This was posted by my friend Norman yesterday on the Impotance Group. With his permission I an adding it to my blog.
Good morning men,
Once again it is one of those times of year when the expression of love and
pro-creation is abundant in the world. I cringe and shake at times because the
accusation comes to mind that I am an outcast to these activities. The
previous past 4 years I continually descended into a deeper state of depression,
frustration, self pity, anguish and eventually torment.
I want to share a portion of an email I sent at the height of my depression when
I was looking for help. And I wantto share my first steps to a comeback.
*** 6/30/08 Heal my Perspective
I have suffered what I call dignity abuse. It is the assault of my self
perception. I am in search of seeing myself as whole and not broken. I have
many 'cut to the bone' experiences.
In this affliction I live a life hiding and fleeing all my days.
I have problems with concepts and statements like 'Live life to its fullest'.
I am exhausted and no longer trust hope. I am as a man that hides from a savage
wild beast. It see me and I see it.
Impotence is crushing me. It is killing me slowly. Has anyone had growth or
life to their withered blossom? Can you help me heal my perspective. It is
always from the torment of brokenness and never from the state of a good
beginning.
Hope has made me lie to myself. I fear accepting this because it is not the
real me. It is a disease or an affliction but it is not me. I have it but I
can't get rid of it. I am like a blind man who has sight for 15 seconds and
then returns to blindness.
How can I understand manhood and the natural use of the sex. For those of you
who have read the Bible. I am in distress as the man at the pool of Bethesda.
Someone always gets in before me and I have no one to truly help me. Year after
year I know, wait, and hope but in the end I am just unhealed and let down.
I don't know how to do this anymore. I need closure. Existing in the state of
continual trying is a sore evil and daily vexation. Help me escape the prison
of my mind. The scars of heart, the let downs and the mis understanding.
The initial joy when I see men who are whole; and then the sorrow for to me it
is withheld. Rejections, poverty, death- Nothing hurts me more than this.
If you have the power of truth-Please set me free.
***
12/24/2011 Perspective in Healing
Men we are more than the sum of our parts. Today I am reminded of Master Po.
A fictional character in a old Tv show called Kung Fu. Fully blind but every
other sense in his body was maxed out to its fullest. Hearing, smelling,
tasting, touching, mental prowess.
If he were able to see yet was impotent he would use all of his other senses to
live out and maintain a wonderful relationship. He would appreciate her beauty,
her scent, her voice, her person. He would caress her with tender love and he
would sexually stimulate her. He would hold her close and he would smile and
delight to be in her presence.
He would receive and give necking with all the joy of youth;as a boy reaching
first base. He would enjoy the tickling as she touched him, the hardness and
sensuality of their firm nipples with all the joy of a youth;as a boy reaching
second base.
She would stimulate him in the perineum and prostate if he had one. The massage
between the thigh and groin would ever so move him. He would stimulate her
clitoris and caress her vagina. He would receive this with all the joy of
youth; as a boy reaching third base.
Together they were fulfilled one climaxing bodily, one climaxing in the heart
both climaxing in spirit for the two are more than one part.! He would recieve
this with all the joy of youth; as a boy reaching fourth base.
***
Whether your impotence is temporary of permanent in physical ability. Follow
the example of Master Po and re align your perspective. Be not mis informed by
mis informed people. Often a NO is a Yes somewhere else.
It feels GREAT to be on the road to recovery. Both mentally and physically.
If I had a friend like the analogy of Master Po. I would have never wasted 4
years of my life and damaging 4 years with my wife. I could have been as the
joy of a youthful boy running around the bases!!!!
Try it. Allow it to happen. It's Truth.
Merry Christmas and Happy Holidays,
I walk with you!
Norman
Sunday, December 25, 2011
Wednesday, December 7, 2011
THE PHYSIOLOGICAL ASPECT
MEN OBSESS ABOUT OUR PENIS
I posted this on the Peyronies Society Fourm and it needs repeated here.
Re: She didn't notice
« Reply #5 on: December 03, 2011, 09:47:33 AM » Quote Modify
--------------------------------------------------------------------------------
Can I say something:
We guys obsess about our penis our ladies are just glad to be with us no matter what. Like I have told many a young man "The size of your penis does not make you a man."
The beautiful green eyed lady I have been married to for over 43 years, (no she is not blond), has been with me through all my journey with peyronies, ED, venous leakage, corporal fibrosis. Then a failed implant attempt. Now a successful implant. The one statement she made to me still brings a joy to my life. "Jack, I did not marry you for your penis." She was by my side through my journey.
I lost over 1 1/2" inches to peyronies. It concerned me but never bothered her. When I came out of surgery at Vanderbilt she had talked with Dr. Milam. I saw that gleam in those beautiful green eyes and knew all was well.
The first night I was home after my implant was activated I lay on my back with a hard on sticking straight up, no pills, no shots just me. I was still 1 1/2" shorter than before peyronies but it did not matter any more.
Over the last 3 years I have been able to gain about 90% of the loss back because of the skills of Dr. Milam and the LGX. I asked her how I felt sexually now to her than before. She told me she never noticed the difference I feel just the same as always.
Guys, we have to stop obsessing over our problems. The women that love us don't care about the size or shape of our penis. That is a man thing. They love us for the man we are.
I have had the privilege of talking with many men that had progressed to the stage with this mess I have. It takes time for implant surgery to heal. One single young man kept telling me I can't a girl will reject me, I can't I have lost too much size to satisfy her, just on and on. Well about 2 months ago he meet a young lady and it was love at first sight for her. One evening after a date he was with her and she started to try to get into his pants. He told he whoa! you need to know something. She asked what? He told her "I'm Bionic." She asked what did that mean, he briefly told her he had an implant. She told him I don't care I want you anyway.
That night he learned a couple of things. The fact he had an implant did not matter, the size of his penis did not matter, that he could satisfy her and he could go longer than any guy his age. Since then they have been almost constant companions.
What I am trying to say is we can not let this damn disease get us down. There is help and hope for all of us. Love the lady you are with and she will give you more than you ever expected. The most important thing is NEVER - EVER / NEVER - EVER / NEVER - EVER - EVER GIVE UP!!!!
Just my feeling this morning.
Jackp
http://jackp-penileimplant.blogspot.com/
I posted this on the Peyronies Society Fourm and it needs repeated here.
Re: She didn't notice
« Reply #5 on: December 03, 2011, 09:47:33 AM » Quote Modify
--------------------------------------------------------------------------------
Can I say something:
We guys obsess about our penis our ladies are just glad to be with us no matter what. Like I have told many a young man "The size of your penis does not make you a man."
The beautiful green eyed lady I have been married to for over 43 years, (no she is not blond), has been with me through all my journey with peyronies, ED, venous leakage, corporal fibrosis. Then a failed implant attempt. Now a successful implant. The one statement she made to me still brings a joy to my life. "Jack, I did not marry you for your penis." She was by my side through my journey.
I lost over 1 1/2" inches to peyronies. It concerned me but never bothered her. When I came out of surgery at Vanderbilt she had talked with Dr. Milam. I saw that gleam in those beautiful green eyes and knew all was well.
The first night I was home after my implant was activated I lay on my back with a hard on sticking straight up, no pills, no shots just me. I was still 1 1/2" shorter than before peyronies but it did not matter any more.
Over the last 3 years I have been able to gain about 90% of the loss back because of the skills of Dr. Milam and the LGX. I asked her how I felt sexually now to her than before. She told me she never noticed the difference I feel just the same as always.
Guys, we have to stop obsessing over our problems. The women that love us don't care about the size or shape of our penis. That is a man thing. They love us for the man we are.
I have had the privilege of talking with many men that had progressed to the stage with this mess I have. It takes time for implant surgery to heal. One single young man kept telling me I can't a girl will reject me, I can't I have lost too much size to satisfy her, just on and on. Well about 2 months ago he meet a young lady and it was love at first sight for her. One evening after a date he was with her and she started to try to get into his pants. He told he whoa! you need to know something. She asked what? He told her "I'm Bionic." She asked what did that mean, he briefly told her he had an implant. She told him I don't care I want you anyway.
That night he learned a couple of things. The fact he had an implant did not matter, the size of his penis did not matter, that he could satisfy her and he could go longer than any guy his age. Since then they have been almost constant companions.
What I am trying to say is we can not let this damn disease get us down. There is help and hope for all of us. Love the lady you are with and she will give you more than you ever expected. The most important thing is NEVER - EVER / NEVER - EVER / NEVER - EVER - EVER GIVE UP!!!!
Just my feeling this morning.
Jackp
http://jackp-penileimplant.blogspot.com/
Friday, August 26, 2011
IMPROPER IMPLANT SIZING
It has recently come to my attention that some doctors are not implanting the AMS 700 LGX properly. They are not putting in a full length implant with the rear tip extenders, when needed, to fit the corpora's. This will quickly lead to problems.
This is a copy of an email I received recently regarding implanting an AMS 700 LGX or a Titan. Also a responce from Todd Doran of Dr. Milam's staff at Vanderbilt. The only editing I did was the doctors name.
This is how some doctors give the LGX a bad name. Be aware and put it on the list of questions you ask your doctor.
Jack
--------------------------------------------------------------------------
Hi Jack,
Did you say you'd be seeing Dr. Milam soon? I wonder if you could ask him a certain question for me?
When I talked toDr. Mxxxxxxx, he said he could do either a Titan or a AMS700LGX, but he said if he put in an AMS700LGX, he'd have to put one in that was shorter than the corporas (because of the expansion in length).
I wondered if you might be able to ask Dr. Milam if he does the same thing, or something different, such as filling the corporas, which is what would be done with the Titan,I believe.
I just wonder if all doctors do this ,or only Dr. Mxxxxxxx, or what.
----------------------------------------------------------------------
Responce from Todd Doran MS PA-C
Here's the bottom line regarding RTE/corporal length, etc. Dr. Milam's philosophy is to measure the corporal length from rear tip to distal tip. We then place a cylinder that equals that length but sometimes RTE are used because the cylinders typically come in 2 cm increments and I can add RTE in 0.5 cm increments so we have infiinite possibilities to accomplish the goal. Here's an example-pt measures 15 cm so we place a 15 cm LGX cylinder with no rear tip because it's available in that size. We'd add 1.5 cm RTE if corporal body was 16.5 cm since next cylinder size is 17 cm. Hope that clarifies a simple concept that is complex for pts to understand and another concept that is misconstrued by surgeons and patients. The advantage of an LGX is that if you need 0.25 cm which is unavailable then we know that the expansion properties will achieve the desired goal where a Titan or CX wouldn't. That's our philosophy. Never agree with placing a device that's too short or too long, you're setting yourself up for disappointment right out of the box.
Todd Todd J. Doran, MS, PA-C Associate in Urologic Surgery Vanderbilt University Dept of Urologic Surgery A-1302 MCN Nashville, TN 37232 615-322-2880
Wednesday, August 24, 2011
Implant Protocal Helps Reduce Penile Shortning
Larry was kind enough to send me the article from the October 2009 Issue of Urology Times.
Included is the update and VED exercise I used developed on the peyroniessociety.org forum. A personal comment. IT Works.
Implant protocol helps reduce penile shortening Pre-procedure use of vacuum device can restore penis to original length, data shows
Publish date: Oct 1, 2009
By: Mac Overmyer
Source: Urology Times
Key Points
The average length of virgin implants and rear tip extenders grew 5.5 cm during the period that the protocol was used.
Daytona Beach, A new noninvasive vacuum protocol for erectile dysfunction patients using an inflatable penile prosthesis can prevent penile shortening, according to results of a study presented at the AUA annual meeting in Chicago.
Cylinder length of a penile prosthesis reflects the length of the penis at the time of the procedure. Penile shortening associated with implants is not an insignificant problem. The average length of implanted cylinders has increased 5.5 cm in patients who have undergone the new protocol.
"There is no question that overall implant length has grown anywhere from 3 to 5 centimeters," said study co-author Martin Dineen, MD, of Atlantic Urological Associates, Daytona Beach, FL. "The vacuum protocol in our hands has virtually eliminated patient complaints of penile shortening."
Dr. Dineen and co-author Steven Wilson, MD, of the Institute for Urologic Excellence, Indio, CA, credit Thomas Sellers, a physician's assistant working in Dr. Dineen's practice, with identifying and refining the protocol.
"It [the initial idea] came from listening to non-implant patients who were using vacuum devices for erections," Sellers said. "They were telling me that they thought they were getting larger. The key to the idea came when I started having the patients mark the device with a felt marker where the end of their penis reached. That is how the protocol was created."
Under the protocol, patients anticipating an implant are instructed to use a vacuum device once daily for 10 minutes, beginning 2 months before the scheduled procedure. Patients with Peyronie's disease should use it twice daily.
"Those who were using it for around 10 minutes without the constriction bands seemed to be getting the most length," Sellers said. "Those who were using it longer did not appear to be gaining any additional length, and those who were using it for a shorter period were not getting as much of a return as they might be."
Sellers and the doctors caution that patients should be told that while they may regain their original length or a length close to it, they should not expect any gains beyond their original length.
After implant surgery, the penile implant is left 50% erect for 2 days and then deflated to 25% for 9 to 14 days. Following that exercise, patients are advised to inflate the device daily for 2 months.
Dr. Dineen and Sellers conducted a review of cylinder sizes they have implanted beginning in 2002, the year the protocol was initiated, through December 2008. the average length of virgin implants and rear tip extenders grew 5.5 cm (from 18.4 cm to 23.89 cm), an increase that reflects both expanding use and modification of the protocol over those 6 years.
High rate of compliance
"When a patient does not have an erection for a long time... the tissues foreshorten," Dr. Dineen said. "The idea behind the pump is that it stretches these tissues back to their normal length gradually. I explain it to patients as having their arm in a cast for 8 weeks. It is a bad idea, a painful idea, to stretch it back out immediately after the cast is taken off."
Despite the rigors of the protocol's schedule, patient compliance is more than 95%, Sellers estimates.
"Having [patients] mark the cylinder every week allows them to see their penis growing longer," he said. "These become motivated patients."
The protocol is now a standard aspect of therapy for patients anticipating an implant in Dr. Dineen's practice. Dr. Wilson uses the protocol only in patients who voice a concern about penile length. He says he feels that patient motivation is important for compliance. An independent, randomized, prospective trial designed to test these initial data is under way.
Drs. Dineen and Wilson are consultants/advisers for American Medical Systems, which provided funding for the study and manufactures the implant used by the researchers.
Penile Implant Protocol Update
Tom Sellers (physician's assistant), an assistant to Dr. Martin Dineen, MD of Atlantic Urological Associates, one of the two researchers involved with the Penile Implant Protocol Study published in Urology Times) (2009), telephoned me on 7-19-2011 after receiving a letter regarding my questions about their protocol being used for patients prior to revision surgeries to replace their old implants. Here is what I was told about the protocol:
1. Through further studies, the protocol is now only needed to be used for 3-4 weeks, as opposed to 2 months prior to surgery. It was found that one month was sufficient. The results achieved should be nearly the same.
2. The Penile Implant Protocol is just as effective for those patients having revision surgeries, as those who are having first-time penile implant surgery.
Prior to First-Time Penile Implant and Penile Implant Revision Surgery:
3. The new Penile Implant Protocols are as follows:
· Use the VED twice a day, holding for 10 min. when fully erect.
· Allow a minimum of one hour between use of the VED.
· Use the VED for 3-4 weeks minimum, but no longer than 2 months.
· Upon first use of the VED, when fully erect, mark on the outside of the clear plastic vacuum tube the length of the penis. This first mark will be used for comparison to subsequent length gains in the penis.
· Weekly take a measurement and mark a new line on the clear plastic vacuum tube (same day of week), marking out the steady progress being made.
· With limited penis sensation (quadriplegic and paraplegics), pump up the VED until a normal full erection is achieved, then stop.
· Gradually continue to increase the vacuum pressure to stretch the penile tissues and rehabilitate them. Again, continue to bring yourself to full erection, then stop.
· The vacuum pump may bruise the blood vessels just below the surface of the skin, which may cause petechiae (very tiny spots beneath the skin) when you first begin using your System. This is a response to placing the penis under vacuum pressure too long, too quickly or after a long period of inactivity. If this happens, discontinue use of the System until discoloration completely disappears – about five to seven days.
· There could also be some blisters appear upon the penis or water appear just under the surface skin of the penis. If this happens, reduce the amount of vacuum suction being used for a while.
After First-Time Penile Implant and Penile Implant Revision Surgery:
4. The new Penile Implant Protocols continues:
· After implant surgery, the penile implant is left 50% erect for 9 days. Following that exercise, patients are advised to inflate the penile implant device daily for 3 months, for 1 hour duration. Add extra pumping every few minutes to increase the stretch.
This protocol should aid in bringing a patient's penis size to near their normal erect size. This is highly advantageous outcome for the patient in that a maximized length and width of a penile implant can be chosen by the surgeon during surgery.
Surgery should be performed by a doctor who has done a lot of penile implant surgeries and revisions. It should be done at a Center of Excellence.
There are many types of VED's available for purchase. Manual pumps are better most usually than those that are battery or electric powered.
A patient recommended high-quality VED is from a company named Firma Medical (www.firmamedical.com). A moderate priced $199 VED Classic model (no prescription needed) was offered as a good option. It has the greatest suction and ease of use, compared to other VED's.
--------------------------------------------------------------------------
This is the VED exercise I used starting in 2005. It was developed by men with peyronies on the peyroniessociety.org forum.
VED EXERCISE
FOR
ED, PEYRONIES, CORPORAL FIBROSIS AND VENOUS LEAKAGE
RECOMMENDED BEFORE PENILE IMPLANT SURGERY FOR A BETTER OUTCOME
The theory behind this exercise is the more fresh blood you can get to your penis the healthier it becomes.
As some of you know the instructions that come with the VED can be vague. Old Man at Peyroniessocitey.org developed this exercise to me.
NEVER PUMP TO THE POINT OF PAIN OR EXCESS PRESSURE!! I did at first and caused a bruise on my penis that took weeks to heal. With this more is not better. Also hair can be a problem getting a good seal. Some of us just keep it trimmed back and others shave around the penis, what ever works for you. Do Not use a constriction ring for exercise.
VED for exercise. Every day.
Start with a good seal and pump to about 80% erect. Hold for 15-20 seconds then release for 15-20 and repump, (do not break seal). Do this for about 5 minutes.
Over the next 5 minutes pump up to a 100% erection using the pump hold and release for 15-20 second method. Do Not Break The Seal.
The next 5 minutes keep pumping to 100% erection using the pump, hold and release. Cautions do not over pump to the point of pain. After about a month you should start to see results.
No you don’t need a stopwatch, approximate times are fine.
VED for sex.
Start by properly placing the constriction ring on the cylinder. Get a good seal and pump to about 80% erection using pump and hold about 5 times. Then increase to about 90% erection and place the constriction ring.
Constriction Rings.
Constriction ring fit is a personal thing what may be right for me will not work for you. It will not be comfortable the first few times you use it. Trial and error are the only way to find which ring holds you best. Do not use over 30 minutes.
IMHO Osborn makes the best constriction rings. I had severe venous leakage and corporal fibrosis so I had to use the Osborn D ring. (Very tight.)
Any questions just let me know.
Jack
7/29/11 Footnote: In response to questions and comments from others I added this footnote. Remember I am a layperson and not affiliated with any doctor, hospital, or device manufacture. Just my own personal research and opinion.
I recommend this exercise for at least a couple of months before implant surgery. It will help keep your penis healthy and you will have a better outcome. Dr. Milam told me to keep up the exercise until about 2 days before my surgery and be careful not to hurt myself.
