dotti105
10-18-2015, 03:34 PM
My husband had a radical prostotectomy by Dr Patel in Celebration, Florida using the DiVinci robot on Sept 21st at the Florida Hospital in Celebration.
I just thought I would give an overview of his experience. (He never gets on TOTV)
Some background: Bill has had high PSAs and an enlarged prostate for several years. His digital exams revealed a "normal" prostate with no abnormal surface features. When his PSA got to 10 is was shortly after moving here and he was seeing Dr Sher at Advanced Urology. Sher did a biopsy and 3 out of 12 cores came back with Adendocarcinoma. so it was time to look at other options.
Bill attended a couple of the MEN ONLY meeting for the Prostate Round table here. He learned a lot and found the men there to be very forthcoming about their experiences. His take away, was that many men after Hormone treatment, Radiation by various means, and watchful waiting all seemed to have lingering long term issues.
Dr Sher suggested that Bill consider having a radical prostotectomy because upon ultrasound it was shown that his prostate was approximately 5x the normal size. (150 grams compared to 30 grams) He offered 2 names as possible surgeons. The first was Dr Raj, who works at Advanced Urology and does the Robotic DiVinci surgery both at Leesburg Hospital and at The Villages Regional Medical center.
We saw Dr Raj and liked him very much. He had done 1250 procedures at that point and because of the size of Bill's prostate he wanted to start Bill on Lupron to shrink the prostate first. Then do surgery removing the prostate after it shrunk. He said the surgery would be 4-5.5 hrs due to the enlarged size. He admitted that he had limited experience with very enlarged prostates.
That gave us some concern.
After researching Lupron, we did not think that is a route that he wanted to choose. Lots of side effects. Often called "medical castration" accompanied by hot flashes, weight gain, mood swings, depression etc. (menopausal symptoms)
We then saw Dr Patel in Celebration. Being a RN, I research options and procedures as well as surgeons and was very impressed with Dr Patel's experience and protocols. He had done over 8,000 DiVinci surgeries when we met with him in May. Now it is over 9,000.
Dr Patel is world renown. The best of the best. He developed, perfected and teaches the techniques he uses. We leaned that Dr Raj trained under him. Dr Patel teaches world wide and has patients from all over the world come here to have him do their surgeries.
He re assured us and told us that Lupron therapy prior to surgery would NOT be a good idea, because it makes the prostate tough and it folds in on itself often trapping nerves as it shrinks. He prefers to treat a prostate that is not altered by medication.
Dr Patel uses what he calls the "trifecta" as his goal for prostate surgery. He uses unique nerve sparing techniques and separates the nerve bundles carefully prior to removing the prostate.
His Trifecta goal is:
1. Removal of entire cancerous prostate and seminal vessels to ensure a PSA of 0 going forward.
2. Save the nerve bundles which control continence, preventing lingering incontinence which many men experience following other techniques
3. Save the nerve bundles that control Erections. Most of his patients, after recovery, have the same quality of erections they had prior to surgery. They do not have to say goodbye to their sex life.
We were impressed with Patel and he was very straight forward and confident. He encouraged Bill to lose weight and get in shape to ensure a quicker recovery. Taking that advice to heart, Bill scheduled his surgery for 6 months later, in Sept. Dr Patel assurred us that Bill's cancer would not kill him, but with his very enlarged prostate he would need it removed to solve his urology problems due to the enlarged prostate. And it is Cancer. He said "If Cancer does not encourage you to lose weight and get in shape, nothing will"
BAM! Bill left his office a changed man. He has always been very active and healthy, although heavier than he should be. Bill and I joined Weight Watchers immediately and he lost 45 pounds prior to his surgery. We both feel that that has really helped him to handle the surgery and recovery.
Dr Patel offers classes prior to surgery regarding how to regain total bladder control and sexual function. Bill chose to have PT for pelvic floor prior to surgery. Many men wait until after surgery to have PT. Ether way it helps control spontaneous bladder leakage. Many questions were answered and lots of information given. The kind of think you think about after you leave the Dr's office were covered in detail and everyone was sent home with brochures and flyers to provide a tangible reference. Lots of good information.
Dr Patel assigns each patient a concierge with whom we could communicate any questions, concerns etc. She called us to give us the surgery time and date. Told us what to bring and expect at the hospital. We were met in the lobby by her on the day of surgery. She took us to a quiet conference room and we did all the paperwork necessary. She told me and our daughter (the official "hand holder") what the sequence of events would be, where to get some lunch and how to find out his room number while he was still in surgery, so that we could take Bill's things there and have a private place to wait. She left us with her cell #, in case we had any questions and concerns during the day of surgery.
