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Adding my "update comment to main post"

Update!

Spoke to the prior authorization specialist who had my info from my meeting with Dr Bodie. She's the one who calls the insurance company to verify anything that's necessary for them to approve of coverage.
She said, "Good news! Blue Cross Blue Shield of California isn't requiring prior authorization or a referral. You're clear for scheduling surgery. Minus the $500 copay and 10% of the surgery up to the $3500 deductible."

What a crazy feeling.

Surgery isn't scheduled yet.
But I feel like it'll be somewhere in Jan-Feb

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If you've read my previous posts, I've struggled with ED for quite some time now.
A year ago I saw a urologist to check my testosterone which came back fine.
Saw a doctor who does implants and was on the recommendation list on franktalk.

I explained I've been using generic cialis and viagra for almost my entire sexlife.
I showed him the lab results from January 2017 so we didn't do any of those tests.

He checked my thyroid physically with no concerns.

He checked my testes and shaft and did notice Peyronie's was evident.
I was kind of shocked! It hurt a bit when he squeezed on the veins in the shaft.
He surmised that venous leakage along with the PD would certainly have an effect on how the penis performed.

In my case, it's somewhat easier to get aroused on my own. Partly due to less nerves, but also because I can coax it better than anyone! Given the right finesse of the tugs, and it does tag quite a bit of coaxing, I can get an erection.
With any distraction however it's quickly gone. I can keep it going with heavy stimulation but that's about it.
And that's WITH 100mg of viagra. Without it, I can get about 75% hard and quickly jerk off before it's gone.

Hurrying has never helped stimulate a woman I'll tell ya.

At this point, we're going to do viagra on the record(i had been ordering it online) for a month or so.
Make sure it's not effective, then I have to get a medical request in to my insurance.
They only cover the $25,000 surgery by 90% and ONLY if it's a medical necessity.
With the Peyronies and venous leakage, I think we have a good case for it getting covered.

I'll keep you guys updated on what happens next!

My Dr was really nice. He explained the procedure takes about an hour (he said he takes his time, other surgeons have gotten it done in 15 minutes! I'd rather he take his time with my dick lol) we talked about the longevity of the implant.
It can last as long as 20+ years! or as little as 5ish. He said 85-90% last 10-11 years. He has had ONE infected implant and it was because the man had sex 2 weeks after surgery which is a no no. His incision got vaginal bacteria on it (shock!) and got infected.

He keeps the patient in hospital overnight with a catheter and semi-pumped implant.

My gf knows what I told her I found out today regarding the VL and PD. Knowing that this is a physical problem, and not just "in my head" I think she'll have more understanding about wanting an implant.

Oh doc and I talked about shots, pump and a supplement you insert in the urethra! ouch!! Pump he said I'd probably hate, and the urethra thing he said almost nobody does. He said if I wanted to try shots we could set up an appointment. I just know they cause more damage and are delaying the inevitable.

Well this is where I am on my adventure so far!!

Happy humping!

jackhammerdreamz wrote:If you've read my previous posts, I've struggled with ED for quite some time now.
A year ago I saw a urologist to check my testosterone which came back fine.
Saw a doctor who does implants and was on the recommendation list on franktalk.

I explained I've been using generic cialis and viagra for almost my entire sexlife.
I showed him the lab results from January 2017 so we didn't do any of those tests.

He checked my thyroid physically with no concerns.

He checked my testes and shaft and did notice Peyronie's was evident.
I was kind of shocked! It hurt a bit when he squeezed on the veins in the shaft.
He surmised that venous leakage along with the PD would certainly have an effect on how the penis performed.

In my case, it's somewhat easier to get aroused on my own. Partly due to less nerves, but also because I can coax it better than anyone! Given the right finesse of the tugs, and it does tag quite a bit of coaxing, I can get an erection.
With any distraction however it's quickly gone. I can keep it going with heavy stimulation but that's about it.
And that's WITH 100mg of viagra. Without it, I can get about 75% hard and quickly jerk off before it's gone.

Hurrying has never helped stimulate a woman I'll tell ya.

At this point, we're going to do viagra on the record(i had been ordering it online) for a month or so.
Make sure it's not effective, then I have to get a medical request in to my insurance.
They only cover the $25,000 surgery by 90% and ONLY if it's a medical necessity.
With the Peyronies and venous leakage, I think we have a good case for it getting covered.