If you have read my story I call “One Mans Journey” it tells of my 10day hospital stay and recovery where I did not use the VED for almost a month. It looked like I had lost all the progress I had made with the VED exercise. When I was able to start back using the exercise within a week I had recovered the gains I had made.
Included is the update and VED exercise I used developed on the peyroniessociety.org forum. A personal comment. IT Works.
Implant protocol helps reduce penile shortening Pre-procedure use of vacuum device can restore penis to original length, data shows
Publish date: Oct 1, 2009
By: Mac Overmyer
Source: Urology Times
Key Points
The average length of virgin implants and rear tip extenders grew 5.5 cm during the period that the protocol was used.
Daytona Beach, A new noninvasive vacuum protocol for erectile dysfunction patients using an inflatable penile prosthesis can prevent penile shortening, according to results of a study presented at the AUA annual meeting in Chicago.
Cylinder length of a penile prosthesis reflects the length of the penis at the time of the procedure. Penile shortening associated with implants is not an insignificant problem. The average length of implanted cylinders has increased 5.5 cm in patients who have undergone the new protocol.
"There is no question that overall implant length has grown anywhere from 3 to 5 centimeters," said study co-author Martin Dineen, MD, of Atlantic Urological Associates, Daytona Beach, FL. "The vacuum protocol in our hands has virtually eliminated patient complaints of penile shortening."
Dr. Dineen and co-author Steven Wilson, MD, of the Institute for Urologic Excellence, Indio, CA, credit Thomas Sellers, a physician's assistant working in Dr. Dineen's practice, with identifying and refining the protocol.
"It [the initial idea] came from listening to non-implant patients who were using vacuum devices for erections," Sellers said. "They were telling me that they thought they were getting larger. The key to the idea came when I started having the patients mark the device with a felt marker where the end of their penis reached. That is how the protocol was created."
Under the protocol, patients anticipating an implant are instructed to use a vacuum device once daily for 10 minutes, beginning 2 months before the scheduled procedure. Patients with Peyronie's disease should use it twice daily.
"Those who were using it for around 10 minutes without the constriction bands seemed to be getting the most length," Sellers said. "Those who were using it longer did not appear to be gaining any additional length, and those who were using it for a shorter period were not getting as much of a return as they might be."
Sellers and the doctors caution that patients should be told that while they may regain their original length or a length close to it, they should not expect any gains beyond their original length.
After implant surgery, the penile implant is left 50% erect for 2 days and then deflated to 25% for 9 to 14 days. Following that exercise, patients are advised to inflate the device daily for 2 months.
Dr. Dineen and Sellers conducted a review of cylinder sizes they have implanted beginning in 2002, the year the protocol was initiated, through December 2008. the average length of virgin implants and rear tip extenders grew 5.5 cm (from 18.4 cm to 23.89 cm), an increase that reflects both expanding use and modification of the protocol over those 6 years.
High rate of compliance
"When a patient does not have an erection for a long time... the tissues foreshorten," Dr. Dineen said. "The idea behind the pump is that it stretches these tissues back to their normal length gradually. I explain it to patients as having their arm in a cast for 8 weeks. It is a bad idea, a painful idea, to stretch it back out immediately after the cast is taken off."
Despite the rigors of the protocol's schedule, patient compliance is more than 95%, Sellers estimates.
"Having [patients] mark the cylinder every week allows them to see their penis growing longer," he said. "These become motivated patients."
The protocol is now a standard aspect of therapy for patients anticipating an implant in Dr. Dineen's practice. Dr. Wilson uses the protocol only in patients who voice a concern about penile length. He says he feels that patient motivation is important for compliance. An independent, randomized, prospective trial designed to test these initial data is under way.
Drs. Dineen and Wilson are consultants/advisers for American Medical Systems, which provided funding for the study and manufactures the implant used by the researchers.
Penile Implant Protocol Update
Tom Sellers (physician's assistant), an assistant to Dr. Martin Dineen, MD of Atlantic Urological Associates, one of the two researchers involved with the Penile Implant Protocol Study published in Urology Times) (2009), telephoned me on 7-19-2011 after receiving a letter regarding my questions about their protocol being used for patients prior to revision surgeries to replace their old implants. Here is what I was told about the protocol:
1. Through further studies, the protocol is now only needed to be used for 3-4 weeks, as opposed to 2 months prior to surgery. It was found that one month was sufficient. The results achieved should be nearly the same.
2. The Penile Implant Protocol is just as effective for those patients having revision surgeries, as those who are having first-time penile implant surgery.
Prior to First-Time Penile Implant and Penile Implant Revision Surgery:
3. The new Penile Implant Protocols are as follows:
· Use the VED twice a day, holding for 10 min. when fully erect.
· Allow a minimum of one hour between use of the VED.
· Use the VED for 3-4 weeks minimum, but no longer than 2 months.
· Upon first use of the VED, when fully erect, mark on the outside of the clear plastic vacuum tube the length of the penis. This first mark will be used for comparison to subsequent length gains in the penis.
· Weekly take a measurement and mark a new line on the clear plastic vacuum tube (same day of week), marking out the steady progress being made.
· With limited penis sensation (quadriplegic and paraplegics), pump up the VED until a normal full erection is achieved, then stop.
· Gradually continue to increase the vacuum pressure to stretch the penile tissues and rehabilitate them. Again, continue to bring yourself to full erection, then stop.
· The vacuum pump may bruise the blood vessels just below the surface of the skin, which may cause petechiae (very tiny spots beneath the skin) when you first begin using your System. This is a response to placing the penis under vacuum pressure too long, too quickly or after a long period of inactivity. If this happens, discontinue use of the System until discoloration completely disappears – about five to seven days.
· There could also be some blisters appear upon the penis or water appear just under the surface skin of the penis. If this happens, reduce the amount of vacuum suction being used for a while.
After First-Time Penile Implant and Penile Implant Revision Surgery:
4. The new Penile Implant Protocols continues:
· After implant surgery, the penile implant is left 50% erect for 9 days. Following that exercise, patients are advised to inflate the penile implant device daily for 3 months, for 1 hour duration. Add extra pumping every few minutes to increase the stretch.
This protocol should aid in bringing a patient's penis size to near their normal erect size. This is highly advantageous outcome for the patient in that a maximized length and width of a penile implant can be chosen by the surgeon during surgery.
Surgery should be performed by a doctor who has done a lot of penile implant surgeries and revisions. It should be done at a Center of Excellence.
There are many types of VED's available for purchase. Manual pumps are better most usually than those that are battery or electric powered.
A patient recommended high-quality VED is from a company named Firma Medical (www.firmamedical.com). A moderate priced $199 VED Classic model (no prescription needed) was offered as a good option. It has the greatest suction and ease of use, compared to other VED's.
--------------------------------------------------------------------------
This is the VED exercise I used starting in 2005. It was developed by men with peyronies on the peyroniessociety.org forum.
VED EXERCISE
FOR
ED, PEYRONIES, CORPORAL FIBROSIS AND VENOUS LEAKAGE
RECOMMENDED BEFORE PENILE IMPLANT SURGERY FOR A BETTER OUTCOME
The theory behind this exercise is the more fresh blood you can get to your penis the healthier it becomes.
As some of you know the instructions that come with the VED can be vague. Old Man at Peyroniessocitey.org developed this exercise to me.
NEVER PUMP TO THE POINT OF PAIN OR EXCESS PRESSURE!! I did at first and caused a bruise on my penis that took weeks to heal. With this more is not better. Also hair can be a problem getting a good seal. Some of us just keep it trimmed back and others shave around the penis, what ever works for you. Do Not use a constriction ring for exercise.
VED for exercise. Every day.
Start with a good seal and pump to about 80% erect. Hold for 15-20 seconds then release for 15-20 and repump, (do not break seal). Do this for about 5 minutes.
Over the next 5 minutes pump up to a 100% erection using the pump hold and release for 15-20 second method. Do Not Break The Seal.
The next 5 minutes keep pumping to 100% erection using the pump, hold and release. Cautions do not over pump to the point of pain. After about a month you should start to see results.
No you don’t need a stopwatch, approximate times are fine.
VED for sex.
Start by properly placing the constriction ring on the cylinder. Get a good seal and pump to about 80% erection using pump and hold about 5 times. Then increase to about 90% erection and place the constriction ring.
Constriction Rings.
Constriction ring fit is a personal thing what may be right for me will not work for you. It will not be comfortable the first few times you use it. Trial and error are the only way to find which ring holds you best. Do not use over 30 minutes.
IMHO Osborn makes the best constriction rings. I had severe venous leakage and corporal fibrosis so I had to use the Osborn D ring. (Very tight.)
Any questions just let me know.
Jack
7/29/11 Footnote: In response to questions and comments from others I added this footnote. Remember I am a layperson and not affiliated with any doctor, hospital, or device manufacture. Just my own personal research and opinion.
I recommend this exercise for at least a couple of months before implant surgery. It will help keep your penis healthy and you will have a better outcome. Dr. Milam told me to keep up the exercise until about 2 days before my surgery and be careful not to hurt myself.
If you have read my story I call “One Mans Journey” it tells of my 10day hospital stay and recovery where I did not use the VED for almost a month. It looked like I had lost all the progress I had made with the VED exercise. When I was able to start back using the exercise within a week I had recovered the gains I had made.
Monday, July 25, 2011
Peyronies and Implants
Published on modernmedicine.com April 1, 2011
Implantable penile prostheses aid curvature, function in men with Peyronie's disease, erectile dysfunction
Two prostheses avoid perceived or real loss of penile length, research showsPublish date: Apr 1, 2011
By: Mac Overmyer
Source: Urology Times
In men with erectile dysfunction due to Peyronie's disease, use of a girth-expanding, length-extending implantable penile prosthesis appears to improve both erectile function and curvature while addressing the frequent problem of real or perceived shortening, researchers say.
Researchers from Vanderbilt University Medical Center, Nashville, TN, presented a study on two such prostheses at the 2010 AUA annual meeting in San Francisco. The devices—the AMS Ultrex and AMS LGX (American Medical Systems, Minnetonka, MN)—significantly improve curvature and erectile function and "contribute substantially to the patient's sexual health," said Benjamin Whittam, MD, a urologic surgery resident at Vanderbilt working with Douglas Milam, MD, and colleagues.
Dr. Whittam told Urology Times that being able to model during the implant procedure, coupled with the device's ability to enhance both girth and length, plays an important role in improving patient self-perception and subsequent sexual health.
In presenting the study, Dr. Whittam noted that some other prostheses allowed for length extension but were associated with concerns about achieving adequate rigidity for modeling and straightening. Other prostheses that allow a degree of modeling and straightening are associated with perceived or real shortening.
Of the two main types of penile prostheses, girth-expanding devices are currently supported by the Peyronie's disease literature, Dr. Whittam said. These devices include the CX (American Medical Systems) and the Titan (Coloplast, Minneapolis).
"However, neither of these has length-expanding attributes," he said. "Length- and girth-expanding devices such as the AMS Ultrex and AMS LGX are associated with risks of urethral dilation. There is also a concern that these devices might not tolerate intraoperative modeling and because of this, would not be that useful in patients with severe curves."
See Footnote
To define the potential benefits of the Ultrex and LGX, the Vanderbilt team conducted a retrospective review of 49 patients who had undergone an Ultrex or LGX implant procedure between 2006 and 2009. The patients had ED associated with penile curvature, and the average curvature was 52.9 degrees. A total of 37 patients received the AMS LGX, and 31 underwent modeling during the implant procedure.
Curvature, SHIM scores improve
The benefits associated with the device were substantial. Of 40 patients with sufficient follow-up (those who presented for activation at 6 weeks), 22 were without any residual curve, and 18 had an average residual curve of 17.7 degrees. Scores on the Sexual Health Inventory for Men (SHIM) improved from a mean of 6.97 preoperatively to 18.54 postoperatively with a mean follow-up of 7.3 months. The percentage of men able to have intercourse increased from 30.8% preoperatively to 97.3% at 7.3 months' follow-up.
There was no incidence of aneurysmal dilatation or device infection observed. One patient had a hematoma that resolved spontaneously, and one patient evidenced reduced glans support. This was resolved with a revision.
"We feel that the use of these devices allows a significant improvement in penile curvature and benefits erectile function as well as sexual health. This is now a standing clinical strategy that allows both girth expansion and length extension and is a viable therapeutic option for patients with Peyronie's disease," Dr. Whittam said.
Dr. Milam is a consultant/adviser for American Medical Systems.
-------------------------------------------------------------------------
Footnote from a email from Dr. Milam's assistant Todd Doran MS PAC 7/26/11
The argument to use a CX in severe peyronies/modeling is due to aneurysmal dilation seen in older Ultrex (predecessor to LGX) and the false belief that an LGX will accentuate the curve. We disagree with that argument and it's still a largely held belief by a lot of implanters. Remember that there are few that have the volume like Dr. Milam, especially with concurrent Peyronie's Disease. The large volume implanter peer group would be less critical in using an LGX in that setting in 2011 than 3 yrs ago even due to success and spreading of the word.
Todd
Todd J. Doran, MS, PA-C
Associate in Urologic Surgery
Vanderbilt University
Dept of Urologic Surgery
A-1302 MCN
Nashville, TN 37232
615-322-2880
I am happy to report that my case was included in the above mentioned study.
Jack
Implantable penile prostheses aid curvature, function in men with Peyronie's disease, erectile dysfunction
Two prostheses avoid perceived or real loss of penile length, research showsPublish date: Apr 1, 2011
By: Mac Overmyer
Source: Urology Times
In men with erectile dysfunction due to Peyronie's disease, use of a girth-expanding, length-extending implantable penile prosthesis appears to improve both erectile function and curvature while addressing the frequent problem of real or perceived shortening, researchers say.
Researchers from Vanderbilt University Medical Center, Nashville, TN, presented a study on two such prostheses at the 2010 AUA annual meeting in San Francisco. The devices—the AMS Ultrex and AMS LGX (American Medical Systems, Minnetonka, MN)—significantly improve curvature and erectile function and "contribute substantially to the patient's sexual health," said Benjamin Whittam, MD, a urologic surgery resident at Vanderbilt working with Douglas Milam, MD, and colleagues.
Dr. Whittam told Urology Times that being able to model during the implant procedure, coupled with the device's ability to enhance both girth and length, plays an important role in improving patient self-perception and subsequent sexual health.
In presenting the study, Dr. Whittam noted that some other prostheses allowed for length extension but were associated with concerns about achieving adequate rigidity for modeling and straightening. Other prostheses that allow a degree of modeling and straightening are associated with perceived or real shortening.
Of the two main types of penile prostheses, girth-expanding devices are currently supported by the Peyronie's disease literature, Dr. Whittam said. These devices include the CX (American Medical Systems) and the Titan (Coloplast, Minneapolis).
"However, neither of these has length-expanding attributes," he said. "Length- and girth-expanding devices such as the AMS Ultrex and AMS LGX are associated with risks of urethral dilation. There is also a concern that these devices might not tolerate intraoperative modeling and because of this, would not be that useful in patients with severe curves."
See Footnote
To define the potential benefits of the Ultrex and LGX, the Vanderbilt team conducted a retrospective review of 49 patients who had undergone an Ultrex or LGX implant procedure between 2006 and 2009. The patients had ED associated with penile curvature, and the average curvature was 52.9 degrees. A total of 37 patients received the AMS LGX, and 31 underwent modeling during the implant procedure.
Curvature, SHIM scores improve
The benefits associated with the device were substantial. Of 40 patients with sufficient follow-up (those who presented for activation at 6 weeks), 22 were without any residual curve, and 18 had an average residual curve of 17.7 degrees. Scores on the Sexual Health Inventory for Men (SHIM) improved from a mean of 6.97 preoperatively to 18.54 postoperatively with a mean follow-up of 7.3 months. The percentage of men able to have intercourse increased from 30.8% preoperatively to 97.3% at 7.3 months' follow-up.
There was no incidence of aneurysmal dilatation or device infection observed. One patient had a hematoma that resolved spontaneously, and one patient evidenced reduced glans support. This was resolved with a revision.
"We feel that the use of these devices allows a significant improvement in penile curvature and benefits erectile function as well as sexual health. This is now a standing clinical strategy that allows both girth expansion and length extension and is a viable therapeutic option for patients with Peyronie's disease," Dr. Whittam said.
Dr. Milam is a consultant/adviser for American Medical Systems.
-------------------------------------------------------------------------
Footnote from a email from Dr. Milam's assistant Todd Doran MS PAC 7/26/11
The argument to use a CX in severe peyronies/modeling is due to aneurysmal dilation seen in older Ultrex (predecessor to LGX) and the false belief that an LGX will accentuate the curve. We disagree with that argument and it's still a largely held belief by a lot of implanters. Remember that there are few that have the volume like Dr. Milam, especially with concurrent Peyronie's Disease. The large volume implanter peer group would be less critical in using an LGX in that setting in 2011 than 3 yrs ago even due to success and spreading of the word.
Todd
Todd J. Doran, MS, PA-C
Associate in Urologic Surgery
Vanderbilt University
Dept of Urologic Surgery
A-1302 MCN
Nashville, TN 37232
615-322-2880
I am happy to report that my case was included in the above mentioned study.
Jack
Friday, July 15, 2011
Ever consider an implant? Here's some entertainment. By LGX Man
Ever consider an implant? Here's some entertainment.
So much talk of ED. Thought I'd give you guys an encyclopedia of "the flip side". It's lengthy, it's fun! ;-)
I've been the proud owner of an AMS 700-LGX Penile Implant for nearly 7 months. It has turned out to be an amazing, life-changing product. I do notice a big difference in size now, After so many years living with ED, it had become a turtle. The new implant is 21cm. plus base extenders, which hold the whole shebang together. I've got some length and yes, it does grow your penis. Here's a truth that not many implanted men talk about. To put these new chambers into your penis, they cauterize, dilate or "hollow-out" the old corpora cavernosa. The "CC" is the part of your penis that has swollen up when sexually aroused. "used to be huh? heh" They then install the new chambers into the "dilated right thru the middle" old chambers. This is the part that causes the increase in girth, right off the bat. After working with my penis for many months, it gets BIG now. Magnum XL size in girth. I had previously been considered about normal, 6" regular. The length is worked on every day and is definitely growing. Read on...
I've followed all instructions from the doctor & manufacturer since the day I had it installed. Nowadays, I keep it inflated to the MAX twice a day for as long as I can stand it. I often go to sleep with it fully inflated. Sometimes I can stand it for an hour and other times I can go all night and have spontaneous sex. The mind once again works with the penis and there are times when the mind "just knows" that it will be having sex in the middle of the night. This is one of my improved thoughts since being implanted. Yeah … nice! I have the AMS LGX (stands for Length/Girth Expansion) and it grows. The more it’s used, the more it gets broken-in (a very good thing, kinda like an old leather jacket). After a period of uncomfortableness (based on your level of tolerance, but 1-3 months average), you will suddenly wake up one day and it will all be working again. Loss of sensation? Not necessarily. I became much more sensitive because it had never really gotten hard enough before to sense the new zones that I’m feeling nowadays. This has caused a huge boost in my self-esteem and confidence level. Before all of this happened, I had gotten to the point of using depression meds. and psych counseling. Suddenly one day I just realized: Many things in my life seem wrong. Many of them are caused by my low self-esteem. Why don't I quit bitching about it do something about it. I decided to use a proven method to fix, at least, the biggest problem. ED. It sure couldn't be much worse than where I was at, right? Those were bleak times.
I watched the chatter on the penile-implant and other discussion forums, as well as the enlightening ED chatroom,at FrankTalk.org. It's clear that people prefer one type (AMS/Titan) over the other. The debate goes on over which one is better, especially with the newer guys who do not read the backlog of postings in the message banks, and have similar new questions all the time. After the operation is done life gets back to normal and guys often just go on with their new lives. The forums go round and round.
