Gat Goren, PAE, LUTS, Part 6

Carl:

Thanks for your contribution to the board. The most informative and intriguing posts are reports by new members like yourself. Every such post--positive or negative--is another point of light in the thick fog.

I added your name to my running tally on page 5 of this thread. Please continue to post periodically on your progress or lack thereof. We all look forward to hearing from you.

(BTW, I especially like posts by guys announcing they are about to have a procedure; this allows us to follow their progress as it unfolds.)

Hi Carl 1950.
If you have not already done so I think there are some things I have learnt to help you get more full nights sleep.
No.1 Check your urine pH. It should be 6.5-6.8. If more acidic (lower number) then start drinking more water... with some lemon juice. You may need to flush a load of stored uric acid out of your body. It took me 5 weeks to get mine right. Read about Gout.
No.2 Drink a big glass of water 'before' going to bed. I learnt this trick from my urologist after he removed my kidney stones. One of the reasons for needing to get up at night to pee is because your urine is to acidic...and it burns at your bladder sphincter and wakes you up. Better to sleep all night and wake up with a full bladder.
No.3 Try taking Vesicare (5mg once a day...if I remember correctly) to stop any spasming of your bladder sphincter....which happens if you continually try to hold on before finally letting your body expel the overly acidic urine its trying to expel. It worked a treat for me.
Urine pH plays a big game in our problems.

Post Edited (IRD1956) : 4/12/2015 3:27:15 PM (GMT-6)

Not Carl...Dave. My name is Ian.
With regards to the sealing of veins....it has always been my understanding that it is the gonadal venous system and its collaterals that gets sealed to remove the head pressure that causes the blood returning from the testicles to divert via the deferencial vein into the prostate. The prostatic venous system returns via the inner iliac which I know was checked for normal pressure after my proceedure.
The patent for the GG proceedure is on line. I will find that link later today and post it here.
If I am wrong..then apologise on advance.

Post Edited (IRD1956) : 4/12/2015 3:54:49 PM (GMT-6)

FWIW: PAE at UNC

Here's something that might be of interest to folks looking at PAE options.

There was a glowing review on the Patient.co.uk web site from a patient after a PAE procedure at the University of North Carolina Medical Center--
http://www.patient.co.uk/forums/discuss/has-anyone-out-there-had-a-prostate-artery-embolization--301859?page=0
(Search for "Chapel Hill" to find the post.)

Here's a page about it from UNC's web site:
http://news.unchealthcare.org/heartandvascular/pae

I'm not necessarily endorsing this, but guys have been asking where they can go for PAE. I thought this might be of interest to them. It caught my eye because I live in North Carolina.

Post Edited (Chicago Dave) : 5/6/2015 9:23:56 PM (GMT-6)

For those who are wonering if a PVP laser or a standard turp is an easier recovery, I have now had both and can report that for me, the stadard turp is better. Around June 2012 I had the 180 watt PVP laser for 70 minutes and had 70g of prostate removed from a very large prostate, which my uro estimated from the cystocopy was 120g + but which the ultrasound and catscan formulas of 1/2 height x width x depth put at closer to 200g.
about 10 days ago, as I previously feared, my gross hematuria of frank blood (like you see when you slice your finger open) returned. My uro believed my prostate was bleeding and as he could not schedule a PVP laser, he used a standard turp procedure for an hour to slice off another 70g of prostate and median lobe tissue. and send it to pathology. I got two pints of whole blood and spent 6 days in hospital being irrigated with a 3 way cath. I got home three days ago. It may be too early to tell because I'm still wearing a foley cath, but I have so far experienced very little pain, no bladder spasms with the turp, whiile I recall the period after the PVP Greenlight laser as eye popping pain on urination and hourly bladder spasms during the week I kept the cath on. Today is a week since my turp and I may get the cath out tomorrow by my uro.
In some ways the turp may have been more of a shock to my body. I barely ate and couldn't poop for 5 days until I got home and used a dulcolax suppository (which the hospital would not approve while I was there - because it was over the counter rather than prescription medecine - absurd!). I gained 35 pounds in water weight on my legs (now down to 21 pounds of water weight remaining). My testicles swelled to at least 3x normal size - they are still swollen but slowly getting better. I am walking easier now with 2 canes. It's the first day that walking in the house hasn't been painful. I sit on a plastic folding chair with a towel on it in the tub to shower and sit on the same chair in front of the sink to brush my teeth. Last night we had Chinese take out delivered and this morning I had a spontaneous poop. They both were cause for celebration.
So same surgeon and patient, same operating time under general anesthesia, same amount of tissue removed. For me the standard turp was better tha the PVP greenlight, and the turp preserves tissue for pathology, the pvp gl vaporises it.
Bob

Post Edited (Bob_NJ) : 4/15/2015 12:07:58 PM (GMT-6)

Carl, Ian and Golsofca
Thank you for the informative updates
Good to know about others who also feel good improvements

Golsofca – Here is some thing that I learned recently about the size of the prostate. I was explained by my brother in law that the decrease in the size of it is bigger than it looks like in the first place. And here is his intelligent calculation: Because the usual size of a normal prostate is around 30, in your case, the extra is 26 (56-30=26)
And if your prostate shrank to from 56 to 48, it means that the extra was reduced from 26 to 18. and that is the real ratio. So 8 out of 26 is = 30% drop
Mine was reduced from 65 to 43 but it was only after a year. So I hope you will have more improvements to update until the end of the first year.

