Looking for Answers in Virginia

07SHNNAC7081522
07SHNNAC7081522 Member Posts: 17
edited March 2014 in Prostate Cancer #1
These discussion boards are very informative! I found out the dreaded news over the cell phone during my son's soccer coach meeting. Because I didn't really grasp the reality of the situation, amazingly, I told the doc...he need to call me back because I was in the middle of a meeting! After the reality soaked in (10 minutes later...)...I can't really describe the sentiment. I was like an emotional time bomb especially the next day. I'm doing much better than two weeks ago. I'm 44, in relative good health, pretty active, etc. Go figure. It was a terrible thing to hear over the phone, but after further thought, I guess there's no other way to break the news. It wasn't necessarily insensitive...he was straight to the point relaying to me that my PSA is 2.2, the stage was T1C (which I guess doesn't mean too much considering the majority of people are diagnosed the same way...), and a Gleason score of 3,4=7. I would classify the call similar to a rollercoaster ride...the term early detection was used a couple times in the conversation along with an estimation of being most likely curable (positive), but he also used the term "aggressive" which scared the you know what out of me. Before I could get the one million questions started, he told to immediately go and purchase a book at your traditional type of book store...Barnes and Noble, Books-a-Million, etc., titled Guide to Surviving Prostate Cancer by Dr Patrick Walsh. I have to admit it's pretty good and answered many of my questions, however the book is dated 2007 and it's 2010 now. With three years omitted, I'm looking for the latest and greatest. I've got a frat brother who is a doctor...immediately told me that at my age for peace of mind...get the gland out of your body, however the dreaded side effects seem so confusing and I understand...everyone is different. Also had a friend that entertained Da Vinci about three years ago...he seems like a happy camper with incontinence completely gone and a little problems with the mojo which he glady told me they've got plenty of stuff out there to fix that...he's 55 having done this at 52. I'm 44 with much optimism leaning totally towards Da Vinci - Sentara Norfolk General has some outstanding oncologists over there...I hear some of the very best - Dr Fabrizio and Dr Lance...I hear they've got two more guys over there that are just as reputable. But...like I said...that was three years ago when he had the procedure done. This book leans more towards "open prostatectomy" and states that it is the gold standard because the surgeon has the element of "feel" on his side. Robotic radical prostatectomy was somewhat looked down upon...it also detailed radiation seeds and I'm now reading much on proton therapy. Both sound like great alternatives, but I don't see any 40+ year old going in these routes...as a matter of fact, it seems everyone under 50 gets the gland taken out. I think I understand the bias...as an educator I was told that no question is a dumb one...I guess the rationale is based upon the younger you are, the better able you are to bounce back physically from the trauma of surgery. I'm in Virginia Beach area...looking for some well informed input. Sorry for being so long winded...
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Comments

  • erisian
    erisian Member Posts: 107
    Don't Rush
    That's the first thing. Most of the treatment options cause irreversible changes.

    What is your PSA history?
    2.2 is well within the normal range, so why did you get a biopsy?
  • 07SHNNAC7081522
    07SHNNAC7081522 Member Posts: 17
    erisian said:

    Don't Rush
    That's the first thing. Most of the treatment options cause irreversible changes.

    What is your PSA history?
    2.2 is well within the normal range, so why did you get a biopsy?

    PSA Range
    Completely understand...this was my first test. I went in because I was experiencing some slight pressure urinating. It was the strangest thing...only to my knowledge occurring in that morning whiz! Upon thinking it was kind of strange, I went into my family physician for a check-up which resulted in me being sent to a urologist for further diagnosis. He noted that the prostate was slightly enlarged and prescribed antibiotics as a first show of defense for prostatitis. Went back in three weeks...apparently, the inflammation went away...free to PSA was 10.3. As a precaution, he elected that I get the biopsy. Still don't know how many biopsy needles were positive. I believe the driving factor was the low free to PSA. I'm going in tomorrow to see my urologist for the first time after the biopsy.
  • erisian
    erisian Member Posts: 107

    PSA Range
    Completely understand...this was my first test. I went in because I was experiencing some slight pressure urinating. It was the strangest thing...only to my knowledge occurring in that morning whiz! Upon thinking it was kind of strange, I went into my family physician for a check-up which resulted in me being sent to a urologist for further diagnosis. He noted that the prostate was slightly enlarged and prescribed antibiotics as a first show of defense for prostatitis. Went back in three weeks...apparently, the inflammation went away...free to PSA was 10.3. As a precaution, he elected that I get the biopsy. Still don't know how many biopsy needles were positive. I believe the driving factor was the low free to PSA. I'm going in tomorrow to see my urologist for the first time after the biopsy.