DOCTORS AND COSTS: After a short period with my newest BFF, I could honestly say that I LOVE MY LGX I have no regrets and nothing but good things going on in my life now. So MUCH has changed! I've also met many nice men on these forums who LOVE their Titan. The key is finding the right doctor and the right implant. That begins the journey. Hopefully you have insurance as the operation can run up to around $32,000. Maybe you're lucky enough to have insurance that will cover the best of the best doctors. It seems that there are increasingly fewer of those doctors and health plans around. The "best of the best" ones are called SEXUAL FUNCTION SPECILISTS. They perform MANY of these operations per year. Some say as many as “thousands” per year. You can get lists of doctors here, just ask and a list will be sent to you. Perhaps your insurance is more limited, as was mine, and you’ll have fewer doctors to choose from. In that case you want to research each of the doctors in your plan as carefully as you can. The amount of research done is up to you. I’m part of a medical foundation on the west coast and found the doctor who had done the most work with implants for the foundation. If you ask here, you’ll get many names of doctors from satisfied IPP recipients. But guys, know when to decide! Too much research can just get you nauseous. Be informed and ask questions of us implanted guys. Believe me, I had new questions each and every day and the guys here on the forums got me through it all.
After checking out doctors, reading as much information as I could get my hands on, and reading the blogs, forums and discussion rooms, I chose to just do it and took that big chance, with great worry, trepidation and fear. Luckily, I had also developed lots of confidence in my doctor through many of his chats, tests, emails and demonstrations. He showed honest excitement to get me fitted into an implant, but had made sure that every other conceivable option was exhausted beforehand (pills, pumps, injections with various mixes). It was determined that I had venous leakage on one side, which kept my penis from staying hard. There are many theories and reasons for ED so I won’t go into it, research!
I worked on myself (swimming often) for a few months to get as healthy as I could be before I underwent surgery. My muscles and skin were toned up, and my veins were standing at attention, ready to have intravenous needles stuck in them, joy!. The operation was a success and I spent the night in the hospital so that they could remove the catheter in the morning, when needed. I was lucky, and was treated like a king all night. I was sent home to recuperate. All was fine until about the 4th day when the intensity of what I had done sunk in. This is where I learned the smart use of ice or something cold. Personally, I kept a bowl of ice water and a few white towels nearby. I had a thick towel underneath me. After wringing the towels out, I used the cold towels to wrap around my scrotum and penis, causing an immense amount of relief. Whatever your method for getting the swelling to subside, do it. Very important at this stage. Ibuprofen and other meds may be necessary, based on you.
Since my first inflation, I've been instructed to "work it" at least twice a day. For the first 2 to 4 weeks, this just meant to inflate the penis and leave it there for 10 to 20 minutes. After that, or when your doctor instructs you to ...you can start keeping it pumped to the MAX whenever you want. The material of the pump is strong and it can take whatever you want it to do. You SHOULD do this at least 2x daily for the first 18 months. It's an investment in time, but heh it's not really so bad now is it? Some days it does seem like a chore but once it's inflated, that’s usually all quickly forgotten or I leave it up and play with it. This is when you can start working on keeping your newly dilated corpora cavernosa (cc) chambers inflated or, in the case of the LGX-700, start pumping it to stretch/grow your penis. It’s pretty much the same idea as how muscles are made. Pump it! I work on keeping the LGX chambers aligned from the shaft into the GLANS. I work on keeping the shaft free of scar tissue growth. Scar tissue grows in immediately and throughout the first 2-6 months after the IPP operation, and is always a threat. You’ll know what it is when it sets in. if you don't WORK IT on a regular basis, at least for the first year to 18 months, you will regret it later. The more you work it, the better the results! Make sure the head of the penis get a full workout. Am I stressing the importance of this task guys? Talk about a wicked new set of feelings during the first few weeks! Now, when I use my penis, it's finally doing exactly what I want it to do, on command (on command of my fingers pumping it up that is) and for however long I want it to perform. I think of the daily routine as something that’s been prescribed and MUST be done. Twice a day! I have to admit that this is one chore that I’ve really grown happy to get done quite often nowadays!
KEEPING THAT PESKY PUMP IN PLACE: You need make sure that you keep that new testicle, known as the pump, adjusted to wherever it has to be in your scrotum. It's up to YOU to follow your doctor and manufacturer’s orders and get the new equipment to where it needs to eventually rest. If you have problems, get to, email or call your doctor! When it comes time to get the pump into the correct position in the scrotum, I found that taking warm showers with lots of soap or better, conditioner and working the pump (and shaft) to where it’s intended to be helped a lot. If the pump is already where it needs to be, you got very lucky but need to make sure that it stays in the proper place in your scrotum. While in the shower, pull gently on the pump and direct it to where you want it to be. You only have just so long before scar tissue forms and that pump takes up residence wherever it has ended up.
WHY I CHOSE THE LGX: My medical foundation ONLY uses the LGX. Why? Because all of the urologists from the foundation (some more skilled than others) went to a few conventions sponsored by each of the two IPP companies. Many did operations based on what type of IPP the various patients had requested. Then they compared results. The doctors at Kaiser, together, as a team, decided that the LGX-700 would be the implant of choice, and the one sponsored by the foundation. I’m not sure if this would be fair to our brother’s with a large penis, who are better suited for a Titan. Luckily, The LGX is generally suited for guys around the normal range, 6” more or less. The Titan is for the bigger guys. Both work differently, research!
After about 3-1/2 months of general aching and re-arranging, suddenly one day it all suddenly “stopped” and my new always half-stiff penis "dropped" about 20 degrees. I stood looking at it in disbelief! Yaay! I was able to get it nearly back to normal flaccid droop. The penis never gets small again, it is always a bit of a shower after one of these implants. Most guys don’t mind that too much for some reason. The chambers are just larger! Whatever pain that had remained was gone and my mind was once again free to start thinking of other things, besides JUST my penis! Guys, LGX / Coloplast Titan, either way... how comfortable are YOU to do the utmost research that you can do, get all the information that you can from the doctor and his staff, and then just do it!
FINDING DOCTORS: We can worry all we want and ask and argue and debate but let's get real. Like most things, it's the luck of the draw when finding a good doctor. If you have fantastic insurance plan, finding the best is probably a lot easier. If your insurance is limited, then you need to find the best that you can get! My LGX was FREE just because the foundation states that all that’s needed is for the urologist to state that it’s needed. Had I realized this, I probably would have approached the subject years earlier. Sticky point: The size of the implant is up to the doctor and any representative of the company that may be there assisting. Make sure that you discuss your options with the doctor that will be performing the operation. The doctor SHOULD BE giving you the proper sized implant for your particular penis. YOU HAVE ONE TIME TO GET THIS RIGHT, MAKE SURE YOU AND YOUR DOCTOR ARE IN SYNC WITH THE SIZE ISSUE. Don’t give yourself reason to complain afterward!
RETURN OF THE CORPORAS: The “corpora spongiosum" (cs), the one surrounding the urethra (around the pee canal, underneath the penis) and also the GLANS. They are supposed to (and HAVE in me) come back to life. When really "aroused", as you often will be after receiving an IPP, you'll suddenly notice that your entire shaft will become engorged. The bottom of your penis as well as the head will finally again fill up with blood as the penis is made to do naturally. This may not happen to everybody, but it WILL happen to many. Once the rest of your penis is working, eventually you will be able to have a fully hard (what many implantee's begin to think of as "natural") penis, not the oval penis that we live with for the first 18 to 24 months after the operation before the CS returns to life. Truth be told: Most guys will eventually get full use of their penis back after a length of time, living with their new implants. The confidence level can become so good that the old parts (CC) may eventually come to life and join the party! Seriously, just do it
Well, that's my story. Now I'm having lots of FUN in life. Picture the PERMANENT BIG SMILE! I hope that you'll consider the fact that it all could be a lot better just by doing it, like I did?
Now, back to the show...
So much talk of ED. Thought I'd give you guys an encyclopedia of "the flip side". It's lengthy, it's fun! ;-)
I've been the proud owner of an AMS 700-LGX Penile Implant for nearly 7 months. It has turned out to be an amazing, life-changing product. I do notice a big difference in size now, After so many years living with ED, it had become a turtle. The new implant is 21cm. plus base extenders, which hold the whole shebang together. I've got some length and yes, it does grow your penis. Here's a truth that not many implanted men talk about. To put these new chambers into your penis, they cauterize, dilate or "hollow-out" the old corpora cavernosa. The "CC" is the part of your penis that has swollen up when sexually aroused. "used to be huh? heh" They then install the new chambers into the "dilated right thru the middle" old chambers. This is the part that causes the increase in girth, right off the bat. After working with my penis for many months, it gets BIG now. Magnum XL size in girth. I had previously been considered about normal, 6" regular. The length is worked on every day and is definitely growing. Read on...
I've followed all instructions from the doctor & manufacturer since the day I had it installed. Nowadays, I keep it inflated to the MAX twice a day for as long as I can stand it. I often go to sleep with it fully inflated. Sometimes I can stand it for an hour and other times I can go all night and have spontaneous sex. The mind once again works with the penis and there are times when the mind "just knows" that it will be having sex in the middle of the night. This is one of my improved thoughts since being implanted. Yeah … nice! I have the AMS LGX (stands for Length/Girth Expansion) and it grows. The more it’s used, the more it gets broken-in (a very good thing, kinda like an old leather jacket). After a period of uncomfortableness (based on your level of tolerance, but 1-3 months average), you will suddenly wake up one day and it will all be working again. Loss of sensation? Not necessarily. I became much more sensitive because it had never really gotten hard enough before to sense the new zones that I’m feeling nowadays. This has caused a huge boost in my self-esteem and confidence level. Before all of this happened, I had gotten to the point of using depression meds. and psych counseling. Suddenly one day I just realized: Many things in my life seem wrong. Many of them are caused by my low self-esteem. Why don't I quit bitching about it do something about it. I decided to use a proven method to fix, at least, the biggest problem. ED. It sure couldn't be much worse than where I was at, right? Those were bleak times.
I watched the chatter on the penile-implant and other discussion forums, as well as the enlightening ED chatroom,at FrankTalk.org. It's clear that people prefer one type (AMS/Titan) over the other. The debate goes on over which one is better, especially with the newer guys who do not read the backlog of postings in the message banks, and have similar new questions all the time. After the operation is done life gets back to normal and guys often just go on with their new lives. The forums go round and round.
DOCTORS AND COSTS: After a short period with my newest BFF, I could honestly say that I LOVE MY LGX I have no regrets and nothing but good things going on in my life now. So MUCH has changed! I've also met many nice men on these forums who LOVE their Titan. The key is finding the right doctor and the right implant. That begins the journey. Hopefully you have insurance as the operation can run up to around $32,000. Maybe you're lucky enough to have insurance that will cover the best of the best doctors. It seems that there are increasingly fewer of those doctors and health plans around. The "best of the best" ones are called SEXUAL FUNCTION SPECILISTS. They perform MANY of these operations per year. Some say as many as “thousands” per year. You can get lists of doctors here, just ask and a list will be sent to you. Perhaps your insurance is more limited, as was mine, and you’ll have fewer doctors to choose from. In that case you want to research each of the doctors in your plan as carefully as you can. The amount of research done is up to you. I’m part of a medical foundation on the west coast and found the doctor who had done the most work with implants for the foundation. If you ask here, you’ll get many names of doctors from satisfied IPP recipients. But guys, know when to decide! Too much research can just get you nauseous. Be informed and ask questions of us implanted guys. Believe me, I had new questions each and every day and the guys here on the forums got me through it all.
After checking out doctors, reading as much information as I could get my hands on, and reading the blogs, forums and discussion rooms, I chose to just do it and took that big chance, with great worry, trepidation and fear. Luckily, I had also developed lots of confidence in my doctor through many of his chats, tests, emails and demonstrations. He showed honest excitement to get me fitted into an implant, but had made sure that every other conceivable option was exhausted beforehand (pills, pumps, injections with various mixes). It was determined that I had venous leakage on one side, which kept my penis from staying hard. There are many theories and reasons for ED so I won’t go into it, research!
I worked on myself (swimming often) for a few months to get as healthy as I could be before I underwent surgery. My muscles and skin were toned up, and my veins were standing at attention, ready to have intravenous needles stuck in them, joy!. The operation was a success and I spent the night in the hospital so that they could remove the catheter in the morning, when needed. I was lucky, and was treated like a king all night. I was sent home to recuperate. All was fine until about the 4th day when the intensity of what I had done sunk in. This is where I learned the smart use of ice or something cold. Personally, I kept a bowl of ice water and a few white towels nearby. I had a thick towel underneath me. After wringing the towels out, I used the cold towels to wrap around my scrotum and penis, causing an immense amount of relief. Whatever your method for getting the swelling to subside, do it. Very important at this stage. Ibuprofen and other meds may be necessary, based on you.
Since my first inflation, I've been instructed to "work it" at least twice a day. For the first 2 to 4 weeks, this just meant to inflate the penis and leave it there for 10 to 20 minutes. After that, or when your doctor instructs you to ...you can start keeping it pumped to the MAX whenever you want. The material of the pump is strong and it can take whatever you want it to do. You SHOULD do this at least 2x daily for the first 18 months. It's an investment in time, but heh it's not really so bad now is it? Some days it does seem like a chore but once it's inflated, that’s usually all quickly forgotten or I leave it up and play with it. This is when you can start working on keeping your newly dilated corpora cavernosa (cc) chambers inflated or, in the case of the LGX-700, start pumping it to stretch/grow your penis. It’s pretty much the same idea as how muscles are made. Pump it! I work on keeping the LGX chambers aligned from the shaft into the GLANS. I work on keeping the shaft free of scar tissue growth. Scar tissue grows in immediately and throughout the first 2-6 months after the IPP operation, and is always a threat. You’ll know what it is when it sets in. if you don't WORK IT on a regular basis, at least for the first year to 18 months, you will regret it later. The more you work it, the better the results! Make sure the head of the penis get a full workout. Am I stressing the importance of this task guys? Talk about a wicked new set of feelings during the first few weeks! Now, when I use my penis, it's finally doing exactly what I want it to do, on command (on command of my fingers pumping it up that is) and for however long I want it to perform. I think of the daily routine as something that’s been prescribed and MUST be done. Twice a day! I have to admit that this is one chore that I’ve really grown happy to get done quite often nowadays!
KEEPING THAT PESKY PUMP IN PLACE: You need make sure that you keep that new testicle, known as the pump, adjusted to wherever it has to be in your scrotum. It's up to YOU to follow your doctor and manufacturer’s orders and get the new equipment to where it needs to eventually rest. If you have problems, get to, email or call your doctor! When it comes time to get the pump into the correct position in the scrotum, I found that taking warm showers with lots of soap or better, conditioner and working the pump (and shaft) to where it’s intended to be helped a lot. If the pump is already where it needs to be, you got very lucky but need to make sure that it stays in the proper place in your scrotum. While in the shower, pull gently on the pump and direct it to where you want it to be. You only have just so long before scar tissue forms and that pump takes up residence wherever it has ended up.
WHY I CHOSE THE LGX: My medical foundation ONLY uses the LGX. Why? Because all of the urologists from the foundation (some more skilled than others) went to a few conventions sponsored by each of the two IPP companies. Many did operations based on what type of IPP the various patients had requested. Then they compared results. The doctors at Kaiser, together, as a team, decided that the LGX-700 would be the implant of choice, and the one sponsored by the foundation. I’m not sure if this would be fair to our brother’s with a large penis, who are better suited for a Titan. Luckily, The LGX is generally suited for guys around the normal range, 6” more or less. The Titan is for the bigger guys. Both work differently, research!
After about 3-1/2 months of general aching and re-arranging, suddenly one day it all suddenly “stopped” and my new always half-stiff penis "dropped" about 20 degrees. I stood looking at it in disbelief! Yaay! I was able to get it nearly back to normal flaccid droop. The penis never gets small again, it is always a bit of a shower after one of these implants. Most guys don’t mind that too much for some reason. The chambers are just larger! Whatever pain that had remained was gone and my mind was once again free to start thinking of other things, besides JUST my penis! Guys, LGX / Coloplast Titan, either way... how comfortable are YOU to do the utmost research that you can do, get all the information that you can from the doctor and his staff, and then just do it!
FINDING DOCTORS: We can worry all we want and ask and argue and debate but let's get real. Like most things, it's the luck of the draw when finding a good doctor. If you have fantastic insurance plan, finding the best is probably a lot easier. If your insurance is limited, then you need to find the best that you can get! My LGX was FREE just because the foundation states that all that’s needed is for the urologist to state that it’s needed. Had I realized this, I probably would have approached the subject years earlier. Sticky point: The size of the implant is up to the doctor and any representative of the company that may be there assisting. Make sure that you discuss your options with the doctor that will be performing the operation. The doctor SHOULD BE giving you the proper sized implant for your particular penis. YOU HAVE ONE TIME TO GET THIS RIGHT, MAKE SURE YOU AND YOUR DOCTOR ARE IN SYNC WITH THE SIZE ISSUE. Don’t give yourself reason to complain afterward!
RETURN OF THE CORPORAS: The “corpora spongiosum" (cs), the one surrounding the urethra (around the pee canal, underneath the penis) and also the GLANS. They are supposed to (and HAVE in me) come back to life. When really "aroused", as you often will be after receiving an IPP, you'll suddenly notice that your entire shaft will become engorged. The bottom of your penis as well as the head will finally again fill up with blood as the penis is made to do naturally. This may not happen to everybody, but it WILL happen to many. Once the rest of your penis is working, eventually you will be able to have a fully hard (what many implantee's begin to think of as "natural") penis, not the oval penis that we live with for the first 18 to 24 months after the operation before the CS returns to life. Truth be told: Most guys will eventually get full use of their penis back after a length of time, living with their new implants. The confidence level can become so good that the old parts (CC) may eventually come to life and join the party! Seriously, just do it
Well, that's my story. Now I'm having lots of FUN in life. Picture the PERMANENT BIG SMILE! I hope that you'll consider the fact that it all could be a lot better just by doing it, like I did?
Now, back to the show...
Monday, June 20, 2011
Rick's Story
This is an email I received today from Rick. He has had a long struggle with ED and other penile problems.
Dr. Milam has a training program at Vanderbilt for Urologist that want to be male sexual function specialist. That work is paying off with new doctors. Dr. Milessa Kaufman is one of those.
His doctor at Vanderbilt was Dr. Milessa Kaufman. She went to medical school at Vanderbilt, Interned at Vanderbilt and then went through Dr. Milam's program on male sexual function and urodynaics. She is now on staff at Vanderbilt.
This is Rick's email:
It was done Tues. the 14th.
Lots to tell...the surgery went great and so did the next day on the hospital. Dr Kaufman has been great. I'
l'll quote her as best as possible. She said "her and everyone in the OR were very impressed with the implant when she filled it up and that I would be very pleased with the result. That result is exactly what the manufacturer wants". Ok you talk about being on cloud 9. Now that's some bedisde manners!
Had a 4 hour drive Wed. morning to get home. It's been a long week. I tried to do to much with Father's Day. I paid. I had to take an oxycodone at 3am. I'll take another this mornning. All the pain is at the incision sight. Not surprising. Vandy calls daily to check on me. I have learned my lesson and will keep a much lower profile for the next week.
I can't wait to use the implant. I feel like a new man. Unbelievable really what a surgery can do for the male ego.
I'll keep you informed as I go forward. Thanks for all your help. I can never state the way finding you and having this done has changed my outlook on life. God Bless you Jack for sharing your story with me.
Rick
Footnote: I have received some feedback, by some men, that say that want a male doctor to preform a implant. That is fine I would have felt that way years ago. If you prefere a male doctor Dr. Milam is always happy to help.