Bill's surgery was 1.5 hrs long. Exactly what Dr Patel had previously told us to anticipate during our first visit. He was in his private room a couple of hours later. Joking and loopy, but with no pain. 4 hrs later his nurse got him out of bed to walk. We walked 2 loops around the unit with no problem on the day of surgery.
Bill had 6 incisions. 4 incisions for the robotic procedure, each about 1" long. 1 larger incision, about 3' long through which the prostate was removed intact. His last incision was for a drain. The morning after surgery the drain was removed. His IV removed and he was discharged home with a foley catheter in place. He had no stitches or staples. The 6 incisions were closed with glue and the glue wore off as the incisions healed. He could shower the day of discharge, just patting dry the incisions.
Dr Patel has all of his patient WALK out of the hospital. No wheelchair. We were home 25 hrs after he checked in at the hospital in Celebration prior to surgery.
Like all of Dr Patel's patients, he was told to walk at least 1 mile a day, starting the day of discharge.He carried his foley bag in a "reusable shopping bag". As we walked each day, neighbors would stop and talk to us. Most had no idea he had a foley still in place. The shopping bag was brilliant!
4 days after surgery he returned to have his catheter removed. At that point he was a "free man". His post op meds were stool softners, tylenol and reglan (to encourage his gut to get back to normal after anesthesia). He did not need any pain medication other than over the counter tylenol at any time after leaving the hospital.
Bill was sleepy and took lots of naps those first few days. He has allergies and had a few coughing fits that made him really feel his incisions. But splinting his tummy with a pillow helped the pain while coughing. That was the hardest "pain" issue he had.
After the foley was removed, he was sent home in Adult pull-ups (Depends). It took a couple of weeks in the Depends before he moved to a "Shield" (think male version of a panty liner) His bladder control has not been an issue. The shield helps with stress incontinence, like bladder leaking associated in coughing, laughing, sneezing etc. This is expected to resolve by 3 months at the latest.
Dr Patel starts his patients on Viagra or Cialis immediately after surgery, not for sexual use, but to get oxygenated blood to the ***** and urethra to encourage healing and prevent excess scar build up around the urethra which was dissected and reconnected during surgery.
No sex for 4 weeks. A vacuum erection device is prescribed to start using daily at 4 weeks as well. That is to encourage blood flow into the ***** causing an immediate erection, which helps to stretch the tissues then have not been used in 4 weeks and to help prevent of loss of length due to scaring around the urethra. Everything works sexually, which was a big relief to us both. With Prostate surgery in the past, the patient's sex life was forever altered.
No weight gain during the recovery process. Hurrah! He is walking 4+ miles a day and went out with the guys to golf at 3.5 weeks. He only pitched and putted. Dr Patel tells his patients to wait 4 weeks before strenuous exercise.
Tomorrow is his 4 week anniversary and he has his tee time set, and will be going back to water aerobics in the morning.
He sees Dr Patel at 6 weeks for his post op visit. He already had his pathology report when he had his foley removed. Pathology was what we hoped for. Clear margins and all cancer contained in the prostate.
This has been so very much easier than either of us could have guessed. Bill's brother had a traditional open procedure prostotectomy 15 yrs ago and he had a foley for a month and could not go back to his desk job for 3 months. Urinary incontinence was 9 months or longer to resolve.
We have only accolades for Dr Patel. He has pioneered and perfected this procedure and everything went as projected. We are so glad that he did not choose any other type of treatment that would have left him with his prostate and dealing with long term issues that so many other men endure.
We heard later from our SIL, who is a Nurse Anesthetist in Melbourne Fl, that Dr Patel has such a world wide reputation that recently a wealthy Chinese business man bought a DiVinci Robot and had Dr Patel bring his team to China to do his surgery. Obviously a man who could afford the best of the best.
We received the Hospital bill last week. This is only the first of many bills or course. The hospital charge was $51,000. Luckily we talked with our insurance co. prior to surgery and found that EVERYTHING was covered. Our cost=$275.00 for 1 night stay in the hospital. Period. We have the Villages, United Health Care Medicare Advantage plan. We couldn't be happier.
Any questions, shoot. It was an amazing experience and all of our anxiety and fears were ungrounded. We highly recommend that any guys out there that are given a diagnoses of Prostate Cancer made a point of at least getting an opinion from Dr Patel. He is the best of the best.
