Thank you to all (and a review of a 54 yr old's decisions)

[PCPilot]

Thank you to everyone! Frank Talk proved helpful to this 54-year-old following a prostatectomy. I’ll provide yet another observation that, perhaps, another can use to make this journey confidently. In the end, that is what it is about…confidence in your choices. There are many options and paths and being confident in your decision, to me, is the key to happiness.

Getting here: Prostate Cancer was a surprise though 3000 hours sitting on an aircraft radar probably didn't help. I had Stage 2 with 25% total volume of Gleason 3+4 once the final pathology returned—glad it is gone! PSA dropped below 0.01 and continence returned quickly. ED, however, marked a continuation of the journey. I went to prostate surgery “maxing out” the erectile function questionnaire. Standard approach was implemented: daily Cialis or Viagra, try taking 5 pills at once to see if that works (still did not at the one year point), bi-mix and tri-mix worked but left me with a two-hour “hangover of pain,” daily VED for a year. The VED worked but was far from ideal for us in a 21-year marriage. My wife noticed my lack of confidence and remained positive even making her case: “I just want to see that confident look in your eyes again and not the worry about what might fail during the act.” We gave it 15 months after the prostatectomy and went to implants.

Choosing the doctor: I met formally with three implant surgeons. I read Frank Talk vigorously prior to my first meeting. My first stop was a local urologist “specializing” in implants. Frank Talk “saved” me. Without Frank Talk I would have likely followed their recommendation. The meeting with the first implanter was brief ending in a “when do you want to do it?” and prescriptions for antibiotics and painkillers. When I asked how many they do a week the answer was, perhaps, two or three A MONTH. We barely discussed outcomes other than a stretch test. Thereafter, I looked to Dr. Carrion in Tampa at USF and Dr. Hakky in Atlanta based on Frank Talk. Both were amazing. Both mentioned I would be in great hands with the other and both talked highly of the other’s techniques. Timing worked better with Dr. Hakky and his practice was a more convenient. I can’t speak to Dr. Carrion’s outcomes but I am exceedingly confident in and pleased with Dr. Hakky. I casually met another urologist in private life and he knew both of them well. He concurred that both are top shelf implanters and either choice should yield great results. Finally, a range of tests should come with your meetings…discussion is neat but evidence informs a plan.

Choosing the implant: So many options…so many choices. I developed some, to quote my implanter, “wicked Peyronies” from the 15 months of ED and, perhaps, shots. TITAN was the lead for both surgeons and they estimated a 20cm implant. Both discussed AMS 700s as well. I started this ED journey at 5.25”L by 4.5”G down a bit from having lost the prostate. Therefore, the maximum girth, while interesting, was not compelling to me…I just wanted to get back to roughly 4.5”. Flaccid state was a higher priority for me. I am deeply involved in all of our child’s sports; camping; and, most decisive in this, SCUBA diving with a wet suit. Being a big “show-er,” I believed, might prove problematic and I could always “upsize” to TITAN at the revision and after this phase of my fatherhood passes. Therefore, we selected AMS 700CX. The LGX was appealing for the flaccid state but I needed the slight extra firmness of the CX to better manage the Peyronies. The cylinders, from Frank Talk research and analysis, seemed more than adequate for sustaining and perhaps even slightly pushing those of us at 4.5” girth. Had I been more than 5.5” girth I would have adjusted my decision criteria and the choice would have proved more difficult. Had I been longer than 6” then I would have adjusted my decision criteria and, again, this would have proved a more difficult decision process. In this case, being “close” to “average” was, well, quite fortunate. Likewise, Dr. Hakky does any incision approach. We chose infrapubic for a faster recovery as I did not care much about a visible scar…the prostatectomy left more than enough scars on my abs. There was some concern about placing the reservoir in the Space of Retzius given I had no prostate. He was able to do it because he had a great plan, plenty of options we discussed ahead of time (obviously), and the results of a good surgeon during the prostatectomy. This, too, feeds confidence in that I wonder if a less experienced surgeon would have even attempted or discussed it.

