equal or worse than
those from the "open" surgery. LRP seems to have a greater incidence
of postive margins in the apical area of the prostate, so if a tumor
near the apical region is suspected and LRP is selected, be sure to
discuss this with the surgeon beforehand.

> Also - if the biopsy showed a Gleason 6, and cancer in only 5% of one
> sample, why would the PSA be 10?

One possibility would be that the tumor is very near the surface of the
prostate and PSA leakage into the system is therefor increased.
Another possibility would be that the Gleason has been misread or
biopsy missed other large areas of tumor. Remember PCa is often
multifocal. Yet another possibility is that there was an infection at
the same time the PSA was drawn and numerous cells were dying,
releasing their PSA into the system...Best wishes and good health, ron

"Mary Fisher" <mary.fisher@zetnet.co.uk> wrote in message
news:4550a68a$0$29543$4c56ba96@master.news.zetnet. net...


> WHAT?
>
> Not according to our surgeon, he took a careful look at everything :-)
>
> Mary


So, once again, "our surgeon" knows best . . (^_^)
Just maybe others know better?

And Mary, there is no need to SHOUT.
It is an internet convention that block caps = shouting.
I wonder why you feel the need to shout? Are you a screech?

M

HH wrote:
>
> And Mary, there is no need to SHOUT.
> It is an internet convention that block caps = shouting.
> I wonder why you feel the need to shout? Are you a screech?

Well, it IS hard to hear her from clear across The Pond.

I.P.

"HH" <hunniberp@hotmailNOSPAMDELETE.com> wrote in message
news:SbOdncaS9cfJI83YnZ2dnUVZ8tOdnZ2d@bt.com...
>
> "Mary Fisher" <mary.fisher@zetnet.co.uk> wrote in message
> news:4550a68a$0$29543$4c56ba96@master.news.zetnet. net...
>
>
>> WHAT?
>>
>> Not according to our surgeon, he took a careful look at everything :-)
>>
>> Mary
>
>
> So, once again, "our surgeon" knows best . . (^_^)

Are you saying that your surgeon knows best?

> Just maybe others know better?

Perhaps :-)
>
> And Mary, there is no need to SHOUT.
> It is an internet convention that block caps = shouting.
> I wonder why you feel the need to shout? Are you a screech?

If you say so.

There are few ways to emphasise in Usenet.

In Britain we use capitals for some words - as you did. It's not a problem
for me, os it a problem for you?

"I.P. Freely" <fuhgheddaboutit@noway.nohow> wrote in message
news:8e34h.16$Fy.7@newsfe04.lga...

>
> Well, it IS hard to hear her from clear across The Pond.

That's because I'm speaking English :-)

I know it's difficult for some people in USA to understand it!

"ron" <oitbso@yahoo.com> wrote in message
news:1162914836.049382.31540@k70g2000cwa.googlegro ups.com...
> Love2camp5@cs.com wrote...snip...
>> Could someone please give me an objective listing of the pro's and
>> con's of traditional, open prostatectomy (sp?) as compared to
>> laparoscopic surgery?
>
> I think that if you are in good physical shape and the LRP and "open"
> docs are good ones, then the differences betwen the two are minimal.
> In both cases you can be out of the hospital in 2 days and back at work
> in 2 weeks. If you're not in such good shap, then I think the LRP is
> easier to tolerate (smaller incisions, but still the length of all LRP
> incisions is pretty close to the length of the "open" incision). With
> a good doc, blood loss is about the same (minimal) with the two
> procedures, so vision is comparable as well (the "open" docs use
> magnifcation too). The ability to "feel" the tissue, which some docs
> say is important in some situations, is lost in the LRP. Usually the
> catheter comes out sooner with the LRP. There are no studies showing
> that the recurrence rates from an LRP are better, equal or worse than
> those from the "open" surgery. LRP seems to have a greater incidence
> of postive margins in the apical area of the prostate, so if a tumor
> near the apical region is suspected and LRP is selected, be sure to
> discuss this with the surgeon beforehand.
>
>> Also - if the biopsy showed a Gleason 6, and cancer in only 5% of one
>> sample, why would the PSA be 10?
>
> One possibility would be that the tumor is very near the surface of the
> prostate and PSA leakage into the system is therefor increased.
> Another possibility would be that the Gleason has been misread or
> biopsy missed other large areas of tumor. Remember PCa is often
> multifocal. Yet another possibility is that there was an infection at
> the same time the PSA was drawn and numerous cells were dying,
> releasing their PSA into the system...Best wishes and good health, ron