    Overdiagnosed?
    It doesn't sound like it with a Gleason 7, but it fits the model of one PSA and a biopsy. Given your young age, it is more likely to be an aggressive cancer, but there is insufficient information at this point. The PSA number is low, and since you have only had one PSA test, there is no way to tell whether or not it is rising, and if so, how fast. The PSA doubling time is a more important indicator of aggressiveness than the PSA number itself, and you don't have that information yet.

    So on that basis, I would say that you should consider getting another PSA in 2 or 3 months, and waiting until after that to make any treatment decisions. Then, even if the second PSA is up, you might want to get another one after that to confirm the trend. There are factors that can affect individual PSA tests, as my oncologist reminds me periodically, so it is unwise to make any important treatment decisions based on a single test. When I've been on chemo, it would only be discontinued after a rise in three consecutive tests, for example, and I have had it bounce along for months at a time with a test every three weeks and no clear trend in any direction.

    The overdiagnosis problem is real, apparently, just to make things more confusing for men in your situation. See: http://dartmed.dartmouth.edu/winter09/html/disc_overdiagnosed.php

    On the other hand, that is just one more reason not to rush into a treatment decision.
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    Hi
    Sorry that you have joined this club......generally during the first couple of months, most if not all of us go thru shock, depression and all the negative feelings associated with this.

    It is a good idea to get a copy of your biopsy report, and all medical data so you can have it available to go to various doctors, support groups, etc.

    YOu also want to have the parrifin blocks of your biopsy sent for a second opinion, determining the gleason score is a complicated process and you want to have an expert review this............Dr. Epstein, Johns Hopkins is a great choice.....simply contact your docs office and have then send the blocks.

    My opinion is a little different than the above poster.......although psa's are basic indicators of trend, the biopsy is the more concrete information

    There is a test called an endorectol MRI with a spectroscopy that will stage your disease, and indicate nodule involements if any, and where they are located.......the mri is covered by insurance however the spectroscopy is consided investigational and is not covered.

    Anyway, get back to us, let us know how many cores were taken, how many positive, the amount of involvement and gleason score of each.

    Also take a deep breath

    We are all with you

    Ira
  • erisian
    erisian Member Posts: 107

    Hi
    Sorry that you have joined this club......generally during the first couple of months, most if not all of us go thru shock, depression and all the negative feelings associated with this.

    It is a good idea to get a copy of your biopsy report, and all medical data so you can have it available to go to various doctors, support groups, etc.

    YOu also want to have the parrifin blocks of your biopsy sent for a second opinion, determining the gleason score is a complicated process and you want to have an expert review this............Dr. Epstein, Johns Hopkins is a great choice.....simply contact your docs office and have then send the blocks.

    My opinion is a little different than the above poster.......although psa's are basic indicators of trend, the biopsy is the more concrete information

    There is a test called an endorectol MRI with a spectroscopy that will stage your disease, and indicate nodule involements if any, and where they are located.......the mri is covered by insurance however the spectroscopy is consided investigational and is not covered.

    Anyway, get back to us, let us know how many cores were taken, how many positive, the amount of involvement and gleason score of each.

    Also take a deep breath

    We are all with you

    Ira

    Where It's Headed
    I agree that the biopsy is certainly a more concrete indicator than the PSA of where it's at, especially since his PSA is only 2.2, but neither says where it's headed. That should be known before any decision is made.
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member
    erisian said:

    Where It's Headed
    I agree that the biopsy is certainly a more concrete indicator than the PSA of where it's at, especially since his PSA is only 2.2, but neither says where it's headed. That should be known before any decision is made.

    Well
    I'm thinking that if the biopsy shows that the cancer is more advanced, the time that it takes to measure a trend based on the psa would be to a disadvantage. Medical treatment might be needed soomer than later.

    By the way , there is a molecular test put out by Aureon that gives some indication of the aggressiveness of the cancer.

