My Journey by Jackp

[jackpTenn]

This is my story of my journey to a sesessful implant.

Urology History


1947 Age 5, Tonsils removed and circumcised.

1. 1972 Vasectomy with removal of a cyst from my scrotum.

2. 1975 Severe prostate infection that took over a year to overcome.

3. 1988 Mild ED. Family doctor would not check testosterone level but did check PSA .5. Lower sex drive made me believe my testosterone level was low.

4. 1995 Peronies. Went to Dr. Shappley with prostrate infection and had him check the penile curve that had recently occurred. He said I had Peronies. Put me on 400IU of vitamin E three times a day and Potaba. Curve went away in about 18 months.

5. 1996 First noticed loss of penile size. Lost approximately 1.25” from approximately 5.5” before Peronies.

6. 1996 first TURP for prostate. 9/1997 second TURP. Did not like the effects of the prostate drugs Dr. Shappley put me on. Caused fatigue, and other symptoms. Started Saw Palmetto and stayed on it until the January 2008.

7. 9/1997 Asked Dr. Shappley if he could do anything to fix the effects of Peronies. He said all he could was make a girl out of me. He was joking but I knew there was nothing he could do.

8. 1996 Started on testosterone replacement therapy (TRT). The first few months Dr. Shapppley had me on shots and then changed to gels. I told him the gels were not working. He said. “Jack lets get the old balls working.” Stayed on gels for years. Made my blood thicker and arthritis doctor did not like my thick blood.

9. 1998 ED worsened. Dr. Shappley put me on Viagira the second week it was on the market. Little Help.

10. 2004 Scope of bladder after prostate infection to see if I had anything in the bladder causing problems. All he found was some infection that finally cleared up after switching off Cipro.

11. 2004 Had tried V, C and L for ED. Little help. On a trip to Mexico Dr. Shappley suggested I try Uprima that was not available in the US. The combo with Levitra help a little.

12. 2004 Had a Color Doppler. ED had gotten very bad. Had a Venous Leakage. Dr. Shappley suggested I try PGE1 (Edex) No help at 60mg. (Shot and ½). Then his assistant wanted me to try Trimix. Selling trimix out of office for $10.00 cash per unit. Started with 4 units. No help. Went back to Dr. Shappley and saw his assistant again. Got a limited prescription for trimix. When asked where to get it filled said they did not know. When I asked where they got trimix got the run around of like Ohio or somewhere.

13. 2005 Went to Dr. Conrad. It had been almost 2 years and no DRE. PSA was 1.2. After a DRE and PSA and consultation Dr. Conrad gave me a prescription for trimix and told me I could get it filled at Peoples Pharmacy. Tried different dosage, no effect. Went up to the strongest dose Peoples had and a full 10 units. No help.

14. 2006 After discussing my options after the failed attempt at trimix Dr. Conrad suggested an implant. Gave me a video and set up the surgery for late October 2006.

15. 10/2006 Chest pains. Had to have a stent placed in my heart. Dr. Shiakh said wait one year before implant surgery. 12/06 Chest pains again and another stent.

16. 10/2006 Asked Dr. Conrad what can I do for sex. I need help. He gave me a prescription for a VED. Met the rep in his office and started VED. I thought more was better and caused an abrasion. Took weeks to heal.

17. 10/2007 Dr. Conrad attempted to do the implant. During the procedure he penetrated my urethra in the corpora at the head. Surgery aborted because of possibility of infection. After follow up Dr. Conrad said come back January. Dr. Conrad explained that corporal fibrosis from trying the shots for ED caused the instrument to move when he tried to push it through.

18. 10/2007 Dr. Conrad was giving me 300mg of testosterone every three weeks. Not helping. Talking to Dr. Brewer, my primary doctor, and explained the problems I was having he said he would help me with my testosterone. Blood work after 3 weeks showed low 120 on the range. Dr. Brewer said 600 my every 3 weeks. It took 2 shots to get that much. Dr. Brewer at my request changed the shots to 300mg every 10 days. A felt better for the first time I long time.

19. 1/2008 Follow up with Dr. Conrad. DRE and PSA of 1.7. I informed him I had back surgery coming up the end of January. He said come back in 6 months.

20. 1/31/2008 Back surgery. Dr. Fernandez. L4-L5. He also suggested I wait about 6 months before implant surgery.

