Hey Everybody...Glad to be Here!!!

[greggshere]

Well hey everybody, I’m very happy I found this forum. I’ve been reading the various threads and feel like I have already learned so much from all of you and your own personal stories. I’m 54 years old and had a DaVinci nerve sparing RP March 4th 2010. Of course my first concern was to get the cancer out, all of it, and ED was last on my mind. Next, my concern was getting the incontinence under control. Well luckily that only took about 4 months before I was completely dry. So finally I was ready to work on the ED portion. My Doc said it could take up to two years to get resolved, and here we are almost 2.5 years afterward and still nothing going on down there. I’ve tried the Trimex injections several times and was not happy with the results. I had a lot of pain with them, besides not liking giving the shot to myself. I decided I would rather be celibate than do those. They just are not for me. So then I tried Cialis and another one that I can’t remember the name of, but nothing.
Now I have always been a morning type of guy, and there were nice old times where I could wake up horny and wake my wife up and commence a beautiful early morning delight. I long for those days again. I’ve been using VED for about a year, and although it does work to an extent, it is not very spontaneous, and makes sex more of a scheduled event. Don’t get me wrong, my wife and I both enjoy being able to at least make love again, but like my wife says, “It’s like thinking about having fried chicken and mashed potatoes and gravy. You know it’s going to be good, but you dread the work involved. Once it’s done it was great, but then you have to still do the dishes.” That just about sums up the way I feel about the VED.
So anyway, after reading a bunch of these threads, I made an appointment with my URO Doc for this coming Monday the 27th to discuss the possibility of him doing an implant. I like the idea of gaining spontaneity again and being able to pump it up whenever or wherever I please. Thanks for being here, and I know I will rely on your support now that I know you are all here.
Gregg

[greggshere]

Sorry I posted two different introductions, I did not think the first one worked, because I could not see it.I created the second post and when I couldn't see it either I emailed Paul. He told me it was a computer thing and that I need to hit "Shift" and refresh at the same time. Well it worked and now I see them both. I just didn't want you all to think I was strange posting two intro's.

[Cajun Jeff]

Welcome Greg, You will love this place... The guys here have so much knowledge on things that you can do to get back in the game. I am a PCa guy as well. The only recomendation I can give you is be agressive with rehab. If your Dr is not willing to help you find another one that will.

Feel free to ask questions either here or if you wish my email is active.

Cajun Jeff

[greggshere]

Well first the good news. I went to see my URO this past Monday and he feels I am a perfect candidate for having an implant. He does them, in fact he also teaches it at the local school of medicine. Since I have tried the shots, pills, and VED and feel none are satisfactory, he feels the implant is the recommended next step if that is what I want. He uses the AMS 700 LGX and prefers them due to the length and girth advantage, as well as the fact it is coated in antibiotic. He said he also would do the Coloplast if I wanted it, but he recommended the LGX. I left very stoked and excited.

Now the bad news, I got the call today that my insurance does not cover "Sexual Dysfunction". I'm like, you have got to be kidding me. So I get prostate cancer at 52 years old and have a great erection prior and a great sex life, go through all the recommended avenues over a 2.5 year period and then I'm told, "sorry we could care less if your dick is broken."
So let's see, if I had cancer of the leg and had to get it amputated they would cover the prosthesis. If a woman has breast cancer and has her breast removed, they cover reconstruction surgery, but they won't cover this. I am pissed off. So my company pays around $1000 a month per employee and I pay another $250 out of my pocket and the damn insurance won't fix this thing that was certainly functional prior to my RP. Gee medicare pays for it. Well I am not done fighting. I'm going to my HR department next week, I'll write a letter to the president of the company if I have to, as well as the President of the United States if I have to. I'm not going to fade away quietly! I'm sure that is what they want and expect. Also, no where in my insurance paper work does it state an exclusion of sexual dysfunction. I personally think they are full of it. I want my HR department to show me the fine print that says the procedure is not covered.