    There is a molecular test performed by a company Aureon, where they , I guess take samples from the parafin blocks from your biopsy and look for aggressive tumors...they then mathematically compare it with other factors such as PSA, gleason, etc to approximately 1000 men who have had radical protectemy, and come up with the likelyhood of the the cancer progressing 8 years in the future.

    But be cautioned on the following; there is a sensitivity of 74percent and a a specificity of 64prcent. What that means is tat among 100 bad tuors, for example, they only can identify 75 of them. And among 100 good tumors, they identify as bad in 36. to be honest this is notmuch different than achieved withjust your psa and gleason and percent tumor.

    I believe that you can contact Aeuron www.aureon.com or 1-888-797-7284
  • 07SHNNAC7081522
    07SHNNAC7081522 Member Posts: 17

    Well
    I'm thinking that if the biopsy shows that the cancer is more advanced, the time that it takes to measure a trend based on the psa would be to a disadvantage. Medical treatment might be needed soomer than later.

    By the way , there is a molecular test put out by Aureon that gives some indication of the aggressiveness of the cancer.

    There is a molecular test performed by a company Aureon, where they , I guess take samples from the parafin blocks from your biopsy and look for aggressive tumors...they then mathematically compare it with other factors such as PSA, gleason, etc to approximately 1000 men who have had radical protectemy, and come up with the likelyhood of the the cancer progressing 8 years in the future.

    But be cautioned on the following; there is a sensitivity of 74percent and a a specificity of 64prcent. What that means is tat among 100 bad tuors, for example, they only can identify 75 of them. And among 100 good tumors, they identify as bad in 36. to be honest this is notmuch different than achieved withjust your psa and gleason and percent tumor.

    I believe that you can contact Aeuron www.aureon.com or 1-888-797-7284

    Good Info
    Thanks for the feedback guys...I'm under the impression as in the result of a positive biopsy that the PSA test conducted has instrumental value, but not as concrete as the biopsy, i.e., "seeing is believing." With the evidence directly in front of me, I'm trying to rationalize with waiting to see of the PSA goes up, getting a second opinion, ...etc. I know its there, so my estimation is to resolve the issue by eliminating the problem. I'm struggling with did I detect it soon enough?...why didn't my physician start screening me at age 40?, what's the best alternative for mid-40 year olds? Its almost ridiculous...I can't say that I'm in the best shape of my life, but clearly I'm not far from it. I go to the Doc today at 4:00 pm...armed with (it seems...) limitless information. Any recommendation for posed questions?
  • erisian
    erisian Member Posts: 107

    Good Info
    Thanks for the feedback guys...I'm under the impression as in the result of a positive biopsy that the PSA test conducted has instrumental value, but not as concrete as the biopsy, i.e., "seeing is believing." With the evidence directly in front of me, I'm trying to rationalize with waiting to see of the PSA goes up, getting a second opinion, ...etc. I know its there, so my estimation is to resolve the issue by eliminating the problem. I'm struggling with did I detect it soon enough?...why didn't my physician start screening me at age 40?, what's the best alternative for mid-40 year olds? Its almost ridiculous...I can't say that I'm in the best shape of my life, but clearly I'm not far from it. I go to the Doc today at 4:00 pm...armed with (it seems...) limitless information. Any recommendation for posed questions?

    Good Question!
    How many cores were positive?
    Out of how many cores?
    Should we send them out for a second-opinion staging workup?
    Have you seen the Dartmouth overdiagnosis study, and if so, what is your opinion of it?
    Is this an aggressive cancer, or not, and what is that opinion based on?
    Do I need to act fast, or is it safe to take some time to decide?
    Should we do one or two more PSA tests to establish a trend and get a PSADT?
    Do you think that "Active Surveillance" might be a sensible approach?
    Would you recommend a molecular test?
    What percentage of prostate cancer patients are my age or younger?
    Do you know of any local prostate cancer support groups?
    And the all-time winner:
    If you were in my position, what would *you* do, and why?

    If you aren't satisfied with an answer, then keep asking questions until you are.

    I certainly understand the desire to "just get it out". It's the natural reaction to a cancer diagnosis, but it may or may not be the wisest course of action. And remember whenever you are talking with doctors that when all you have is a hammer, everything looks like a nail. So a surgeon will probably recommend surgery, a radiation oncologist will probably recommend radiation, etc...

