Issues for out-of-town implants and revisions

[Tybeeman]

Dear Tybeeman and flyweed,
Congratulations on your successful experience with your local doctor. For me, the implant was (is) a major empowerment, self-image benefit and the cost of travel to see the best surgeon, even though geographically remote, was not an inhibiting factor. Based on my research, I found Dr. Eid to be eminently qualified -- and a nice guy, as well -- that is why I chose him for my first implant. However, my subsequent infection was devastating for my wife and I. It was so pervasive that no replacement three piece or malleable rod could be swapped at removal of the infected device. I was told to expect scarring and fibrosis in the corpora which would make a subsequent implant more challenging -- not to mention the dreaded penile shortening. I can assure you gentlemen there is nothing “fishy” regarding the devastation of spending eight nights in a crowded New York hospital while they search for a bacteria that has robbed you of your manhood.
It wasn’t until I saw a video with Dr. Kramer on YouTube where an implant was performed on a gentleman with a similar negative experience with infection and subsequent scarring fibrosis that I allowed myself to consider at least a malleable, semirigid rod (likely to fit more easily in my scarred corpora, with minimal infection potential) or, if corpora scarring could be dealt with, an AMS 700 (antibiotic treated, with ostensible increased infection protection) might be fitted. I found Dr. Kramer to be most knowledgeable, responsive, and pleasant and I gave him complete discretion regarding what procedure would be most practicable. When he opened me up for surgery, after cleaning up the corpora, he determined that the three-piece device was feasible, with acceptable infection risk. It is now nine weeks post-surgery and I am delighted to be infection free with my resuscitated member performing as advertised. For that, I am extremely grateful.
I had no intention of slamming Midwest doctors (or Dr. Eid) in my post. My intent was to inspire others who have had a bad experience with hopeful possibilities and that, regardless of where the physician is located, diligence is required to identify a surgeon with appropriate competence and experience; and one that is capable of communicating and delivering on the alternatives. All best.
MT5400

MT5400, You still miss the point of my message. So I know you are from the mid west so read it carefully. Your title was "Issues for out-of-town implants and revisions" You talked about the problem with having problem and having to travel long distant again then you start telling us that you are going go another long distant for another Doctor for a revision. Let me put this a different way. You title should have read, "There are no issues for out of town implants and revision".By the way I traveled out of town to have me implant.

[TANGERINE]

The problem with having surgery out of town is the following:

If there is a complication of surgery, then you will face added expense and added time at the out of town location. This risk of getting trapped out of town happens since local doctors will be reluctant to fix the problem caused by your original surgery (or they might not have the expertise to ideally handle the problem).

When figuring out who should do my surgery, I gave a very large amount of thought to this "out of town issue" since I faced the prospect of traveling 3000 miles across the country. The decision was difficult since my area has many talented surgeons and I do have a full time job to return to.

90 percent of implant patients are satisfied with implant surgery. This figure is based on reports from centers that are expert enough to bother writing and publishing a paper in the medical literature. But, from reading here on franktalk, there are several anecdotal patient reports regarding smaller issues involving pump position, length, girth, numbness, etc; so , I roughly guesstimate that only 40% are "truly ecstatic" with their implant (this is just a guess).

Here was my justification for traveling a long distance to seek out the best:

a) Sex and the awesomeness of my dick are really central to me; so I would be willing to "climb a mountain" if it meant that I would get a properly sized fully functional penis. I firmly believe that to optimize your chances of being in the "ecstatic group", you need to visit one of the top 6 surgeons in the world. It is true that you might get lucky using someone less famous than the big 6, but that is playing "dick roulette"

b) implant surgery is not simple, and there are complications. I knew that infection happens at a rate of around one in a hundred for all of the really experienced places (do realize that it is significantly higher at low volume places). Before my surgery, I discussed very specifically what would happen if there was infection and I was told that the implant would be removed, a malleable would be placed as a temporary spacer, and I would then need to come back again for the final 3 piece implant many months later. This meant that my single operation would turn into 3 or 4 operations total before I was where I wanted to finally be. I accepted that risk, again using my "willing to climb a mountain" philosophy. This meant that I would sustain more time away from work, more costs for surgery, and more pain and suffering for handling of the infection----but, I was willing to "climb a mountain," so that one in a hundred risk of all hell breaking loose was acceptable to me

c) If I had a complication, I am not convinced that I would feel comfortable with the local urologist's experience at handling that complication as expertly and elegantly as one of the grand master surgeons.

d) Based on what I have read here on franktalk, implantees who are unhappy with their original implant install have commonly run to one of the grand master surgeons for revision. After that revision, things seemed to be OK. So, really, it seems better to "climb a mountain" to get things done right the first time.


My personal opinion: I went into surgery with the mindset that I had a roughly 1% chance of infection (which meant I would be facing lots more expense and lots more surgery and time away from work). I accepted that risk. Also, I knew that I would have a 5% chance that there would be some sort of complication that might require me to return to the distant center of excellence; again I accept that risk so that I would have the best chance of excellence.

