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Medical Forum / Diseases and Disorders / Prostate Cancer / November 2004VA
Should I sign up with the VA Hospital here in Boise Idaho since I have been diag's with PCa ? Does anyone know of a Dr David Rice here in Boise ? He is my Uro Doc...he seems to be good and to know his stuff... If I decide on Surg...does anyone recommend St Als here in Boise...guess I will be asking a LOT of questions? Howie "Sign up"? Are you retired military? Do you have documented, approved service-connected disabilities? Are you in the VA system? Is Dr. Rice a VA surgeon? Realize that a prostatectomy is one of the most demanding surgeries known to medical science. You want one of the best urology surgeons, with a good RRP track record, not just a good local one. Your sex life and urine control, even bowel control, are at stake even if your PC is caught early. I.P. > Should I sign up with the VA Hospital here in Boise Idaho since I have > been diag's with PCa ? Does anyone know of a Dr David Rice here in Boise > ? He is my Uro Doc...he seems to be good and to know his stuff... If I > decide on Surg...does anyone recommend St Als here in Boise... How do I check out a Uro Doc This Dr Rice of Boise Idaho removes the prostate by Laposcoptomy (Dont mind my spelling) like they do a gall bladder. Opinions please.. Howie > How do I check out a Uro Doc This Dr Rice of Boise Idaho removes the > prostate by Laposcoptomy (Dont mind my spelling) like they do a gall > bladder. Opinions please.. Howie From what I have read, surgeons are now getting as good results with laparoscopic surgery as with retropubic surgery (the kind that cuts a deep slit through the abdomen). It has been said that the laparoscopic surgeries take longer, but may have a faster recovery and a lower incidence of side effects. If surgery is your choice of treatment, LRP is certainly a viable option. However everything in medicine seems to be controversial. You can find people who will regard anything but the old style RP to be risky and others who think radiation is the only safe treatment. I can say for certain that quite a few people on this newsgroup have had LRP (laparoscopic radical prostatectomy). To my knowledge, none of them died and the incidence of side effects they report doesn't sound any worse than for the other type of surgery. Unfortunately, I can't think of a good way to evaluate the doctor. If you can track down any of his patients, that may help. If you find someone who knows any staff at the hospitals where he works, that might help. If nothing else, I would evaluate a doctor on how he relates to me. Does he listen, or only talk? Does he answer questions or only spout platitudes? Does he have a gentle touch, for example with the digital rectal exam, or does he ram his finger in and out without regard for the patient? Is he open to questions about his experience with this procedure or does he act cross if someone questions him about what he's done? Alan But until it gets a 15-year track record equivalent to that of the RRP, it's still just another experimental technique. It's a personal call, but I'm not lettin' 'em experiment with my life as long as there are proven options available. Besides, the lap approach has pathology (prognosis of the patient's future) shortcomings, discussed in the books. And how does a laparoscopic surgeon evaluate the involvement of the seminal vesicles and neurovascular bundles? Does he make a separate incision s he can examine or excise some lymph nodes? And while I might evaluate my psychiatrist or pediatric GP by his beside manner, I pick my surgeons by their mechanical skills. I.P. >> How do I check out a Uro Doc This Dr Rice of Boise Idaho removes the >> prostate by Laposcoptomy (Dont mind my spelling) like they do a gall [quoted text clipped - 34 lines] > > Alan <Snip> >> Unfortunately, I can't think of a good way to evaluate the >> doctor. If you can track down any of his patients, that may >> help. If you find someone who knows any staff at the hospitals >> where he works, that might help. <Snip> Perhaps it was because I elected to go with my doctors opinion that cryosurgery was the choice of procedures the he would go with, that he, on his own, gave me names and phone numbers of some of his patients he had done that procedure on. That showed me that at least he believed in the procedure and his ability. Any doctor that is reluctant to work with you on this matter is, to say the least, suspect. <Snip> >> If nothing else, I would evaluate a doctor on how he >> relates to me. Does he listen, or only talk? Does he >> answer questions or only spout platitudes? Does he >> have a gentle touch, for example with the digital rectal >> exam, or does he ram his finger in and out without >> regard for the patient? <Snip> I had the misfortune to get a physical by a doctor that I had hoped to switch over to for a family doctor. When he was preparing to give me a DRE I asked him to be easy that I had hemorrhoids. The S.O.B. just RAMMED his finger in for the exam. I never went back to him. Evidently I have been lucky. That has been my only experience with a doctor that I think is sadistic. Bob Austin > How do I check out a Uro Doc This Dr Rice of Boise Idaho removes the > prostate by Laposcoptomy (Dont mind my spelling) like they do a gall [quoted text clipped - 3 lines] > > "Have a nice Thanksgiving" Howard, I don't know Dr Rice but think the urologist community in Boise is pretty close. My uro is Dr Fredrikkson (with Saltzer) and he works out of St Lukes in Meridian as well as