Uro follow up.

I had my first visit with my Uro since the day of my biopsy results. It was mainly just a consultation. He asked what questions me and my wife had. We went over his basic AS procedures.

We talked about their surgeons some, and Dr. Smith at Vanderbilt. Before I get beat up for that with my diagnosis, it is not for now, but just gathering knowledge should the time come I could need one. I do have appointment set up with Dr. Smith on Jan 7 just to get to meet him and go over the case.

I also let him know I was looking for a RO or two to talk to as well to get a good grasp of all the options that are out there and when they would think the time would be for doing something if I decided to go that route. He stated that was a good idea.

We talked about diet- (I keep telling people my wife is starving me). My wife asked a lot of questions about that. He stated what I think the average answer is on here.... no empirical evidence to show that any thing really helps more than others. His basic theory is- If it is good for the heart it probably is good for most of the rest of the body. No red meat is not as good as chicken or fish, chicken or fish, not that much different. Balanced diet, lower fat, more veggies and fruit was his advice.
On a good note, after 1 to no cokes a day, just water, concord grape juice, and green tea my Ph has gone from 5 to 5.5. That is a good thing. Her starvation diet must be doing something good for me. I did have a NY Strip Sunday for lunch. Skipped the potato and had green beans and some baked beans. She even let me have chicken nachos for dinner last night. I think she was to tired to protest.

We talked about what he thought he would need to see before we would need to move off of AS. Basically he said no number is correct. The total picture needs looked at. If the PSA goes up and the finger, MRI and maybe another biopsy shows no change, no worries. If PSA stay the same but others change we would have to look at it.

I am very happy with the AS. My wife will be the worry wort in the deal. She would like me to get it out now, but she says it is my body. The Uro is happy with my decision. He explained the process in easy terms to help my wife. Thanks to you guys- he said I already have more information and done more research than most people that come in for the second visit.

My wife wanted the first PSA test of AS today so they took blood for that.

The Path group had send the slides to the office for me to pick up today. I told the doctor about it. He called the Path guy to tell him to send them to John Hopkins and they said ok. I got a call about 10 minutes after I left saying they were sending the slides to my doctor to send. I told them that wasn't what the Dr. said a few minutes ago. She said the Path Group did not want the slides to be transferred that much. I asked what the difference was from them getting them back and sending them or getting them to my PCP and her sending them. I got the "that's just what they said". At this point with packing U haul's, doing a double closing on houses tomorrow and moving in, I just don't have that fight in me today, so she can send them along.

I did ask the size of my prostate and added it to my signature.

Thanks for all the help you guys have given in the past month.

Larry

Great job of doing this methodically and stepwise. Your options will always be there. I think you’re making wise choices.

Thanks for the update...and I don't think there's anything wrong with meeting with a surgeon or RO now. Hopefully, you'll be on AS forever (or at least a very long time), but If you ever get off AS, you'll be ahead of the game. Good luck!

dude - You, I, and several others share the analytical approach to medical decision-making. I applaud not only your application of sound logic, but also your choice in the current situation.

At a PCa support group meeting last evening, we had a presentation on the AS program at Chicago's NorthShore Medical System. Their program is much like that of JH, and it made such great sense to me. They use not only the numbers, but also their interviews with the patient about his life, lifestyle, preferences, fears, etc., to determine when, if ever, to move to treatment.

If I did not have the contraindications that I do, I would have opted for AS myself.

Carry on!

Thanks for all of the support. I am working toward more of a moderation, but I do really need to lose some weight. I do know I have felt better without the red meat and other sugary things. May be just mental. i do like the Ph going up. I know that can have a lot to do with other issues in my body.

I also finally got over a 2 month long ear infection that had been driving me nuts.

We moved in the new house yesterday. Now we need to try to find room for the "stuff". We downsized from 2900 sq ft to 2000. My wife did not think there would be that much difference. I told her we are closer to half of what we had than having the whole thing. Goodwill is going to love us this month!

I did get the bed set up and the TV, DVD, Xbox all set up. That is the important stuff. Internet and Directv coming today.

Blackjack,

HA!

We use the xbox to watch Amazon Prime and Netflix. Occasionally if one of the kids is over we do game night with the connect. We like the bowling, boxing, and Olympic sports.

i moved, but not to my mom's basement!

On a funny note, when I first had trouble peeing (or do I need to be formal and urinate), my PCP gave me the low dose Cialis. It came with a coupon since it is so expensive.

She stated that this would work but insurance most likely would not cover it until we tried all the other things that don't work as well. I said "is that what I think it is?". She said yes. It would help the issue and any other benefits were just her building good will with me for the future!

not the number you wanted.

do let us know what the doctor says.

Andrew

Not sure if a difference of 0.3 is significant. but would have been nice if it were lower
See what the doc says and keep us posted

Well, apparently the person answering the phones the other day either can't read of didn't really care. I got the official letter from the pathologist today and it was 5.5. That makes the doubling time come in at 10.2 months.

The finally got the issue with the slides figured out and they are going to the path group and then to JH. Hopefully I will hear something back from them next week.

I will try to get in touch with the urologist tomorrow or Friday to see if he has thoughts about it going up almost a full point in 3 months.

I would be lying if I did not say it is concerning to me. I will let you know his thoughts when I get in touch with him.

Hey BBQ,
If I'm reading your data correctly, you had a bx on 10/26/18. Your had your PSA checked on 11/27/18.
That seems really soon afterward. My uro said wait at least 8-10 weeks before retesting PSA. I made this mistake this year when I took a PSA draw in June, 8 weeks after my bx and skyrocketed to 12.8. It's subsequently dropped back down to 5.1 last week. Next bx, I'm not getting a follow-up PSA for at least 14 weeks just to be sure. JH second opinion is a great next step. Your uro may just say that 4-5 is where "you live". Maybe ask him about an MRI as a next step. Good luck.

After 4 weeks, your prostate is still healing from the biopsy, which could easily elevate your PSA. Going forward, remember some basics about PSA testing: for the 48 hours before, no bike riding (or horseback), no sex (not even manual), drink plenty of water.

Keep us posted.

bbqdude, I had two PSA tests at Vanderbilt and both times was given a DRE first. When I questioned the administering physician assistant about it she acted like I was nuts. That along with a lack of an active surveillance option (at least thats what Smith led me to believe) had me and my prostate making a hasty retreat out of there. Four years later I still have mine. Best of luck to you!