Dr. Milam has a training program at Vanderbilt for Urologist that want to be male sexual function specialist. That work is paying off with new doctors. Dr. Milessa Kaufman is one of those.
His doctor at Vanderbilt was Dr. Milessa Kaufman. She went to medical school at Vanderbilt, Interned at Vanderbilt and then went through Dr. Milam's program on male sexual function and urodynaics. She is now on staff at Vanderbilt.
This is Rick's email:
It was done Tues. the 14th.
Lots to tell...the surgery went great and so did the next day on the hospital. Dr Kaufman has been great. I'
l'll quote her as best as possible. She said "her and everyone in the OR were very impressed with the implant when she filled it up and that I would be very pleased with the result. That result is exactly what the manufacturer wants". Ok you talk about being on cloud 9. Now that's some bedisde manners!
Had a 4 hour drive Wed. morning to get home. It's been a long week. I tried to do to much with Father's Day. I paid. I had to take an oxycodone at 3am. I'll take another this mornning. All the pain is at the incision sight. Not surprising. Vandy calls daily to check on me. I have learned my lesson and will keep a much lower profile for the next week.
I can't wait to use the implant. I feel like a new man. Unbelievable really what a surgery can do for the male ego.
I'll keep you informed as I go forward. Thanks for all your help. I can never state the way finding you and having this done has changed my outlook on life. God Bless you Jack for sharing your story with me.
Rick
Footnote: I have received some feedback, by some men, that say that want a male doctor to preform a implant. That is fine I would have felt that way years ago. If you prefere a male doctor Dr. Milam is always happy to help.
Friday, May 27, 2011
Difficult/Delayed Ejaculation
Some of the feedback I am getting is men are not getting the proper dosage of Lovaza. This is from the Lovaza web site.
DOSAGE AND ADMINISTRATION
•The daily dose of LOVAZA is 4 grams per day taken as a single 4-gram dose (4 capsules) or as two 2-gram doses (2 capsules given twice daily). (2)
•Patients should be advised to swallow LOVAZA capsules whole. Do not break open, crush, dissolve or chew LOVAZA. (2)
It will not help if you are on any antidepressant with maybe the exception of Welbutrin.
It takes up to 2 months to help. It helped me in about 6 weeks.
Your feedback after taking it for a couple of months will be appreciated, It could help others.
Jack
DOSAGE AND ADMINISTRATION
•The daily dose of LOVAZA is 4 grams per day taken as a single 4-gram dose (4 capsules) or as two 2-gram doses (2 capsules given twice daily). (2)
•Patients should be advised to swallow LOVAZA capsules whole. Do not break open, crush, dissolve or chew LOVAZA. (2)
It will not help if you are on any antidepressant with maybe the exception of Welbutrin.
It takes up to 2 months to help. It helped me in about 6 weeks.
Your feedback after taking it for a couple of months will be appreciated, It could help others.
Jack
Sunday, May 15, 2011
DELAYED OR DIFFICULT EJACULATION
DIFFICULT OR DELAYED EJACULATION
I, along with a lot of others, suffer from delayed or difficult ejaculation. It started years before my implant. I am on testosterone replacement and it helps a lot of things but did little for my delayed/difficult ejaculation.
Ejaculation during intercourse was all but impossible most of the time and really got bad the last couple of year or so. It was so difficult I would have to finish myself after intercourse.
I have asked every doctor that I have seen for the last 6 or so years about it and did they know of anything I could do or try. Unfortunately they said there was not.
Last February I was in the hospital for a week with a-fib caused by a reaction from Cipro. I was on blood thinner in the hospital and that brought thing back to life some but quickly faded.
I cannot take statins for cholesterol. My bad cholesterol is OK but my good is low. My heart doctor wanted to add a medicine to help. I insisted NO statins. He said it was omega-3. I thought YUCK I tried those and did not like the after taste and fishy breath. So I agreed to give it a try.
He gave me a prescription for Lovaza 1GM two twice a day. To my surprise no fishy taste or bad breathe. About 6 weeks into Lovaza my wife and I notice a marked difference in our sex life. I was able to ejaculate during intercourse. My initial thought was it was just a onetime thing.
It has been a month+ now and every time we have intercourse I am able to ejaculate during intercourse.
I asked a pharmacist I go to church with about Lovaza. She told me you would have to take 48 OTC fish oil pills to equal the dose I am taking.
Lovaza is the only new medicine I take. All other and activity is the same.
I don’t know why but it has worked for me. Ask your doctor if you can try it.
Note: If you are on an antidepressant or drugs with ED as a side effect this may not help you.
Jack
I, along with a lot of others, suffer from delayed or difficult ejaculation. It started years before my implant. I am on testosterone replacement and it helps a lot of things but did little for my delayed/difficult ejaculation.
Ejaculation during intercourse was all but impossible most of the time and really got bad the last couple of year or so. It was so difficult I would have to finish myself after intercourse.
I have asked every doctor that I have seen for the last 6 or so years about it and did they know of anything I could do or try. Unfortunately they said there was not.
Last February I was in the hospital for a week with a-fib caused by a reaction from Cipro. I was on blood thinner in the hospital and that brought thing back to life some but quickly faded.
I cannot take statins for cholesterol. My bad cholesterol is OK but my good is low. My heart doctor wanted to add a medicine to help. I insisted NO statins. He said it was omega-3. I thought YUCK I tried those and did not like the after taste and fishy breath. So I agreed to give it a try.
He gave me a prescription for Lovaza 1GM two twice a day. To my surprise no fishy taste or bad breathe. About 6 weeks into Lovaza my wife and I notice a marked difference in our sex life. I was able to ejaculate during intercourse. My initial thought was it was just a onetime thing.
It has been a month+ now and every time we have intercourse I am able to ejaculate during intercourse.
I asked a pharmacist I go to church with about Lovaza. She told me you would have to take 48 OTC fish oil pills to equal the dose I am taking.
Lovaza is the only new medicine I take. All other and activity is the same.
I don’t know why but it has worked for me. Ask your doctor if you can try it.
Note: If you are on an antidepressant or drugs with ED as a side effect this may not help you.
Jack
Saturday, May 14, 2011
LGX Man's Story
I've been the proud 4+ month owner of an AMS 700-LGX. It's fantastic! It's everything that I wanted it to be and I do notice a big difference in size now because I had been ED for so long that it was becoming a turtle. The implant is 21cm with extenders, and I've followed instructions from the manufacturer to the T and then some. I now keep it inflated to the max twice a day for as long as I can stand it. I sometimes sleep with it hard. Sometimes I can stand it for an hour and sometimes I can go all night. This usually results in wild dreams and reality and has caused a change in my overall well-being and confidence level. I've also "worked it" at least twice a day, Aside from any great sex that I now get, I "exercise" my new best friend. I keep working on getting the LGX chambers through the canal that the doctors hollowed out. During these times of exercise, I squeeze and work my new chambers to get and keep them in alignment with the canal that my doctor originally dilated and pulled the new chambers through. Talk about a wicked new feeling guys! If this freaks you, you should watch one of the videos on an IPP website. After a while, like most things, this new twice-daily exercise has become commonplace as I work it to avoid scar tissue growth in the canals. Scar tissue grows in within the first 2-3 months after the IPP operation, and is always a threat if you don't WORK IT on a regular basis, at least for the first year to 18 months. Get that new testicle, known as the pump to wherever it has to be in your scrotum. It's up to YOU to follow your doctor and manufacturers orders and get the new equipment to where it needs to eventually rest. If you have problems, don't be like most guys, get to your doctor!
I watch the emails from the penile-implant forum and other forums with a very open mind. It's clear that people prefer one type (AMS/Titan) over the other. The debate goes on (and on and on), especially with the newer guys who don't read the backlog of postings in the message bank and have similar new questions all the time. After 4 months, I LOVE my LGX and am definitely NOT sorry I did it. I've also met many nice men here who LOVE their Titan. The key is finding the right doctor and there lies the big mystery, unless you're lucky enough to have insurance that will cover the best of the best doctors. There are one or two of those doctors around, perhaps even more but the amount of research is up to you. You can get lists of doctors here, just ask. I had a limited choice. and lots of us have even more limited insurance choices than me. For them, it starts getting expensive, i hear up to $32,000 and anywhere in-between.
I chose to just do it and took that big chance, with great worry, trepidation and fear i might add, but confidence in my doctor through many of his chats, tests and demonstrations. I find that when I think positive, I usually get lucky. This guy was excited to get me going again and made sure that every other conceivable option was exhausted beforehand (pills, pumps, injections with various mixes). It was determined that I had leakage on one side which kept the little one from staying hard. So I worked for a few months to get to my healthiest and got physically fit before I underwent the operation so that by muscles and skin were toned up, and my veins were bulging and good to go through the various rigors of surgery. The representative from the IPP companies are, supposedly, always right there to hand off the unit to the doctor, as though it's GOLD. They are supposed to be the patients' advocates and make sure that the operation is done correctly. Correctly me if I'm wrong, but I think that is a standard among both companies now. The operation was a success and I spent the night so that they could remove the catheter in the morning when needed. I was sent home to recuperate. I was fine until about the 4th day and then the intensity of what I had done sunk in.
Recommendation: When it comes time to get your pump into the correct position in your scrotum, take warm showers and work that pump to where it needs to be. If it's already there, you got very lucky. While in the shower, pull gently on the pump and direct it to where you want it to be. You only have just so long before scar tissue forms and that pump is wherever it is, and permanently. As far as the chambers on the LGX (i don't know the Titan well but I wish it well and I'm sure it's awesome), you've got to work those chambers into the GLANS/HEAD. I've never been a shower jerker but doing so has helped me get the pump into place with little pressure or pain, and has given me invaluable time to get those chambers where they needed to be, working them towards the GLANS. Now, when I use my little buddy, on it's own, it's finally doing exactly what I wanted it to do and the chambers are lined up into the center of my GLANS. If you've ever trained a dog, you'll realize that this is similar, you just have to keep doing it over and over and over, with consistency. You need to help get those chambers into the best position in your penis. It's not automatic! Think of it as something that is prescribed. Twice a day! Definitely not the worst thing you've ever HAD to do eh, especially with your newfound friend named woody. And yes, my girth is really big. I've always wondered if this is because the old corpora cavernosa's are STILL there, just hollowed out so it pushes the wall of the old ones outward and the new ones are put into the center of the old ones. Anyway, it gets BIG now. Magnum XXL size in girth. Sometimes lately, I even impress myself with it. What do others think of my theory on the new big girth?
My medical foundation (Kaiser) ONLY uses LGX. Why? Because all of the urologists from the foundation (some more skilled than others) went to a few conventions sponsored by each of the two IPP companies. Many did operations based on what type of IPP the various implantee's had requested, and then compared results. The doctors at Kaiser, together, as a team, decided that the LGX 700 would be the implant of choice, and the one sponsored by the foundation. As far as kickbacks, perhaps my question was a bit more deep. Which companies wine and dine and keep the doctors the most satisfied? You know what, who cares, does it really matter? I had no choice of which implant to choose (but had chosen the LGX in my mind because of the ability to work it and grow it). Have I mentioned that I love Love LOVE {;-) the one that I got. Envision that commercial where the guy is always walking around with a big dumb smile on his face. All the good things are TRUE, for me at least. But my positive attitude got me through the worst part (oh it smarted for months). At about 3-1/2 months of aching and re-arranging, suddenly one day it just all stopped and my new usually half-stiff penis "dropped" about 20 degrees. I was able to get it back to normal flaccid size. The pain was gone and my mind was once again free to start thinking of other things, besides my penis. True. I spent over 3 full months just concentrating on my new buddy. Guys, LGX/Coloplast Titan, either way... how comfortable are you to do the utmost research that you can do, get all the information that you can from the doctor and his staff, and then just do it!
We can worry all we want and ask and argue and debate but let's get real. Like most things, it's the luck of the draw when finding most things, especially a good doctor. Sometimes you get lucky and sometimes not. For instance, my GP is a complete flake but I've learned how to work the medical foundation to which I am a member, and I get what I need. My LGX was FREE just because my urologist said I needed it. Had I realized this, I probably would not have waited so long. There seem to be a lot of scare tactics based on peoples fears, especially about the glans being floppy, length of the new penis, etc. Truth is, the Corpora "Spongiosum", the one surrounding the urethra (around the pee canal) and the GLANS will usually come back to life. One day when you're really "aroused", as you often will be after receiving an IPP, you'll suddenly notice that your entire shaft will become engorged. The bottom of your penis as well as the head will fill up with blood as the penis is made to do naturally. This may not happen to everybody, but it WILL happen to many. Once the rest of your penis is working, eventually you will be able to have a fully hard (what many implantee's begin to think of as "natural") penis, not the oval penis that we live with for the first 18 to 24 months after the operation. Truth be told: Most guys will eventually get full use of their penis back after a length of time, living with their new implants.
Well, that's my story. Now I'm just having FUN, picture the BIG SMILE!
LGX Man
NOTE: The corpora's are just dialated during surgery.
I watch the emails from the penile-implant forum and other forums with a very open mind. It's clear that people prefer one type (AMS/Titan) over the other. The debate goes on (and on and on), especially with the newer guys who don't read the backlog of postings in the message bank and have similar new questions all the time. After 4 months, I LOVE my LGX and am definitely NOT sorry I did it. I've also met many nice men here who LOVE their Titan. The key is finding the right doctor and there lies the big mystery, unless you're lucky enough to have insurance that will cover the best of the best doctors. There are one or two of those doctors around, perhaps even more but the amount of research is up to you. You can get lists of doctors here, just ask. I had a limited choice. and lots of us have even more limited insurance choices than me. For them, it starts getting expensive, i hear up to $32,000 and anywhere in-between.
I chose to just do it and took that big chance, with great worry, trepidation and fear i might add, but confidence in my doctor through many of his chats, tests and demonstrations. I find that when I think positive, I usually get lucky. This guy was excited to get me going again and made sure that every other conceivable option was exhausted beforehand (pills, pumps, injections with various mixes). It was determined that I had leakage on one side which kept the little one from staying hard. So I worked for a few months to get to my healthiest and got physically fit before I underwent the operation so that by muscles and skin were toned up, and my veins were bulging and good to go through the various rigors of surgery. The representative from the IPP companies are, supposedly, always right there to hand off the unit to the doctor, as though it's GOLD. They are supposed to be the patients' advocates and make sure that the operation is done correctly. Correctly me if I'm wrong, but I think that is a standard among both companies now. The operation was a success and I spent the night so that they could remove the catheter in the morning when needed. I was sent home to recuperate. I was fine until about the 4th day and then the intensity of what I had done sunk in.
Recommendation: When it comes time to get your pump into the correct position in your scrotum, take warm showers and work that pump to where it needs to be. If it's already there, you got very lucky. While in the shower, pull gently on the pump and direct it to where you want it to be. You only have just so long before scar tissue forms and that pump is wherever it is, and permanently. As far as the chambers on the LGX (i don't know the Titan well but I wish it well and I'm sure it's awesome), you've got to work those chambers into the GLANS/HEAD. I've never been a shower jerker but doing so has helped me get the pump into place with little pressure or pain, and has given me invaluable time to get those chambers where they needed to be, working them towards the GLANS. Now, when I use my little buddy, on it's own, it's finally doing exactly what I wanted it to do and the chambers are lined up into the center of my GLANS. If you've ever trained a dog, you'll realize that this is similar, you just have to keep doing it over and over and over, with consistency. You need to help get those chambers into the best position in your penis. It's not automatic! Think of it as something that is prescribed. Twice a day! Definitely not the worst thing you've ever HAD to do eh, especially with your newfound friend named woody. And yes, my girth is really big. I've always wondered if this is because the old corpora cavernosa's are STILL there, just hollowed out so it pushes the wall of the old ones outward and the new ones are put into the center of the old ones. Anyway, it gets BIG now. Magnum XXL size in girth. Sometimes lately, I even impress myself with it. What do others think of my theory on the new big girth?
My medical foundation (Kaiser) ONLY uses LGX. Why? Because all of the urologists from the foundation (some more skilled than others) went to a few conventions sponsored by each of the two IPP companies. Many did operations based on what type of IPP the various implantee's had requested, and then compared results. The doctors at Kaiser, together, as a team, decided that the LGX 700 would be the implant of choice, and the one sponsored by the foundation. As far as kickbacks, perhaps my question was a bit more deep. Which companies wine and dine and keep the doctors the most satisfied? You know what, who cares, does it really matter? I had no choice of which implant to choose (but had chosen the LGX in my mind because of the ability to work it and grow it). Have I mentioned that I love Love LOVE {;-) the one that I got. Envision that commercial where the guy is always walking around with a big dumb smile on his face. All the good things are TRUE, for me at least. But my positive attitude got me through the worst part (oh it smarted for months). At about 3-1/2 months of aching and re-arranging, suddenly one day it just all stopped and my new usually half-stiff penis "dropped" about 20 degrees. I was able to get it back to normal flaccid size. The pain was gone and my mind was once again free to start thinking of other things, besides my penis. True. I spent over 3 full months just concentrating on my new buddy. Guys, LGX/Coloplast Titan, either way... how comfortable are you to do the utmost research that you can do, get all the information that you can from the doctor and his staff, and then just do it!
We can worry all we want and ask and argue and debate but let's get real. Like most things, it's the luck of the draw when finding most things, especially a good doctor. Sometimes you get lucky and sometimes not. For instance, my GP is a complete flake but I've learned how to work the medical foundation to which I am a member, and I get what I need. My LGX was FREE just because my urologist said I needed it. Had I realized this, I probably would not have waited so long. There seem to be a lot of scare tactics based on peoples fears, especially about the glans being floppy, length of the new penis, etc. Truth is, the Corpora "Spongiosum", the one surrounding the urethra (around the pee canal) and the GLANS will usually come back to life. One day when you're really "aroused", as you often will be after receiving an IPP, you'll suddenly notice that your entire shaft will become engorged. The bottom of your penis as well as the head will fill up with blood as the penis is made to do naturally. This may not happen to everybody, but it WILL happen to many. Once the rest of your penis is working, eventually you will be able to have a fully hard (what many implantee's begin to think of as "natural") penis, not the oval penis that we live with for the first 18 to 24 months after the operation. Truth be told: Most guys will eventually get full use of their penis back after a length of time, living with their new implants.
Well, that's my story. Now I'm just having FUN, picture the BIG SMILE!
LGX Man
NOTE: The corpora's are just dialated during surgery.
CATCH PHRASES
CATCH PHRASES
AMS or C0LOPLAST REP.
These are just my own opinion and a result of reading many posts and talking to a lot of men.
If the doctor has to have the AMS or Coloplast rep present he is not completely skilled if any technical problems arise. They use the excuse that the rep has to bring the implant to the OR. The very great implant centers have the implants available in all sizes with or without the rep. They DO NOT let the rep “scrub in.”
My mind goes back to my first implant attempt. The doctor told me that the AMS rep was present and now he was ready to operate. Even with the rep present he punctured my urethra. Thought little of it at the tie. Now every time I hear that it scares the hell out of me.
Another thing that scare the hell out of me is, the doctor says: “During surgery I will decide which implant is best for you.” I know of several men that went into surgery expecting to come out with a LGX and woke up with a CX or other implant.
If the doctor has done a proper consultation he should know which implant is best for you!!!
One side effect of peyronies and PCa is loss of penile size. The old school thought was peyronies and /or corporal fibrosis makes the CX or Titan the best choice. That has changed with the LGX; a very skilled doctor for a man with these problems can use it. If the doctor does not have the skills needed to use the LGX with these problems find one that does.