21. 5/2008 Current blood work for testosterone still shows low. Dr. Brewer has increased my shot to 400mg every 10 days.

4/2008 Went to Dr. Wake the head of The Urology Department at the University of Tennessee Medical School, Memphis. Was less than impressed. He basically tried to talk me out of an implant. When I was through asking questions it was obvious that he did not have the skills I needed. I knew more about peyronies, implants and testosterone replacement than he did.


VED.
Was using it all wrong. Applying too much pressure and holding it for a long time. After the failed implant I found the Peronies Society web site. There I was talking to Old Man an avid fan of the VED. He gave me a routine of pump and hold for 10-15 minutes.
I use the VED most days for exercise of the penis. It has helped. And for sex I only pump to about 80-90% erect for better feelings and use an Osborn ring for sex.
The men on the Peronies Society web site recommend the VED for Peronies and corporal fibrosis. This routine has worked for me.
I have a Love/Hate relationship with the VED. It took a while to learn how to use it properly. I hate the constriction rings, I have to use a real tight one and it cuts way down on the feelings. I also have to watch how long I have it on.

May 21, 2008

6/3/08 Appointment today with Dr. Yari Walzer. Normal office check in routine gave the nurse a copy of my Urology History. I had my list of 16 questions.
Dr. Walzer came in the exam room and introduced himself and said “Jack I have read your history and I can not help you. You need to go to Vanderbilt or Texas. You do not need any more problems and I do not need the money. You need a doctor that does at least 100 of these operations a year and in this area doctors only do one or two a month.”

We talked a bit more and he suggested that I probably needed the resection surgery on my corpora’s. Then he did an exam of my penis.

After the exam we decided on a referral to Vanderbilt and I would hear from him in a couple of days or so. He also offered to do the follow up locally.

My conclusion of Dr. Walzer was that he was honest, upfront and wanted the best care possible for me. Will continue to use him for Urology issues locally.

6/10/2008 Dr. Walzer’s nurse Kitty called this morning. Referred me to Dr. Douglas Milam with Vanderbilt. Called this morning for an appointment. Recoponsist said his nurse would call me in a few days to make an appointment.

6/19/2008 Received appointment card from Vanderbilt for 8/22/08 along with Patient Registration forms. Will get medical records from Dr. Conrad and the Hospital to carry with me to Nashville.

6/30/08 Peggy, Dr. Milam’s nurse called and rescheduled my appointment for exam and pre-op to July 25th at 1:15. She went ahead and scheduled surgery for August 14th. Wants me to fax medical records when I get them along with cardiac clearance.
Peggy said that Dr. Milam does at least 3 or 4 of these a week and that I may not have to have a radical corporal procedure (will be decided at the exam).


7/10/08 I finally received my records form Dr. Conrad. Faxed 25 pages to Peggy at Dr. Milam’s office that included one page cardiac clearance from Dr. Shaikh.

7/25/08 Vanderbilt Hospital, Nashville TN a 3.5 hour drive from home. Driving instructions put me right in the hospital. Checked in at the Urology Center was greeted promptly and finished filling out paper work.
In the exam room I met Todd Doran PA-C for Dr. Douglas Milam. We went over my history and he answered most of my questions before I could ask. He explained that they use the AMS 700 LGX and use the pubical approach. He did an exam of my penis and said everything looked good for surgery.
After the exam by Doran Dr. Milam came in and introduced himself. We talked about my history and what to expect and not to expect from the implant. I asked about the other models of the AMS 700 and he said they only use the AMS 700 LGX and are in the process of publishing a paper next year to get all doctors using the LGX. He explained that the surgery was 75 minutes and I would only be in the hospital over night.
Dr. Milam did a stretch test on my penis and showed me how much erection I would have. He explained that because of the Peronies Scar the penis would only stretch so far. I estimate I will end up with approximately 4 inches and normal girth. This is down from the 5.5 inches before Peronies. I told Dr. Milam that so long as I have a useable erection that is OK. He wanted me to know what to expect and that would be all I could get back. (Note: My wife and I already knew that I could not gain back the size before Peronies. She explained to me that women are more interested in girth than length and that most of the feeling during sex come from girth.). Dr. Milam also said to continue daily use of the VED for exercise and that it would help the outcome, but to be careful not to hurt or bruise my penis and to stop the day before surgery.
Dr. Milam explained that I would see Todd Doran PA-C most of the time but he would do the actual surgery and would be available if needed. Post op will be in two weeks 8/27/08 with Doran and again in six weeks. No sex for six weeks until Doran teaches me how to use the implant. The final Post Op will be with Dr. Milam in 3 months.
Dr. Milam said he had never punctured a urethra and had seen only one other. He assured me that he would take all precautions to make sure the urethra was not punctured and I would have a successful outcome. He said the only complication he could think of was if they could not get a Foley Catheter in because of the previous urethra puncture. I told Dr. Milam I had a catheter with back surgery in January and he said everything should be fine.
After the exam with Dr. Milam I had to empty my bladder for a bladder scan and then to the Nurses office to schedule my appointments and get pre op and post op instructions. Then down to the lab for blood work and anesthesia work up.
I arrived at the parking garage at 12:45 and was on my way home before 4:30. Wait time was a minimum from other experiences and the staff was all professional and I was generally impressed that these people know what they are doing and how to do it.






