Is the AUS 800 for me? Please help me decide.

Kongo said:

Points
Jerry,

All of your points are cogently expressed and I must say that your thoughts on Medicare and the cost of treatments in these days of skyrocketing health care costs are very well put. Back in 1995 I did a year fellowship on Capitol Hill working as a legislative assistant for a U.S. senator. Normally I worked defense issues but frequently I was on the hook to take calls from people worried about cuts to their Medicare or Social Security benefits. We referred to them as the "greedy geezers." You certainly don't fit into that category.

Certainly you have to weigh the risk versus reward aspects of this treatment option and the possibility that there might be an extended transition period that was uncomfortable and even that when it was all over you might be worse off than you are now.

I wouldn't even consider the medical cost issue and Medicare. You've paid your premiums and earned the benefits. While being altruistic is a great virtue, I would certainly not feel you were bankrupting the system to have an AUS implanted or to repair scar tissue on the urethra.

In my own decision process about which treatment options I considered, quality of life was the one factor that was the highest importance to me. It trumped everything else by a wide margin. I would rather have a shorter life than a longer one with poor quality. When I go, I want to slide sideways into the grave with all the credit cards maxed out, a cigar in one hand, a martini in the other singing, "Man, what a ride" or "I did it my way."

Of course, quality of life is perceived differently by everyone. For me it was not to be in diapers, to maintain a active and healthy sex life, and to avoid as many other potential side effects as possible. But I very much understand that what may be unacceptable for me is perfectly OK with someone else. I often read threads by men (or women) who say that although the sex is gone, they are still alive and isn't that great?. Huh? I just don't see it that way at all, particularly with prostate cancer where so many of the treatment options have similar outcomes and few of us are destined to die from this disease regardless of what treatment choice we make. I told my wife once (jokingly) that if I were ever in an accident and was in a coma that she should ask: "Doc, is he ever going to get laid again?" If the doc said no, her response was to be: "Pull the plug!" Don't get me wrong. I love life and want as much of it as possible. I just want it on my own terms and feel I have already had a rich and full time here and am not too worried about eking out every last minute. None of us are getting out of here alive anyway.

When I initially read your post my first thought was that you were using your mature years as a crutch for avoiding doing something that could significantly improve your quality of life. Too often we read threads in this forum of patients who are quietly accepting poor treatment from doctors because they aren't more aggressive in standing up for themselves and firing their doctor if that's necessary. As you have elaborated on your situation I do see your points more clearly. I might not make the same decision as you but I won't judge yours.

I do hope that you fully explore all the options and perhaps see a urologist that specializes in treatments that could improve your continence but at the end of the day, you're the one who has to live with it.

My very best to you and thanks for sharing openly on such a personal topic.

K

Old-timer said:

Kongo, I Am Deeply Moved
Your profound and clearly stated analysis of my situation and decision is bringing second thoughts. Honestly, most of what you are saying is not totally new to me. I have gone through this thing forward and backwards, right side up, and bottom side down. My view of what’s correct has changed from time to time. Perhaps I should take another look.

I am considering putting several “documents” together and calling another family conference. As always, I know my wife and two daughters will proclaim their full support for what I decide. However, having them along gives me comfort and helps me clarify my thinking.

The documents I will put together include, but are not necessarily limited to, postings on this discussion board: mine, yours, and a few others that seem to be pertinent.

Depending on what comes out of that conference, I may make an appointment with one of my urologists to fix the scar tissue. That would be the next step, as you likely know.

Please don’t get your hopes up too high. This may be just a dream! I’ll keep you posted.

Take care.

Jerry

tdorman said:

Jerry
I am 73 and had the AUS activated a couple weeks ago. Am completely dry, no pads. I had radiation in 2003 that created a lot of scar tissue and some damage to the urethra. The band could not be attached to the urethra normally due to the damage from radiation. The actual surgery took almost 4 hours because of the scar tissue. Dr Lockhart, USF Medical School in Tampa, used a special procedure developed by his friend at Duke some years ago. I undertand it is used often now with patients who have had radiation and damage to the urethra. I am told the AUS does not last as long in patients who have had radiation. If mine wears out I will have a new one installed at any age if I am healthy enough for the procedure.

I could not be more pleased with the outcome.

Best to you.

Ted