That's a very reasonable response - showing that there are no 10%
positives - or negatives.

There are many approaches and many results, some are good, some are less
good.

In Britain fewer LRPs are done because there are only a few surgeons who
have the necessary experience at this time. It will change. The end results
are similar. I suspect it's less expensive to do LRPs than open surgery.

Mary
>

Linda,

In addition to evaluating the relative benefits of one type of surgery
over the other, I think it is especially important to evaluate the
surgeon him or herself.

Experience is very, very important. Some urologists do
hundreds of prostatectomies a year. They've seen and dealt
with almost every variation in physical and tumor anatomy.
They have a kind of knowledge in their eyes and hands and
brains that goes way beyond what people can get from books.

Another issue is commitment. As a layman, I can't evaluate
a surgeon's skill, but I can tell whether he takes his time or
is short with me, whether he listens to questions and answers
them, whether he asks questions of me or just assumes he
knows everything, whether he discusses what the tests mean
or just blows them off as uninteresting - in short, whether he's
a careful, thoughtful, interested person or not.

Your friend may also wish to consult with a radiation
oncologist. If he does, all the same considerations about
experience and commitment still apply.

Good luck to him.

Alan

"Alan Meyer" <ameyer2@yahoo.com> wrote in message
[snip]
> Another issue is commitment. As a layman, I can't evaluate
> a surgeon's skill, but I can tell whether he takes his time or
> is short with me, whether he listens to questions and answers
> them, whether he asks questions of me or just assumes he
> knows everything, whether he discusses what the tests mean
> or just blows them off as uninteresting - in short, whether he's
> a careful, thoughtful, interested person or not.

These are important characteristics in a clinician, but not necessarily the
key criteria for a surgeon. Essentially I'd want a great mechanic,
regardless of his or her "people skills." If you have friends who are
doctors or nurses, or surgeons who don't do PCa work, ask them who they
think is good with a scalpel. You may find that great hands are not always
accompanied by a great personality.

Alex

Mary Fisher wrote:
> "HH" wrote
>> And Mary, there is no need to SHOUT.
>> It is an internet convention that block caps = shouting.
>> I wonder why you feel the need to shout? Are you a screech?
>

> There are few ways to emphasise in Usenet.

Exactly. We can stay safe with "text only" and use caps for emphasis, or
we can allow HTML to use Italics and expose ourselves to yet another
malware path. "Internet convention" doesn't take reality into account.

I.P.

Mary Fisher wrote:
> "I.P. Freely" wrote
>
>> Well, it IS hard to hear her from clear across The Pond.
>
> That's because I'm speaking English :-)
>
> I know it's difficult for some people in USA to understand it!

I have a HELL of a time understanding the speech in your movies, and it
keeps me from watching some of your TV shows.

I.P.

"I.P. Freely" <fuhgheddaboutit@noway.nohow> wrote in message
news:Gbb4h.218$fs7.119@newsfe05.lga...
> Mary Fisher wrote:
>> "I.P. Freely" wrote
>>
>>> Well, it IS hard to hear her from clear across The Pond.
>>
>> That's because I'm speaking English :-)
>>
>> I know it's difficult for some people in USA to understand it!
>
> I have a HELL of a time understanding the speech in your movies, and it
> keeps me from watching some of your TV shows.

I don't watch ANY of yours.