Getting implanted: I am only five days post-op but let me get the main point out: “Wow!” Far better than expected. Dr. Hakky discussed slight upsizing during pre-surgery. We agreed he could try. It didn’t work out. He was able to get in an 18cm + 1cm RTE and nicely placed up in the glans. He has a robust anti-infection protocol which I joked “I could probably eat a deadly virus today and come out just fine.” He also focuses on pain management…there are plenty of ways to do this. Whatever he does in surgery is remarkable--I had three days of almost no pain…the first day felt completely fine. Day Three we unwrapped the bandages and he did a check-up. He inflated it to 60-70% which, I have to be honest, got me closer to my “maker.” I took 800mg of Motrin when I returned to the hotel to account for that ache. That’s about it for pain meds so far. I tried the prescribed Gabapentin but did not like the “out of body” experience it provided. The hospital staff and facilities at Northside Gwinett Outpatient are first-rate. We chose a hotel for seven days to remain close to Dr. Hakky’s office for the follow-ups. Frankly, it would also be a bit awkward to show the early recovery to our kid…they know the basics and why it is important but that is about it. Fully deflated, I am outside confidently today in running shorts without much “show” although I do wear tight compression underwear and definitely feel the “rub” on the glans.

Observations from the early days:
1. Take a urine catch from the hospital. There was no “aiming down” with the bandages on. Urinate in the shower or the catch.
2. Clear out your bowels prior to surgery. Doing a BM with the bandages on was a logistical and engineering feat. The job got done but took a lot of planning—or accept a mess.
3. Rest, rest, rest. You have nothing to do but recover. You got here to get your life back—don’t risk a good recovery.

The journey ahead: We will have a virtual follow-up in two weeks and an in-person clearance in a month. He cleared me to begin cycling each day and I’m sure the product rep will provide more guidance next week. I’ve seen the range of cycling protocols out on Frank Talk. Clearly the path is daily “work-outs” create “better results”—I’ll do that in accordance with the Frank Talk “wisdom” after I complete my surgeons initial recommendations. I am confident I will see my pre-surgery length and girth in a few months or less. I am confident that tomorrow looks far better than last week. I am confident that these were the best decisions I’ve made in this prostate cancer journey. Much of that confidence comes from each of you posting openly about your own journey. Thank you.

Happy to chat more with anyone who has questions…I feel it is now my “duty” to provide to others what was provided to me by this forum.

[Iwillbeatpd]

Glad to hear all is going well so far!

I also had hardly any pain from day 1-3. I’d say I’m in more pain now from cycling but that’s to be expected as we stretch the tissues. I wasn’t expecting to be cycled on day 3 in the office lol, but glad I did so I could get started on my own. It was kind of a rip the band aid effect lol.

Wishing you a great recovery!

[HikerMan]

Thank you to everyone! Frank Talk proved helpful to this 54-year-old following a prostatectomy. I’ll provide yet another observation that, perhaps, another can use to make this journey confidently. In the end, that is what it is about…confidence in your choices. There are many options and paths and being confident in your decision, to me, is the key to happiness.

Getting here: Prostate Cancer was a surprise though 3000 hours sitting on an aircraft radar probably didn't help. I had Stage 2 with 25% total volume of Gleason 3+4 once the final pathology returned—glad it is gone! PSA dropped below 0.01 and continence returned quickly. ED, however, marked a continuation of the journey. I went to prostate surgery “maxing out” the erectile function questionnaire. Standard approach was implemented: daily Cialis or Viagra, try taking 5 pills at once to see if that works (still did not at the one year point), bi-mix and tri-mix worked but left me with a two-hour “hangover of pain,” daily VED for a year. The VED worked but was far from ideal for us in a 21-year marriage. My wife noticed my lack of confidence and remained positive even making her case: “I just want to see that confident look in your eyes again and not the worry about what might fail during the act.” We gave it 15 months after the prostatectomy and went to implants.

Choosing the doctor: I met formally with three implant surgeons. I read Frank Talk vigorously prior to my first meeting. My first stop was a local urologist “specializing” in implants. Frank Talk “saved” me. Without Frank Talk I would have likely followed their recommendation. The meeting with the first implanter was brief ending in a “when do you want to do it?” and prescriptions for antibiotics and painkillers. When I asked how many they do a week the answer was, perhaps, two or three A MONTH. We barely discussed outcomes other than a stretch test. Thereafter, I looked to Dr. Carrion in Tampa at USF and Dr. Hakky in Atlanta based on Frank Talk. Both were amazing. Both mentioned I would be in great hands with the other and both talked highly of the other’s techniques. Timing worked better with Dr. Hakky and his practice was a more convenient. I can’t speak to Dr. Carrion’s outcomes but I am exceedingly confident in and pleased with Dr. Hakky. I casually met another urologist in private life and he knew both of them well. He concurred that both are top shelf implanters and either choice should yield great results. Finally, a range of tests should come with your meetings…discussion is neat but evidence informs a plan.