The LGX is the only implant that will expand in length and girth., all others only expand in girth. I had both peyronies and corporal fibrosis, among other problems. With the skills of Dr. Milam and the LGX I have regained well over 90% of my penis length and my girth has returned to my youthful 6.28”
The only exception I know of is if you have an erect penis over 7” in length the Titan is the best choice for you. Regardless of what a lot of men think very few of us are over 7”.
Again, my own opinion from my personal story and all the research I have done.
Jack
AMS or C0LOPLAST REP.
These are just my own opinion and a result of reading many posts and talking to a lot of men.
If the doctor has to have the AMS or Coloplast rep present he is not completely skilled if any technical problems arise. They use the excuse that the rep has to bring the implant to the OR. The very great implant centers have the implants available in all sizes with or without the rep. They DO NOT let the rep “scrub in.”
My mind goes back to my first implant attempt. The doctor told me that the AMS rep was present and now he was ready to operate. Even with the rep present he punctured my urethra. Thought little of it at the tie. Now every time I hear that it scares the hell out of me.
Another thing that scare the hell out of me is, the doctor says: “During surgery I will decide which implant is best for you.” I know of several men that went into surgery expecting to come out with a LGX and woke up with a CX or other implant.
If the doctor has done a proper consultation he should know which implant is best for you!!!
One side effect of peyronies and PCa is loss of penile size. The old school thought was peyronies and /or corporal fibrosis makes the CX or Titan the best choice. That has changed with the LGX; a very skilled doctor for a man with these problems can use it. If the doctor does not have the skills needed to use the LGX with these problems find one that does.
The LGX is the only implant that will expand in length and girth., all others only expand in girth. I had both peyronies and corporal fibrosis, among other problems. With the skills of Dr. Milam and the LGX I have regained well over 90% of my penis length and my girth has returned to my youthful 6.28”
The only exception I know of is if you have an erect penis over 7” in length the Titan is the best choice for you. Regardless of what a lot of men think very few of us are over 7”.
Again, my own opinion from my personal story and all the research I have done.
Jack
Saturday, February 26, 2011
Oliver's Story
Hi Jack
Jack and my stories are much alike but with different outcomes. I'm 66, about 50 lbs overwieght, and some health problems. I can't give you exact dates but you'll be able to see a time line how I got to this point
I had a vasectomy in 1973. I started having HBP sometime in the 80's. Then in late 2000 my wife said I wasn't getting as hard as I used to. So the next time I went to the Dr. and told him he prescribed Vagra. I started taking them and the first few worked like a dream or maybe I was dreaming. After the first few they worked off and on, more off then on. The next Dr. (GP) I had made a comment that there was surgery for ED and I knew that I wanted that, but I was afraid of having the surgery.
In 2002 I had emergency bypass surgery (4) The Dr. (Cardiologist) told me he didn't know why I was walking. Because I needed to use Nitro on every once in a while. I had to, and was happy to stop the pill. By this time the pill was just a burning money.
My (GP) sent me to a Uro and we started using a VED. He did say there was surgery for this but I had to try all the other options first. I knew I wanted to go there (an implant) and started to check it out. The VED gave me a very nice erection. It was bigger around and maybe a little longer. I tried to pump ever night and it started to stay a little larger as long as I pumped every night but as soon as I missed a night or two it deflated down to its normal size. I had to use a small ring and most of the time I used two. It hurt like hell to have them on, my little friend would turn purple and when I ripped them off I though all the skin was coming with it. I also could not ejactulate untill I took them off. This was less that ideal for us.
Next we tried shots but they didn't work very good so we used both the Ved and shots. The shots also hurt (not giving the shot) while wating for it to go down. The last time I used the shot I tried 60 units. 40 is the most you were supposed to use. 60 units did nothing, it just hung there looking at the ground.
All during this time of failure we had a good sex life. We both like oral, we have toys and we invented some games that helped but it wasn't the same. Using just the VED we could get it "puffed" up, but not enough for pentration. Not being able to pentrate and ejactulate into her was devastating. I think the guys with ED and their gals will understand what I talking about.
The time was here. I'm going to get an implant. I want it now, after all how bad could it be? After bypass surgery this will be a snap. It can't be much more that a vasectomy, you know a little cut in the sac, slide a couple tubes into your weiner, put a bag up in your belly and drop in the pump. Piece of cake.
A couple of mistakes I made was not finding the penile implant blog at Yahoo. I tried Web Md but couldn't get a responce. Another mistake was wanting a implant so bad I would have jumped up on a fender of a car and let them do it in the parking lot. I did ask the Uro how many he did and he said 6 or 7 and I was talking per month, He was talking per year. I also asked about loss of lenght, something I could not afford. All he would say is that the head would be soft, well He was wrong there. Another mistake and DON'T YOU make the same..CHECK, check, check did I say check out your Uro. The surgery is not simple and don't want to get what I got.
The day was coming..Go in have my pre op check up and be there the first thing in the morning, have the surgery wait a week jump on a plane and go to Daytona...As soon as the girls did my EKG I knew something was wrong. The Dr. said he though I had had a heart attact. Oh shit another delay. Two weeks later I had a stress test and everything was ok. The date was set, April 16, our wedding anniversary. What a presant.
I finally had it done, I got it, its in me only 6 weeks to go. I got home and the first thing I found out was the pump was so low in my sac that I would sit on it. That was where most of my pain came from. I do like where it is now.
The time came to get the first pump up. He pumped it up and WHERE THE HELL DID IT GO!!??? All the ass hole would say is you got a nice hard erection walked out the door and had his nurse come in and try to put it down. I started out with 5.25" and ended up with 3" That's almost 43%. We cried for weeks. I have an erection but its not long enough to get where it has to go.
I've been on the yahoo blog for 4 yrs or so and have wrote many times about Our loss. I get people typing back saying I should be happy with 3" hard over 5.25" soft. My responce to them is try it! Get a cock ring or a piece of tape and put it on with only 3" of useable penis and then type back to me and let me know if we should be happy. I've never heard back from anyone.
Another problems I'm having is getting one side to come down. I would say it will only go down 10% of the time the first time I try. It can take anywhere from 1/2 hour to 8/9 hours to get it down. I also have what I think is a knot in a tube. At times when it comes down it won't come down as far as the other side, so then they don't go up even. So I end up with the head bending to the right.
I know this is getting long so I just want to add is I am NOT tring to talk anyone out of having an implant. DO IT, DO IT,DO IT. I'm going to as soon as I can find a BEST Uro to do it. And get the insurance to work with me When you do it just be sure to CHECK out the Uro, try to find a Male Sexual Function Specialist, don't hurry a few weeks more won't any difference.
By the way the Quack (Uro) that screwed me up left town and moved to Texas.
Feel free to email me if you have any questions If I can help you I would be more that happy to answer your questions. w26b265@yahoo.com
Oliver
Jack and my stories are much alike but with different outcomes. I'm 66, about 50 lbs overwieght, and some health problems. I can't give you exact dates but you'll be able to see a time line how I got to this point
I had a vasectomy in 1973. I started having HBP sometime in the 80's. Then in late 2000 my wife said I wasn't getting as hard as I used to. So the next time I went to the Dr. and told him he prescribed Vagra. I started taking them and the first few worked like a dream or maybe I was dreaming. After the first few they worked off and on, more off then on. The next Dr. (GP) I had made a comment that there was surgery for ED and I knew that I wanted that, but I was afraid of having the surgery.
In 2002 I had emergency bypass surgery (4) The Dr. (Cardiologist) told me he didn't know why I was walking. Because I needed to use Nitro on every once in a while. I had to, and was happy to stop the pill. By this time the pill was just a burning money.
My (GP) sent me to a Uro and we started using a VED. He did say there was surgery for this but I had to try all the other options first. I knew I wanted to go there (an implant) and started to check it out. The VED gave me a very nice erection. It was bigger around and maybe a little longer. I tried to pump ever night and it started to stay a little larger as long as I pumped every night but as soon as I missed a night or two it deflated down to its normal size. I had to use a small ring and most of the time I used two. It hurt like hell to have them on, my little friend would turn purple and when I ripped them off I though all the skin was coming with it. I also could not ejactulate untill I took them off. This was less that ideal for us.
Next we tried shots but they didn't work very good so we used both the Ved and shots. The shots also hurt (not giving the shot) while wating for it to go down. The last time I used the shot I tried 60 units. 40 is the most you were supposed to use. 60 units did nothing, it just hung there looking at the ground.
All during this time of failure we had a good sex life. We both like oral, we have toys and we invented some games that helped but it wasn't the same. Using just the VED we could get it "puffed" up, but not enough for pentration. Not being able to pentrate and ejactulate into her was devastating. I think the guys with ED and their gals will understand what I talking about.
The time was here. I'm going to get an implant. I want it now, after all how bad could it be? After bypass surgery this will be a snap. It can't be much more that a vasectomy, you know a little cut in the sac, slide a couple tubes into your weiner, put a bag up in your belly and drop in the pump. Piece of cake.
A couple of mistakes I made was not finding the penile implant blog at Yahoo. I tried Web Md but couldn't get a responce. Another mistake was wanting a implant so bad I would have jumped up on a fender of a car and let them do it in the parking lot. I did ask the Uro how many he did and he said 6 or 7 and I was talking per month, He was talking per year. I also asked about loss of lenght, something I could not afford. All he would say is that the head would be soft, well He was wrong there. Another mistake and DON'T YOU make the same..CHECK, check, check did I say check out your Uro. The surgery is not simple and don't want to get what I got.
The day was coming..Go in have my pre op check up and be there the first thing in the morning, have the surgery wait a week jump on a plane and go to Daytona...As soon as the girls did my EKG I knew something was wrong. The Dr. said he though I had had a heart attact. Oh shit another delay. Two weeks later I had a stress test and everything was ok. The date was set, April 16, our wedding anniversary. What a presant.
I finally had it done, I got it, its in me only 6 weeks to go. I got home and the first thing I found out was the pump was so low in my sac that I would sit on it. That was where most of my pain came from. I do like where it is now.
The time came to get the first pump up. He pumped it up and WHERE THE HELL DID IT GO!!??? All the ass hole would say is you got a nice hard erection walked out the door and had his nurse come in and try to put it down. I started out with 5.25" and ended up with 3" That's almost 43%. We cried for weeks. I have an erection but its not long enough to get where it has to go.
I've been on the yahoo blog for 4 yrs or so and have wrote many times about Our loss. I get people typing back saying I should be happy with 3" hard over 5.25" soft. My responce to them is try it! Get a cock ring or a piece of tape and put it on with only 3" of useable penis and then type back to me and let me know if we should be happy. I've never heard back from anyone.
Another problems I'm having is getting one side to come down. I would say it will only go down 10% of the time the first time I try. It can take anywhere from 1/2 hour to 8/9 hours to get it down. I also have what I think is a knot in a tube. At times when it comes down it won't come down as far as the other side, so then they don't go up even. So I end up with the head bending to the right.
I know this is getting long so I just want to add is I am NOT tring to talk anyone out of having an implant. DO IT, DO IT,DO IT. I'm going to as soon as I can find a BEST Uro to do it. And get the insurance to work with me When you do it just be sure to CHECK out the Uro, try to find a Male Sexual Function Specialist, don't hurry a few weeks more won't any difference.
By the way the Quack (Uro) that screwed me up left town and moved to Texas.
Feel free to email me if you have any questions If I can help you I would be more that happy to answer your questions. w26b265@yahoo.com
Oliver
Tuesday, February 15, 2011
AMS 700 LGX MCHANICAL RELIABILITY
There has been a lot of discussion about the mechinical reliability of the AMS 700 LGX on the forums. This is a copy of emails between Todd Doran and myself.
--------------------------------------------------------------------------------
From: Jack P [jwp104@att.net]
Sent: Saturday, January 29, 2011 5:47 PM
To: Doran, Todd James
Subject: IPP Life Span
Todd
Twice a day almost every day for the first 18 months I inflated my IPP and held it for at least 5 minutes. Today at 27 months post op I still inflate it almost daily.
There is some discussion that I am decreasing the life of my LGX. I believe Dr. Eid's site says a maximum of 3 times a week. Is that true? It works so well the way I do it.
Thanks for the advice, you have always been right on with me and I appreciate that.
Jack
-------------------------------------------------------------------------------
2/15/11
Dr. Milam agreed with me citing same reference. Keep doing what you're doing. Good luck trying to wear the device out from a mechanical reliability standpoint.
Todd
Todd J. Doran, MS, PA-C
Associate in Urologic Surgery
Vanderbilt University
Dept of Urologic Surgery
A-1302 MCN
Nashville, TN 37232
615-322-2880
--------------------------------------------------------------------------------
From: Jack P [jwp104@att.net]
Sent: Saturday, January 29, 2011 5:47 PM
To: Doran, Todd James
Subject: IPP Life Span
Todd
Twice a day almost every day for the first 18 months I inflated my IPP and held it for at least 5 minutes. Today at 27 months post op I still inflate it almost daily.
There is some discussion that I am decreasing the life of my LGX. I believe Dr. Eid's site says a maximum of 3 times a week. Is that true? It works so well the way I do it.
Thanks for the advice, you have always been right on with me and I appreciate that.
Jack
-------------------------------------------------------------------------------
2/15/11
Dr. Milam agreed with me citing same reference. Keep doing what you're doing. Good luck trying to wear the device out from a mechanical reliability standpoint.
Todd
Todd J. Doran, MS, PA-C
Associate in Urologic Surgery
Vanderbilt University
Dept of Urologic Surgery
A-1302 MCN
Nashville, TN 37232
615-322-2880
Sunday, February 6, 2011
Dr. Douglas F. Milam M D
Dr. Milam has a new web site www.milamurology.com. It is very informative about Dr. Milam and the procedures he does for for men.
The site is new and still "a work in progress".
I am often asked how do I get a consultation with Dr. Milam and what information do I need to provide.
I have, with permission, done a cut and past so you will know exactly what to expect. Full information is on his web site.
Dr. Milam is a world class doctor at a world class facality.
Jackp
Douglas F. Milam M.D.
Urologic Surgery
Home
About Us
Surgical Procedures
Urethral Stricture Repair
Surgical Procedures to Improve Continence in Men
Penile Implant
Surgical Treatment of Peyronie's Disease
Evaluation of Voiding Dysfunction
Incontinence in Men
Urinary Retention
Severe Lower Urinary Tract Symptoms
Urinary Frequency, Urgency, and Urge Incontinence
Urodynamic Testing
Cystoscopy
Patient Information
IPSS-AUA Symptom Score
Sexual Function Questionnaire
Schedule a Consultation:
Our practice is focused on helping patients with important urologic problems that require surgical intervention. We are happy to meet with you at either our Vanderbilt Clinic location in Nashville, Tennessee or our Cool Springs satellite office in Franklin, Tennessee. Please call (615) 322-2880 for an appointment. You will be asked to provide basic identifying information along with a description of your urologic problem. Your urologic information will be reviewed by Dr. Milam and our appointment staff will call back within 2-3 days to schedule a date for consultation. Review of your clinical information is very important as this allows us to schedule most x-ray or other urologic testing to be done the day of your visit.
Let Us Help You Find Our Offices:
We see patients in two locations in the Nashville, Tennessee area. Many of our patients see us at our office in the Department of Urologic Surgery on the third floor of the Vanderbilt Clinic. For that location we recommend parking in the Vanderbilt Central Garage directly across the street from the Vanderbilt Clinic. Specific directions and a map to the Vanderbilt Clinic location are shown on the Vanderbilt Clinic location page.
Our satellite office is in the Cool Springs area of Franklin, Tennessee. We are located on the second floor of the Cool Springs Surgical Center building. Specific directions to that location can be found on the Cool Springs (Franklin, TN) location page. That address is: 2009 Mallory Lane Suite 210, Franklin, TN 37067
Tell me more about the process of reviewing my clinical information....
In the past we found that many patients drove long distances to see us and then needed to be scheduled for follow-up testing on a later date. We understand that many of our patients have complicated urologic surgical problems that require specialized urologic testing before a diagnosis can be established. Two years ago we began coordinating the initial visit with diagnostic testing that appeared to be necessary based on the clinical diagnosis and information provided by the patient during the scheduling process. This was extremely successful and has saved many patients multiple trips to our offices. We try our best, but are not always successful. Some patients do need to return for one or more follow-up visits before their surgical procedure can be scheduled. Please help us by providing as much information as possible to our scheduling personnel. We are attempting to help you by making your visit to the urologic surgical practice as efficient as possible.
The site is new and still "a work in progress".
I am often asked how do I get a consultation with Dr. Milam and what information do I need to provide.
I have, with permission, done a cut and past so you will know exactly what to expect. Full information is on his web site.
Dr. Milam is a world class doctor at a world class facality.
Jackp
Douglas F. Milam M.D.
Urologic Surgery
Home
About Us
Surgical Procedures
Urethral Stricture Repair
Surgical Procedures to Improve Continence in Men
Penile Implant
Surgical Treatment of Peyronie's Disease
Evaluation of Voiding Dysfunction
Incontinence in Men
Urinary Retention
Severe Lower Urinary Tract Symptoms
Urinary Frequency, Urgency, and Urge Incontinence
Urodynamic Testing
Cystoscopy
Patient Information
IPSS-AUA Symptom Score
Sexual Function Questionnaire
Schedule a Consultation:
Our practice is focused on helping patients with important urologic problems that require surgical intervention. We are happy to meet with you at either our Vanderbilt Clinic location in Nashville, Tennessee or our Cool Springs satellite office in Franklin, Tennessee. Please call (615) 322-2880 for an appointment. You will be asked to provide basic identifying information along with a description of your urologic problem. Your urologic information will be reviewed by Dr. Milam and our appointment staff will call back within 2-3 days to schedule a date for consultation. Review of your clinical information is very important as this allows us to schedule most x-ray or other urologic testing to be done the day of your visit.
Let Us Help You Find Our Offices:
We see patients in two locations in the Nashville, Tennessee area. Many of our patients see us at our office in the Department of Urologic Surgery on the third floor of the Vanderbilt Clinic. For that location we recommend parking in the Vanderbilt Central Garage directly across the street from the Vanderbilt Clinic. Specific directions and a map to the Vanderbilt Clinic location are shown on the Vanderbilt Clinic location page.
Our satellite office is in the Cool Springs area of Franklin, Tennessee. We are located on the second floor of the Cool Springs Surgical Center building. Specific directions to that location can be found on the Cool Springs (Franklin, TN) location page. That address is: 2009 Mallory Lane Suite 210, Franklin, TN 37067
Tell me more about the process of reviewing my clinical information....
In the past we found that many patients drove long distances to see us and then needed to be scheduled for follow-up testing on a later date. We understand that many of our patients have complicated urologic surgical problems that require specialized urologic testing before a diagnosis can be established. Two years ago we began coordinating the initial visit with diagnostic testing that appeared to be necessary based on the clinical diagnosis and information provided by the patient during the scheduling process. This was extremely successful and has saved many patients multiple trips to our offices. We try our best, but are not always successful. Some patients do need to return for one or more follow-up visits before their surgical procedure can be scheduled. Please help us by providing as much information as possible to our scheduling personnel. We are attempting to help you by making your visit to the urologic surgical practice as efficient as possible.
Saturday, January 15, 2011
One Mans Journey
One Man’s Journey
Forward
This is my journey back to sexual health after being robbed of it by peyronies and the side effects of low testosterone, loss of nigh time erections, venous leakage and corporal fibrosis.
Mostly it consists of my daily entries after a failed implant attempt by a local urologist. In my experience general practice urologist are not what most men need. You need a Male Sexual Function Specialist.
This story contains my thoughts and opinions only. I am in no way connected to any doctor, hospital or product.