Nor ours - we don't have a tv :-)

Mary

"I.P. Freely" <fuhgheddaboutit@noway.nohow> wrote in message
news8b4h.217$fs7.87@newsfe05.lga...
> Mary Fisher wrote:
>> "HH" wrote
>>> And Mary, there is no need to SHOUT.
>>> It is an internet convention that block caps = shouting.
>>> I wonder why you feel the need to shout? Are you a screech?
>>
>
>> There are few ways to emphasise in Usenet.
>
> Exactly. We can stay safe with "text only" and use caps for emphasis,

As I prefer,

> or we can allow HTML to use Italics and expose ourselves to yet another
> malware path. "Internet convention" doesn't take reality into account.

No. I'm not a lover of fancy stuff in mails and posts. But whatever one does
one will irritate some people :-)

Mary

Mary Fisher wrote:
> whatever one does
> one will irritate some people :-)

Another nail on the head. So ya just makes a review pass -- maybe two
reviews if it's a really contentious topic -- through a newly written
post to check for OBVIOUS faux paux, hits SEND, and lets the masses sort
it out. Trying to guess all the ways people might read something -- let
alone avoiding offending everyone -- is a losing, agonizing, literally
impossible task. If we all thought alike, we wouldn't need elections,
have wars, or see bad movies.

I.P.

"I.P. Freely" <fuhgheddaboutit@noway.nohow> wrote in message
news:6ro4h.220$wl2.93@newsfe05.lga...
> Mary Fisher wrote:
>> whatever one does one will irritate some people :-)
>
> Another nail on the head. So ya just makes a review pass -- maybe two
> reviews if it's a really contentious topic -- through a newly written post
> to check for OBVIOUS faux paux, hits SEND, and lets the masses sort it
> out.

I wish I understood that :-)

> Trying to guess all the ways people might read something -- let alone
> avoiding offending everyone -- is a losing, agonizing, literally
> impossible task.

Oh I understand that :-)

> If we all thought alike, we wouldn't need elections, have wars, or see bad
> movies.

I don't see any movies ... but wouldn't it be nice not to need elections or
have wars?

Mary

Mary Fisher wrote:
> "I.P. Freely" wrote
>> Mary Fisher wrote:
>>> whatever one does one will irritate some people :-)
>> Another nail on the head. So ya just makes a review pass -- maybe two
>> reviews if it's a really contentious topic -- through a newly written post
>> to check for OBVIOUS faux paux, hits SEND, and lets the masses sort it
>> out.
>
> I wish I understood that :-)

IOW, one writes a post the way s/he feels it needs to be written, takes
a quick look at the finished product to spot any obvious unintended
faults -- and maybe one extra review if it's a sore topic -- and SENDS
it. There will always be complaints or counter-points because we all
think differently, so why waste time trying to avoid them? Political
correctness is a) impossible to define to everyone's satisfaction and b)
one of the most dangerous threats the world faces.

I.P.

Love2camp5@cs.com wrote:
> Could someone please give me an objective listing of the pro's and
> con's of traditional, open prostatectomy (sp?) as compared to
> laparoscopic surgery?
>
> I presume you still have the misery of the catheter in both cases, and
> I know my hubby said that was the worst part anyway.
>
> > Thanks for any help I can pass on.
>
> Linda
> Pennsylvania


Hello all--

In this situation the gold standard of medicine is a doctor who follows
up with you and works with you on the residual effects of the surgery.
Most surgeons (incl. our world-famous one) dropped out of the scene
after a couple of weeks and sent my husb. to an ED specialist. And it
took 10 mos. for him to get the proper treatment.

The critical thing you can do for your husband is get the correct info
and work with the doctor to help restore Ererctile Function.. I looked
at a website called oboticoncology.com. and Dr. Samadi whose site this
is an ideal choice for a doctor (besides having done a lot of them).
This doctor is Special because as soon as he finishes cutting you he
hands you to a colleague whose expertise is restoring EF after surgery.
This treatment is a process -- it's not just a couple of hours.
That's the easy part.

