James
thanks for the positive note...
There are several excellent USA and UK trained prostate surgeons in Panama, and I visited with one of them who probably spent 45 minutes with me discussing options, gave me almost a complete physical and charged $50.
The dr who did my colonoscopy about 2 years ago is on the board of directors of the new Johns Hopkins hospital and he chatted with me, as did an internist who does lots of followup work for both of them post surgery.
First, all three of these men said if they had a DX of prostate cancer they would go to MSKCC. Of a total of nine I asked in Panama and the USA, eight said MSKCC, and one said perhaps MD Anderson but "if I had the travel time, probably New York, Sloan Kettering or Mt Sinai."
I could have had the open surgery in Panama for about $5,000 plus some extras, but the surgeon was a bit concerned about my obesity and other risk factors. ALL doctors suggested that because of sleep apnea, obeisity, high blood pressure, no diabetes yet, but certainly down the wrong track, that the least invasive and shortest surgery was recommended. My Taos urologist, Panama board and Tufts and MSKCC trained, from day one felt although there was no DaVinci in New Mexico (they finally got one a few months ago) or in Panama, I should "shop around and make yourself an expert" and report back to him.
about a week later, computer printouts in hand, I told him I would like to try to get an appointmetn with Dr. G and MSKCC but also liked Mt. Sinai, Cleveland Clinic, and a few others. he smiled and said he was biased in favor of MSKCC but indeed hoped I would reach the same conclusion. Now with sleep apnea just about abated, tryglycerides ande cholesterol normal, and 50% of my blood pressure drugs reduced, I feel positive of my decision.
An important final observation and I hope readers here who gave me the idea will spread the word and even call this guy.
I read that Dr. Randy Fagin in Austin specialized in obese prostate surgery. I did not want to wait and I certainly have not felt good about the 13 months of girlie hormones. So I called him last year and sent him an email. I forgot about it.
Enroute to my grandson in Tucson, along I-10 in southern New Mexico at 4pm on a Sunday afternoon Dr Fagin called my cell phone. He chatted for 20 minutes.
He explained that even with his expertise he has to "abort" some procedures, revert to open surgery, and in some cases halt the operation. Obese patients are a risk all the way down the line, but he would see me if I insisted. He asked who I had checked with, and by then I had already had my first appt with Dr. G in NYC.
Dr Fagin laughed and said something like, "Well, it is important to get second or third opions and be proactive and do your research.,
But wow! You got into see Dr. Guillonneau? Let's just say you are already playing for the New York Yankees! No need to try out for the Pittsburgh Pirates or Chicago Cubs!"
As we say in the old days in Brooklyn Dr. Fagin is a "mensch"
thanks for all the encouragement.
mark