My personal experience: I traveled to a location 3000 miles away, I had surgery on tuesday morning, I was on the plane back home friday afternoon, and I was able to enjoy a gentle half mile hike through the woods 7 days after my original surgery and had sex 3 or 4 weeks after surgery. So, I was lucky since I was not in the bottom 1 percent who get infection. Moreover, I was also not in the bottom 10 percent who are not happy with the implant. And finally, I was fortunately not in the bottom 50% who complain of a minor issue such as mild length/girth loss or numbness.

I lucked out, and I am ecstatic about my implant placement/performance/size.
But, was it luck or was it that I "made my own luck" by hedging the bet though using a center of excellence ?

Everyone has different circumstances, finances, tolerance for travel, and tolerance of unfamiliar cities. I respect that the decision whether to travel (or not) is a personal one determined by many factors.

PS: as I proof-read the above, I noticed that I stated "thrilled with length" which means I did not lose length -- we all acknowledge that the implant is NOT going to lead to longer length -- you have what you have

[alibaba]

There is a big problem of doctors not wanting to take over after another doctor. The closest urologist that agreed to follow-up care if I needed it after the Kramer implant was 150 miles away and my map thing shows in that radius there are 214 urologists. I made many calls before going to Baltimore and told no.

[Hawkman]

There is a big problem of doctors not wanting to take over after another doctor. The closest urologist that agreed to follow-up care if I needed it after the Kramer implant was 150 miles away and my map thing shows in that radius there are 214 urologists. I made many calls before going to Baltimore and told no.

Amen to that! I had a difficult time getting my urologist to remove my 3 sutures even with an approval letter. Finally, he consented to let his nursing staff do it. The local urology group (5 Urologists) utterly refused to remove my catheter after I had prostate surgery at Memorial Sloane Kettering Cancer Center in Manhattan. They said, "that's the problem when you choose to go out of town for surgery. They fear liability and they are usually too arrogant to be the follow-up for your preferred surgeon, especially if it is a surgery they also perform.

[alibaba]

There is a big problem of doctors not wanting to take over after another doctor. The closest urologist that agreed to follow-up care if I needed it after the Kramer implant was 150 miles away and my map thing shows in that radius there are 214 urologists. I made many calls before going to Baltimore and told no.

Amen to that! I had a difficult time getting my urologist to remove my 3 sutures even with an approval letter. Finally, he consented to let his nursing staff do it. The local urology group (5 Urologists) utterly refused to remove my catheter after I had prostate surgery at Memorial Sloane Kettering Cancer Center in Manhattan. They said, "that's the problem when you choose to go out of town for surgery. They fear liability and they are usually too arrogant to be the follow-up for your preferred surgeon, especially if it is a surgery they also perform.

Agreed. June 6th my internist in St. Louis referred me to the hospital here for CT's, ultrasounds and surgery at my request. I told him it physically exhausts my wife and I driving back and forth to St. Louis plus there would be the added expense of meals and the hotels at $151 a night plus about $25 in taxes. I made 5 trips to the hospital and 2 phone calls. They kept telling me they had no orders for me. I would come home and email the doctor who would tell me they absolutely did fax 10 pages of orders and the time the fax confirmation had on it. After those 7 contacts telling me they never received any orders I threw a fit. The gal tells me if I had gone to their local hospital owned doctors ( both hospitals have bought nearly every practice in SE Mo) there would have been no problem. I went to a walk in emergency clinic they owned and got a script for the ultrasound. No issue. Had it in a couple days but it took till the 27th for them to admit they had the rest of the orders and 29th to take the tumor out. Top that off, I had to start fresh inputting all my meds and surgical history. They claimed I had not been there in years even though I went to see them in Feb 2017 to get the presurgery testing for the Kramer implant. (They refused because I did not use a local urologist and I went to St. Louis for the test, first time for that). They claimed a computer update deleted my medical history. I cannot say it was retaliation but convenient. Then post surgery, the surgeon told me I really need to change to the competing hospital for oncology so I did. All my tests disappeared. Yes we send slides off. No we do not know what doctor requested them. No we don't know where they were sent to, but yes they were returned when they were done testing( they gave me the slides at my request). You will have to contact the doctor who ordered the tests on them to get the results but we don't know who that was. None of your doctors ordered the tests we shipped them off too? Sorry, we cannot help you then. I hate that shit.
I have to name Dr.Rybak in Bellville Illinois who said he would have no problem seeing me after Dr. Kramers implant if I needed anyone. I have met the man and he is a very very nice guy and I respect his implant advice.A sincere man that wants to help and will take on another doctor's patient because it is the patient he cares about. Cheers.

[TomW46]

I also agree. I decided to skip the airline tickets and go local for my revision.

Dr, Eid has one of the lowest infection rates of any doctor but somebody has to the be 1 in 300 for there to be the one.

Agree again. I have no serious complaint with Dr. Kramer.

[alibaba]

I also agree. I decided to skip the airline tickets and go local for my revision.

Dr, Eid has one of the lowest infection rates of any doctor but somebody has to the be 1 in 300 for there to be the one.

Agree again. I have no serious complaint with Dr. Kramer.

I think your have a better chance of getting a good implant from a local after a super star did your first, even if things were a touch off base. Everything is stretched out and made to fit. It is basically a slip out slide back in deal with a revision unless it was a complete disaster to begin with like some have had or undersized.