Folks, our world-famous surgion sent patient home with a script for
Viagra to "maintain blood flow to the area." Well, there is not an
iota of evidence to show that these drugs work for that particular
purpose. I spent a lot of time researching this and also I heard it
from my husband's ed doctor who is probably the foremost authority on
this subject in the world!

(Google Arnold Melman). I can't list all his credentials but he is
editor of the In't Journal of Impotency, prof. and chairman of uro
dept. at major teaching hospital and has just written a book on Viagra
and how it functions. (I can't go into everything he's written -- it
would be too long). (BTW he recently devel. a promising new gene
therapy for ED which I will write about elsewhere).

In his words taking Viagra does not work in this particular situation
and you migth as well donate money to the drug companies. Now, I felt
bad when he said that but I have seen with my own eyes what a powerful
psych. effect these drugs have. That's why people report improvement.

I was going to write a separate post on restoring EFafter surg. but I
hope there are a lot f men listening who are going to have or have
recently had RP. There is only one treatment proven to be effective in
restoring EF after surgery and that is penile INJECTIONS. And the
earlier you start the better. Besides this type of exercise is more fun
than the Stairmaster.

I can't tell you how upset I am that it took six months for my husband
to realize things weren't working out the natural way and spent a
another few months with the wrong ED doctors (2) until he got his
injection kit. This lapse was a complete waste of precious time and
it's criminal that not only do doctors not mention this therapy but
they give you a completely useless remedy.

Unfortunately, your doctor won't explain this to you bec. it's easier
to prescribe a pill.

If you want any citations for above email me but you can read all this
on Dr. Samadi's website.

If your doctor refuses to cooperate find another one right away -
probably an ED specialist. And they are not all equal -- i spent
months trying to find the right guy.

Believe me, you will thank me for directing you to immed. "penile
rehab" bec. it has been shown to improve EF and also has the benefit of
preventing shrinkage of the genitals.

God, I really hope this gets through to the right guys. (I may repost
under diff. heading).

All the best,


Leah

callalily wrote:
> Love2camp5@cs.com wrote:
> > Could someone please give me an objective listing of the pro's and
> > con's of traditional, open prostatectomy (sp?) as compared to
> > laparoscopic surgery?
> >
> > I presume you still have the misery of the catheter in both cases, and
> > I know my hubby said that was the worst part anyway.
> >
> > > Thanks for any help I can pass on.
> >
> > Linda
> > Pennsylvania
>
>
> Hello all--
>
> In this situation the gold standard of medicine is a doctor who follows
> up with you and works with you on the residual effects of the surgery.
> Most surgeons (incl. our world-famous one) dropped out of the scene
> after a couple of weeks and sent my husb. to an ED specialist. And it
> took 10 mos. for him to get the proper treatment.
>
> The critical thing you can do for your husband is get the correct info
> and work with the doctor to help restore Ererctile Function.. I looked
> at a website called oboticoncology.com. and Dr. Samadi whose site this
> is an ideal choice for a doctor (besides having done a lot of them).
> This doctor is Special because as soon as he finishes cutting you he
> hands you to a colleague whose expertise is restoring EF after surgery.
> This treatment is a process -- it's not just a couple of hours.
> That's the easy part.
>
> Folks, our world-famous surgion sent patient home with a script for
> Viagra to "maintain blood flow to the area." Well, there is not an
> iota of evidence to show that these drugs work for that particular
> purpose. I spent a lot of time researching this and also I heard it
> from my husband's ed doctor who is probably the foremost authority on
> this subject in the world!
>
> (Google Arnold Melman). I can't list all his credentials but he is
> editor of the In't Journal of Impotency, prof. and chairman of uro
> dept. at major teaching hospital and has just written a book on Viagra
> and how it functions. (I can't go into everything he's written -- it
> would be too long). (BTW he recently devel. a promising new gene
> therapy for ED which I will write about elsewhere).
>
> In his words taking Viagra does not work in this particular situation
> and you migth as well donate money to the drug companies. Now, I felt
> bad when he said that but I have seen with my own eyes what a powerful
> psych. effect these drugs have. That's why people report improvement.
>
> I was going to write a separate post on restoring EFafter surg. but I
> hope there are a lot f men listening who are going to have or have
> recently had RP. There is only one treatment proven to be effective in
> restoring EF after surgery and that is penile INJECTIONS. And the
> earlier you start the better. Besides this type of exercise is more fun
> than the Stairmaster.
>
> I can't tell you how upset I am that it took six months for my husband
> to realize things weren't working out the natural way and spent a
> another few months with the wrong ED doctors (2) until he got his
> injection kit. This lapse was a complete waste of precious time and
> it's criminal that not only do doctors not mention this therapy but
> they give you a completely useless remedy.
>
> Unfortunately, your doctor won't explain this to you bec. it's easier
> to prescribe a pill.
>
> If you want any citations for above email me but you can read all this
> on Dr. Samadi's website.
>
> If your doctor refuses to cooperate find another one right away -
> probably an ED specialist. And they are not all equal -- i spent
> months trying to find the right guy.
>
> Believe me, you will thank me for directing you to immed. "penile
> rehab" bec. it has been shown to improve EF and also has the benefit of
> preventing shrinkage of the genitals.
>
> God, I really hope this gets through to the right guys. (I may repost
> under diff. heading).
>
> All the best,
>
>
> Leah