    Your doctor didn't start screening at 40 because the guidelines say start at 50, unless there is a family history, then 45. So you are very young to have this. That, by itself, points to two likely possibilities -- either it is an aggressive cancer, or it has been detected at a very early stage, or both.

    Best wishes for an informative meeting and a good prognosis!
  • 07SHNNAC7081522
    07SHNNAC7081522 Member Posts: 17
    erisian said:

    Good Question!
    How many cores were positive?
    Out of how many cores?
    Should we send them out for a second-opinion staging workup?
    Have you seen the Dartmouth overdiagnosis study, and if so, what is your opinion of it?
    Is this an aggressive cancer, or not, and what is that opinion based on?
    Do I need to act fast, or is it safe to take some time to decide?
    Should we do one or two more PSA tests to establish a trend and get a PSADT?
    Do you think that "Active Surveillance" might be a sensible approach?
    Would you recommend a molecular test?
    What percentage of prostate cancer patients are my age or younger?
    Do you know of any local prostate cancer support groups?
    And the all-time winner:
    If you were in my position, what would *you* do, and why?

    If you aren't satisfied with an answer, then keep asking questions until you are.

    I certainly understand the desire to "just get it out". It's the natural reaction to a cancer diagnosis, but it may or may not be the wisest course of action. And remember whenever you are talking with doctors that when all you have is a hammer, everything looks like a nail. So a surgeon will probably recommend surgery, a radiation oncologist will probably recommend radiation, etc...

    Your doctor didn't start screening at 40 because the guidelines say start at 50, unless there is a family history, then 45. So you are very young to have this. That, by itself, points to two likely possibilities -- either it is an aggressive cancer, or it has been detected at a very early stage, or both.

    Best wishes for an informative meeting and a good prognosis!

    Very Informative Meeting
    Good Morning Gentlemen! Just off my initial meeting with my doctor. 5 needles of 12 were positive. Looks like the majority of the PC is 3+3 (in two areas; 4 of the 5 needles) and one area was 3+4 (have to look at my notes...) All questions answered...my research proved to be very beneficial. He laid out all the stops...radiation, cryo, da vinci...I threw out there proton therapy. I didn't realize proton therapy was so expensive...I mean I knew it was somewhat expensive...but apparently it's significantly higher. All good treatment therapy, but considering the fact that its most likely localized, the fact of non-palpability and being good candidate for nerve sparing (...especially with the 3+4 in there), I believe its best to remove the gland for a better survivability rate for the future. The biopsy has been reviewed twice by two different pathologists...I don't think by way of the diagnosis that a second opinion is viable...the PC is definitely there. I don't know of the percentages of men my age who have PC in general...in this area, my doc noted on one hand the people that he's treated bringing to my attention that the percentage is significantly lower than the norm which means that the risk is higher regarding my vulnerability of a more aggressive type of PC (my interpretation). I think it's best that I move forward for the preservation of life...and that is to remove...most likely via Da Vinci.
  • Feb2010
    Feb2010 Member Posts: 51

    Very Informative Meeting
    Good Morning Gentlemen! Just off my initial meeting with my doctor. 5 needles of 12 were positive. Looks like the majority of the PC is 3+3 (in two areas; 4 of the 5 needles) and one area was 3+4 (have to look at my notes...) All questions answered...my research proved to be very beneficial. He laid out all the stops...radiation, cryo, da vinci...I threw out there proton therapy. I didn't realize proton therapy was so expensive...I mean I knew it was somewhat expensive...but apparently it's significantly higher. All good treatment therapy, but considering the fact that its most likely localized, the fact of non-palpability and being good candidate for nerve sparing (...especially with the 3+4 in there), I believe its best to remove the gland for a better survivability rate for the future. The biopsy has been reviewed twice by two different pathologists...I don't think by way of the diagnosis that a second opinion is viable...the PC is definitely there. I don't know of the percentages of men my age who have PC in general...in this area, my doc noted on one hand the people that he's treated bringing to my attention that the percentage is significantly lower than the norm which means that the risk is higher regarding my vulnerability of a more aggressive type of PC (my interpretation). I think it's best that I move forward for the preservation of life...and that is to remove...most likely via Da Vinci.

