Thinking Out Loud

[Lost Sheep]

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?

[Tybeeman]

Are you close to Anchorage? Couple good doctors there. Have a Coloplast center of excellences in Seattle.

[ThePlumber1964]

Have you checked Dr. Karpman in CA (Mountain View)? I do not know if he provides services to VA.

http://healthy-male.com/meet-dr-karpman/

[Cnidium]

Im under 30 years old, and I will not settle for anything less than Kramer or Eid. And the entire expense of ~$25,000 will be out of pocket. I hope that demonstrates my adamant preference for at top surgeon. I feel like its rolling the dice with a surgeon that you cannot verify good results with.

[warrenw]

I feel like its rolling the dice with a surgeon that you cannot verify good results with.

I have to agree with @Cnidium. If and when I do this, it will only be Kramer or Eid. Yes, I'm on the opposite coast, but convenience is way down the list when choosing the best doctor for this specialized surgery.

[joe456]

Lost Sheep It's your mom ney and dick . its all up you really. what you think of your doc there. ask poeple that he's done get their opinion.

[Tybeeman]

Guys especially Cnidium and warrenw

I think we all wish we had the money to put out $25,000.00 for the doctor of our choice. Like the man said, it is your money and your dick. For all the rest of us that have to rely on the insurance we have and in this mans case the VA, we need to give encouragement for all our brothers trying to make a difficult decision. When you come on here and act like that in this great country full of very talented surgeons. There are only 2 of them capable of preforming a 45 minute out patient procedure. It comes close to being laughable. That said, everyone and me needs to do there research and come up with the best possible solution. FT has been great for me to get the information to come up with the best questions. The easiest advise to give anyone on here to go to a world class surgeon. If they told you tomorrow you had a brain tumor would you fly across country for a surgeon at John Hopkins to do the surgery? No, you would probably find one close. In other words this is not brain surgery, but we all think our little head is just as complicated as out big head.

[Donnie1954]

I used a local surgeon, my Urologist, and couldn't be more pleased. Even the 'super stars' make misteaks. They really are human after all.
Donnie

[ThePlumber1964]

Very good point, Donnie. However, I will always insist on the fact that doing your homework is always a good practice, specially on this delicate situation.

[Donnie1954]

That is so true. I asked a lot of questions and trusted God as I couldn't afford to travel and I have to stay near home. My wife is disabled.
Donnie