Correct website is roboticoncology.com It will also answer you other
questios.

lfc

"I.P. Freely" <fuhgheddaboutit@noway.nohow> wrote in message
news:3aq4h.227$wl2.37@newsfe05.lga...
> Mary Fisher wrote:
>> "I.P. Freely" wrote
>>> Mary Fisher wrote:
>>>> whatever one does one will irritate some people :-)
>>> Another nail on the head. So ya just makes a review pass -- maybe two
>>> reviews if it's a really contentious topic -- through a newly written
>>> post to check for OBVIOUS faux paux, hits SEND, and lets the masses sort
>>> it out.
>>
>> I wish I understood that :-)
>
> IOW, one writes a post the way s/he feels it needs to be written, takes a
> quick look at the finished product to spot any obvious unintended
> faults -- and maybe one extra review if it's a sore topic -- and SENDS

Don't shout, IP, are you a screech?

<quote :-) >

> it. There will always be complaints or counter-points because we all think
> differently, so why waste time trying to avoid them? Political correctness
> is a) impossible to define to everyone's satisfaction and b) one of the
> most dangerous threats the world faces.

Hurrah!

Mary

"callalily" <lfcjjk@aol.com> wrote in message
news:1163014488.059066.187700@f16g2000cwb.googlegr oups.com...
>
> In this situation the gold standard of medicine is a doctor who follows
> up with you and works with you on the residual effects of the surgery.

I agree - but this is true for all surgery.
>
> The critical thing you can do for your husband is get the correct info
> and work with the doctor to help restore Ererctile Function.. I looked
> at a website called oboticoncology.com. and Dr. Samadi whose site this
> is an ideal choice for a doctor (besides having done a lot of them).
> This doctor is Special because as soon as he finishes cutting you he
> hands you to a colleague whose expertise is restoring EF after surgery.
> This treatment is a process -- it's not just a couple of hours.
> That's the easy part.
>
> Folks, our world-famous surgion sent patient home with a script for
> Viagra to "maintain blood flow to the area." Well, there is not an
> iota of evidence to show that these drugs work for that particular
> purpose.

Our surgeon dismissed Viagra, he said they had something much better. We see
him next week :-)
>
>
> I was going to write a separate post on restoring EFafter surg. but I
> hope there are a lot f men listening who are going to have or have
> recently had RP. There is only one treatment proven to be effective in
> restoring EF after surgery and that is penile INJECTIONS. And the
> earlier you start the better. Besides this type of exercise is more fun
> than the Stairmaster.