I dedicate this to my lovely wife of 42 years for all her support also to Dr. Douglas Milam and Todd Doran PA-C and the staff at Vanderbilt University Hospital in Nashville TN, and Old Man of the peyronies society forum.
This is my journey. Hopefully it will encourage others on the road to an IPP (inflatable penile implant).
My personal thanks to all whom have supported me.
Jackp
One Man’s Journey
I have had peyronies disease for 15 years. (1995)
My first symptom.
Penis curved up form plaque just behind the glans (head).
My Peyronies Disease progression, Treatments, Doctors, Psychological Stages, observable changes.
The history is long. All my problems are from the peyronies in 1995.
Urology History
1947 Age 5, Tonsils removed and circumcised.
1. 1972 Vasectomy with removal of a cyst from my scrotum.
2. 1975 severe prostrate infection that took over a year to overcome.
3. 1988 Mild ED. Family doctor would not check testosterone level but did check PSA .5. Lower sex drive made me believe my testosterone level was low.
4. 1995 Peyronies. Went to Dr. Shappley with prostrate infection and had him check the penile curve that had recently occurred. He said I had Peyronies. Put me on 400IU of vitamin E three times a day and Potaba. Curve went away in about 18 months.
5. 1996 First noticed loss of penile size. Lost approximately 1.25” from approximately 5.5” before Peyronies.
6. 1996 first TURP for prostate. 9/1997 second TURP. Did not like the effects of the prostate drugs Dr. Shappley put me on. Caused fatigue, and other symptoms. Started Saw Palmetto and stayed on it until the January 2008.
7. 9/1997 Asked Dr. Shappley if he could do anything to fix the effects of Peyronies. He said all he could was make a girl out of me. He was joking but I knew there was nothing he could do.
8. 1996 Started on testosterone replacement therapy (TRT). The first few months Dr. Shapppley had me on shots and then changed to gels. I told him the gels were not working. He said. “Jack lets get the old balls working.” Stayed on gels for years. Made my blood thicker and arthritis doctor did not like my thick blood.
9. 1998 ED worsened. Dr. Shappley put me on Viagira the second week it was on the market. Little Help.
10. 2004 Scope of bladder after prostate infection to see if I had anything in the bladder causing problems. All he found was some infection that finally cleared up after switching off Cipro.
11. 2004 Had tried V, C and L for ED. Little help. On a trip to Mexico Dr. Shappley suggested I try Uprima that was not available in the US. The combo with Levitra helped a little.
12. 2004 Had a Color Doppler. ED had gotten very bad. Had a Venous Leakage. Dr. Shappley suggested I try PGE1 (Edex) No help at 60mg. (Shot and ½). Then his assistant wanted me to try Trimix. Selling trimix out of office for $10.00 cash per unit. Started with 4 units. No help. Went back to Dr. Shappley and saw his assistant again. Got a limited prescription for trimix. When asked where to get it filled said they did not know. When I asked where they got trimix got the run around of like Ohio or somewhere.
13. 2005 Went to Dr. Conrad. It had been almost 2 years and no DRE. PSA was 1.2. After a DRE and PSA and consultation Dr. Conrad gave me a prescription for trimix and told me I could get it filled at Peoples Pharmacy. Tried different dosage, no effect. Went up to the strongest dose Peoples had and a full 10 units. No help.
14. 2006 After discussing my options after the failed attempt at trimix Dr. Conrad suggested an implant. Gave me a video and set up the surgery for late October 2006.
15. 10/2006 Chest pains. Had to have a stent placed in my heart. Dr. Shiakh said wait one year before implant surgery. 12/06 Chest pains again and another stent.
16. 10/2006 Asked Dr. Conrad what can I do for sex. I need help. He gave me a prescription for a VED. Met the rep in his office and started VED. I thought more was better and caused an abrasion. Took weeks to heal.
17. 10/2007 Dr. Conrad attempted to do the implant. During the procedure he penetrated my urethra in the corpora at the head. Surgery aborted because of possibility of infection. After follow up Dr. Conrad said come back January. Dr. Conrad explained that corporal fibrosis from trying the shots for ED caused the instrument to move when he tried to push it through.
18. 10/2007 Dr. Conrad was giving me 300mg of testosterone every three weeks. Not helping. Talking to Dr. Brewer, my primary doctor, and explained the problems I was having he said he would help me with my testosterone. Blood work after 3 weeks showed low 120 on the range. Dr. Brewer said 600 my every 3 weeks. It took 2 shots to get that much. Dr. Brewer at my request changed the shots to 300mg every 10 days. A felt better for the first time I long time.
19. 1/2008 Follow up with Dr. Conrad. DRE and PSA of 1.7. I informed him I had back surgery coming up the end of January. He said come back in 6 months.
20. 1/31/2008 Back surgery. Dr. Fernandez. L4-L5. He also suggested I wait about 6 months before implant surgery.
21. 5/2008 Current blood work for testosterone still shows low. Dr. Brewer has increased my shot to 400mg every 10 days.
4/2008 Went to Dr. Wake the head of The Urology Department at the University of Tennessee Medical School, Memphis. Was less than impressed. He basically tried to talk me out of an implant. When I was through asking questions it was obvious that he did not have the skills I needed. I knew more about peyronies, implants and testosterone replacement than he did.
VED.
Was using it all wrong. Applying too much pressure and holding it for a long time. After the failed implant I found the Peyronies Society web site. There I was talking to Old Man an avid fan of the VED. He gave me a routine of pump and hold for 10-15 minutes.
I use the VED most days for exercise of the penis. It has helped. And for sex I only pump to about 80-90% erect for better feelings and use an Osborn ring for sex.
The men on the Peyronies Society web site recommend the VED for Peronies and corporal fibrosis. This routine has worked for me.
I have a Love/Hate relationship with the VED. It took a while to learn how to use it properly. I hate the constriction rings, I have to use a real tight one and it cuts way down on the feelings. I also have to watch how long I have it on.
May 21, 2008
6/3/08 Appointment today with Dr. Yari Walzer. Normal office check in routine gave the nurse a copy of my Urology History. I had my list of 16 questions.
Dr. Walzer came in the exam room and introduced himself and said “Jack I have read your history and I can not help you. You need to go to Vanderbilt. You do not need any more problems and I do not need the money. You need a doctor that does at least 100 of these operations a year and in this area doctors only do one or two a month.”
We talked a bit more and he suggested that I probably needed the resection surgery on my corpora’s. Then he did an exam of my penis.
After the exam we decided on a referral to Vanderbilt and I would hear from him in a couple of days or so. He also offered to do the follow up locally.
My conclusion of Dr. Walzer was that he was honest, upfront and wanted the best care possible for me. Will continue to use him for Urology issues locally.
6/10/2008 Dr. Walzer’s nurse Kitty called this morning. Referred me to Dr. Douglas Milam with Vanderbilt. Called this morning for an appointment. Recoponsist said his nurse would call me in a few days to make an appointment.
6/19/2008 Received appointment card from Vanderbilt for 8/22/08 along with Patient Registration forms. Will get medical records from Dr. Conrad and the Hospital to carry with me to Nashville.
6/30/08 Peggy, Dr. Milam’s nurse called and rescheduled my appointment for exam and pre-op to July 25th at 1:15. She went ahead and scheduled surgery for August 14th. Wants me to fax medical records when I get them along with cardiac clearance.
Peggy said that Dr. Milam does at least 3 or 4 of these a week and that I may not have to have a radical corporal procedure (will be decided at the exam).
7/10/08 I finally received my records form Dr. Conrad. Faxed 25 pages to Peggy at Dr. Milam’s office that included one page cardiac clearance from Dr. Shaikh.
7/25/08 Vanderbilt Hospital, Nashville TN a 3.5 hour drive from home. Driving instructions put me right in the hospital. Checked in at the Urology Center was greeted promptly and finished filling out paper work.
In the exam room I met Todd Doran PA-C for Dr. Douglas Milam. We went over my history and he answered most of my questions before I could ask. He explained that they use the AMS 700 LGX and use the pubical approach. He did an exam of my penis and said everything looked good for surgery.
After the exam by Doran Dr. Milam came in and introduced himself. We talked about my history and what to expect and not to expect from the implant. I asked about the other models of the AMS 700 and he said they only use the AMS 700 LGX and are in the process of publishing a paper next year to get all doctors using the LGX. He explained that the surgery was 75 minutes and I would only be in the hospital over night.
Dr. Milam did a stretch test on my penis and showed me how much erection I would have. He explained that because of the Peyronies Scar the penis would only stretch so far. I estimate I will end up with approximately 4 inches and normal girth. This is down from the 5.5 inches before Peyronies. I told Dr. Milam that so long as I have a useable erection that is OK. He wanted me to know what to expect and that would be all I could get back. (Note: My wife and I already knew that I could not gain back the size before Peyronies. She explained to me that women are more interested in girth than length and that most of the feeling during sex come from girth.). Dr. Milam also said to continue daily use of the VED for exercise and that it would help the outcome, but to be careful not to hurt or bruise my penis and to stop the day before surgery.
Dr. Milam explained that I would see Todd Doran PA-C most of the time but he would do the actual surgery and would be available if needed. Post op will be in two weeks 8/27/08 with Doran and again in six weeks. No sex for six weeks until Doran teaches me how to use the implant. The final Post Op will be with Dr. Milam in 3 months.
Dr. Milam said he had never punctured a urethra and had seen only one other. He assured me that he would take all precautions to make sure the urethra was not punctured and I would have a successful outcome. He said the only complication he could think of was if they could not get a Foley Catheter in because of the previous urethra puncture. I told Dr. Milam I had a catheter with back surgery in January and he said everything should be fine.
After the exam with Dr. Milam I had to empty my bladder for a bladder scan and then to the Nurses office to schedule my appointments and get pre op and post op instructions. Then down to the lab for blood work and anesthesia work up.
I arrived at the parking garage at 12:45 and was on my way home before 4:30. Wait time was a minimum from other experiences and the staff was all professional and I was generally impressed that these people know what they are doing and how to do it.
Posted on Implant Group 8/13/08
As most of you know I was scheduled for my implant at Vanderbilt for
tomorrow.
7/27/08 I was eating lunch at the local O'Charley’s and cut a bit larger
than usual piece of prime rib. With all going on with family and
friends I swallowed before I was ready.
The meat stuck in my esophagus just before entering my stomach. Went
home and tried everything I knew to get it to go one way or another. NO
LUCK.
2:00 in the morning my wife took me to the local ER. They tried twice
to get it out. The second try they put me to sleep. Woke up and still
there.
They transferred me to the main hospital in Memphis and brought in a
Surgeon.
Tuesday about noon they put me to sleep again and tried with a rigid
scope. No Luck. Seems that I am longer than normal, esophagus that is.
They were so aggressive that the doctors collapsed a my left lung and
put my heart into A-Fib. Woke up in recovery with a doctor cutting in
my side to put in a tube, "called him a couple of bad words." Then they
brought in a heart doctor.
Two days of hell in the room with at least six (6) IV's. Then on
Thursday afternoon back to surgery. The Dr. marked my chest that
morning just in case they had to go after it. This time it went through
when they put the tube down. Back to hospital room NPO with a stomach
pump. I was on ice chips until Monday morning. Liquid diet, did not
know so little would make you feel full.
Thursday morning (I think) wife and I had a Come to Jesus meeting with all the Doctors. On what to expect.
Tuesday afternoon the surgeon and then the heart Dr released me to go
home. While in the hospital I asked about the implant surgery and they
said postpone it for a couple of months. Had a long talk with heart
doctor before leaving the hospital and he assured me that in a couple
of months I could get the implant but first I had to get the A-Fib
fixed.
Went to heart doctor today and the A-fib is much better. Wants me to
wait a couple of weeks and if the meds do not fix the A-fib they will
shock it back.
I've lost 15 pounds. When I came home the next morning I looked in the
mirror and did not see myself. What A Shock.
With heart doctors blessing I have rescheduled the pre op at Vanderbilt
to October 24 and the implant to October 30. I WANT MYSELF BACK BY THE
END OF THE YEAR!
If it has not been one obstacle it has been another but come "Hell or
High Water" I am going to get the implant.
8/21/08 Epilog: Went to Dr. Shirwany’s for my pre op before the cardiac conversion. Nurse checked my blood and that was fine. Went to the exam room and took my BP she said I hear a normal heart beat. She went and got the EKG and sure enough my heart was back to normal rhythm.
Dr. Shirwany came in and was almost as happy as my wife and I about not having to do the Cardiac Conversion.
For the arrhythmia in the hospital they added Cartia, a calcium channel blocker and Amodarone to the BP meds I was already taking, Ramipil, and ACE inhibitor and spironolactone are my normal BP meds and have controlled my BP well. I told Dr. Shirwany that in my past calcium channel blocker caused me lots of problems and fatigue and not sleeping were the worst. I asked if I could get off the new meds because of the side effects. He said that for now I needed these but he would cut the dose in half. He also said that in mid November after the implant I would ware a monitor for few days and then reevaluate the meds.
I signed a release so he could get the records of my last cardiac cath 7/07 and other history from my previous heart doctor.
He said after he received these records he would mail me a cardiac release for the implant surgery.
In the hospital the surgeons almost killed me. If it had not been for Dr. Shirwany I don’t think I would have made it. IMHO
9/23/08
Went to Dr. Walzer for semi annual DRE and PSA. DRE was normal.
9/25/08 Dr. Walzer’s office called with results of PSA. Result was 1.1 that is normal. Asked her to send me a copy.
10/15/08 Phyllis with Dr. Milam’s office called and wanted to move the surgery up a week. Pre op is now scheduled for 10/22/08 and surgery for 10/23/08 @10:30. Will drive up to Nashville the 22nd and spend the night.
10/16/08 received cardiac clearance from Dr. Shirwany and faxed it to Phyllis 615-343-9815.
10/22/08 Vanderbilt Pre Op.
Pre op went well, had all my paperwork in order and a cardiac clearance letter from Dr. Shirwany. EKG was normal and cleared for surgery the next day.
10/23/08 Vanderbilt Hospital – Penile Implant
Check in time was 10:30. Went to pre op holding room and had 2 antibiotic IV’s. Dr. Milam came in about 1:00 we talked and he said everything looked fine. A few minutes later one of his assistants came in and we talked for a while. I mentioned the previous surgery where the Dr. penetrated my urethra and he said he knew all about it. I believe that Dr. Milam and staff had a pre op meeting and knew my history well.
About 2:00 I was taken to surgery and Dr. Milam had a few words and then I was asleep.
Woke up about 3:30 in recovery and felt like I had to pee real badly. Had a Foley Catheter and nurse said everything went as planned and the wanting to pee was normal.
My wife had meeting with Dr. Milam after surgery and he told her everything was OK but I would be in pain for a while.
About 4 or 4:30 Dr. Milam came into the room and said everything went well and he thought I would be well pleased with the outcome. He said I would have some asymmetry because of the scar tissue from the previous attempt but I would hardly notice it.
The next morning about 5:30 the catheter was removed. Had a light breakfast urinated on my own and was on the way back to the hotel by 9:00. We arrived home about 2:00.
To say I am satisfied with the results to date would be an understatement. Just the look on my wife’s face when I got back to the room told me everything was OK. She has supported me all these years and I never saw her happier for me.
My testicles are black and blue, but that was expected. The pump is in front of my right testicle and I have to pull it down to the center every day. Dr.said it would be easier for me to get to there.
I have the AMS 700 LGX. If I am reading the paperwork right I will have an erection of about 12 CM (4.7 inches). If I get a 20% increase over time I will be within ¾ inch of my pre peyronies size. Right now I can tell the flaccid state is larger, no more turtle effect. This is more than I expected before surgery I would have guessed about a 4-inch length. I know size is not everything we have been dealing with peyronies about 13 years and learned length is not where it is with sex. You can adapt to most any size and still have fun.
A better than expected length is credited to the proper VED exercise given to me by Old Man of peyroniessocitey.org. That year of proper VED exercise gave me a better than expected outcome.
11/5/2008 Post Op with Todd Doran, Everything normal. Still sore. Pump is in place so I do not have to pull it down anymore. Advised to remove the strips on the incision the next time I shower (looks good after removal). No tub or hot tub for another 4 weeks. Lifting restriction of 15 pounds.
12/04/08 Activation: I was at Vanderbilt at 8:30 this morning for my implant activation. Doran showed me where the relief button is and them activated the pump. He then had me pump it up. For the first time in years I had an erection that stood straight out and stayed on its own.
AMS that gave full instructions on how to use the implant gave me an “owners manual”. I was advised to pump up the implant 2 times a day for at lest 5 minutes until the next appointment in 3 months.
I was told to pump the implant up at least 3 rimes before trying to use it. I now know why the first few times you pump the implant it stings some for a while. When I arrived home I showed my wife the erection and let her feel of it. Feels just like an erect penis of a 20 year old. When we went to bed I pumped it up again. Lying on my back with my penis sticking straight up and hard gave me a feeling of being normal again.
The actual measured result in the office was 4.25 inches. I was informed that over the next 3 months to a year I should gain at least another ½ inch. This puts me closer to my pre peyronies of approximately 5.5 inches.
The VED was a “gods send” over the last years. After I found the proper exercise for peyronies I gained some size back. Lost about a quarter inch from VED to implant. My Venous Leakage, and Corporal Fibrosis was so bad that I had to use a very tight constriction ring that sometimes did not hold, but I don’t know what I would have done without it. I will give the VED a proper send off New Years in a Barn Fire.
Took me a long time to get here. In my time I would have had the implant years go. God’s time was now. It has been a difficult road but here I am happily lying on my back with a hard on that a 20 year old would envy. I have a “date” with my wife to put it to use tomorrow after noon. Can hardly wait.
12/5/08 Date with wife: All went well still soreness when I pump up the implant and it interferes with feelings. This will all heal with time. Learning curve with use but that is part of the fun.
I HAVE MY NEW TOY FOR CHRISTMAS!!!
1/5/09 One-month post activation. The implant is expanding into the head and have gained back some length. The last month has been a learning curve, tried to just not push it. Today when activated to full length there is a little soreness. Sex the last time was great.
There was still some soreness Christmas but New Years it was 98% gone. Feelings are returning. Great sex new years!!!
2/19/09 This afternoon I decided to take a nap. While lying there I pumped
up my implant. I kept pumping about 20 times after the bulb got hard.
My girth got sore and a little soreness at the glans. Then I noticed
the best erection I have had scene the implant. Like my doctor said
it takes 3 month to a year to get the LGX to full size.
I do not let the soreness keep me from using the implant. It is not
that bad. The first few weeks I was real sore, but that is the price
we pay for success.
3/6/09 I was at Vanderbilt with Dr. Milam this for my three-month post activation
follow-up.
In the three months science activation my erection has become 1/2 inch longer!!!
Dr. Milam said that my implant, AMS 700 LGX, would continue to expand and that
most expansion is between 6 and 18 months.
The proper instructions that I received post op, which I followed, has my pump
in the proper easy to use location. I mentioned that some implant patients did
not receive these instructions and had trouble with pump location. He said that
by the end of the year the paper he and his team are publishing would advise all
doctors doing implants to use the LGX and give patients proper post op
instructions. This is just one of the instructions that patients did not
receive.
To say that my wife and I are happy with the implant is an understatement. I
must remind those considering implants that it is a choice of last resort after
all else fails. My peyronies started in 1995 followed a multitude of
problems, low testosterone, ED, loss of nighttime erections, venous leakage and
corporal fibrosis.
Corporal fibrosis was caused by injection therapy for ED. I tell men never put a
needle in your penis for ED. Some have good luck but most, like me, end up with
problems.
My one-year follow up is in October. Dr. Milam said I would see better and better
results.
I owe a lot of my excellent result to the proper VED exercise I did a
year before the implant.