Choosing the implant: So many options…so many choices. I developed some, to quote my implanter, “wicked Peyronies” from the 15 months of ED and, perhaps, shots. TITAN was the lead for both surgeons and they estimated a 20cm implant. Both discussed AMS 700s as well. I started this ED journey at 5.25”L by 4.5”G down a bit from having lost the prostate. Therefore, the maximum girth, while interesting, was not compelling to me…I just wanted to get back to roughly 4.5”. Flaccid state was a higher priority for me. I am deeply involved in all of our child’s sports; camping; and, most decisive in this, SCUBA diving with a wet suit. Being a big “show-er,” I believed, might prove problematic and I could always “upsize” to TITAN at the revision and after this phase of my fatherhood passes. Therefore, we selected AMS 700CX. The LGX was appealing for the flaccid state but I needed the slight extra firmness of the CX to better manage the Peyronies. The cylinders, from Frank Talk research and analysis, seemed more than adequate for sustaining and perhaps even slightly pushing those of us at 4.5” girth. Had I been more than 5.5” girth I would have adjusted my decision criteria and the choice would have proved more difficult. Had I been longer than 6” then I would have adjusted my decision criteria and, again, this would have proved a more difficult decision process. In this case, being “close” to “average” was, well, quite fortunate. Likewise, Dr. Hakky does any incision approach. We chose infrapubic for a faster recovery as I did not care much about a visible scar…the prostatectomy left more than enough scars on my abs. There was some concern about placing the reservoir in the Space of Retzius given I had no prostate. He was able to do it because he had a great plan, plenty of options we discussed ahead of time (obviously), and the results of a good surgeon during the prostatectomy. This, too, feeds confidence in that I wonder if a less experienced surgeon would have even attempted or discussed it.

Getting implanted: I am only five days post-op but let me get the main point out: “Wow!” Far better than expected. Dr. Hakky discussed slight upsizing during pre-surgery. We agreed he could try. It didn’t work out. He was able to get in an 18cm + 1cm RTE and nicely placed up in the glans. He has a robust anti-infection protocol which I joked “I could probably eat a deadly virus today and come out just fine.” He also focuses on pain management…there are plenty of ways to do this. Whatever he does in surgery is remarkable--I had three days of almost no pain…the first day felt completely fine. Day Three we unwrapped the bandages and he did a check-up. He inflated it to 60-70% which, I have to be honest, got me closer to my “maker.” I took 800mg of Motrin when I returned to the hotel to account for that ache. That’s about it for pain meds so far. I tried the prescribed Gabapentin but did not like the “out of body” experience it provided. The hospital staff and facilities at Northside Gwinett Outpatient are first-rate. We chose a hotel for seven days to remain close to Dr. Hakky’s office for the follow-ups. Frankly, it would also be a bit awkward to show the early recovery to our kid…they know the basics and why it is important but that is about it. Fully deflated, I am outside confidently today in running shorts without much “show” although I do wear tight compression underwear and definitely feel the “rub” on the glans.

Observations from the early days:
1. Take a urine catch from the hospital. There was no “aiming down” with the bandages on. Urinate in the shower or the catch.
2. Clear out your bowels prior to surgery. Doing a BM with the bandages on was a logistical and engineering feat. The job got done but took a lot of planning—or accept a mess.
3. Rest, rest, rest. You have nothing to do but recover. You got here to get your life back—don’t risk a good recovery.

The journey ahead: We will have a virtual follow-up in two weeks and an in-person clearance in a month. He cleared me to begin cycling each day and I’m sure the product rep will provide more guidance next week. I’ve seen the range of cycling protocols out on Frank Talk. Clearly the path is daily “work-outs” create “better results”—I’ll do that in accordance with the Frank Talk “wisdom” after I complete my surgeons initial recommendations. I am confident I will see my pre-surgery length and girth in a few months or less. I am confident that tomorrow looks far better than last week. I am confident that these were the best decisions I’ve made in this prostate cancer journey. Much of that confidence comes from each of you posting openly about your own journey. Thank you.

Happy to chat more with anyone who has questions…I feel it is now my “duty” to provide to others what was provided to me by this forum.

Wow, almost my same story to the tee,
and we're almost the same age.

Brother, you are going to LOVE your life in a few months!
As I write this my wife is laying next to me sleeping.

It is an amazing feeling knowing you can drive her crazy at anytime, anyplace or anywhere you want.
After my prostatectomy I went thru a pretty dark period.
By the Grace of God I found this place and I must have spent 20 hours pouring over every post I could find.

Nothing beats knowledge from experience and the men who walked before me had it.

....and I wanted it.
And in this place I found it.
1. Healing protocol
2. My Doctor(!)
3. Correct clothing options
4. Inflation /deflation tips.

Just an absolute treasure trove of Information.

Like you, I just want to thank the incredible posters here.