I'll keep you guys updated on what happens next!

My Dr was really nice. He explained the procedure takes about an hour (he said he takes his time, other surgeons have gotten it done in 15 minutes! I'd rather he take his time with my dick lol) we talked about the longevity of the implant.
It can last as long as 20+ years! or as little as 5ish. He said 85-90% last 10-11 years. He has had ONE infected implant and it was because the man had sex 2 weeks after surgery which is a no no. His incision got vaginal bacteria on it (shock!) and got infected.

He keeps the patient in hospital overnight with a catheter and semi-pumped implant.

My gf knows what I told her I found out today regarding the VL and PD. Knowing that this is a physical problem, and not just "in my head" I think she'll have more understanding about wanting an implant.

Oh doc and I talked about shots, pump and a supplement you insert in the urethra! ouch!! Pump he said I'd probably hate, and the urethra thing he said almost nobody does. He said if I wanted to try shots we could set up an appointment. I just know they cause more damage and are delaying the inevitable.

Well this is where I am on my adventure so far!!

Happy humping!

Do yourself a great big favour and let the doctor decide what is best for you after he has you on the table..... doctor knows best.

Larry

Jack,

Could you tell us who your doctor is?

You say:
"He surmised that venous leakage along with the PD would certainly have an effect on how the penis performed."

How did he diagnose your venous leakage? Just via the symptoms you report? Is he unwilling to do a doppler ultrasound?

Did you mean to say the PD caused the venous leakage? Can you explain what Peyronie's symptoms you have been experiencing in your life. Can you feel hardened veins/chords or lumps, maybe some curvature or indents in you penis?

What level of ineffectiveness did he say you need for him to recommend an implant? You already said that viagra did something for you, your girlfriend said you don't even need it, I'm not saying you don't I'm just in a similar situation because Cialis works but not completely and the doses keep increasing.

Do you live with your GF? You sound like you're close to going through with this and I'm wondering if your GF thinks your crazy! I imagine she would, mostly because not many people in the world know much about implants other than us on this forum....

More about his diagnosis of the VL and PD, how severe were these?

I had my implant done by Dr Hakky in Atlanta. I was a difficult case because I am immunosuppresed from medication from a liver transplant I had 2 years ago. The man is a true genius and one of the most compassionate brilliant men I have ever met. Best of luck! I had spectacular results due to his techniques (pre, surgery and post).

Thanks Jack. Definitely keeping the discussion going!

@geophd:
You're right I worded that awkwardly, the Peyronies he felt could be contributing to the venous leakage.
More specifically the veins leading blood away from the shaft may not be closing to keep blood inside.
Which now that I think about it makes a lot of sense. If I'm not concentrating all my effort on my dick, that sucker looses blood quickly.

He did NOT do a doppler ultrasound, perhaps he didn't feel it would show much? I didn't push him on that. Or maybe it would be hard to see? I don't know how it works.
He said since there was no history of diabetes, cancer, blood pressure etc. Venous leakage was the likely candidate for this...

re: peyronies.... I am not sure what exactly I'm feeling for, he was the one who felt my penis and said he felt some scarring.
I don't physically have any left/right curve but some curving upwards. I don't have any intense pains that I could attribute to it.

I have spoken with his nurse via secure messaging and she has passed on my information to their "prior authorization" specialist.
They can take it from there and whatever they feel is necessary to improve the case for an implant they'll let me know.
Getting authorization now or trying to at least, would be good to know in the event I do decide to take that route.

Yes I live with my girlfriend. We talked about it and discussed the symptoms that were discussed by my doctor and I.
I explained that the reason sometimes we can have adequate sex is because of the pills I take. Which I admitted I take almost daily when she wasn't aware of that frequency.
They have definitely become less effective at which point I explained the shots and pump. Neither of which I am interested in.
She suggested maybe I wait until I'm 40 (7 years away) to get an implant, at which point I asked if she'd like to wait 7 years to have spontaneous sex
as much as either of us wanted? lol She was definitely open to the idea and became more curious about it all. What's involved, how successful it is, will I lose stimulation etc.

I am fully aware of the pain, recovery, cost, and irreversible nature of this surgery.
I did get a prescription for 20mg Viagra (the real stuff not from india) to make sure the pills really are becoming useless.

At the end of the day, I feel Dr Bodie and I will be able to work my sexual confidence back up whether it's pills or implant.