I just thought I would give an overview of his experience. (He never gets on TOTV)
Some background: Bill has had high PSAs and an enlarged prostate for several years. His digital exams revealed a "normal" prostate with no abnormal surface features. When his PSA got to 10 is was shortly after moving here and he was seeing Dr Sher at Advanced Urology. Sher did a biopsy and 3 out of 12 cores came back with Adendocarcinoma. so it was time to look at other options.
Bill attended a couple of the MEN ONLY meeting for the Prostate Round table here. He learned a lot and found the men there to be very forthcoming about their experiences. His take away, was that many men after Hormone treatment, Radiation by various means, and watchful waiting all seemed to have lingering long term issues.
Dr Sher suggested that Bill consider having a radical prostotectomy because upon ultrasound it was shown that his prostate was approximately 5x the normal size. (150 grams compared to 30 grams) He offered 2 names as possible surgeons. The first was Dr Raj, who works at Advanced Urology and does the Robotic DiVinci surgery both at Leesburg Hospital and at The Villages Regional Medical center.
We saw Dr Raj and liked him very much. He had done 1250 procedures at that point and because of the size of Bill's prostate he wanted to start Bill on Lupron to shrink the prostate first. Then do surgery removing the prostate after it shrunk. He said the surgery would be 4-5.5 hrs due to the enlarged size. He admitted that he had limited experience with very enlarged prostates.
That gave us some concern.
After researching Lupron, we did not think that is a route that he wanted to choose. Lots of side effects. Often called "medical castration" accompanied by hot flashes, weight gain, mood swings, depression etc. (menopausal symptoms)
We then saw Dr Patel in Celebration. Being a RN, I research options and procedures as well as surgeons and was very impressed with Dr Patel's experience and protocols. He had done over 8,000 DiVinci surgeries when we met with him in May. Now it is over 9,000.
Dr Patel is world renown. The best of the best. He developed, perfected and teaches the techniques he uses. We leaned that Dr Raj trained under him. Dr Patel teaches world wide and has patients from all over the world come here to have him do their surgeries.
He re assured us and told us that Lupron therapy prior to surgery would NOT be a good idea, because it makes the prostate tough and it folds in on itself often trapping nerves as it shrinks. He prefers to treat a prostate that is not altered by medication.
Dr Patel uses what he calls the "trifecta" as his goal for prostate surgery. He uses unique nerve sparing techniques and separates the nerve bundles carefully prior to removing the prostate.
His Trifecta goal is:
1. Removal of entire cancerous prostate and seminal vessels to ensure a PSA of 0 going forward.
2. Save the nerve bundles which control continence, preventing lingering incontinence which many men experience following other techniques
3. Save the nerve bundles that control Erections. Most of his patients, after recovery, have the same quality of erections they had prior to surgery. They do not have to say goodbye to their sex life.
We were impressed with Patel and he was very straight forward and confident. He encouraged Bill to lose weight and get in shape to ensure a quicker recovery. Taking that advice to heart, Bill scheduled his surgery for 6 months later, in Sept. Dr Patel assurred us that Bill's cancer would not kill him, but with his very enlarged prostate he would need it removed to solve his urology problems due to the enlarged prostate. And it is Cancer. He said "If Cancer does not encourage you to lose weight and get in shape, nothing will"
BAM! Bill left his office a changed man. He has always been very active and healthy, although heavier than he should be. Bill and I joined Weight Watchers immediately and he lost 45 pounds prior to his surgery. We both feel that that has really helped him to handle the surgery and recovery.
Dr Patel offers classes prior to surgery regarding how to regain total bladder control and sexual function. Bill chose to have PT for pelvic floor prior to surgery. Many men wait until after surgery to have PT. Ether way it helps control spontaneous bladder leakage. Many questions were answered and lots of information given. The kind of think you think about after you leave the Dr's office were covered in detail and everyone was sent home with brochures and flyers to provide a tangible reference. Lots of good information.
Dr Patel assigns each patient a concierge with whom we could communicate any questions, concerns etc. She called us to give us the surgery time and date. Told us what to bring and expect at the hospital. We were met in the lobby by her on the day of surgery. She took us to a quiet conference room and we did all the paperwork necessary. She told me and our daughter (the official "hand holder") what the sequence of events would be, where to get some lunch and how to find out his room number while he was still in surgery, so that we could take Bill's things there and have a private place to wait. She left us with her cell #, in case we had any questions and concerns during the day of surgery.