Carl - Please update more about your condition after the treatment. I think it's important to all of us. Thank you

Post Edited (Graham_A) : 4/19/2015 4:34:21 AM (GMT-6)

'For those who are wonering if a PVP laser or a standard turp is an easier recovery, I'

WOW Bob_NJ. Thank you for all the information. And I really wish you well.

ClapTheHammer spotted something very interesting: Namely that IRD1956 reported, "I think maybe I am also the first person in Australia to have had a GG embolisation done in Australia....with the supervisory help of Dr Goren...who seems to be an incredibly nice guy."

Any reports on Goren-supervised GG being done elsewhere?

IRD1956: How much did the procedure cost you?

Thanks.

Ira

Golfosca. Since it is a good few 'pages' back, I want to inform readers again that I read on an Israeli site in Hebrew that Dr Gat, and Dr. Goren, closed their operations in Israel and moved to Cyprus after the Israeli Health Ministry forbade them to perform the procedure for financial recompense after 'deeming' the procedure 'experimental'. It would be interesting to see if the Australian Health Ministry sees it differently or perhaps the procedure is at last undergoing full medical trials in Australia to determine it's effectiveness.

I don't have connections with Israel's health Ministry so I would be overjoyed if perhaps, someone else who reads this blog, could clarify if this is true or not. When you, (Golfosca), say, 'too many difficulties', what does that mean? Bureaucratic??

Thank you guys
Thank you Chicago Dave
I wasn't aware that this forum is so active
It's nice to know

Graham, I really liked your comment about the calculation. This is very clever and realy makes sense

I think that there is another thing I didn't mention before - The fact that Dr Gat and his stuff continue to follow up my progress is something very unusual in medical field I think. Correct me if I'm wrong. It seems that they care about you. Every now and then they give me a call to ask how do I feel and ask questions to understand where I stand. This is something you can't expect from doctors in USA ir UK (in general). Usually you just receive the treatment and that's it. And the last thing they feel obligated is to know how are you and if the treatment was successful or not.

IRD1956 - Thank you for the information! It looks very useful. I will do that and update you

I can update you all that after a small regression (I was told that it might occur) there is another improvement which makes it all really good right now. I will continue to update if you like
Thank you all for your wonderful support

Graham - about the herbal tea: I drink every evening a cup of "Lemon Verbena"
And it doesn't disturb me at all
I would recommand you to read this article:
http://www.dailymail.co.uk/health/article-21754/The-true-benefits-herbal-tea.html

It's very informative and usuful

I previously posted (and you can look it up) about my experience last year with PAE and varicocele repair in India. June will be my one year anniversary of the procedures, and I have some general observations.

First, my nightly excursions to the bathroom have been halved, and sometimes as few as once a night. When you consider that I was going every hour on the hour, that's pretty good improvement. It might be even better, except for the fact that the doctor was able to embolize only one side, due to the tortuousness of the other side.

Second, there are times when I find myself having to go more often, but this is unusual.

Third, my erectile dysfunction was better for a while, but now, I don't do well without a 1.5 max dose of whatever. 30mg Cialis, or 150mg Viagra. Meh.

Fourth, from time to time, I pass a small "stone" in my urine, which I've surmised to be prostatic calculi being freed by the prostatic tissue necrosis.

Finally, after having had PSA levels for the past 10 years at 1.7-1.8, my latest done by my GP came in at 3.6., free PSA 69% (Negative DRE). Now, since my dad died in 2013 of metastatic PC, I'm obviously not going to ignore this, but I'm not going to panic over it either. I've suffered from prostatitis off and on for the past 25 years. And, the night before the test, I forgot to abstain from sex and mama and I had quite an extended session. And finally, I have found some evidence online that a prostatic infarction can also jump the PSA number considerably. (And what else is a PAE but an infarction of the prostate?)

So, I see my UROL next week, will abstain, and get another PSA, DRE, TRUS, and see where we go from there. Maybe another course of antibiotics. If it turns out I have PC, I guess I'll start posting to another thread on this site before too awfully long. . . Mom had BC, Dad PC, so I've been expecting this to show up in my yearly checks, and I am on TRT so my UROL checks me every 6 months, as well. Not the best genetics, I fear.

God has one helluva sense of humor running the ureters through our prostates.

Post Edited (Gavrikon) : 4/27/2015 9:55:53 PM (GMT-6)

Hi Chicago Dave
Good to see your updates
It feels like a good comunity here

Gavrikon- Thank you for the info
Sounds very interesting. I would realy appriciate if you can continue to update about your case

Graham - Did you try the thing with the herbal tea?
I would like to read your thoughts

Thank you all

Gavikron- I am approaching the 2 year mark post-PAE. I notice you mentioned that PAE should likely raise the PSA levels. This wasn't true in my case. I have been a 0.8 ever since I had my first check. Last PSA check was a month ago.

After more than a month without my Proscar, I've had no decline in function.
I had tried to stop flomax prior to stopping Proscar, that experiment lasted 4 days.
Started back on flomax and ditched the Proscar. This is what my Uro wanted me to do.