He was very open minded. He didn't suggest or turn down any of my suggestions.
If I put 25k on the table tomorrow he would respect my choice.
If I wanted to do pumps, shots, or pills he would support that as well.

We discussed the implants and their lifespan, the recovery process, etc.
Everyone here knows that implants are the more involved, painful and permanent but most reliable choice when it comes to resolving ED.

lol I'm not saying all this to try and fight to defend myself, I appreciate everyone's words and help throughout this.
15 years of embarrassing sexual encounters, man it would just be nice to have a hard-on whenever you want right?

Thanks everyone
Any more questions, thoughts etc please let me know.

Very interesting, I'm eager to see how this pans out for you. It seems exciting to see you making moves to fix your problem and get back to a healthy sex life.

Yes peyronie's can cause venous leakage. When I don't think about keeping my dick hard it starts going down, just like you say. First time in my life this has been an issue, you might have been experiencing this forever from early peryonie's/tissue I guess.

For Peyronie's you should squeeze your limp penis a little up and down the shaft with the tips of your fingers and feel for any small abnormalities, tough material/nodules. But if you have never recognized any then it will probably be hard or impossible for you to now, it should be easily recognized but maybe you've had it for so long that it just seems normal to you... And I'm curious he didn't do a doppler ultrasound to confirm the venous leakage for the insurance pre-approval, I had thought that was required. I mention this because none of the urologists I have went to have agreed to do an ultrasound despite the fact that I present classic symptoms of venous leakage. Perhaps they don't really need it to diagnose it.

Overall, where my mind is going here is that he seems very much on your side to make an implant available to you. What was his medical suggestion/advice for your treatment, or did he leave that completely up to your decision? I was hoping to go to a surgeon urologist and ask his advice. making the decision myself rather than being recommended seems a little daunting.

I'm wondering how you decided on Dr. Brodie, is he in your insurance network? Have you considered others? I ask because I'm considering Dr. Karpman because he is in my network but I think I'd prefer Dr. Eid. I feel like Karpman is highly qualified and would save me A TON of money but then again Dr. Eid is arguably one of the best implant surgeons globally. Personally, I would lay 25k on Dr. Eid's table before anyone else if I was paying out of pocket.

How often are you able to have sex at the moment, could you/do you do it daily considering you're taking pills daily? I ask because I am capable of having sex everyday right now but the cialis is becoming less and less reliable and sex is becoming more of a stress. I'm curious to see if your doctor would recommend the implant even if you're currently able to have frequent sex.

Sorry about all the questions but of course it's not like any of my friends are also considering implants right now if you know what I mean.

Best wishes to you. There is a lot to consider. Keep us updated on your decisions.

geophd wrote:Very interesting, I'm eager to see how this pans out for you. It seems exciting to see you making moves to fix your problem and get back to a healthy sex life.

Yes peyronie's can cause venous leakage. When I don't think about keeping my dick hard it starts going down, just like you say. First time in my life this has been an issue, you might have been experiencing this forever from early peryonie's/tissue I guess.

For Peyronie's you should squeeze your limp penis a little up and down the shaft with the tips of your fingers and feel for any small abnormalities, tough material/nodules. But if you have never recognized any then it will probably be hard or impossible for you to now, it should be easily recognized but maybe you've had it for so long that it just seems normal to you... And I'm curious he didn't do a doppler ultrasound to confirm the venous leakage for the insurance pre-approval, I had thought that was required. I mention this because none of the urologists I have went to have agreed to do an ultrasound despite the fact that I present classic symptoms of venous leakage. Perhaps they don't really need it to diagnose it.

Overall, where my mind is going here is that he seems very much on your side to make an implant available to you. What was his medical suggestion/advice for your treatment, or did he leave that completely up to your decision? I was hoping to go to a surgeon urologist and ask his advice. making the decision myself rather than being recommended seems a little daunting.

I'm wondering how you decided on Dr. Brodie, is he in your insurance network? Have you considered others? I ask because I'm considering Dr. Karpman because he is in my network but I think I'd prefer Dr. Eid. I feel like Karpman is highly qualified and would save me A TON of money but then again Dr. Eid is arguably one of the best implant surgeons globally. Personally, I would lay 25k on Dr. Eid's table before anyone else if I was paying out of pocket.