Posted on Implant Group 8/13/08

As most of you know I was scheduled for my implant at Vanderbilt for
tomorrow.
7/27/08 I was eating lunch at the local O'Charleys and cut a bit larger
than usual piece of prime rib. With all going on with family and
friends I swallowed before I was ready.
The meat stuck in my esophagus just before entering my stomach. Went
home and tried everything I knew to get it to go one way or another. NO
LUCK.
2:00 in the morning my wife took me to the local ER. They tried twice
to get it out. The second try they put me to sleep. Woke up and still
there.
They transferred me to the main hospital in Memphis and brought in a
Surgeon.
Tuesday about noon they put me to sleep again and tried with a rigid
scope. No Luck. Seems that I am longer than normal, esophagus that is.
They were so aggressive that the doctors collapsed a my left lung and
put my heart into A-Fib. Woke up in recovery with a doctor cutting in
my side to put in a tube, "called him a couple of bad words." Then they
brought in a heart doctor.
Two day of hell in the room with at least six (6) IV's. Then on
Thursday afternoon back to surgery. The Dr. marked my chest that
morning just in case they had to go after it. This time it went through
when they put the tube down. Back to hospital room NPO with a stomach
pump. I was on ice chips until Monday morning. Liquid diet, did not
know so little would make you feel full.
Saturday morning (I think) wife and I had a Come to Jesus meeting with all the Doctors. On what to expect.
Tuesday afternoon the surgeon and then the heart Dr released me to go
home. While in the hospital I asked about the implant surgery and they
said postpone it for a couple of months. Had a long talk with heart
doctor before leaving the hospital and he assured me that in a couple
of months I could get the implant but first I had to get the A-Fib
fixed.
Went to heart doctor today and the A-fib is much better. Wants me to
wait a couple of weeks and if the meds do not fix the A-fib they will
shock it back.
I've lost 15 pounds. When I came home the next morning I looked in the
mirror and did not see myself. What A Shock.
With heart doctors blessing I have rescheduled the pre op at Vanderbilt
to October 24 and the implant to October 30. I WANT MYSELF BACK BY THE
END OF THE YEAR!
If it has not been one obstacle it has been another but come "Hell or
High Water" I am going to get the implant.

8/21/08 Epilog: Went to Dr. Shirwany’s for my pre op before the cardiac conversion. Nurse checked my blood and that was fine. Went to the exam room and took my BP she said I hear a normal heart beat. She went and got the EKG and sure enough my heart was back to normal rhythm.
Dr. Shirwany came in and was almost as happy as my wife and I about not having to do the Cardiac Conversion.
For the arrhythmia in the hospital they added Cartia, a calcium channel blocker and Amodarone to the BP meds I was already taking, Ramipil, and ACE inhibitor and spironolactone are my normal BP meds and have controlled my BP well. I told Dr. Shirwany that in my past calcium channel blocker caused me lots of problems and fatigue and not sleeping were the worst. I asked if I could get off the new meds because of the side effects. He said that for now I needed these but he would cut the dose in half. He also said that in mid November after the implant I would ware a monitor for few days and then reevaluate the meds.
I signed a release so he could get the records of my last cardiac cath 7/07 and other history from my previous heart doctor.
He said after he received these records he would mail me a cardiac release for the implant surgery.
In the hospital the surgeons almost killed me. If it had not been for Dr. Shirwany I don’t think I would have made it. IMHO

9/23/08
Went to Dr. Walzer for semi annual DRE and PSA. DRE was normal.

