Meeting on Friday

The final frontier. Deciding when, if and how.
Lebanese
Posts: 41
Joined: Sat Jan 17, 2015 11:13 am

Meeting on Friday

Postby Lebanese » Tue Dec 15, 2015 6:31 pm

hello brothers,

Finally the shit is serious now. Today I had an appointment with my doctor. He saw the test and he agreed to do the operation. It was a quick meeting. We will be meeting again on friday with the AMS representative so I can ask them both whatever I want. I have some questions in mind but i need your experience here guys. Can you plz help me cover all the questions i need to ask. Can you please advise me what should i ask ?
Any help is really appreciated and thx alot in advance.

Cheers to all

hardernharder
Posts: 73
Joined: Tue Mar 24, 2015 7:50 pm

Re: Meeting on Friday

Postby hardernharder » Tue Dec 15, 2015 7:42 pm

Hi,
What ever you do, use a high volume experienced surgeon like
Best wishes,

alibaba
Posts: 3027
Joined: Sun Oct 12, 2014 8:04 pm

Re: Meeting on Friday

Postby alibaba » Tue Dec 15, 2015 7:48 pm

Main questions I would have for the AMS?Boston Scientific rep would be
1. Will there be a supply of different sizes on hand for proper sizing or only 1 or 2 so you get whatever they have?
2. do you have a sample I can examine, feel, pump up and see it work?
3. Will you have a conceal reservoir on hand and is there reason why or why not that would be recommended?

I think it is coo you have a a chance to ask questions like that. We felt rushed ( last appointment of the day and staff had gone home) and I still would like to find out this info before the surgery. Dr. Milam's staff is hard to get hold of. d
LGX 21cm .Milam 01/13/16. Horror; both service and surgical outcome. hated infrapubic installation. Kramer revision 03/01/17. 22cm Titan +1.5cm extender. Those who think their opinion is the only one that matters are a danger to themselves and others.

roninhouston
Posts: 254
Joined: Tue Mar 03, 2015 2:25 pm
Location: Houston

Re: Meeting on Friday

Postby roninhouston » Tue Dec 15, 2015 7:49 pm

Someone posted 93 questions to ask before you get an IPP. I narrowed them down to a these and asked FT. If you search for my original thread you can read my FT responses: "Friday 14th: Joining the Bionic Brotherhood"
viewtopic.php?f=6&t=5717&p=34000&hilit=Friday+the+14th+joining+bionic+brotherhood#p34000
====================================
Dear FT, I have some questions you can answer, my doctor is going to answer these questions but it would be interesting to see what the real world has experienced:

How much time should the I take off from work post-op?

What medications are prescribed post-op for pain?

What activity restrictions will I have post-op and for how long (e.g. limitations on lifting weights, driving, etc.)?

Note: I walk 30 minutes, ride a bike 4 miles and exercise on strength/cardio machines 4 to 5 days a week?

Dr. Cornell plans on a AMS CX IPP device, how much are the cylinders left inflated immediately after surgery
(empty, partial inflation, full inflation). For how long?

Can the IPP device be deflated upon my return to work; if not, how is the inflated penis best concealed?

How long will I need to have my penis pointed up post-op?

When do I begin to cycle the IPP?

Do I need to return to the office for removal of sutures post-op or can the sutures be removed by me? When?

What OTC meds do I need for the incision? Itching? Ointment? Stool Softner?

Do I need to wear a pad over the incision?

We scheduled a follow up visit, how often thereafter will I come into the office?

What is the post-op recovery time for incision, first pump up, and first intercourse?

Does the Dr. Cornell place the pump in the final scrotal location or do I manipulate the pump post-operatively into a scrotal position?
-----------------------------------------------------------
Hope this helps you formulate some questions. I also created two threads: "What I Know Now: Pre-Op" and "What I Know Now: Post-OP".
Bionic with AMS CX on August 14, 2015. Inflated September 15th by Dr. Robert Cornell.
Was 69 with VL
. Pre-Op VED Protocol Therapy and Post-Op VED Protocol Therapy: Pre-Op length by 6th month.

roninhouston
Posts: 254
Joined: Tue Mar 03, 2015 2:25 pm
Location: Houston

Re: Meeting on Friday

Postby roninhouston » Tue Dec 15, 2015 8:39 pm

Lebanese, Since I ask these questions I thought I should tell you how I now can answer them.
--------------------------------------------------------------------------------------------------------
How much time should I take off from work post-op?
I had IPP on Friday, was driving and running errands on Wednesday. Returned to work on the next Monday.

