Thinking Out Loud
Posted: Wed Jun 07, 2017 3:46 pm
Thinking aloud about where to have my penile implant (obviously, in my penis)
Local surgeon or highly experienced surgeon)
While I still have misgivings about proceeding with my local urologist (who has relatively limited implant surgery experience-20 in the past 12 months), the roadblocks to having the surgery with Dr. Kramer are substantial.
I live in Alaska and have medical care provided by the Veteran's Administration. Alaska VA is cooperative, but Maryland VA's bureaucracy is difficult to navigate. Bypassing Maryland VA to go directly to Dr. Kramer by Alaska VA authorization is possible, so I have a choice between my local urologist or Dr. Kramer (or even Dr. Eid, though all the groundwork has been laid for going to the Maryland VA Hospital or University of Maryland Hospital).
The arguments for having the operation in Maryland are
ability to choose the appropriate implant manufacturer and model AFTER the operation has begun (not available in Alaska)
surgical team well-practised and surgical suite optimally set up for implant surgery (at U of M, not so much at Maryland VA)
low infection rate
Dr. Kramer's reputation and expertise in placement of peripheral components, pump, reservoir, etc
Dr. Kramer's reputation for optimal sizing of the implant, distal tip placement, crus placement and using as few rear tip extenders as possible
Dr. Kramer's reputation for minimal bleeding, swelling, post-op pain and swift recovery
the arguments for having the operation in Alaska are
Fewer bureacratic surprizes/roadblocks likely
Recovery at home without waiting in a hotel a few days for swelling to subside before flying 13 hours
Recovery at home with a friend to help
Followup doctor will be the one who actually did the surgery
Local surgeon leaves inflation at a very high level, suggesting an easier activiation regimen
$1500 to $2000 cheaper out-of-pocket (at my income level, this is substantial)
Likely to be completed before July. Maryland may take a month or two longer, with additional risk of bureaucratic roadblocks
Any thoughts before I make the decision final?
Local surgeon or highly experienced surgeon)
While I still have misgivings about proceeding with my local urologist (who has relatively limited implant surgery experience-20 in the past 12 months), the roadblocks to having the surgery with Dr. Kramer are substantial.
I live in Alaska and have medical care provided by the Veteran's Administration. Alaska VA is cooperative, but Maryland VA's bureaucracy is difficult to navigate. Bypassing Maryland VA to go directly to Dr. Kramer by Alaska VA authorization is possible, so I have a choice between my local urologist or Dr. Kramer (or even Dr. Eid, though all the groundwork has been laid for going to the Maryland VA Hospital or University of Maryland Hospital).
The arguments for having the operation in Maryland are
ability to choose the appropriate implant manufacturer and model AFTER the operation has begun (not available in Alaska)
surgical team well-practised and surgical suite optimally set up for implant surgery (at U of M, not so much at Maryland VA)
low infection rate
Dr. Kramer's reputation and expertise in placement of peripheral components, pump, reservoir, etc
Dr. Kramer's reputation for optimal sizing of the implant, distal tip placement, crus placement and using as few rear tip extenders as possible
Dr. Kramer's reputation for minimal bleeding, swelling, post-op pain and swift recovery
the arguments for having the operation in Alaska are
Fewer bureacratic surprizes/roadblocks likely
Recovery at home without waiting in a hotel a few days for swelling to subside before flying 13 hours
Recovery at home with a friend to help
Followup doctor will be the one who actually did the surgery
Local surgeon leaves inflation at a very high level, suggesting an easier activiation regimen
$1500 to $2000 cheaper out-of-pocket (at my income level, this is substantial)
Likely to be completed before July. Maryland may take a month or two longer, with additional risk of bureaucratic roadblocks
Any thoughts before I make the decision final?