Mercy Medical in Nampa. There are a lot of good uro's in the area but do not know much about the VA in Boise. I will avoid the VA as I have great insurance coverage w/ the company I work for. As lots of questions when you are at your urologist. And see if you can get a second opinion in you feel uncomforaable with what you are hearing. Phil(ski) Reformatted....and emailed as well..... Howie.....I do not have a clue about WebTV.....I work on the Microsoft news groups only. But Curtis has it and can help you. First of all, you are using HTML instead of plain text.......secondly, you are using coloured stationary......and thirdly, you obviously have a signature that you add (Have a nice Thanksgiving) and that is probably what is showing up as the half-a$$ed attachment. It is not a *real* attachment. Curtis......can you sort him out? We usually can't do that with WebTV on our MS ng's. Cheers.....Heather How do I check out a Uro Doc This Dr Rice of Boise Idaho removes the prostate by Laposcoptomy (Dont mind my spelling) like they do a gall bladder. Opinions please.. Howie "Have a nice Thanksgiving" And don't forget that signatures can be virus paths. I.P. "Heather" <casey@nospam.ca.invalid> wrote > you obviously have a > signature that you add (Have a nice Thanksgiving) Not in my book, grin. "Auntie Virus" > And don't forget that signatures can be virus paths. > > I.P. > > > you obviously have a > > signature that you add (Have a nice Thanksgiving) With a wetv set, simply push Remove Signature at the bottom of your Email, then push send, that removes your HTML sig. Thats what I have done here. Lewis Hender in Edmonton. Oh, yeah . . . what are the attachments you keep sending? No one in their right mind is going to open them in today's online environment. I.P. > Should I sign up with the VA Hospital here in Boise Idaho The so-called attachments are simply his HTML fancy letter head.....which is showing up as an attachment, but isn't one.....did you see a paper clip on the upper right??? No!! Howard.....just post in plain text. That is the norm on news groups. No one opens attachments, particularly on my antivirus news group. Those wild and crazy virus writers get cute sometimes (mild sarcasm mode). Cheers......Heather > Oh, yeah . . . what are the attachments you keep sending? No one in their > right mind is going to open them in today's online environment. > > I.P. > > > Should I sign up with the VA Hospital here in Boise Idaho > The so-called attachments are simply his HTML fancy letter head.....which > is > showing up as an attachment, but isn't one.....did you see a paper clip on > the upper right??? It was on the left, exactly where it is with real attachments with my browser. But I don't open attachments from the Pope (afraid they might be religious). I.P. Hi Eye Pee...... Yes, the paper clip showed up on the left.....but it didn't show up on the right side of the message.......ergo, no attachment. It is just his signature (have a happy thanksgiving).....embedded in the post. Curtis will be able to sort him out. I will have to teach you how to view an attachment without opening it......(VBG) Then you can open emails from the Pope....or a Cardinal or two. Cheers..Heather > > The so-called attachments are simply his HTML fancy letter head.....which > > is [quoted text clipped - 6 lines] > > I.P. I can always just Save and scan them first, but that's a hassle. I just delete 'em, and inform my friends not to send 'em to me except in special cases when formatting is critical. If I get a message from the Pope, I'll KNOW it's bogus. ;-) I.P. > I will have to teach you how to view > an attachment without opening it......(VBG) Then you can open emails from > the Pope....or a Cardinal or two. How do I post in plain text ? I have webtv..? Did he mean the Have a nice Thanksgiving thing ? > Should I sign up with the VA Hospital here in Boise Idaho since I have > been diag's with PCa ? Does anyone know of a Dr David Rice here in Boise > ? He is my Uro Doc...he seems to be good and to know his stuff... If I > decide on Surg...does anyone recommend St Als here in Boise...guess I > will be asking a LOT of questions? Howie Care for prostate cancer at VA hospitals depends a lot on the doctors. Curtis Palmer, who I hope will respond, had to go through a couple before he found one he was happy with. > ------------------------------------------------------------------------ > > "Have a nice Thanksgiving" Right. I'd never have gone to just any VA hospital (or just any civilian hospital) for significant surgery. But I've now had three very significant surgeries done in two carefully chosen VA hospitals by carefully chosen and researched surgeons, with solid confidence and apparently excellent results. Several VA hospitals, including the ones I used, are intimately, formally allied with nearby university teaching hospitals. The people who cut me do their surgeries hundreds of times, teach the same surgery in med school, and research and write endless papers in their field. The faculty tumor board discusses MY case at great length at each weekly meeting, so I have a huge body of state-of-the-art expertise advising my every decision. I had my local urologist check the training, residency, and reputation of my university urological oncologist/surgeon before I selected that surgeon (I could have chosen any of the faculty), this VA/university teaching hospital is a center of excellence in prostate cancer research and treatment, the VA in general has a world-class volume of prostate patients, and VA physicians set global standards in