How do you know this is the only treatment? You trusted your surgeon at
first (as we do ours). This theory might well prove not to be right for all
people.

I really don't fancy injections and I don't think Spouse would, we haven't
talked about it because it hasn't been mentioned. Yet - it could be that he
has it up his sleeve for when he sees us :-) I hope not.

Mary

Mary Fisher wrote:

> I really don't fancy injections and I don't think Spouse would, we haven't
> talked about it because it hasn't been mentioned. Yet - it could be that he
> has it up his sleeve for when he sees us :-) I hope not.

Sounds like your objection to injections is based on fear, not fact.
Several couples here who have tried it have been amazed at its ease and
very happy with the results.

I.P.

"I.P. Freely" <fuhgheddaboutit@noway.nohow> wrote in message
news:71s4h.531$wl2.264@newsfe05.lga...
> Mary Fisher wrote:
>
>> I really don't fancy injections and I don't think Spouse would, we
>> haven't talked about it because it hasn't been mentioned. Yet - it could
>> be that he has it up his sleeve for when he sees us :-) I hope not.
>
> Sounds like your objection to injections is based on fear,

Why do you say that?

> not fact. Several couples here who have tried it have been amazed at its
> ease and very happy with the results.

I've no doubt, but that doesn't mean that it's right for everyone nor that
it's available for everyone :-)

Mary
>
> I.P.

Mary Fisher wrote:
> "I.P. Freely"wrote
>> Mary Fisher wrote:
>>
>>> I really don't fancy injections and I don't think Spouse would, we
>>> haven't talked about it because it hasn't been mentioned. Yet - it could
>>> be that he has it up his sleeve for when he sees us :-) I hope not.
>> Sounds like your objection to injections is based on fear,
>
> Why do you say that?

You say:
"we haven't talked about it"
"it hasn't been mentioned"
yet add
"I don't fancy injections"
"I don't think spouse would"
"I hope that's not up our doc's sleeve"

NOBODY fancies sticking a needle is his limp tallywhacker until a) he
tries it in desperation, b) doesn't feel it, c) goes BOINNNNNNNNG, and
d) makes his S.O. scream again.

I.P.

"Alex" <tuchasoffentisch@_NO_SPAM_gmail.com> wrote in message
news:uB84h.23695$TV3.4363@newssvr21.news.prodigy.c om...
>
> "Alan Meyer" <ameyer2@yahoo.com> wrote in message
> [snip]
>> Another issue is commitment. As a layman, I can't evaluate
>> a surgeon's skill, but I can tell whether he takes his time or
>> is short with me, whether he listens to questions and answers
>> them, whether he asks questions of me or just assumes he
>> knows everything, whether he discusses what the tests mean
>> or just blows them off as uninteresting - in short, whether he's
>> a careful, thoughtful, interested person or not.
>
> These are important characteristics in a clinician, but not necessarily the key criteria
> for a surgeon. Essentially I'd want a great mechanic, regardless of his or her "people
> skills." If you have friends who are doctors or nurses, or surgeons who don't do PCa
> work, ask them who they think is good with a scalpel. You may find that great hands are
> not always accompanied by a great personality.

I'm sure you're right Alex. There must be people out there
with no people skills who are nevertheless good surgeons.
However I still want a doctor who strikes me as truly committed
to the welfare of the patient.

When you work with someone for a while you get a feeling
about their commitment and their competence. It's easy to
be wrong and some of us are better at judging people than
others, but I am loathe to accept treatment from a doctor
I have a bad feeling about.