9/25/08 Dr. Walzer’s office called with results of PSA. Result was 1.1 that is normal. Asked her to send me a copy.

10/15/08 Phyllis with Dr. Milam’s office called and wanted to move the surgery up a week. Pre op is now scheduled for 10/22/08 and surgery for 10/23/08 @10:30. Will drive up to Nashville the 22nd and spend the night at.

10/16/08 received cardiac clearance from Dr. Shirwany and faxed it to Phyllis 615-343-9815.

10/22/08 Vanderbilt Pre Op.
Pre op went well, had all my paperwork in order and a cardiac clearance letter from Dr. Shirwany. EKG was normal and cleared for surgery the next day.

10/23/08 Vanderbilt Hospital – Penile Implant
Check in time was 10:30. Went to pre op holding room and had 2 antibiotic IV’s. Dr. Milam came in about 1:00 we talked and he said everything looked fine. A few minutes later one of his assistants came in and we talked for a while. I mentioned the previous surgery where the Dr. penetrated my urethra and he said he knew all about it. I believe that Dr. Milam and staff had a pre op meeting and knew my history well.
About 2:00 I was taken to surgery and Dr. Milam had a few words and then I was asleep.
Woke up about 3:30 in recovery and felt like I had to pee real badly. Had a Foley Catheter and nurse said everything went as planned and the wanting to pee was normal.
My wife had meeting with Dr. Milam after surgery and he told her everything was OK but I would be in pain for a while.
About 4 or 4:30 Dr. Milam came into the room and said everything went well and he thought I would be well pleased with the outcome. He said I would have some asymmetry because of the scar tissue from the previous attempt but I would hardly notice it.
The next morning about 5:30 the catheter was removed. Had a light breakfast urinated on my own and was on the way back to the hotel by 9:00. We arrived home about 2:00.

To say I am satisfied with the results to date would be an understatement. Just the look on my wife’s face when I got back to the room told me everything was OK. She has supported me all these years and I never saw her happier for me.

My testicles are black and blue, but that was expected. The pump is in front of my right testicle and I have to pull it down to the center every day. Dr.said it would be easier for me to get to there.

I have the AMS 700 LGX. If I am reading the paperwork right I will have an erection of about 12 CM (4.7 inches). If I get a 20% increase over time I will be within ¾ inch of my pre peyronies size. Right now I can tell the flaccid state is larger, no more turtle effect. This is more than I expected before surgery I would have guessed about a 4-inch length. I know size is not everything we have been dealing with peyronies about 13 years and learned length is not where it is with sex. You can adapt to most any size and still have fun.

A better than expected length is credited to the proper VED exercise given to me by Old Man of peyroniessocitey.org. That year of proper VED exercise gave me a better than expected outcome.

11/5/2008 Post Op with Todd Doran, Everything normal. Still sore. Pump is in place so I do not have to pull it down anymore. Advised to remove the strips on the incision the next time I shower (looks good after removal). No tub or hot tub for another 4 weeks. Lifting restriction of 15 pounds.

Had to wait in exam room for about 90 minutes. Nurse came in and said they were having a problem with an anther patient. Offered juice while I waited. Told the nurse wait would be ok I would appreciate it if I had a problem. Left home at 11:00 and back by 8:30 after stopping for dinner at Cracker Barrel.

12/04/08 Activation: I was at Vanderbilt at 8:30 this morning for my implant activation. Doran showed me where the relief button is and them activated the pump. He then had me pump it up. For the first time in years I had an erection that stood straight out and stayed on its own.
AMS that gave full instructions on how to use the implant gave me an “owners manual”. I was advised to pump up the implant 2 times a day for at lest 5 minutes until the next appointment in 3 months.
I was told to pump the implant up at least 3 rimes before trying to use it. I now know why the first few times you pump the implant it stings some for a while. When I arrived home I showed my wife the erection and let her feel of it. Feels just like an erect penis of a 20 year old. When we went to bed I pumped it up again. Lying on my back with my penis sticking straight up and hard gave me a feeling of being normal again.
The actual measured result in the office was 4.25 inches. I was informed that over the next 3 months to a year I should gain at least another ½ inch. This puts me closer to my pre peyronies of approximately 5.5 inches.
The VED was a “gods send” over the last years. After I found the proper exercise for peyronies I gained some size back. Lost about a quarter inch from VED to implant. My Venous Leakage, and Corporal Fibrosis was so bad that I had to use a very tight constriction ring that sometimes did not hold, but I don’t know what I would have done without it. I will give the VED a proper send off New Years in a Barn Fire.
Took me a long time to get here. In my time I would have had the implant years go. God’s time was now. It has been a difficult road but here I am happily lying on my back with a hard on that a 20 year old would envy. I have a “date” with my wife to put it to use tomorrow after noon. Can hardly wait.