prostate research and knowledge (Bostwick, for example, left the VA to found and run the gold standard Gleason grading lab). I didn't just use the VA 'cause it was cheap (i.e., 100% free for me); I chose this VA hospital because of its superiority. Had it or something like it not been available, reasonably nearby (3-hour drive), I'd have used my insurance and paid a hefty deductible to do it in the public sector. Do I blame the VA for the week of recovery ward hassles? No; the nursing shortage is nationwide, and I've had very similar experiences in very good private hospitals and better experiences in other VA hospitals. I.P. "Leonard Evens" <len@math.northwestern.edu> wrote > > Care for prostate cancer at VA hospitals depends a lot on the doctors. > Curtis Palmer, who I hope will respond, had to go through a couple before > he found one he was happy with. I signed up today at the VA, but as I waited in business office waiting..I spoke with another vet and he was bad mouthing some of the doctors there... hi howard - first and foremost - not all VA hospitals are the same. when i was told that i had pca and requested nerve sparing, i was told, "our purpose is the get the cancer out, not spare nerves!!!" this was not an acceptable answer and i started researching VA hospitals. others in the newsgroup told me of other VA hospitals that did do nerve sparing, so this hospital was not the norm. plus, when i discussed this with my surgeon who was on loan from the air force base. it was decided by him - to transfer me to scott AFB and that is where i had my surgery. great hospital - best care. really felt good about the way i was treated. but when it comes to VA hospitals, they're different. standardized care even down to routine things - such as requesting a VED. all i did was call them and they put one in the mail for me. no hassles. bev and her husband had one heck of a time getting one and he even had to attend class on it before they would issue him one - yet, they are suppose to all operating under the same VA medical system. my advice - check out the VA hospital you are wanting to go to... very, very thorough because a lot is at stake. a comment on which treatment to go for. an outside factor is your age, which i saw is 63. what my doctor told me is that - right now - i'm able to withstand surgery, but something might happen down the road to where surgery would not be option - for health reasons. how right he was - because he didn't know i have a leaking heart valve and i know it's not going to get better with time. ~ curtis knowledge is power - growing old is mandatory - growing wise is optional "Many more men die with prostate cancer than of it. Growing old is invariably fatal. Prostate cancer is only sometimes so." http://community.webtv.net/PALMER_ENT/doc Now, it almost seems funny what we had to do to get the pump. Talk about jumping through hoops!! Bev > hi howard - first and foremost - not all VA hospitals are the same. > when i was told that i had pca and requested nerve sparing, i was told, [quoted text clipped - 32 lines] > invariably fatal. Prostate cancer is only sometimes so." > http://community.webtv.net/PALMER_ENT/doc Just as all hospitals are not alike neither are all VA hospitals alike. One of the top doctors in the country is at the VA hospital in Richmond Virginia once a week. It's his way of giving back to his country. Sign up! Any one who has ever served in the armed forces is eligible to use the VA facilities. If you are a Vietnam vet you are entitled to disability for PC. It is listed as a result of possible contact with agent orange. Also you do not have to have ever stepped foot in Vietnam if you were on certain bases where agent orange was handled, loaded etc. Bev > Should I sign up with the VA Hospital here in Boise Idaho since I have > been diag's with PCa ? Does anyone know of a Dr David Rice here in Boise > ? He is my Uro Doc...he seems to be good and to know his stuff... If I > decide on Surg...does anyone recommend St Als here in Boise...guess I > will be asking a LOT of questions? Howie ---------------------------------------------------------------------------- ---- > "Have a nice Thanksgiving" That's if you retired from the military, applied for specific disabilities, and were awarded service connection for them. Takes years to do this unless done at the time you retired. I.P. > Sign up! Any one who has ever served in the armed forces is eligible to > use > the VA facilities. No, no, not anymore!! The VA does not turn away any person who has served the country be it 2 years or 28 years!! Also there is a whole list of cancers etc because of exposure during Vietnam which do not show up until years later. Bev > That's if you retired from the military, applied for specific disabilities, > and were awarded service connection for them. Takes years to do this unless [quoted text clipped - 5 lines] > > use > > the VA facilities. That's amazing, considering that I had to buy my own shoulder surgery a couple of years because the VA couldn't get to it within 15 months -- and it was specifically a service-connected (thus automatically covered) injury. They also charge me for medicines for service-connected problems, claiming lack of funds even after their budget has been increased by 40% under Bush. Something's very wrong with that picture. I.P. > No, no, not anymore!! The VA does not turn away any person who has served > the country be it 2 years or 28 years!! [quoted text clipped - 15 lines] >> > use >> > the VA facilities. |
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