Alan

"I.P. Freely" <fuhgheddaboutit@noway.nohow> wrote in message
news:5ot4h.48$X97.6@newsfe02.lga...
> Mary Fisher wrote:
>> "I.P. Freely"wrote
>>> Mary Fisher wrote:
>>>
>>>> I really don't fancy injections and I don't think Spouse would, we
>>>> haven't talked about it because it hasn't been mentioned. Yet - it
>>>> could be that he has it up his sleeve for when he sees us :-) I hope
>>>> not.
>>> Sounds like your objection to injections is based on fear,
>>
>> Why do you say that?
>
> You say:
> "we haven't talked about it"
> "it hasn't been mentioned"
> yet add
> "I don't fancy injections"
> "I don't think spouse would"
> "I hope that's not up our doc's sleeve"

I didn't say that last :-)

But none of the words you repeat suggest fear.

You're reading something into my words which aren't there, perhaps you have
or had a suppressed fear ...

Mary

I.P. Freely wrote:

> NOBODY fancies sticking a needle is his limp tallywhacker until a) he
> tries it in desperation, b) doesn't feel it, c) goes BOINNNNNNNNG, and
> d) makes his S.O. scream again.

Scream? You're doing it too hard if that's the result.

A long series of low moans and sighing. Some gentle gasping building
to rhythmic grunting and panting accompanied by squishing and the
bedsprings creaking.

If you're very lucky, she might mutter something, "I'm coming, shoot,
shoot it in now" or "those girls will be so envious if they could see
me."

-kh

Mary Fisher wrote:
> "I.P. Freely" wrote
> Mary wrote
>> "I hope that's not up our doc's sleeve"
>
> I didn't say that last :-)

Cut & pasted from your post:
"I really don't fancy injections and I don't think Spouse would, we
haven't talked about it because it hasn't been mentioned. Yet - it could
be that he has it up his sleeve for when he sees us :-) I hope not."

> But none of the words you repeat suggest fear.

That's up to readers to decide. Whether fear is behind your disdain for
injections is you two's problem, not ours.

> You're reading something into my words which aren't there, perhaps you have
> or had a suppressed fear ...

Puleeeez . . .

I.P.

On 9 Nov 2006 02:40:34 -0800, tchtic@yahoo.com wrote:

>A long series of low moans and sighing. Some gentle gasping building
>to rhythmic grunting and panting accompanied by squishing and the
>bedsprings creaking.
>
>If you're very lucky, she might mutter something, "I'm coming, shoot,
>shoot it in now" or "those girls will be so envious if they could see
>me."


more typical for me would be "...darling, do remind me to straighten
that picture on the wall behind you.."

"I.P. Freely" <fuhgheddaboutit@noway.nohow> wrote in message
news:EuJ4h.34$h56.23@newsfe07.lga...
> Mary Fisher wrote:
>> "I.P. Freely" wrote
>> Mary wrote
>>> "I hope that's not up our doc's sleeve"
>>
>> I didn't say that last :-)
>
> Cut & pasted from your post:
> "I really don't fancy injections and I don't think Spouse would, we
> haven't talked about it because it hasn't been mentioned. Yet - it could
> be that he has it up his sleeve for when he sees us :-) I hope not."
>
>> But none of the words you repeat suggest fear.
>
> That's up to readers to decide. Whether fear is behind your disdain for
> injections is you two's problem, not ours.

Disdain?

You really ARE reading things into what I say :-)
>
>> You're reading something into my words which aren't there, perhaps you
>> have or had a suppressed fear ...
>
> Puleeeez . . .

Well, my saying that is the same as your saying what you did about me :-)


>
> I.P.

<Love2camp5@cs.com> wrote in message
news:1162912813.059064.210840@k70g2000cwa.googlegr oups.com...
> Could someone please give me an objective listing of the pro's and
> con's of traditional, open prostatectomy (sp?) as compared to
> laparoscopic surgery? This is for someone we know; the doctor has told
> him that laparoscopic is better because they can use a camera to look
> around inside, whereas in open surgery, it is all done blindly by feel.

First, how's Jim. I haven't heard (I think) in the last 12 months.