[Cajun Jeff]

GREG, I so feel your pain.. BCBS is my insurance and was told exactly the same thing. Too bad so sad! Thats their take. It sure pisses me off too. The good thing is after the 2 year mark with lots of work and with injections things are getting better for us. Best of luck with your insurance fight.

Cajun Jeff

[bob1138]

Greg,
Sorry you are being screwed around by your insurance company.
You really do sound like a perfect implant candidate.
I underwent the Coloplast Titan Penile Implant Procedure in December 2007 after developing ED Post-Prostatectomy in 2004.
The Titan completely corrected my ED and my wife and I love it.
One point about the LGX vs Titan.
The LGX is coated with an antibiotic and the Titan has a hydrophilic coating and is soaked in an aqueous antibiotic solution prior to the Implant Procedure. Thus, they both have an antibiotic coating before entering your body.
Best of luck --- hope you prevail with your Insurer.

Bob

[Bionic_by_AMS]

Now the bad news, I got the call today that my insurance does not cover "Sexual Dysfunction".

Go back to the URO office ... ask them to speak to whom actually filled out the forms to the Ins. co. find out what "codes" they entered.
It's all about the codes!
Make sure the codes for your robotic surgery were entered, not just your "Sexual Dysfunction"! (which are not covered)

Now you may have an exclusion for ED built into the policy? ... so it's a good idea after checking with the URO assistant, to speak to your HR dept. You may have to appeal to the Ins. co. but it's worth the effort.

Good luck on a successful outcome ...

[greggshere]

Thanks for the replies gentlemen, the lady at the URO said she sent them my full record which included everything from my initial biopsy to my last appointment. My wife's insurance says in the fine print of her policy that sexual dysfunction is not covered except in cases of "organic disease". This sounds to me like it "would" be covered under hers. My company is self insured and BCBS just administers the work portion. Since the company actually foots the bills I'm hoping I can plead my case to HR or higher and maybe get them to say ok. I actually had my RP done under the wife's plan and we only switched over to my company last year. I figured they would claim it was pre-existing and would not cover it for that reason, but no, they said sexual dysfunction. I'm definitely appealing. It really pisses me off to no end that someone sitting up in an office, either female or a guy that actually has a functional dick, can just say sorry dude live with it, deal with it. They will pay one way or another, either $40K for my implant or $40K worth or mental heath. They cover that, so I'll just start seeing a psychiatrist all the time out of spite!

[greggshere]

Well it has been a couple of months since my last post. I took up my plite with the HR folks, and they sent me to a gal within the company that is supposed to be the learned person that knows all. After hearing the whole story she said she would see what she could do. After a couple of weeks she came back and said there was really nothing that could be done, but that there was another review board within the company that went beyond the scope of the insurance that I could appeal to. She provided me with the address and I sent a very detailed and nice letter to them explaining the situation and what I was hoping they would see as something they could have compassion for. Well unfortunately they sent me back a cold letter that in so many words said not only no, but HELL NO!. Not only that, but also realize that you have used all your appeals and there are no more. Now just drop dead and leave us alone. Ok they didn't save it exactly like that, but that was the jist of it.
Anyway, I just completed open enrollment and went back on my wife's insurance starting in January, so I am now hopeful that they will cover the implant surgery. Yes my insurance was BCBS of SC. My wife's insurance is what I was under when my prostate was removed. I guess if they don't cover it come January, I'll be on to plan C, going to Cleveland. Life shouldn't be this difficult.
Gregg

[seeking info]

PLEASE keep fighting. ALL insurances should pay. They reconstruct breast for women after breast cancer so they can look normal and feel normal. Our prostates are just as important to our feeling good about ourselves as a womans breast. It should be an even playing ground. How is it that medicare pays but private insurances dont. I pray you get what your implant. Why the discrimination! Both male and female lives were destroyed by cancer! Fight brother! Fight hard!
seeking info aka Scott