12/5/08 Date with wife: All went well still soreness when I pump up the implant and it interferes with feelings. This will all heal with time. Learning curve with use but that is part of the fun,

I HAVE MY NEW TOY FOR CHRISTMAS!!!

1/5/09 One-month post activation. The implant is expanding into the head and have gained back some length. The last month has been a learning curve, tried to just not push it. Today when activated to full length there is a little soreness. Sex the last time was great.

There was still some soreness Christmas but New Years it was 98% gone. Feelings are returning. Great sex new years!!!

2/19/09 This afternoon I decided to take a nap. While lying there I pumped
up my implant. I kept pumping about 20 times after the bulb got hard.
My girth got sore and a little soreness at the glans. Then I noticed
the best erection I have had scene the implant. Like my doctor said
it takes 3 month to a year to get the LGX to full size.

I do not let the soreness keep me from using the implant. It is not
that bad. The first few weeks I was real sore, but that is the price
we pay for success.

3/6/09 I was at Vanderbilt with Dr. Milam this for my three-month post activation
follow-up.

In the three months science activation my erection has become 1/2 inch longer!!!
Dr. Milam said that my implant, AMS 700 LGX, would continue to expand and that
most expansion is between 6 and 18 months.

The proper instructions that I received post op, which I followed, has my pump
in the proper easy to use location. I mentioned that some implant patients did
not receive these instructions and had trouble with pump location. He said that
by the end of the year the paper he and his team are publishing would advise all
doctors doing implants to use the LGX and give patients proper post op
instructions. This is just one of the instructions that patients did not
receive.

To say that my wife and I are happy with the implant is an understatement. I
must remind those considering implants that it is a choice of last resort after
all else fails. My peyronies started in 1995 followed a multitude of
problems, low testosterone, ED, loss of nighttime erections, venous leakage and
corporal fibrosis.

Corporal fibrosis was caused by injection therapy for ED. I tell men never put a
needle in your penis for ED. Some have good luck but most, like me, end up with
problems.

My one-year follow up is in October. Dr. Milam said I would see better and better
results.

I owe a lot of my excellent result to the proper VED exercise I did a
year before the implant.

4/3/09 Dr. Walzer, Prostate Infection. DRE and levequin. This was my first trip to Dr. Walzer post implant. (He is the Dr. that referred me to Vanderbilt). He did a penile exam and pumped up the implant and was impressed at the difference. I had a spot of blood in my underwear and he wants to do a kidney ultra sound 4/22/09

4/22/09 Dr. Walzer’s. Kidney and bladder ultrasound. 2 stones in left kidney. Reflection in bladder and slight elevation in urine. Have to go to the hospital for a flat panel x-ray and a cistocope 5/7 to check the shadow in the bladder. May have to have a lipotripsy for stones.

5/7/09 Dr. Walzer’s/ X-rays from 5/4/09 show two (2) stones in each kidney. Scope of bladder found no problems. Prostate enlarged and he wants me to start back on Saw Palmetto. If stones do not pass on there own come back in 6 months and have kidneys x-rayed a week before. Bring old and new x-rays next visit. 11/10/09 1:00 PM.

5/31/09 Had a fever and back pain like kidney stones trying to pass. Methodist Hospital Germanton ER. Waited a long time for doctor to examine me threatened to leave after 4 hours, then I got attention. CT scan showed. “No acute findings. Bilateral, nephrolithiasis, nonobstructing. 2 on R and 3 on L with largest 7mm on left. Penile prosthesis without acute findings. No acute findings. No Free fluid/air or fat standing.

I was given 2 antibiotics IV, IB for fever and an Rx for antibiotics. And sent home.

7/20/09 Dr. Shirwany’s for heart follow up. Every thing looks good. I still have trouble with difficult ejaculation and asked him about going off the diuretic. My research showed that it could be part of the problem and he agreed. He did not see any problem just watch my BP and if it rises increase the Altace. OK to start Saw Palmetto. Blood work for cholesterol.