What medications are prescribed post-op for pain?
Tamadol. Took it for a few days and then Tylenol.

What activity restrictions will I have post-op and for how long (e.g. limitations on lifting weights, driving, etc.)?
Note: I walk 30 minutes, ride a bike 4 miles and exercise on strength/cardio machines 4 to 5 days a week?
I took two weeks off from exercising, tried not to lift anything over a gallon of milk,i.e., 8 pounds. After two weeks starting riding recumbent exerciser and resumed walking. Four weeks returned to normal workouts. NOTE: Had to buy a new split bike seat, the pump is painful sitting on it.

Dr. Cornell plans on a AMS CX IPP device, how much are the cylinders left inflated immediately after surgery
(empty, partial inflation, full inflation). For how long?
They were about fifty percent inflated until I went for full inflation at 31 days.

Can the IPP device be deflated upon my return to work; if not, how is the inflated penis best concealed?
I did not deflate until I was inflated by the doctor. Wore underwear that kept my penis pointing up. There are several threads on FT, one I gave my opinions and recommendations.

How long will I need to have my penis pointed up post-op?
Doctor said until inflated, but actually continued for a few weeks afterwards. The underwear had become comfortable, I now back to my boxer shorts. The straight up position helps insure you do not heal crooked and positions the pump at the bottom of the scrotum.

When do I begin to cycle the IPP?
After the doctor inflated the IPP he told me to do it at least twice a day in sets of three. Each time increase a couple of pumps more than the last. I had followed the VED Protocol Therapy and was able to pump to max within a few days of inflation. VED Protocol Therapy recommends 60 minutes daily for three months post-op.

Do I need to return to the office for removal of sutures post-op or can the sutures be removed by me? When?
Sutures dissolved themselves.

What OTC meds do I need for the incision? Itching? Ointment? Stool Softner?
Incision: Neosporin. No itching and no other ointment needed. Colase is a good stool softner, START a couple of days before surgery. I started one day before surgery and wish I had started at three.

Do I need to wear a pad over the incision?
The hospital gave me several bundle of gauze I put against the incision until it healed.

We scheduled a follow up visit, how often thereafter will I come into the office?
Activated at 31 days and returned at 60 days. Will have regular visit three month after that.

What is the post-op recovery time for incision, first pump up, and first intercourse?
Incision healed up in a week are so. At inflation the doctor said I was still swollen. My first pump up was at 31 days. Doctor said, "go forth and use it". Actually it was to sore to use for a couple of more weeks.

Does the Dr. Cornell place the pump in the final scrotal location or do I manipulate the pump post-operatively into a scrotal position?
The pump was placed in my scrotum and I did not have to manipulate it into place.

-----------------------------------------------------------
Hope this helps you formulate some questions. I also created two threads: "What I Know Now: Pre-Op" and "What I Know Now: Post-OP".
Bionic with AMS CX on August 14, 2015. Inflated September 15th by Dr. Robert Cornell.
Was 69 with VL
. Pre-Op VED Protocol Therapy and Post-Op VED Protocol Therapy: Pre-Op length by 6th month.

David_R
Posts: 2145
Joined: Mon Nov 02, 2015 1:03 pm

Re: Meeting on Friday

Postby David_R » Tue Dec 15, 2015 10:28 pm

All of the questions and answers in here are good ones. You guys' experiences offer a lot to a new guy getting an implant.
David

Lebanese
Posts: 41
Joined: Sat Jan 17, 2015 11:13 am

Re: Meeting on Friday

Postby Lebanese » Wed Dec 16, 2015 9:24 am

Thx alot for your help. I will write down all the questions and the answers after the meeting and will post it here.

cincinnatus1951
Posts: 299
Joined: Wed Jun 17, 2015 11:54 am
Location: Houston TX, USA

