da Vinci Surgeons in Denver, CO

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Hi steve,

Nice to see someone from around here!  We are up in Genessee CO, and having the davinci with Dr. Stephen Ruyle on April 03, 2007. 

Would love to stay in touch!  and if you don't mind where are you at in the process?

Tanya and Ken

 

Steve, I responded to your question on your radiation thread, however forgot to mention that my husbands is also on both sides. Dr's here have not mentioned chances of ED dropping to 50%. He is a t2c with 20% on both sides, geason 3+3=6 and psa of 4.1. (11 samples on 1 side and 10 on the other.) Both docs still believe good chance of recovery........

Steve,

You have to go with what makes you comfortable among the different treatment possibilities available to you. If seeds is what your choice turns out to be and you are comfortable with that decision, it's the right decision for you. My very best wishes with what ever you choose.

The Doc gave you a realistic 50/50 chance of ED with surgery. No matter how skilled the surgeon there is not a way to prevent some amount of damage although a highly skilled surgeon can limit it. Better and better results are becoming reality as you can see from just reading the stories of others...albiet YMMV. So much is up to anatomy, preoperative function, tumor extent and comorbid conditions (diabetes, HTN and so on). Nothing is a guarentee.

I don't see your stats as being an unusually high risk for ED compared to the average man unless the location is what he's referring to. Probably 80% of prostate cancers are bilateral. location of the tumor could be a reason. Something like 80-85% of tumors arise at the apex which is close to where the nerves course so yeah, it takes a very skilled hand to seperate the prostate away while removing enough tissue to get those good clear margins a surgeon always strives for. Picture peeling wet tissue off an orange without tearing it and you have a picture of what it's like to seperate all the tiny nerve branches away from the prostate. Picture the apex as a ragged sort of valentine. You know it's a heart by the shape but the bottom is a little ragged looking. It would take a good eye and a lot of skill to leave behind good tissue while removing the organ. Something is going to get at least bruised along the way.

Paul had 1 positive core and 3 suspicious cores among the biopsy cores taken. 3 were on left side and 1 on the right. 2 were at the apex. Oddly, it was the right side that stuck a little, not the left and intraoperative biopsies of the apex cleared the way for the Doc to spare the nerves.
It's taken a while but his function has returned to a level that has him feeling like he's in a good place now. The was no urinary incontinence at all. Bottom line...he made the right decision for him.

swim

Steve, Have you thought about talking to someone like an onocologist? We talked to my dad's old doc today. He gave us very good advice today regarding radiation vs. surgery. I trust this doc with all I have. He gave my dad more years to live than anyone one, including docs at MD Anderson thought remotely possible. He told us that if it were him, he would opt for the da Vinci with a good surgeon, like, Dr. F.a.g.i.n (word police will omit his name) in Austin. He said that he has done the most in this part of the country. He did say that if we wanted seeds, find the MOST qualified doc for the procedure, however if we wanted to go radiation, Proton therapy at Loma Linda was the only way to go.... Hope this helps. Courtney

Steve,

Michael here from Boulder. I had Davinci surgery with Dr's Ruyle and Montoya. They perform Davinci's as a team and when I had mine done last June, they had performed 240(I am sure alot more by now). They are the most experienced Davinci surgeons in Colorado and I highly recommend them. If you have any more questions about them, or anything else, let me know. I will be glad to share anything about my experiences with you.

Tanya and Ken,

I just included my stats in my signature profile. Hopefully, it will attach.

Incontinence: My catheter was removed 8 days post surgical. I never leaked at night in bed but leaked a lot during the day for 30 days. Leakage diminished and I stopped wearing pads at 90 days. I still had some stress incontinence and wore light pads occasionally for another 30 days. I did begin to see a physical therapist at 90 days who I believed helped me to strengthen my pelvic floor muscles and improve my general continence. I saw her for eight sessions. 

