Due Diligence Backfires

Hi everybody...I'm new to this forum.

This is one of those cases where trying to be careful and doing due diligence has backfired.

I was scheduled for a DaVinci radical prostatectomy with Dr. Randy Fagin in Austin last month.

Then I got a call from a friend of a friend who had been through all of this a few years ago. I told him that I had considered my options carefully, and spoken with several physicians to obtain second opinions before reaching the decision to have the DaVinci surgery. The consensus was that at my age (61), this was the best option. He told me that I had NOT gotten a proper second opinion, because everybody I had spoken with was working off of the same pathology report.

So I decided to postpone the surgery and had my slides sent to MD Anderson in Houston. The result was a slight downgrading. Initially I had 5 positive cores (1 3+3, 4 3+4's), and the new report was 3 3+3's and 2 3+4's. Last week I drove to Houston and met with one of the MD Anderson surgeons, whose opinion was that the slight change was not enough to alter the original recommendation. He told me that if my case were more serious, he would recommend MD Anderson for multi-track therapies, but that since my case was relatively simple, he had no objection to my choice of surgery in Austin, assuming a skilled surgeon.

So I returned to Austin and phoned to reschedule my surgery the next day. I was shocked to find out that Dr. Fagin will be leaving his group at the end of March. He will take on an administrative position with another institution in Austin, and will no longer be practicing surgery. Oh, and by the way, there are no available surgery slots before he leaves.

I am so bummed out. Having gone through the process of getting all psyched up for this, reading all the good testimonials for this surgeon and convincing myself that this was the right course of action, I now feel like I'm back to square one. Is it wrong to think that they could have at least given me a heads up about this when I called to postpone? Or even when I set up the initial date?

I'm trying to figure out what to do next. I liked the surgeon at MD Anderson (John Davis), and from what I've read he appears to be quite skilled. Should I just use him in spite of the more complicated travel logistics, or are there other Austin surgeons I should consider?

Any advice would be appreciated.

CB in Austin
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Age: 61 PSA: 5.9
Biopsy: 11/2/2010 Gleason 5/12 positive (3+3's and 3+4's)

Welcome CB,

Tough story and a bit of bad luck for sure, but you should be able to find another good surgeon in your area. Your due dillegence wasn't the problem, you just didn't know about your original surgeons plans in the future. No fault there.
Please keep us posted of your journey.

David in SC

I flew out of town for my surgery and had no regrets.  If you find another surgeon that you are happy with that is great.  If on your own personal report card, you give the doctor in Austin a B and you give the doctor at MD Anderson an A, then make the trip.  The relatively small inconvenience of travel will hardly be a blip on the radar.  If you have imperfect results with a surgeon that you feel like settled for, you will have a long time to regret it.    

Good Luck!

>>This is one of those cases where trying to be careful and doing due diligence has backfired.<<

that's one possible conclusion.  not the one i would have reached tho.

ed

CB,
I'm one of those who had their surgery with Dr. Fagin. He certainly is one of the best DaVinci surgeons. I received a letter from him telling me that he is no longer with the Urology team. He gave my case to Dr. Giesler for all follow up appointments. Doing the surgery at MD Anderson shouldn'd cause to much of a logistical problem. You only spend one night in the hospital and your first visit to get the pathology report and remove the catheter is one to 2 weeks later. After that you can have all follow up visits and PSA tests done locally.

Overall, I would consider this a small bump in the road. There are are many good surgeons who will an equally good job.

Hopefully it doesn't bother you too bad. Plus, if you had gone ahead, and then he left, follow up would have been an issue.

Good luck.

Goodlife

cbmagi, you asked, so I'll offer an option. Search Dr. Kella at Urology San Antonio. In my opinion, Dr. Kella is one of the best. Contact me via PM if I can help.

Post Edited (coxjajb) : 3/24/2011 7:35:45 PM (GMT-6)