Bill's surgery was 1.5 hrs long. Exactly what Dr Patel had previously told us to anticipate during our first visit. He was in his private room a couple of hours later. Joking and loopy, but with no pain. 4 hrs later his nurse got him out of bed to walk. We walked 2 loops around the unit with no problem on the day of surgery.
Bill had 6 incisions. 4 incisions for the robotic procedure, each about 1" long. 1 larger incision, about 3' long through which the prostate was removed intact. His last incision was for a drain. The morning after surgery the drain was removed. His IV removed and he was discharged home with a foley catheter in place. He had no stitches or staples. The 6 incisions were closed with glue and the glue wore off as the incisions healed. He could shower the day of discharge, just patting dry the incisions.
Dr Patel has all of his patient WALK out of the hospital. No wheelchair. We were home 25 hrs after he checked in at the hospital in Celebration prior to surgery.
Like all of Dr Patel's patients, he was told to walk at least 1 mile a day, starting the day of discharge.He carried his foley bag in a "reusable shopping bag". As we walked each day, neighbors would stop and talk to us. Most had no idea he had a foley still in place. The shopping bag was brilliant!
4 days after surgery he returned to have his catheter removed. At that point he was a "free man". His post op meds were stool softners, tylenol and reglan (to encourage his gut to get back to normal after anesthesia). He did not need any pain medication other than over the counter tylenol at any time after leaving the hospital.
Bill was sleepy and took lots of naps those first few days. He has allergies and had a few coughing fits that made him really feel his incisions. But splinting his tummy with a pillow helped the pain while coughing. That was the hardest "pain" issue he had.
After the foley was removed, he was sent home in Adult pull-ups (Depends). It took a couple of weeks in the Depends before he moved to a "Shield" (think male version of a panty liner) His bladder control has not been an issue. The shield helps with stress incontinence, like bladder leaking associated in coughing, laughing, sneezing etc. This is expected to resolve by 3 months at the latest.
Dr Patel starts his patients on Viagra or Cialis immediately after surgery, not for sexual use, but to get oxygenated blood to the ***** and urethra to encourage healing and prevent excess scar build up around the urethra which was dissected and reconnected during surgery.
No sex for 4 weeks. A vacuum erection device is prescribed to start using daily at 4 weeks as well. That is to encourage blood flow into the ***** causing an immediate erection, which helps to stretch the tissues then have not been used in 4 weeks and to help prevent of loss of length due to scaring around the urethra. Everything works sexually, which was a big relief to us both. With Prostate surgery in the past, the patient's sex life was forever altered.
No weight gain during the recovery process. Hurrah! He is walking 4+ miles a day and went out with the guys to golf at 3.5 weeks. He only pitched and putted. Dr Patel tells his patients to wait 4 weeks before strenuous exercise.
Tomorrow is his 4 week anniversary and he has his tee time set, and will be going back to water aerobics in the morning.
He sees Dr Patel at 6 weeks for his post op visit. He already had his pathology report when he had his foley removed. Pathology was what we hoped for. Clear margins and all cancer contained in the prostate.
This has been so very much easier than either of us could have guessed. Bill's brother had a traditional open procedure prostotectomy 15 yrs ago and he had a foley for a month and could not go back to his desk job for 3 months. Urinary incontinence was 9 months or longer to resolve.
We have only accolades for Dr Patel. He has pioneered and perfected this procedure and everything went as projected. We are so glad that he did not choose any other type of treatment that would have left him with his prostate and dealing with long term issues that so many other men endure.
We heard later from our SIL, who is a Nurse Anesthetist in Melbourne Fl, that Dr Patel has such a world wide reputation that recently a wealthy Chinese business man bought a DiVinci Robot and had Dr Patel bring his team to China to do his surgery. Obviously a man who could afford the best of the best.
We received the Hospital bill last week. This is only the first of many bills or course. The hospital charge was $51,000. Luckily we talked with our insurance co. prior to surgery and found that EVERYTHING was covered. Our cost=$275.00 for 1 night stay in the hospital. Period. We have the Villages, United Health Care Medicare Advantage plan. We couldn't be happier.
Any questions, shoot. It was an amazing experience and all of our anxiety and fears were ungrounded. We highly recommend that any guys out there that are given a diagnoses of Prostate Cancer made a point of at least getting an opinion from Dr Patel. He is the best of the best.