ED: Ruyle/Montoya were aggressive with my ED therapy. I immediately started 25mg Viagra daily after catheter removal. I also injected myself twice a week with Trimix. Now at a little over 6 months, I still have a lot of recovering to do, but can get an erection using Viagra that is enough for penetration. This has been the case since about 6 weeks post surgical when my wife and I first had sex. Both of my nerves were spared. The docs are confident that ED will continue to improve. At my 6 month visit, Montoya told me that statistics are revealing that robotic patients could see improvement through 1 1/2 to 2 years post surgery; the nerves contiue to heal and regenerate. So, I am hopeful for further recovery.

Surgery: The surgery lasted I believe 3 hours(not sure)and I went home the next day, no complications. Surgery was at Pres/St. Lukes. I didn't have a great hospital experience; inattentive and not very compassionate nurses. Stay with Ken as much as you can if you can. My wife left in the evening assuming I would be well taken care of and I wasn't, my experience. There was one complication at my 30 day visit. The incision above my belly button opened up when the sutures were removed. It was partially healed but left a gapping hole that required frequent attention until it granulated in and healed, an inconvenience but not a big deal in the scheme of what I went through. 

Anything else, just ask, I'll be glad to share.

This is a wonderful forum. I continue to learn from others experiences. Thank you.

Tanya,

I read your new post/thread and am sorry to hear of your difficulties.

I did not have problems scheduling and was not re-scheduled. I did have to wait 8-10 weeks for my surgery and that was hard enough. I did have good access post surgically to my Dr and staff for questions. I was frustrared several times by lack of follow up by the office staff, but I was very presistent when I needed to be in getting what I needed. I have had several of my post op visits rescheduled by phone calls before my visit. I attributed that to the Dr's changing schedule due to more urgent demands. My pre-operative appointment with the dr that scheduled by the surgical scheduler, never made it to the dr's schedule and our appearence was a surprise to the dr, good thing he was there. Overall, I would give the practice a C- in their quality of operations based on their operations last spring. THey may have deteriorated from there with the move. I do belive though, that the new practice and facility will evolve to be the premier urolical center in this region.

I do not have answers regarding Pres/St Lukes. You will have to look into that.

Before choosing Ruyle/Montoya, I looked into ***elson/Eisner. At the time of my surgery they had done less than half of the number of DaVincis and that drove me to Ruyle/Montoya. In the end, the experience of the surgeons was paramount to me.

If you guys are interested, you are welcome to call me or we can meet in Denver for coffee and you can pick my brain on more details. Or, just ask and I will post.

Michael

I was there for my 6 month exam in January. It is a very impressive facility with alot of resources under one roof.

I believe that the move there has caused a lot of problems. After they get settled, I believe that it will be a very good facility.

Is there an expert scientist who would comment on the path, which the palladium seed implant (brachytherapy) physician's instrument passes from the skin as it travels toward the desired destination? Which anatomical structures may be severed as the seed holder passes to its' intended target?

Post Edited (Shamrock Leary) : 2/14/2007 7:21:25 AM (GMT-7)

Re: Posting above…     Hi ~ Shamrock Leary, Look for   JustJulie's Brachytherapy Journey in the Helpful Hint's Page... Links are listed on 2nd posting... Please consider starting your own personal thread with statistics... so we can all welcome you to the forum.   It's truly a great place to be... Helping Hands ~ Helping Each Other... J Lee & Buddy   (Direct Link ~ just click on the title below and a new window will open!   Reminder … click on the REFRESH icon once you get there) Helpful Hints for New Members... Hope this helps you! :) Updated 02-05-2007

Hi Bluebird, I have ruled surgery out in favor of seeds.  Mine should be just about as easy as it gets as I do not have to have hormone therapy or EBR.  I just go in for the seeds and then wait on my next PSA.  Seems like a no-brainer to me.  Am in the process of scheduling.  Thanks for checking.  You do a great job.  What a service to the readers on this forum!!  Thanks for your work.

Steve