RRP is a bigger cut, but only one.
RRP is longer in the hospital, but lately it seems like only by a day.
RRP is longer recuperation, but only a couple of weeks.
RRP, according to surgeons, gives a doc a better feel for the cancer.
LRP gives a better visual of the walnut-sized prostate and smaller
attachments
LRP can be a bloodier operation
LRP leaves one full of gas that is a pain to expel

That's all I can think of right now.




--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA .1 .1 .1 .27 .37 .75
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
2/06, 6/06
PSA .07 .05 .06 .09 .08 .132 .145
Casodex added daily 07/06
PSA <0.04
Non Illegitimi Carborundum

On 7 Nov 2006 07:20:13 -0800, "Love2camp5@cs.com" <Love2camp5@cs.com>
wrote:

>Could someone please give me an objective listing of the pro's and
>con's of traditional, open prostatectomy (sp?) as compared to
>laparoscopic surgery? This is for someone we know; the doctor has told
>him that laparoscopic is better because they can use a camera to look
>around inside, whereas in open surgery, it is all done blindly by feel.

The choice seems to me to be confounded by (a) comparison stalemate;
trying to gauge the relative merits of 2 approaches which entail
qualitative differences/advantages...('view' vs 'feel' immediately
springs to mind) and (b) the ethos of the expert practitioner with
whom you eventually decide to place your trust; presumably the 'best'
open surgeon is not going to recommend LRP..the best at LRP is
unlikely to steer you towards RP.
From what I was able to gather in this forum there is a happy
consensus of neutrality over the substance of your question and this,
coupled with inevitably sparse data relating to long-term outcomes of
the much more recent LRP/RLRP, renders "what is best?" unanswerable.

So, for me, and with all other things begin 'equal' that left the
nitty-gritty of the operation itself as the deciding factor and I
chose an LRP (2 weeks ago) because I had seen nothing which
convincingly challenged the claim that LRP/RLRP was a 'lite' procedure
compared to the traditional open RP. Even if the differences were
slight I could see no good reason to ignore them.


>The issue also is that the laparascopic would have to be done far away,
>whereas the open could be done close to home.

I'm in the UK but with interminable road-works anything up to 3 hours
from my chosen hospital - that counts as long-ish here and meant
adding an extra day hospital stay after catheter removal to 'make
sure'.
>
>I presume you still have the misery of the catheter in both cases, and
>I know my hubby said that was the worst part anyway.


Quite! I'm 30% incontinent but much happier not to have that tube
pulling on my dick.

rosbif wrote:

> more typical for me would be "...darling, do remind me to straighten
> that picture on the wall behind you.."

That speaks for more prep-time. Assert your role as the provider,
protector, as in the cave-man days.

Bulk up using free weights, upgrade your wardrobe with earth tone
natural fibers, shower and shave. During your spare moments, read up
on HVAC, plumbing, and small appliance repair. When you fix something
in the house, let her see you carrying a 3 pound sledge hammer and the
acetelyne torch. Maintain her car and take one morning each month to
wash and wax it. Dinner? Herbed roast beef and red wine, prepare it
yourself and serve it to her.

-kh

tchtic@yahoo.com wrote:
> rosbif wrote:
>
>> more typical for me would be "...darling, do remind me to straighten
>> that picture on the wall behind you.."
>
> That speaks for more prep-time. Assert your role as the provider,
> protector, as in the cave-man days.
>
> Bulk up using free weights, upgrade your wardrobe with earth tone
> natural fibers, shower and shave. During your spare moments, read up
> on HVAC, plumbing, and small appliance repair. When you fix something
> in the house, let her see you carrying a 3 pound sledge hammer and the
> acetelyne torch. Maintain her car and take one morning each month to
> wash and wax it. Dinner? Herbed roast beef and red wine, prepare it
> yourself and serve it to her.

NOW I know why I don't get no nookie! I'd rather go windsurfing than all
that, and she knows it. ;-)
Maybe this winter . . .

I.P.