8/23/09 My implant was 10 months ago today. The implant continues to expand in length and I have gained back to 90% of my length before peyronies. Sex with my wife is wonderful. I can stay erect as long as I/she desire. With the AMS 700 LGX expanding into the glans (head) I do not have the floppy head that a lot of men complained of before the LGX was available. Once in a while I still have a little soreness in the glans as the implant continues to expand but the soreness is not bad enough to interfere with sex.

All I asked Dr. Milam for was a usable erection. I got that and so much more. I never dreamed I would get about an inch of length back. Flaccid size is impressive I was never a shower. Now when I look at myself in the mirror after a shower I still say to myself, is that me.

9/8/09 About 10 days ago I noticed I was gaining weight and my joints and feet were swelling. I decided to go back on the diuretic. Within 24 hours I lost 6 pounds and my joints and feet went back to normal. Did not notice any improvement in ejaculation while off the diuretic.

10/09/09 See my summary on my one-year post op update.

[jackpTenn]

10/09/2009 My one-year post op at Vanderbilt.

The exam and follow up with Todd Doran PA, and Dr. Douglas Milam

I am delighted with my implant and all the care I received at Vanderbilt. During the exam and follow up questions I spent about 45 minutes with Todd and Dr. Milam. I had a few questions and learned a lot.

We started out with Todd and an intern. I pumped up my implant. Todd showed the intern where the tips of the implant extend into my glans. Of course the glans was flaccid and with a slight downward pressure on the tip you could see where the tip of the implants are. Both sides fit to the same size and approximately ½ way into the glans.

We discussed my success with the implant and the impact it had on my life. I am happy to say the impact has been better than I ever expected. During the discussion Todd asked what is the most common complaint with men with pryronies. Loss of size, length and girth. The AMS 700 LGX is the only implant that can help restore length.

I wish I had a recording but I will tell you basically what Todd said. The AMS 700 LGX will straighten out a peyronies curve. Peyronies is not normally in the erection chambers when the implant is activated it will straighten out the penis. I said to Todd that some men go into surgery expecting an LGX and come out with a CX or other implant. I asked if there was a reason for that. He said that when that happens the doctor does not fully understand the anatomy of the penis and the workings of the implant. Dr. Milam was an engineer before becoming a surgeon and fully understands the mechanical function of the implant and penis. He said that all there patients, with peyronies, that have the LGX have a straight erection like mine.

I have a diminished blood flow to the glans. I told Todd that it is more noticeable now that I have been off blood thinners for a year. He said that was what happens is a lot of men. I asked how could I help blood flow to the glans without the blood thinners. I asked if Cialis would help. He said it would and recommended the daily dosage of 5mg. He wrote me a prescription for the 5mg daily dosage. I will take it along with the coupon for a free months supply from www.cialis.com to the pharmacy today. My prescription drug plan (Medicare Part D) does not cover it so I need to shop around the cost.

I asked about the Ambicor 2 piece implant for a gentleman in the New England area. He said they only use it if they cannot get a reservoir in. He said it has a much lower satisfaction rate than the other implants.

I asked about pain with peyronies for another gentleman. He has been having pain with erections and other urinary symptoms. They know Dr. Levine and his work. They disagree with not doing any surgery for peyronies if you have pain. They did not get specific as to what they prescribe for pain only different men have different symptoms and they prescribe different things, and they also occasionally recommend surgery for the pain. They also recommended a second opinion on the urinary symptoms and said they would be glad to help him with that.

We talked about penile injection therapy for ED. They do not recommend it and do not prescribe it. Injection therapy caused my condition to get worse with corporal fibrosis.

We talked about the peyronies society web site. Todd said that now he has a face to put with those coming in after visiting the web site. He said that they have been able to help several men after viewing the site. Todd said he has looked at the site and likes the fact that we are straightforward and informative. The information is usually straight and factual.

We talked about the difference in the pubic and scrotal approach. 98% of the implant that Dr. Milam does is the pubic approach. He said that the dorsal nerves are easy to identify and keep out of harms way. He said that if there is a problem with the corporatomy it is much easier to repair with the pubic approach. We discussed my punctured urethra that happened with the local doctor using the scrotal approach. Todd said that the instrument to dilate the corpora is curved and if not done properly with the scrotal approach that a punctured urethra can happen. He said Dr. Milam is very detailed about this and reminds his students all the time of this.