4/3/09 Dr. Walzer, Prostate Infection. DRE and levequin. This was my first trip to Dr. Walzer post implant. (He is the Dr. that referred me to Vanderbilt). He did a penile exam and pumped up the implant and was impressed at the difference. I had a spot of blood in my underwear and he wants to do a kidney ultra sound 4/22/09
4/22/09 Dr. Walzer’s. Kidney and bladder ultrasound. 2 stones in left kidney. Reflection in bladder and slight elevation in urine. Have to go to the hospital for a flat panel x-ray and a cistocope 5/7 to check the shadow in the bladder. May have to have a lipotripsy for stones.
5/7/09 Dr. Walzer’s/ X-rays from 5/4/09 show two (2) stones in each kidney. Scope of bladder found no problems. Prostate enlarged and he wants me to start back on Saw Palmetto. If stones do not pass on there own come back in 6 months and have kidneys x-rayed a week before. Bring old and new x-rays next visit. 11/10/09 1:00 PM.
5/31/09 Had a fever and back pain like kidney stones trying to pass. Methodist Hospital Germanton ER. Waited a long time for doctor to examine me threatened to leave after 4 hours, then I got attention. CT scan showed. “No acute findings. Bilateral, nephrolithiasis, nonobstructing. 2 on R and 3 on L with largest 7mm on left. Penile prosthesis without acute findings. No acute findings. No Free fluid/air or fat standing.
I was given 2 antibiotics IV, IB for fever and an Rx for antibiotics. And sent home.
7/20/09 Dr. Shirwany’s for heart follow up. Every thing looks good. I still have trouble with difficult ejaculation and asked him about going off the diuretic. My research showed that it could be part of the problem and he agreed. He did not see any problem just watch my BP and if it rises increase the Altace. OK to start Saw Palmetto. Blood work for cholesterol.
8/23/09 My implant was 10 months ago today. The implant continues to expand in length and I have gained back to 90% of my length before peyronies. Sex with my wife is wonderful. I can stay erect as long as I/she desire. With the AMS 700 LGX expanding into the glans (head) I do not have the floppy head that a lot of men complained of before the LGX was available. Once in a while I still have a little soreness in the glans as the implant continues to expand but the soreness is not bad enough to interfere with sex.
All I asked Dr. Milam for was a usable erection. I got that and so much more. I never dreamed I would get about an inch of length back. Flaccid size is impressive I was never a shower. Now when I look at myself in the mirror after a shower I still say to myself, is that me.
10/09/2009 My one-year post op at Vanderbilt.The exam and follow up with Todd Doran PA, and Dr. Douglas MilamI am delighted with my implant and all the care I received at Vanderbilt. During the exam and follow up questions I spent about 45 minutes with Todd and Dr. Milam. I had a few questions and learned a lot.We started out with Todd and an intern. I pumped up my implant. Todd showed the intern where the tips of the implant extend into my glans. Of course the glans was flaccid and with a slight downward pressure on the tip you could see where the tip of the implants are. Both sides fit to the same size and approximately ½ way into the glans. We discussed my success with the implant and the impact it had on my life. I am happy to say the impact has been better than I ever expected. During the discussion Todd asked what is the most common complaint with men with peyronies. Loss of size, length and girth. The AMS 700 LGX is the only implant that can help restore length. I wish I had a recording but I will tell you basically what Todd said. The AMS 700 LGX will straighten out a peyronies curve. Peyronies is not normally in the erection chambers when the implant is activated it will straighten out the penis. I said to Todd that some men go into surgery expecting an LGX and come out with a CX or other implant. I asked if there was a reason for that. He said that when that happens the doctor does not fully understand the anatomy of the penis and the workings of the implant. Dr. Milam was an engineer before becoming a surgeon and fully understands the mechanical function of the implant and penis. He said that all there patients, with peyronies, that have the LGX have a straight erection like mine.I have a diminished blood flow to the glans. I told Todd that it is more noticeable now that I have been off blood thinners for a year. He said that was what happens is a lot of men. I asked how could I help blood flow to the glans without the blood thinners. I asked if Cialis would help. He said it would and recommended the daily dosage of 5mg. He wrote me a prescription for the 5mg daily dosage. I will take it along with the coupon for a free months supply from www.cialis.com to the pharmacy today. My prescription drug plan (Medicare Part D) does not cover it so I need to shop around the cost. JI asked about the Ambicor 2 piece implant for a gentleman in the New England area. He said they only use it if they cannot get a reservoir in. He said it has a much lower satisfaction rate than the other implants. I asked about pain with peyronies for another gentleman. He has been having pain with erections and other urinary symptoms. They know Dr. Levine and his work. They disagree with not doing any surgery for peyronies if you have pain. They did not get specific as to what they prescribe for pain only different men have different symptoms and they prescribe different things, and they also occasionally recommend surgery for the pain. They also recommended a second opinion on the urinary symptoms and said they would be glad to help him with that.We talked about penile injection therapy for ED. They do not recommend it and do not prescribe it. Injection therapy caused my condition to get worse with corporal fibrosis. We talked about the peyronies society web site. Todd said that now he has a face to put with those coming in after visiting the web site. He said that they have been able to help several men after viewing the site. Todd said he has looked at the site and likes the fact that we are straightforward and informative. The information is usually straightforward and factual. We talked about the difference in the pubic and scrotal approach. 98% of the implant that Dr. Milam does is the pubic approach. He said that the dorsal nerves are easy to identify and keep out of harms way. He said that if there is a problem with the corporatomy it is much easier to repair with the pubic approach. We discussed my punctured urethra that happened with the local doctor using the scrotal approach. Todd said that the instrument to dilate the corpora is curved and if not done properly with the scrotal approach that a punctured urethra can happen. He said Dr. Milam is very detailed about this and reminds his students all the time of this. I asked about revisions. Dr. Milam said that they do “a ton” of revisions. I asked about the life expectancy of the implant. Dr. Milam said 93% were performing normally at five years. Both Dr. Milam and I have some engineering background. I am a retired Boiler Inspector and Mechanical Contractor. We compared it this way; you can buy the best HVAC system on the market and use the worst or cheapest contractor in town. The system will not perform properly because of an improper installation. If you buy the same equipment from a first rate contractor you get a properly performing system that will save you money in the long run. I said it to him like this; I charge an A/C system with a digital thermostat to the manufacturer’s specifications. 90% of the systems I go to the first time are at least ½ to 1 pound of Freon overcharged. This cuts the efficiency of the system by about 20-30%. Moral, to get the best results use the best equipment and an experienced well qualified people. We discussed additional penile length. I have gained weight and need to loose 20-30 pounds. Yes I am a big guy 6’2’, 255 pounds. I was told that if I loose the weight I would gain 1 to 1 ½ inches. That will put me back at my length before peyronies. Now all I have to do is get off my butt and do it. I have started back walking 2 miles a day, but as my wife says I need to cut back on the sweets, bread and portions. I lost over 20 pounds several years ago on the Atkins Diet and considering going back to it. Girth: My erect girth is back to where I was as a teen’s or early 20”s. If I remember my algebra correctly 2” diameter x 3.14 = 6.28” or 1” radios x 3.14 squared = 6.28”. Any way the wife and I are very happy with it. The best part of this whole experience is the renewed confidence I have. I feel NORMAL for the first time in years. There was the pain of surgery, the 6 weeks waiting to activate the device, the discomfort when the device was first activated, getting used to the pump in the scrotum and the about 3 month learning curve of using the implant. The small amount of discouragement when first activated that I was not as long as in the VED but as Dr. Milam said at my 3Month check up I regained it as the AMS 700 LGX continues to expand Dr. Milam, Todd and I talked about the publication on using the AMS 700 LGX. It has just been submitted to The Journal of Urology and will take 6 to 9 months before it is published. There is a meeting next month (11/09) in California of the Sexual Medicine Society. Dr. Milam has a major presentation at that meeting on the AMS 700 LGX. Dr. Milam will send me a copy of the publication when it is printed and I have his permission to publish it on the peyronies society web site a yahoo implant group. I also have kidney stones 3 on the left side and 2 on the right. I showed Dr. Milam the report from a CT I had the end of May. He said so long as I was not in pain the wait and see that my local doctor recommended is normal. Dr. Milam and I discussed that when my local urologist did a bladder scope, after the ultra sound for kidney stones, that he said that with an implant I was limited with options if I had prostate problems. I had a couple of TURP’s about 12 years ago. Dr. Milam said that with the implant there was no problem with any prostate procedure with the implant. Dr. Milam and his team do all kinds of penile surgery from surgical correction of penile curvature, penile implants, and artificial urinary sphincter to control incontinence, circumcision and lots more. Before anyone asks, No you cannot gain additional length or girth with the implant above what you normally have. Any one that tells you their product or device will is selling “snake oil.” Dr. Milam told me I did not need to make the trip back to Nashville any more but if I needed him just let him know. I will always be a patient of his and Vanderbilt.
October 23, 2010
Second Anniversary
Today the wife and I celebrate the two year mark of my penile implant surgery at Vanderbilt.
It has been an amazing adventure. The pain and discomfort of surgery are a distant memory. The joy of having a normal sexual relationship with my lovely wife of 42 years is best described as spiritual.
Our advice to anyone thinking about an implant, find a great doctor like Dr. Douglas Milam at Vanderbilt. The results for us is I have gained back over 90% of my penile length lost to peyronies, ED, venous leakage and corporal fibrosis. The bonus was the gain in girth. I am back to my youthful girth of 6.28".
If you read my story it was a long and difficult one. If I had it to go through again I would for the same results.
To Dr. Douglas Milam, Todd Doran MS PA-C and the staff at Vanderbilt Thank You seems so inadequate. You are amazing people doing amazing work. God Bless You.
JackP
Forward
This is my journey back to sexual health after being robbed of it by peyronies and the side effects of low testosterone, loss of nigh time erections, venous leakage and corporal fibrosis.
Mostly it consists of my daily entries after a failed implant attempt by a local urologist. In my experience general practice urologist are not what most men need. You need a Male Sexual Function Specialist.
This story contains my thoughts and opinions only. I am in no way connected to any doctor, hospital or product.
I dedicate this to my lovely wife of 42 years for all her support also to Dr. Douglas Milam and Todd Doran PA-C and the staff at Vanderbilt University Hospital in Nashville TN, and Old Man of the peyronies society forum.
This is my journey. Hopefully it will encourage others on the road to an IPP (inflatable penile implant).
My personal thanks to all whom have supported me.
Jackp
One Man’s Journey
I have had peyronies disease for 15 years. (1995)
My first symptom.
Penis curved up form plaque just behind the glans (head).
My Peyronies Disease progression, Treatments, Doctors, Psychological Stages, observable changes.
The history is long. All my problems are from the peyronies in 1995.
Urology History
1947 Age 5, Tonsils removed and circumcised.
1. 1972 Vasectomy with removal of a cyst from my scrotum.
2. 1975 severe prostrate infection that took over a year to overcome.
3. 1988 Mild ED. Family doctor would not check testosterone level but did check PSA .5. Lower sex drive made me believe my testosterone level was low.
4. 1995 Peyronies. Went to Dr. Shappley with prostrate infection and had him check the penile curve that had recently occurred. He said I had Peyronies. Put me on 400IU of vitamin E three times a day and Potaba. Curve went away in about 18 months.
5. 1996 First noticed loss of penile size. Lost approximately 1.25” from approximately 5.5” before Peyronies.
6. 1996 first TURP for prostate. 9/1997 second TURP. Did not like the effects of the prostate drugs Dr. Shappley put me on. Caused fatigue, and other symptoms. Started Saw Palmetto and stayed on it until the January 2008.
7. 9/1997 Asked Dr. Shappley if he could do anything to fix the effects of Peyronies. He said all he could was make a girl out of me. He was joking but I knew there was nothing he could do.
8. 1996 Started on testosterone replacement therapy (TRT). The first few months Dr. Shapppley had me on shots and then changed to gels. I told him the gels were not working. He said. “Jack lets get the old balls working.” Stayed on gels for years. Made my blood thicker and arthritis doctor did not like my thick blood.
9. 1998 ED worsened. Dr. Shappley put me on Viagira the second week it was on the market. Little Help.
10. 2004 Scope of bladder after prostate infection to see if I had anything in the bladder causing problems. All he found was some infection that finally cleared up after switching off Cipro.
11. 2004 Had tried V, C and L for ED. Little help. On a trip to Mexico Dr. Shappley suggested I try Uprima that was not available in the US. The combo with Levitra helped a little.
12. 2004 Had a Color Doppler. ED had gotten very bad. Had a Venous Leakage. Dr. Shappley suggested I try PGE1 (Edex) No help at 60mg. (Shot and ½). Then his assistant wanted me to try Trimix. Selling trimix out of office for $10.00 cash per unit. Started with 4 units. No help. Went back to Dr. Shappley and saw his assistant again. Got a limited prescription for trimix. When asked where to get it filled said they did not know. When I asked where they got trimix got the run around of like Ohio or somewhere.
13. 2005 Went to Dr. Conrad. It had been almost 2 years and no DRE. PSA was 1.2. After a DRE and PSA and consultation Dr. Conrad gave me a prescription for trimix and told me I could get it filled at Peoples Pharmacy. Tried different dosage, no effect. Went up to the strongest dose Peoples had and a full 10 units. No help.
14. 2006 After discussing my options after the failed attempt at trimix Dr. Conrad suggested an implant. Gave me a video and set up the surgery for late October 2006.
15. 10/2006 Chest pains. Had to have a stent placed in my heart. Dr. Shiakh said wait one year before implant surgery. 12/06 Chest pains again and another stent.
16. 10/2006 Asked Dr. Conrad what can I do for sex. I need help. He gave me a prescription for a VED. Met the rep in his office and started VED. I thought more was better and caused an abrasion. Took weeks to heal.
17. 10/2007 Dr. Conrad attempted to do the implant. During the procedure he penetrated my urethra in the corpora at the head. Surgery aborted because of possibility of infection. After follow up Dr. Conrad said come back January. Dr. Conrad explained that corporal fibrosis from trying the shots for ED caused the instrument to move when he tried to push it through.
18. 10/2007 Dr. Conrad was giving me 300mg of testosterone every three weeks. Not helping. Talking to Dr. Brewer, my primary doctor, and explained the problems I was having he said he would help me with my testosterone. Blood work after 3 weeks showed low 120 on the range. Dr. Brewer said 600 my every 3 weeks. It took 2 shots to get that much. Dr. Brewer at my request changed the shots to 300mg every 10 days. A felt better for the first time I long time.
19. 1/2008 Follow up with Dr. Conrad. DRE and PSA of 1.7. I informed him I had back surgery coming up the end of January. He said come back in 6 months.
20. 1/31/2008 Back surgery. Dr. Fernandez. L4-L5. He also suggested I wait about 6 months before implant surgery.
21. 5/2008 Current blood work for testosterone still shows low. Dr. Brewer has increased my shot to 400mg every 10 days.
4/2008 Went to Dr. Wake the head of The Urology Department at the University of Tennessee Medical School, Memphis. Was less than impressed. He basically tried to talk me out of an implant. When I was through asking questions it was obvious that he did not have the skills I needed. I knew more about peyronies, implants and testosterone replacement than he did.
VED.
Was using it all wrong. Applying too much pressure and holding it for a long time. After the failed implant I found the Peyronies Society web site. There I was talking to Old Man an avid fan of the VED. He gave me a routine of pump and hold for 10-15 minutes.
I use the VED most days for exercise of the penis. It has helped. And for sex I only pump to about 80-90% erect for better feelings and use an Osborn ring for sex.
The men on the Peyronies Society web site recommend the VED for Peronies and corporal fibrosis. This routine has worked for me.
I have a Love/Hate relationship with the VED. It took a while to learn how to use it properly. I hate the constriction rings, I have to use a real tight one and it cuts way down on the feelings. I also have to watch how long I have it on.
May 21, 2008
6/3/08 Appointment today with Dr. Yari Walzer. Normal office check in routine gave the nurse a copy of my Urology History. I had my list of 16 questions.
Dr. Walzer came in the exam room and introduced himself and said “Jack I have read your history and I can not help you. You need to go to Vanderbilt. You do not need any more problems and I do not need the money. You need a doctor that does at least 100 of these operations a year and in this area doctors only do one or two a month.”
We talked a bit more and he suggested that I probably needed the resection surgery on my corpora’s. Then he did an exam of my penis.
After the exam we decided on a referral to Vanderbilt and I would hear from him in a couple of days or so. He also offered to do the follow up locally.
My conclusion of Dr. Walzer was that he was honest, upfront and wanted the best care possible for me. Will continue to use him for Urology issues locally.
6/10/2008 Dr. Walzer’s nurse Kitty called this morning. Referred me to Dr. Douglas Milam with Vanderbilt. Called this morning for an appointment. Recoponsist said his nurse would call me in a few days to make an appointment.
6/19/2008 Received appointment card from Vanderbilt for 8/22/08 along with Patient Registration forms. Will get medical records from Dr. Conrad and the Hospital to carry with me to Nashville.
6/30/08 Peggy, Dr. Milam’s nurse called and rescheduled my appointment for exam and pre-op to July 25th at 1:15. She went ahead and scheduled surgery for August 14th. Wants me to fax medical records when I get them along with cardiac clearance.
Peggy said that Dr. Milam does at least 3 or 4 of these a week and that I may not have to have a radical corporal procedure (will be decided at the exam).
7/10/08 I finally received my records form Dr. Conrad. Faxed 25 pages to Peggy at Dr. Milam’s office that included one page cardiac clearance from Dr. Shaikh.
7/25/08 Vanderbilt Hospital, Nashville TN a 3.5 hour drive from home. Driving instructions put me right in the hospital. Checked in at the Urology Center was greeted promptly and finished filling out paper work.
In the exam room I met Todd Doran PA-C for Dr. Douglas Milam. We went over my history and he answered most of my questions before I could ask. He explained that they use the AMS 700 LGX and use the pubical approach. He did an exam of my penis and said everything looked good for surgery.
After the exam by Doran Dr. Milam came in and introduced himself. We talked about my history and what to expect and not to expect from the implant. I asked about the other models of the AMS 700 and he said they only use the AMS 700 LGX and are in the process of publishing a paper next year to get all doctors using the LGX. He explained that the surgery was 75 minutes and I would only be in the hospital over night.
Dr. Milam did a stretch test on my penis and showed me how much erection I would have. He explained that because of the Peyronies Scar the penis would only stretch so far. I estimate I will end up with approximately 4 inches and normal girth. This is down from the 5.5 inches before Peyronies. I told Dr. Milam that so long as I have a useable erection that is OK. He wanted me to know what to expect and that would be all I could get back. (Note: My wife and I already knew that I could not gain back the size before Peyronies. She explained to me that women are more interested in girth than length and that most of the feeling during sex come from girth.). Dr. Milam also said to continue daily use of the VED for exercise and that it would help the outcome, but to be careful not to hurt or bruise my penis and to stop the day before surgery.
Dr. Milam explained that I would see Todd Doran PA-C most of the time but he would do the actual surgery and would be available if needed. Post op will be in two weeks 8/27/08 with Doran and again in six weeks. No sex for six weeks until Doran teaches me how to use the implant. The final Post Op will be with Dr. Milam in 3 months.
Dr. Milam said he had never punctured a urethra and had seen only one other. He assured me that he would take all precautions to make sure the urethra was not punctured and I would have a successful outcome. He said the only complication he could think of was if they could not get a Foley Catheter in because of the previous urethra puncture. I told Dr. Milam I had a catheter with back surgery in January and he said everything should be fine.
After the exam with Dr. Milam I had to empty my bladder for a bladder scan and then to the Nurses office to schedule my appointments and get pre op and post op instructions. Then down to the lab for blood work and anesthesia work up.