Re: Meeting on Friday

Postby cincinnatus1951 » Wed Dec 16, 2015 4:35 pm

Lebanese: Understand your concerns. Since I have had to start using doctors more than in the past. I have found that preparing a "talk paper" that describes the symptoms, your research on the issue and state your desires for treatment as well as those you are less inclined to. I also list all the questions I have for the doctor. I then e-mail it to the nurse a few days before an appointment. Attached are the questions I posed to my uro when I had my discussion about implants.
Most doctors appreciate the patient involvement, research and general level of interest. Most doctors have at least scanned the talk paper, some obviously have not and one was annoyed and challenged "Who is the doctor here?" Needless to say, I don't use that doc anymore.
There is nothing magic about my questions, most (and more) are covered in the replies. I have found the talk paper approach to be very helpful in making sure your don't forget anything and to focus the discussion with the doc.
Good Luck.
QUESTIONS:
Non implant improvement:
Is there a ”normal” to nerve re-growth? Lab work suggests other systems are working OK. Any guesses to what I can expect for the future? If we could get back to normal sex, preferably with pills, we’d wait rather than go for implants. That being said I am not getting any younger and if I’m doing implants, it should be sooner than later.

Is my problem nerve damage? How do we rule out venous leakage as either a primary or contributing cause?

Implant:
What prosthesis would Dr. recommend? (The most popular prosthesis is the AMS-LGX. The specific length is determined by measurements taken during surgery.)
What results can we expect.? Does the glans expand and become sensitive? Is the penis surface skin hard, or is it “squishy” such as post vacuum pumping?
What pre –op protocols need to be observed? Ie: vacuum pumping, antiseptic washes, shaving, other?
Can I expect to lose penile length (I don’t have much to give up after prostate surgery)
What can I expect post op?
What hospital does Dr. use?
How long between scheduling and operating?
I have a frenum piercing in my penis. I removed that for prostate surgery. Will we need to do any special disinfection for implant surgery?

ISSUES:
An internet search of penile implants indicates not all recipients are happy campers. The main issues appear to be post op infection with need for removal and aggressive infection therapy.
Rejection of the implant without infection
Significant loss of size (1.5 to 2 inches)
Pain due to: inflating the prosthesis, pain during intercourse.
Folding, kinking and pinching of the cylinders and/or tubing among components
How to minimize these side effects.
Is there a way of predicting the probability of size and pain issues?
We just have to decide how much risk we want to take to get back to normal or as normal as normal gets.

Cincinnatus 1951
Age 79, Wife 77 Married 52yrs RPP Dr Brian Miles, Houston Methodist, July 2013. Used VED, pills, MUSE, and trimix with no or mixed results. 18cm Titan, one RTE by Dr Mohit Khera, Baylor, Houston, Jan 2016

woodturner
Posts: 117
Joined: Fri Dec 20, 2013 1:48 pm

Re: Meeting on Friday

Postby woodturner » Wed Dec 16, 2015 7:23 pm

Before getting my implant I did an extensive amount of research about implants, doctors, recovery and the actual surgery. The 2 most important things I learned were:
**How many procedures do you perform annually?
**What is your infection rate??
The doctor that did mine does approximately 150 implants per year with an infection rate of less than 1%
He told me that about 10% of the urologists do about 90% of the implant surgeries.

My strongest recommendation is to find a high volume implant surgeon and then ask your questions.
Total ED since a 6/2010 RPA. Pills and injections didn't work. 2nd revision with a Coloplast Titan (24CM w & 2CM RTEs)on 12/15/2022. 68 years old

Lebanese
Posts: 41
Joined: Sat Jan 17, 2015 11:13 am

Re: Meeting on Friday

Postby Lebanese » Fri Dec 18, 2015 6:03 pm

Hello brothers,

I had the meeting today with my doctor but the ams representative couldn't be with us.
Anyway it was not pleasant. This doctor who is known to be a top uro here in my country have never done the 3-piece implant.
He tried to convince me to do the 2 piece since it is half the price (i'm paying it all out of my pocket) and it is not complicated (no reservoir).
I couldnt find an experienced surgeon in my country bcz it is expensive to do the 3-pieces implant and no one does it. (Ironic to say because your famous Dr Eid is from my country)
I am still young (31) and each day passing i'm losing. Traveling abroad (outside middle east) is really hard for me because I have no family, visa is hard to get, hotels are expensive, no one to help,etc....
So guys I have to ask this: what do u think about the 2-pieces implant? (AMS Ambicor)

Cheers guys


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