How often are you able to have sex at the moment, could you/do you do it daily considering you're taking pills daily? I ask because I am capable of having sex everyday right now but the cialis is becoming less and less reliable and sex is becoming more of a stress. I'm curious to see if your doctor would recommend the implant even if you're currently able to have frequent sex.

Sorry about all the questions but of course it's not like any of my friends are also considering implants right now if you know what I mean.

No worries about all the questions. Questions are good!!!
And this is the place to ask them

He left it more in my hands. As stated before, we did discuss the caveats of each solution. Pumps, pills, shots, implant.
We did go with pills(authentic ones) first to make sure they aren't working well enough. Then going from there.
There's nothing wrong with flat out asking them what you should do if you are unsure. They will give you their opinion which you can weigh for yourself.

I'm not sure about the ultrasound stuff either. I could ask him (it's nice having a portal to email to his staff and get questions to him)
Perhaps the ultrasound doesn't always prove determinate enough?

I Chose Dr. Bodie based on another gentleman who lives in my state(MN) that went to him. He had great things to say about him and Bodie is also on the Physician Finder Franktalk provides.
The superstars are all good and everything but I'm not one to spend hundreds to fly to Florida to get orange juice when I can get great orange juice in my own town.
A silly analogy but I just mean, I know Bodie is a good surgeon he comes recommended, he's a good guy very chill and young. He hasn't made a monopoly out of the surgery which I kind of like too. (nothing against Eid)
His practice is 10 minutes from my house and valet is $6 so it was a good choice to make.

There's nothing wrong with shopping around. It's your body and choice after all! I'm not much of a shop around type of guy If I felt he wasn't a good fit I would move on but he's a good guy all around.
You can ask your doctor about speaking to any of his past implant patience too. They can't give you the patient information but he can give your contact info to them and they can reach out to you if they want.
Hey may be able to show you his work I'm not sure how photos of past operations are covered by confidentiality.... Has anyone on here had Karpman do their implant? You could ask around and get opinions from them as well.
If you haven't met with Karpman definitely do that first. First impressions are big in my opinion. If he(or she?) is not personable, or understanding or doesn't listen, get outta there.

Oh regarding the "thought they needed that for qualification" That may very well be. I haven't heard from the Prior Auth people from the hospital. They will let me know what they find out after they talk to my insurance.


We have sex about once every week or two. Sometimes twice a week(rare). All of these times are within the window of an ED pill. Often times the intercourse is done in the early mornings when I have a partial morning wood (still a side-effect from the previous day's ED pill). My confidence levels are pretty low to the point where I typically rely on her to make the move to have sex. The orgasm ratio is about a 5:1 so she's having an orgasm maybe once a month via my penis. Sometimes if she wants, I will finish her off with a toy. (Sex doesn't have to end when the guy cums haha). The last 6 months-year have seen me cum faster too. I think as I feel the pill not working as well, my brain hurries up and allows the sensations to hit me faster so I can orgasm. Selfish subconscious thinking I suppose.

I wouldn't say the sex is frequent, and it's definitely a worry (will I have sex later? should I take a pill now?).
Performance is definitely not consistent and the quality is dropping which is why if the pills he has recommended don't provide full erections, I'll be going implant in the future.

Have a good weekend!

Update!

Spoke to the prior authorization specialist who had my info from my meeting with Dr Bodie. She's the one who calls the insurance company to verify anything that's necessary for them to approve of coverage.
She said, "Good news! Blue Cross Blue Shield of California isn't requiring prior authorization or a referral. You're clear for scheduling surgery. Minus the $500 copay and 10% of the surgery up to the $3500 deductible."

What a crazy feeling.

Surgery isn't scheduled yet.
But I feel like it'll be somewhere in Jan-Feb

Wow! Moving right along here and at a completely reasonable price. Congrats!!! (?) So how did the brand name viagra turn out? Same ol'? So you've decided to go forward with the surgery?

What have the discussions with your girlfriend been like?

Also, I thought you were in MN but you have Blue Cross Blue Shield of CA?

It would be great if you could document the experience i.e., erection size before and after, sensations following the implant, location of the pump, whether your glans engorge, what your girlfriend's experience is with the implant, etc. etc.

This would be very valuable because you are currently able to get erections with the pills but just not reliable. It would be great to compare sex on the pills with sex with the implant. Young guys would be eager to read your experience.

Must be exciting, best of luck!