I arrived at the parking garage at 12:45 and was on my way home before 4:30. Wait time was a minimum from other experiences and the staff was all professional and I was generally impressed that these people know what they are doing and how to do it.
Posted on Implant Group 8/13/08
As most of you know I was scheduled for my implant at Vanderbilt for
tomorrow.
7/27/08 I was eating lunch at the local O'Charley’s and cut a bit larger
than usual piece of prime rib. With all going on with family and
friends I swallowed before I was ready.
The meat stuck in my esophagus just before entering my stomach. Went
home and tried everything I knew to get it to go one way or another. NO
LUCK.
2:00 in the morning my wife took me to the local ER. They tried twice
to get it out. The second try they put me to sleep. Woke up and still
there.
They transferred me to the main hospital in Memphis and brought in a
Surgeon.
Tuesday about noon they put me to sleep again and tried with a rigid
scope. No Luck. Seems that I am longer than normal, esophagus that is.
They were so aggressive that the doctors collapsed a my left lung and
put my heart into A-Fib. Woke up in recovery with a doctor cutting in
my side to put in a tube, "called him a couple of bad words." Then they
brought in a heart doctor.
Two days of hell in the room with at least six (6) IV's. Then on
Thursday afternoon back to surgery. The Dr. marked my chest that
morning just in case they had to go after it. This time it went through
when they put the tube down. Back to hospital room NPO with a stomach
pump. I was on ice chips until Monday morning. Liquid diet, did not
know so little would make you feel full.
Thursday morning (I think) wife and I had a Come to Jesus meeting with all the Doctors. On what to expect.
Tuesday afternoon the surgeon and then the heart Dr released me to go
home. While in the hospital I asked about the implant surgery and they
said postpone it for a couple of months. Had a long talk with heart
doctor before leaving the hospital and he assured me that in a couple
of months I could get the implant but first I had to get the A-Fib
fixed.
Went to heart doctor today and the A-fib is much better. Wants me to
wait a couple of weeks and if the meds do not fix the A-fib they will
shock it back.
I've lost 15 pounds. When I came home the next morning I looked in the
mirror and did not see myself. What A Shock.
With heart doctors blessing I have rescheduled the pre op at Vanderbilt
to October 24 and the implant to October 30. I WANT MYSELF BACK BY THE
END OF THE YEAR!
If it has not been one obstacle it has been another but come "Hell or
High Water" I am going to get the implant.
8/21/08 Epilog: Went to Dr. Shirwany’s for my pre op before the cardiac conversion. Nurse checked my blood and that was fine. Went to the exam room and took my BP she said I hear a normal heart beat. She went and got the EKG and sure enough my heart was back to normal rhythm.
Dr. Shirwany came in and was almost as happy as my wife and I about not having to do the Cardiac Conversion.
For the arrhythmia in the hospital they added Cartia, a calcium channel blocker and Amodarone to the BP meds I was already taking, Ramipil, and ACE inhibitor and spironolactone are my normal BP meds and have controlled my BP well. I told Dr. Shirwany that in my past calcium channel blocker caused me lots of problems and fatigue and not sleeping were the worst. I asked if I could get off the new meds because of the side effects. He said that for now I needed these but he would cut the dose in half. He also said that in mid November after the implant I would ware a monitor for few days and then reevaluate the meds.
I signed a release so he could get the records of my last cardiac cath 7/07 and other history from my previous heart doctor.
He said after he received these records he would mail me a cardiac release for the implant surgery.
In the hospital the surgeons almost killed me. If it had not been for Dr. Shirwany I don’t think I would have made it. IMHO
9/23/08
Went to Dr. Walzer for semi annual DRE and PSA. DRE was normal.
9/25/08 Dr. Walzer’s office called with results of PSA. Result was 1.1 that is normal. Asked her to send me a copy.
10/15/08 Phyllis with Dr. Milam’s office called and wanted to move the surgery up a week. Pre op is now scheduled for 10/22/08 and surgery for 10/23/08 @10:30. Will drive up to Nashville the 22nd and spend the night.
10/16/08 received cardiac clearance from Dr. Shirwany and faxed it to Phyllis 615-343-9815.
10/22/08 Vanderbilt Pre Op.
Pre op went well, had all my paperwork in order and a cardiac clearance letter from Dr. Shirwany. EKG was normal and cleared for surgery the next day.
10/23/08 Vanderbilt Hospital – Penile Implant
Check in time was 10:30. Went to pre op holding room and had 2 antibiotic IV’s. Dr. Milam came in about 1:00 we talked and he said everything looked fine. A few minutes later one of his assistants came in and we talked for a while. I mentioned the previous surgery where the Dr. penetrated my urethra and he said he knew all about it. I believe that Dr. Milam and staff had a pre op meeting and knew my history well.
About 2:00 I was taken to surgery and Dr. Milam had a few words and then I was asleep.
Woke up about 3:30 in recovery and felt like I had to pee real badly. Had a Foley Catheter and nurse said everything went as planned and the wanting to pee was normal.
My wife had meeting with Dr. Milam after surgery and he told her everything was OK but I would be in pain for a while.
About 4 or 4:30 Dr. Milam came into the room and said everything went well and he thought I would be well pleased with the outcome. He said I would have some asymmetry because of the scar tissue from the previous attempt but I would hardly notice it.
The next morning about 5:30 the catheter was removed. Had a light breakfast urinated on my own and was on the way back to the hotel by 9:00. We arrived home about 2:00.
To say I am satisfied with the results to date would be an understatement. Just the look on my wife’s face when I got back to the room told me everything was OK. She has supported me all these years and I never saw her happier for me.
My testicles are black and blue, but that was expected. The pump is in front of my right testicle and I have to pull it down to the center every day. Dr.said it would be easier for me to get to there.
I have the AMS 700 LGX. If I am reading the paperwork right I will have an erection of about 12 CM (4.7 inches). If I get a 20% increase over time I will be within ¾ inch of my pre peyronies size. Right now I can tell the flaccid state is larger, no more turtle effect. This is more than I expected before surgery I would have guessed about a 4-inch length. I know size is not everything we have been dealing with peyronies about 13 years and learned length is not where it is with sex. You can adapt to most any size and still have fun.
A better than expected length is credited to the proper VED exercise given to me by Old Man of peyroniessocitey.org. That year of proper VED exercise gave me a better than expected outcome.
11/5/2008 Post Op with Todd Doran, Everything normal. Still sore. Pump is in place so I do not have to pull it down anymore. Advised to remove the strips on the incision the next time I shower (looks good after removal). No tub or hot tub for another 4 weeks. Lifting restriction of 15 pounds.
12/04/08 Activation: I was at Vanderbilt at 8:30 this morning for my implant activation. Doran showed me where the relief button is and them activated the pump. He then had me pump it up. For the first time in years I had an erection that stood straight out and stayed on its own.
AMS that gave full instructions on how to use the implant gave me an “owners manual”. I was advised to pump up the implant 2 times a day for at lest 5 minutes until the next appointment in 3 months.
I was told to pump the implant up at least 3 rimes before trying to use it. I now know why the first few times you pump the implant it stings some for a while. When I arrived home I showed my wife the erection and let her feel of it. Feels just like an erect penis of a 20 year old. When we went to bed I pumped it up again. Lying on my back with my penis sticking straight up and hard gave me a feeling of being normal again.
The actual measured result in the office was 4.25 inches. I was informed that over the next 3 months to a year I should gain at least another ½ inch. This puts me closer to my pre peyronies of approximately 5.5 inches.
The VED was a “gods send” over the last years. After I found the proper exercise for peyronies I gained some size back. Lost about a quarter inch from VED to implant. My Venous Leakage, and Corporal Fibrosis was so bad that I had to use a very tight constriction ring that sometimes did not hold, but I don’t know what I would have done without it. I will give the VED a proper send off New Years in a Barn Fire.
Took me a long time to get here. In my time I would have had the implant years go. God’s time was now. It has been a difficult road but here I am happily lying on my back with a hard on that a 20 year old would envy. I have a “date” with my wife to put it to use tomorrow after noon. Can hardly wait.
12/5/08 Date with wife: All went well still soreness when I pump up the implant and it interferes with feelings. This will all heal with time. Learning curve with use but that is part of the fun.
I HAVE MY NEW TOY FOR CHRISTMAS!!!
1/5/09 One-month post activation. The implant is expanding into the head and have gained back some length. The last month has been a learning curve, tried to just not push it. Today when activated to full length there is a little soreness. Sex the last time was great.
There was still some soreness Christmas but New Years it was 98% gone. Feelings are returning. Great sex new years!!!
2/19/09 This afternoon I decided to take a nap. While lying there I pumped
up my implant. I kept pumping about 20 times after the bulb got hard.
My girth got sore and a little soreness at the glans. Then I noticed
the best erection I have had scene the implant. Like my doctor said
it takes 3 month to a year to get the LGX to full size.
I do not let the soreness keep me from using the implant. It is not
that bad. The first few weeks I was real sore, but that is the price
we pay for success.
3/6/09 I was at Vanderbilt with Dr. Milam this for my three-month post activation
follow-up.
In the three months science activation my erection has become 1/2 inch longer!!!
Dr. Milam said that my implant, AMS 700 LGX, would continue to expand and that
most expansion is between 6 and 18 months.
The proper instructions that I received post op, which I followed, has my pump
in the proper easy to use location. I mentioned that some implant patients did
not receive these instructions and had trouble with pump location. He said that
by the end of the year the paper he and his team are publishing would advise all
doctors doing implants to use the LGX and give patients proper post op
instructions. This is just one of the instructions that patients did not
receive.
To say that my wife and I are happy with the implant is an understatement. I
must remind those considering implants that it is a choice of last resort after
all else fails. My peyronies started in 1995 followed a multitude of
problems, low testosterone, ED, loss of nighttime erections, venous leakage and
corporal fibrosis.
Corporal fibrosis was caused by injection therapy for ED. I tell men never put a
needle in your penis for ED. Some have good luck but most, like me, end up with
problems.
My one-year follow up is in October. Dr. Milam said I would see better and better
results.
I owe a lot of my excellent result to the proper VED exercise I did a
year before the implant.
4/3/09 Dr. Walzer, Prostate Infection. DRE and levequin. This was my first trip to Dr. Walzer post implant. (He is the Dr. that referred me to Vanderbilt). He did a penile exam and pumped up the implant and was impressed at the difference. I had a spot of blood in my underwear and he wants to do a kidney ultra sound 4/22/09
4/22/09 Dr. Walzer’s. Kidney and bladder ultrasound. 2 stones in left kidney. Reflection in bladder and slight elevation in urine. Have to go to the hospital for a flat panel x-ray and a cistocope 5/7 to check the shadow in the bladder. May have to have a lipotripsy for stones.
5/7/09 Dr. Walzer’s/ X-rays from 5/4/09 show two (2) stones in each kidney. Scope of bladder found no problems. Prostate enlarged and he wants me to start back on Saw Palmetto. If stones do not pass on there own come back in 6 months and have kidneys x-rayed a week before. Bring old and new x-rays next visit. 11/10/09 1:00 PM.
5/31/09 Had a fever and back pain like kidney stones trying to pass. Methodist Hospital Germanton ER. Waited a long time for doctor to examine me threatened to leave after 4 hours, then I got attention. CT scan showed. “No acute findings. Bilateral, nephrolithiasis, nonobstructing. 2 on R and 3 on L with largest 7mm on left. Penile prosthesis without acute findings. No acute findings. No Free fluid/air or fat standing.
I was given 2 antibiotics IV, IB for fever and an Rx for antibiotics. And sent home.
7/20/09 Dr. Shirwany’s for heart follow up. Every thing looks good. I still have trouble with difficult ejaculation and asked him about going off the diuretic. My research showed that it could be part of the problem and he agreed. He did not see any problem just watch my BP and if it rises increase the Altace. OK to start Saw Palmetto. Blood work for cholesterol.
8/23/09 My implant was 10 months ago today. The implant continues to expand in length and I have gained back to 90% of my length before peyronies. Sex with my wife is wonderful. I can stay erect as long as I/she desire. With the AMS 700 LGX expanding into the glans (head) I do not have the floppy head that a lot of men complained of before the LGX was available. Once in a while I still have a little soreness in the glans as the implant continues to expand but the soreness is not bad enough to interfere with sex.
All I asked Dr. Milam for was a usable erection. I got that and so much more. I never dreamed I would get about an inch of length back. Flaccid size is impressive I was never a shower. Now when I look at myself in the mirror after a shower I still say to myself, is that me.
10/09/2009 My one-year post op at Vanderbilt.The exam and follow up with Todd Doran PA, and Dr. Douglas MilamI am delighted with my implant and all the care I received at Vanderbilt. During the exam and follow up questions I spent about 45 minutes with Todd and Dr. Milam. I had a few questions and learned a lot.We started out with Todd and an intern. I pumped up my implant. Todd showed the intern where the tips of the implant extend into my glans. Of course the glans was flaccid and with a slight downward pressure on the tip you could see where the tip of the implants are. Both sides fit to the same size and approximately ½ way into the glans. We discussed my success with the implant and the impact it had on my life. I am happy to say the impact has been better than I ever expected. During the discussion Todd asked what is the most common complaint with men with peyronies. Loss of size, length and girth. The AMS 700 LGX is the only implant that can help restore length. I wish I had a recording but I will tell you basically what Todd said. The AMS 700 LGX will straighten out a peyronies curve. Peyronies is not normally in the erection chambers when the implant is activated it will straighten out the penis. I said to Todd that some men go into surgery expecting an LGX and come out with a CX or other implant. I asked if there was a reason for that. He said that when that happens the doctor does not fully understand the anatomy of the penis and the workings of the implant. Dr. Milam was an engineer before becoming a surgeon and fully understands the mechanical function of the implant and penis. He said that all there patients, with peyronies, that have the LGX have a straight erection like mine.I have a diminished blood flow to the glans. I told Todd that it is more noticeable now that I have been off blood thinners for a year. He said that was what happens is a lot of men. I asked how could I help blood flow to the glans without the blood thinners. I asked if Cialis would help. He said it would and recommended the daily dosage of 5mg. He wrote me a prescription for the 5mg daily dosage. I will take it along with the coupon for a free months supply from www.cialis.com to the pharmacy today. My prescription drug plan (Medicare Part D) does not cover it so I need to shop around the cost. JI asked about the Ambicor 2 piece implant for a gentleman in the New England area. He said they only use it if they cannot get a reservoir in. He said it has a much lower satisfaction rate than the other implants. I asked about pain with peyronies for another gentleman. He has been having pain with erections and other urinary symptoms. They know Dr. Levine and his work. They disagree with not doing any surgery for peyronies if you have pain. They did not get specific as to what they prescribe for pain only different men have different symptoms and they prescribe different things, and they also occasionally recommend surgery for the pain. They also recommended a second opinion on the urinary symptoms and said they would be glad to help him with that.We talked about penile injection therapy for ED. They do not recommend it and do not prescribe it. Injection therapy caused my condition to get worse with corporal fibrosis. We talked about the peyronies society web site. Todd said that now he has a face to put with those coming in after visiting the web site. He said that they have been able to help several men after viewing the site. Todd said he has looked at the site and likes the fact that we are straightforward and informative. The information is usually straightforward and factual. We talked about the difference in the pubic and scrotal approach. 98% of the implant that Dr. Milam does is the pubic approach. He said that the dorsal nerves are easy to identify and keep out of harms way. He said that if there is a problem with the corporatomy it is much easier to repair with the pubic approach. We discussed my punctured urethra that happened with the local doctor using the scrotal approach. Todd said that the instrument to dilate the corpora is curved and if not done properly with the scrotal approach that a punctured urethra can happen. He said Dr. Milam is very detailed about this and reminds his students all the time of this. I asked about revisions. Dr. Milam said that they do “a ton” of revisions. I asked about the life expectancy of the implant. Dr. Milam said 93% were performing normally at five years. Both Dr. Milam and I have some engineering background. I am a retired Boiler Inspector and Mechanical Contractor. We compared it this way; you can buy the best HVAC system on the market and use the worst or cheapest contractor in town. The system will not perform properly because of an improper installation. If you buy the same equipment from a first rate contractor you get a properly performing system that will save you money in the long run. I said it to him like this; I charge an A/C system with a digital thermostat to the manufacturer’s specifications. 90% of the systems I go to the first time are at least ½ to 1 pound of Freon overcharged. This cuts the efficiency of the system by about 20-30%. Moral, to get the best results use the best equipment and an experienced well qualified people. We discussed additional penile length. I have gained weight and need to loose 20-30 pounds. Yes I am a big guy 6’2’, 255 pounds. I was told that if I loose the weight I would gain 1 to 1 ½ inches. That will put me back at my length before peyronies. Now all I have to do is get off my butt and do it. I have started back walking 2 miles a day, but as my wife says I need to cut back on the sweets, bread and portions. I lost over 20 pounds several years ago on the Atkins Diet and considering going back to it. Girth: My erect girth is back to where I was as a teen’s or early 20”s. If I remember my algebra correctly 2” diameter x 3.14 = 6.28” or 1” radios x 3.14 squared = 6.28”. Any way the wife and I are very happy with it. The best part of this whole experience is the renewed confidence I have. I feel NORMAL for the first time in years. There was the pain of surgery, the 6 weeks waiting to activate the device, the discomfort when the device was first activated, getting used to the pump in the scrotum and the about 3 month learning curve of using the implant. The small amount of discouragement when first activated that I was not as long as in the VED but as Dr. Milam said at my 3Month check up I regained it as the AMS 700 LGX continues to expand Dr. Milam, Todd and I talked about the publication on using the AMS 700 LGX. It has just been submitted to The Journal of Urology and will take 6 to 9 months before it is published. There is a meeting next month (11/09) in California of the Sexual Medicine Society. Dr. Milam has a major presentation at that meeting on the AMS 700 LGX. Dr. Milam will send me a copy of the publication when it is printed and I have his permission to publish it on the peyronies society web site a yahoo implant group. I also have kidney stones 3 on the left side and 2 on the right. I showed Dr. Milam the report from a CT I had the end of May. He said so long as I was not in pain the wait and see that my local doctor recommended is normal. Dr. Milam and I discussed that when my local urologist did a bladder scope, after the ultra sound for kidney stones, that he said that with an implant I was limited with options if I had prostate problems. I had a couple of TURP’s about 12 years ago. Dr. Milam said that with the implant there was no problem with any prostate procedure with the implant. Dr. Milam and his team do all kinds of penile surgery from surgical correction of penile curvature, penile implants, and artificial urinary sphincter to control incontinence, circumcision and lots more. Before anyone asks, No you cannot gain additional length or girth with the implant above what you normally have. Any one that tells you their product or device will is selling “snake oil.” Dr. Milam told me I did not need to make the trip back to Nashville any more but if I needed him just let him know. I will always be a patient of his and Vanderbilt.
October 23, 2010
Second Anniversary
Today the wife and I celebrate the two year mark of my penile implant surgery at Vanderbilt.
It has been an amazing adventure. The pain and discomfort of surgery are a distant memory. The joy of having a normal sexual relationship with my lovely wife of 42 years is best described as spiritual.
Our advice to anyone thinking about an implant, find a great doctor like Dr. Douglas Milam at Vanderbilt. The results for us is I have gained back over 90% of my penile length lost to peyronies, ED, venous leakage and corporal fibrosis. The bonus was the gain in girth. I am back to my youthful girth of 6.28".
If you read my story it was a long and difficult one. If I had it to go through again I would for the same results.
To Dr. Douglas Milam, Todd Doran MS PA-C and the staff at Vanderbilt Thank You seems so inadequate. You are amazing people doing amazing work. God Bless You.
JackP
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