I asked about revisions. Dr. Milam said that they do “a ton” of revisions.

I asked about the life expectancy of the implant. Dr. Milam said 93% were performing normally at five years. Both Dr. Milam and I have some engineering background. I am a retired Boiler Inspector and Mechanical Contractor. We compared it this way; you can buy the best HVAC system on the market and use the worst or cheapest contractor in town. The system will not perform properly because of an improper installation. If you buy the same equipment from a first rate contractor you get a properly performing system that will save you money in the long run. I said it to him like this; I charge an A/C system with a digital thermostat to the manufacturer’s specifications. 90% of the systems I go to the first time are at least ½ to 1 pound of Freon overcharged. This cuts the efficiency of the system by about 20-30%. Moral, to get the best results use the best equipment and an experienced well qualified people.

We discussed additional penile length. I have gained weight and need to loose 20-30 pounds. Yes I am a big guy 6’2’, 255 pounds. I was told that if I loose the weight I would gain 1 to 1 ½ inches. That will put me back at my length before peyronies. Now all I have to do is get off my butt and do it. I have started back walking 2 miles a day, but as my wife says I need to cut back on the sweets, bread and portions. I lost over 20 pounds several years ago on the Atkins Diet and considering going back to it.

Girth: My erect girth is back to where I was as a teen’s or early 20”s. If I remember my algebra correctly 2” diameter x 3.14 = 6.28” or 1” radios x 3.14 squared = 6.28”. Any way the wife and I are very happy with it.

The best part of this whole experience is the renewed confidence I have. I feel NORMAL for the first time in years.

There was the pain of surgery, the 6 weeks waiting to activate the device, the discomfort when the device was first activated, getting used to the pump in the scrotum and the about 3 month learning curve of using the implant. The small amount of discouragement when first activated that I was not as long as in the VED but as Dr. Milam said at my 3
Month check up I regained it as the AMS 700 LGX continues to expand

Dr. Milam, Todd and I talked about the publication on using the AMS 700 LGX. It has just been submitted to The Journal of Urology and will take 6 to 9 months before it is published. There is a meeting next month (11/09) in California of the Sexual Medicine Society. Dr. Milam has a major presentation at that meeting on the AMS 700 LGX. Dr. Milam will send me a copy of the publication when it is printed and I have his permission to publish it on the peyronies society web site a yahoo implant group.

I also have kidney stones 3 on the left side and 2 on the right. I showed Dr. Milam the report from a CT I had the end of May. He said so long as I was not in pain the wait and see that my local doctor recommended is normal.

Dr. Milam and I discussed that when my local urologist did a bladder scope, after the ultra sound for kidney stones, that he said that with an implant I was limited with options if I had prostate problems. I had a couple of TURP’s about 12 years ago. Dr. Milam said that with the implant there was no problem with any prostate procedure with the implant.

Dr. Milam and his team do all kinds of penile surgery from surgical correction of penile curvature, penile implants, and artificial urinary sphincter to control incontinence, circumcision and lots more.

Before anyone asks, No you cannot gain additional length or girth with the implant above what you normally have. Any one that tells you their product or device will is selling “snake oil.”


Dr. Milam told me I did not need to make the trip back to Nashville any more but if I needed him just let him know. I will always be a patient of his and Vanderbilt.

JackP

[jackpTenn]

At the one year mark of my implant I thought well this is the greatest thing that has ever happend for me and the wife.

Well I am here to tell you it has now been 21 months since my implant and man the words to describe how great it is fail me. It is better than my wildest dreams. The gain of over 1" in length lost to peyronies was a great boost for me. The wife could care less about the length gain, she was happy just as I was. She likes the new girth the most. I have to say it is impressive after all the years of fighting peyronies and ED along with the other complications.

Yes we can make love for as long as I or she likes. Ejaculate and keep on going. Any and all positions work well. She likes to get on top and ride me, she said she missed that during my journey. I like the missionary so we accomidate each other.

At our age we still make love about 6 times a month. Life is good.

JackP

Note: Guys with PCa or peyronies even just severe ED. God may have closed a door for you but if you will look around you will find he also opened a window. I tried to find my window in my time but it was not God's time. In God's time he opened my window that lead me to Dr. Douglas Milam at Vanderbilt in Nashville TN. It can and will happen for you.