    VA BEACH AS WELL
    Are the doctors that you have mentioned at Sentara really good?
    I have decided on surgery, open or Da Vinci. Just looking for
    who's got the most experience in their field. Good luck.
  • lewvino
    lewvino Member Posts: 1,010

    Very Informative Meeting
    Good Morning Gentlemen! Just off my initial meeting with my doctor. 5 needles of 12 were positive. Looks like the majority of the PC is 3+3 (in two areas; 4 of the 5 needles) and one area was 3+4 (have to look at my notes...) All questions answered...my research proved to be very beneficial. He laid out all the stops...radiation, cryo, da vinci...I threw out there proton therapy. I didn't realize proton therapy was so expensive...I mean I knew it was somewhat expensive...but apparently it's significantly higher. All good treatment therapy, but considering the fact that its most likely localized, the fact of non-palpability and being good candidate for nerve sparing (...especially with the 3+4 in there), I believe its best to remove the gland for a better survivability rate for the future. The biopsy has been reviewed twice by two different pathologists...I don't think by way of the diagnosis that a second opinion is viable...the PC is definitely there. I don't know of the percentages of men my age who have PC in general...in this area, my doc noted on one hand the people that he's treated bringing to my attention that the percentage is significantly lower than the norm which means that the risk is higher regarding my vulnerability of a more aggressive type of PC (my interpretation). I think it's best that I move forward for the preservation of life...and that is to remove...most likely via Da Vinci.

    You have probably all ready
    You have probably all ready heard it mentioned but if you go with DaVinci look for a surgeon with ton's of experience. Not 100's....Look for someone in the 1000 + range.

    It has a high learning curve and the ones with the most skill will do the best when it comes to nerve sparing. Very delicate portion of the surgery.

    Larry Age 55 (7 months post davinci)
  • 2ndBase
    2ndBase Member Posts: 220
    Stress Less
    I had a very aggressive cancer with psa of 24 and gleason 9 at age 52. It had already spread and I was given one shot of lupron to shrink the tumor and then radiation treatments. You do not need hormones but you might want to think about avoiding surgery and just take radiation. It killed ALL the cancer in my totally cancerous prostate. I have no side effects from the radiation and am still working and playing 7 years later after being given 2 years to live if lucky. Mostly, just do not stress about this. You will be fine and once you make the decision to do something just be sure you were the only one who made it.
  • erisian
    erisian Member Posts: 107
    2ndBase said:

    Stress Less
    I had a very aggressive cancer with psa of 24 and gleason 9 at age 52. It had already spread and I was given one shot of lupron to shrink the tumor and then radiation treatments. You do not need hormones but you might want to think about avoiding surgery and just take radiation. It killed ALL the cancer in my totally cancerous prostate. I have no side effects from the radiation and am still working and playing 7 years later after being given 2 years to live if lucky. Mostly, just do not stress about this. You will be fine and once you make the decision to do something just be sure you were the only one who made it.

    Brachytherapy?
    You didn't mention that one. Just wondering if you discussed that, or if it's not a viable option in your case. It might preserve your fertility, which any of the removal options will not.
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member

    Good Info
    Thanks for the feedback guys...I'm under the impression as in the result of a positive biopsy that the PSA test conducted has instrumental value, but not as concrete as the biopsy, i.e., "seeing is believing." With the evidence directly in front of me, I'm trying to rationalize with waiting to see of the PSA goes up, getting a second opinion, ...etc. I know its there, so my estimation is to resolve the issue by eliminating the problem. I'm struggling with did I detect it soon enough?...why didn't my physician start screening me at age 40?, what's the best alternative for mid-40 year olds? Its almost ridiculous...I can't say that I'm in the best shape of my life, but clearly I'm not far from it. I go to the Doc today at 4:00 pm...armed with (it seems...) limitless information. Any recommendation for posed questions?

    I wonder what was the involvement of each positive core?, what
    percent involvement? you gave the gleason, but not the involvement.

    As far as surgery, you get only one operation...ONE....one chance to do it right...no do overs....so even if you need to travel to timbucktoo...get the best.........John Hopkins might be a good choice for you......YOU WANT A SUPERSTAR

    Ira
  • bdhilton
    bdhilton Member Posts: 802 Member

    PSA Range
    Completely understand...this was my first test. I went in because I was experiencing some slight pressure urinating. It was the strangest thing...only to my knowledge occurring in that morning whiz! Upon thinking it was kind of strange, I went into my family physician for a check-up which resulted in me being sent to a urologist for further diagnosis. He noted that the prostate was slightly enlarged and prescribed antibiotics as a first show of defense for prostatitis. Went back in three weeks...apparently, the inflammation went away...free to PSA was 10.3. As a precaution, he elected that I get the biopsy. Still don't know how many biopsy needles were positive. I believe the driving factor was the low free to PSA. I'm going in tomorrow to see my urologist for the first time after the biopsy.

