Good news!!!

I just had my second shrink appointment, and it was even more of a 'non-event' than the first one - I think it only lasted about 10 minutes... Basically he said that he had reviewed my chart and the first shrink's notes, and didn't see any real need to go over the same ground again. He asked a couple of questions, and that was it. I had the letter in my email within 10 minutes after the appointment...

So now it's time to start hunting for surgeons!

WheelyCurious

Great news

I hope your search goes easily and you find a fantastic surgeons

Al the best

Good news! Just got a call from the office of one of the two surgeons I am most likely to use to schedule a consult - I see him on May 8th... So more progress!

WheelyCurious

Fantastic news! You're getting closer.

Well my consult with the surgeon is tomorrow afternoon... I should have done it sooner, but per a lot of advice on getting the most out of a medical appointment, I've made a list of questions to bring with me...

This is what I've come up with so far, any suggestions about things I should add?

Questions:

1. Surgery needs:

A. Orchiectomy

B. Scrotectomy

C. Leak reduction (VERY IMPORTANT!)

D. Ease cath access / unbury penis?

2. Pain management?

Opioids NOT acceptable

3. Recovery time?

A. Out of Hospital

B. Light activity, especially TRANSFERS

C. Driving / semi-normal

D. Full

4. Activity restrictions / care needs after?

A. GF NOT capable of significant assistance

B. Possible need for Skilled Nursing Facility stay?

5. Other testing needs?

A. Urodynamics

B. Cystoscopy

C. Ultrasound (my PCP thinks not needed due to CT of abdomen 10/22 w/ no abnormalities)

WheelyCurious

Having been a charge nurse in a skilled nursing facility, I wouldn't wish a stay in one of those places on my worst enemy.

Losethem (imported) wrote: Mon May 08, 2023 5:39 pm Having been a charge nurse in a skilled nursing facility, I wouldn't wish a stay in one of those places on my worst enemy.

I've been there in the past, (car accident, where my only injury was a fracture in my left 5th metacarpal, had to spend 30 days in one because I couldn't load bear on that hand) and I totally agree that being in an SNF seriously sucks... However given the modern 'drive through medicine' attitude of many hospitals, and the fact that my GF is totally unable to do any sort of assistance that needs vision (she's legally blind) or physical effort like lifting me because of her other physical limitations, I might not have a lot of choice...

The big question as I see it is how long it takes from surgery to being able to do transfers without needing physical assistance - that is probably the heaviest task I MUST be able to do in order to recover at home, if only to be able to get to and from the bathroom...

What might be an interesting question is how my disability changes the usual expectations on recovery - I'm not going to be putting a lot of load on my leg / trunk muscles, but my arms are my legs, and how does that change things?

We have a pretty decent data set on recovery patterns for AB surgery, but I haven't seen much on recovery for paraplegics....

WheelyCurious

Good luck man. That whole situation is touch.

Well I had my consult! Everything looks like a go, though not clear how soon... The doc said he would have one of his staff call me to set up a date. He is also putting in orders for the tests I mentioned needing. He also said that he wants to get the plastic surgeon involved to see about improving my access to the penis.

So going down my list from earlier....

1. Surgery needs:

He is OK with the Orchie, is worried about the scrotectomy because he thinks I'd be at increased risk of infection / other complications because of being in a chair. However he will do it if I insist (I do) He isn't sure about the leak reduction, wants to see results from the Urodynamics and Cystoscopy. He says that plastic surgery will need to look at what I need for improving access, but he sees it mostly as reducing the pubic fat pad... (He also wants me to lose weight)

WheelyCurious wrote: Mon May 08, 2023 2:50 pm 2. Pain management?

Opioids NOT acceptable,

but he says that he has done 'hundreds' and that the patients don't need opioids and do fine w/ over the counter Motrin / Tylenol.

3. Recovery time?

He said it's 'day surgery' so no hospital stay, and that I should be able to do transfers that day. About a week to get back to driving, and 6 weeks to be back to 'normal'

WheelyCurious wrote: Mon May 08, 2023 2:50 pm 4. Activity restrictions / care needs after?

Other than taking it easy, no special care needs. He said there wouldn't be any wound care, so presumably everything will be done w/ surgical glue, etc... He said no need to worry about nursing home, but said he'd advise me to do as much preparation in advance like having meals precooked and so on to minimize the amount of work I'd need to do in the first few days.

5. Other testing needs?

As mentioned he is supposed to be ordering Urodynamics and Cystoscopy, that will possibly affect what he wants to do about leakage...

So reasonable progress, sounds about as good as I can hope for at this point.

WheelyCurious

No surgery date yet, but I did get a call to schedule the urodynamics and cystoscopy on June 22... Progress is glacial, but happening...

WheelyCurious