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having surgery in another state.

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Posted 3/8/2007 12:21 AM (GMT -5)
hello all,
my husband is having his prostatectomy across the country (with dr peter scardino at memorial sloan kettering in nyc) and we are having a hard time figuring out how to coordinate all of this. i wanted to hear from those of you who traveled for your surgery -
did your local urologist or primary doctor have contact with the surgeon?
how did you handle the follow-up (ie who took out the catheter? did you travel again for a follow-up visit or did you stay home with the local doctor?)

also, for those of you who did open surgery (which is what he is doing), did you have to have "staples" removed? the local doctor here asked about who would remove the staples, but the surgeon in nyc didn't say anything about this. i'm confused.

we have found this whole process to be daunting... you are really out there on your own to figure everything out (we have not been impressed with our local primary care doctor). however we are very happy to be going to a top surgeon in the field, so that is a relief!

thanks for any info/advice
Posted 3/8/2007 1:25 AM (GMT -5)
Dear Gralestel

while your process has been daunting, you are to be commended on getting one of the best surgeons in the country to perform your husband's open surgery! i am sure that you will get plenty of advice from others who have had the first hand experience of traveling away from home for their surgery (which is not my case). i suggest that you phone the doctors office and get all of these points clarified by the doctor or his key assistant as to how best to coordinate with local doctors after surgery. if you are not happy with your local primary care doctor, consider a change in the future when things settle down. many of us are confronted with local doctors who are not always supportive of our choices for PC treatment, especially away from home. my urologist strongly recommended local robotic surgery to me, but I elected proton radiation away from home. i think he will continue to treat me when needed (e.g., future PSA tests), but i will still feel somewhat guilty going back to him. all the best of luck to you and your husband.

Dave
Posted 3/8/2007 2:56 AM (GMT -5)
Hi Gralestel,
While I had the robotic procedure just three weeks ago, I understand that the open surgery will keep him in the hospital a bit longer. The catheter may not be an issue if you consider the following. First you are likely better to stay in the area a couple additional days after discharge versus getting him on a plane flight or long drive right away. The catheter period is still the same by nature, as far as how long it stays in. And that can be done at your local doctors office provided they can perform a cystogram to confirm that it is safe to remove the catheter. If you decide to have the catheter removed closer to home, keep in mind the cystogram must be run and if your local staff has to have your husband go to the hospital to do it, what's the point of not staying a couple days longer near NYC. I know hotel rates are bad there, but traveling with the catheter is something I tried to avoid. My procedure was about 300 miles from home, but my sister and other family members were within 40 minutes of the City of Hope where I was operated on. I stayed. My wife was able to work remotely and while I was gone for 12 days, we managed ok. But in the end we were homesick, and we hurried back as soon as we felt ok. They did not use stables in my procedure, and this could be why your surgeon has not expressed any concerns. My sutures were of the disolving variety and required no further action. PCDAVE does give you great advise though, just make a few calls and ask the key questions. You may want to ask how many days before surgery should your husband be there as well. You also may want to ask about housing for you. Many places do have special rates available with local hotels.

Tony
Posted 3/8/2007 6:11 AM (GMT -5)

Gralestel:

I'm your man for the answers to your questions.  I had open surgery this past August at Hopkins (A. Partin, presiding), travelled via plane.  At the outset, travelling for surgical treatment with an "expert" (Scardino is in that category) is a piece of cake.  Here's what to expect:

1.  Pre-op testing done by local internist.

2.  I flew to BWI on a Monday, met with Partin and had other pre-op interviews/testing on Tuesday, had surgery on Wednesday.

3.  Discharged Friday, 48 hours after surgery.  Checked in hotel for an overnight stay.  Departed Saturday morning for flight home.  (Take one of those pillows they give you at the hospital and sit on it during the flight home.  I stood up in the stern galley once we were at cruising altitude...a little more comfortable position.  Also, if you have the means, rather than taking a cab to the airport, order a sedan which is more accommodating.)

4.  The following Friday (nine days post surgery) had staples removed by my local urologist.  (You can schedule this ahead of time.)

5.  Had catheter removed on Monday by local urologist (could have had it removed on the 10th day post surgery but for the fact the 10th day fell on a Saturday, traditionally a day the local urologist's office is closed).  By the way, I did not have a cystogram.  Not required by my surgeon.

6.  I was fortunate and had a negative post-surgery pathology report re margins and nodes and <0.1 PSA three months post-surgery. 

7.  No reason for follow-up at Hopkins or with local urologist other than what is described above.

8.  Next scheduled treatment:  November 2007 PSA.

Hope I have answered your questions and relieved some of your anxiety.   


Post Edited (SJC) : 3/8/2007 8:05:31 AM (GMT-7)

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