    You only get to do this
    You only get to do this right once...so my advise is to select your poison based on experience and successful stats of the doc doing the treatment...If you need to travel, travel...I flew back to Atlanta from Chicago 2 1/2 days after surgery (I had the Open RRP not robotics)...

    Best of luck and God bless you in this journey
  • 07SHNNAC7081522
    07SHNNAC7081522 Member Posts: 17
    Feb2010 said:

    VA BEACH AS WELL
    Are the doctors that you have mentioned at Sentara really good?
    I have decided on surgery, open or Da Vinci. Just looking for
    who's got the most experience in their field. Good luck.

    Sentara General Doc's
    These guys are really good...downside...you can't get in there to get the ball rolling. Interesting today I received the call to get my initial consultation for the surgeon of my choice...they told me I could get in there on the 26th...I was like "that's quick..." That's when the receptionist stated...26th of April. That's nearly a month from now; not to mention the potential two month wait to get the surgery done. I definitely didn't like that at all..
  • 07SHNNAC7081522
    07SHNNAC7081522 Member Posts: 17
    erisian said:

    Brachytherapy?
    You didn't mention that one. Just wondering if you discussed that, or if it's not a viable option in your case. It might preserve your fertility, which any of the removal options will not.

    Brachtherapy
    Erisian - the seeds were an option of consideration. I'm just more in concert with total removal at this point...
  • 07SHNNAC7081522
    07SHNNAC7081522 Member Posts: 17

    I wonder what was the involvement of each positive core?, what
    percent involvement? you gave the gleason, but not the involvement.

    As far as surgery, you get only one operation...ONE....one chance to do it right...no do overs....so even if you need to travel to timbucktoo...get the best.........John Hopkins might be a good choice for you......YOU WANT A SUPERSTAR

    Ira

    Good Question
    I need to further expand on that question with my doctor...that's the one question I did not ask. As far as travelling to timbucktoo, how would arrangements like that work? John Hopkins was in fact my first choice of preference, but the logistics of it all...I'm open to flying up there, (it's no more than a skip and a jump from Norfolk) but I would think that there would be some challenges with flying back or for that matter, would I be allowed to fly back. Where would I stay...as I said, that is what I really wanted to do in the first place...any thoughts?
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,333 Member

    Good Question
    I need to further expand on that question with my doctor...that's the one question I did not ask. As far as travelling to timbucktoo, how would arrangements like that work? John Hopkins was in fact my first choice of preference, but the logistics of it all...I'm open to flying up there, (it's no more than a skip and a jump from Norfolk) but I would think that there would be some challenges with flying back or for that matter, would I be allowed to fly back. Where would I stay...as I said, that is what I really wanted to do in the first place...any thoughts?

    Hi again
    You need to have a copy of all your medical records, so you can go from doc to doc....get a copy of the biopsy report, psa report and any other information from your doc...simply call the office.....

    Make the appt with johns hopkins.....there are hospital social workers that will help with arrangements, apartments , hotels, support personnel or whatever is needed....
    the surgeon will know , or will direct you. ....arrangements at the hospital are only details.

    Ira
  • 07SHNNAC7081522
    07SHNNAC7081522 Member Posts: 17

    Hi again
    You need to have a copy of all your medical records, so you can go from doc to doc....get a copy of the biopsy report, psa report and any other information from your doc...simply call the office.....

    Make the appt with johns hopkins.....there are hospital social workers that will help with arrangements, apartments , hotels, support personnel or whatever is needed....
    the surgeon will know , or will direct you. ....arrangements at the hospital are only details.

    Ira

    Hello Hopeful
    Called up to Johns Hopkins today...consultation could not take place with Dr Allaf until the end of April...still looking at two months minimum before I could get the work done...is that pretty typical these days? My buddy who had this procedure done three years ago...within two weeks of the diagnosis, he was in the batter's box. Have things changed that much?