Ok,  I am trying to think ahead,   we hope to decide on the doctor and date for Surgery by Thursday the 4th of November.   I know it will be on or before December 9th.    I would like it sooner

So,  now I am thinking about how I should , if I should change my diet prior to and after surgery.   the Doctors say no,  but the statistics say yes.     Statistics say that people that cut their animal fat intake in half,  reduce their recurrance by 50% .

And advice

Questions for my Doctors,  trying to see 3.

1.   Which procedure has the highest 20 year success rate

2.   Do you keep statistics,  non recurrance, continance, potency percentages

3.   How long have you been doing this procedure, how many have you done

4.   What is the difference in Open vs. Robotic procedure

5.   Do you use nerve sparing and dorsal vein sparing

6.   If cancer has spread to lymph notes, then what, I am sure mine hasn’t , but

7.   What have you changed / improved in your procedure during the last year

8.   If you were me, What would you do, and what doctor would you use

9.   When is the earliest date available?   Can I be the first one in the morning?

Congressional Reform Act of 20101.

1. Term Limits. 12 years only, one of the possible options below..

   A. Two Six-year Senate terms

   B. Six Two-year House terms 

   C. One Six-year Senate term and three Two-Year House terms

2. No Tenure / No Pension. A. Congressman collects a salary while in office and receives no pay when they are out of office.

3. Congress (past, present & future) participates in Social Security. All funds in the Congressional retirement fund move to the Social Security system immediately. All future funds flow into the Social Security system, and Congress participates with the American people.

4. Congress can purchase their own additional retirement plan, just as all Americans do.

5. Congress will no longer vote themselves a pay raise. Congressional pay will rise by the lower of CPI or 3%. (or the same as social security)

6. Congress loses their current health care system and participates in the same health care system as the American people.

7. Congress must equally abide by all laws they impose on the American people.

8. All contracts with past and present Congressmen are void effective 1/1/11. The American people did not make this contract with Congressmen. Congressmen made all these contracts for themselves. Serving in Congress is an honor, not a career. The Founding Fathers envisioned citizen legislators, serve your term(s), then go home and back to work.

Between research on the prostate, and working on some Six Sigma projects in Warsaw, exercising twice a day, and a few honey do items,  I have been watching Johnny Carson reruns and Marx Brothers reruns.    But the mind is a terrrible thing.   Your mind can think faster than you can meditate.     We attended our son’s church this last Sunday,  the sermon was very appropriate for me.   It was about “Fear”, or at least that is how I interpreted it.     When we entered the church, I got a cup of tea and a cookie.   The bible was opened to Psalm 119 verse 147  – 149,  profoundly appropriate for me (look it up).    I appreciate all your prayers.    I also pray freguently myself for myself and for others worse off than me.    It helps be stop worrying about the unknown.

This brings me back to Rev. Robs sermon;  Why are we afraid to do what God has called us to do.    Probably the fear of control, or the fear of the unknown.   The fear of what might happen.    I am working on controlling my own fears, it involves risk,  Doing the right things always involves risks.    Who am I,  God will show me the way.

Talked to another personal friend who is a Doctor at a major hospital.    He ask me what I was thinking.    I said I am leaning towards Davinci surgery.   He said go to someone who has done a thousand.    He also said Henry Ford has one of the top 2 int he country.    He said that Canada has a new process called HIFU,  High Intensity Frequency Ultrasound.    But,  suggests I stick with more conventional methods.

We visited an Oncologist yesterday.   You know I had a page full of questions.   He was exceptional.    He is also a fellow Rotarian.   So,  my questions were as follows:

1.   What are my options;  his answer,  there are no real comparitive studies,  both radiation and surgery are good.  Radiation and Surgery are both better today than 5 years ago.    Seeds are OK,  but not good for enlarged prostate and might as well have surgery, same amount of time.

2.   What is my risk and stage,  he said I have a low to middle risk score.

3.   What option has the highest non recurrance;   Probably surgery, but varies by patient.

4.   Can you do radiation after open surgery;   Yes,  but he does not recommend open surgery,  he thinks robotic is just as good in the right surgeons hands

5.   Can you do surgery after radiation;  Yes , but difficult do to scar tissue

6.   Can you do radiation after robot surgery; Yes

7.   I am a chess player, what are the next 3 moves if the first one is not 100%;   Surgery,  radiation, hormone, chemo, and maybe a vacine

8.    Other options;  Sweden does a lot of watchful waiting,  but they are gradually changing because men are living longer

9.   Others;   Radiation could be very effective with new IGRT radiation.    Radiation does have more side effects in 15 to 20 years.

2.

This is a lot tougher than I thought.   Though Karen is doing most of the research, we are both calling surgeons and hospitals.    We researched on the internet the top 25 hospitals per US News for Urology, and other sites.    Then we went to individual hospital sites to see what they had.   Plus, we added a couple hospitals based on referals.    The hospitals that we called were Mt. Sinai, John Hopkins, Mayo Jacksonville, and Mayo Mn., Henry Ford, Indiana, U of M.    From our research we knew what Surgeons preformed mostly Robotic Prostate procedures.    We did not call Cleveland Clinic, though highly rated, because they do not have specialized surgeons that just do Robotic Prostate procedures.  We wanted surgeons that had done more than 200 prostate robotic procedures, that did not use interns for the important stuff.  We would like to have the procedure in late November or Early December.

We have been calling these 7 with mild success.   We have had at least one phone call to each of the 7.  Some won’t talk at all, some are pretty open.  Few have much data they will really share.   Some have data on their web site but not by surgeon.   Some of the teaching hospitals use more interns.  Some of the Surgeons are booked through December.

We will try to narrow it down in the next few days.    Doing research and call ing hospitals is a lot tougher on the nerves than one might guess.   Please continue to pray for us. 

I am practicing what I preach as a leadership expert,  focus.   I have emailed several of my favorite customers and said I have a higher priority for the next few months.    This hurts, but we need to focus and get this right.

Visited 3 doctors today.   A potential surgeon, my Symmetry Clinic Doctor, and my family physician.   This is not easy, hard on my nerves.   But,  all three visits went very well.   Everything sounds good except when it comes to the nerve bundle discussions.   I plan on seeing at least 2 more surgeons, maybe an oncologist.   The surgeon suggested I wait at least 6 to 8 weeks after the biopsy before surgery, to let the prostate heal.   LOL,  so they can yank it out more easily.

Karen has been a huge help doing all the research on hospitals and surgeons.     Your prayers are wonderful,  and I am good at visual healing and praying.

PS,  your next phyiscal,  have a PSA test and a digital exam.

I am truly blessed with all the friends that have called and emailed their support and prayers.   And all the calls from those that have had the same journey.    It all helps.

One friend suggested I visualize the cancer being a block of ice and I am melting it.  Another friend suggested visualizing rabbits (white blood cells) eating all the bad lettuce (cancer cells).   So,  now I do both.    I started with 100 rabbits, but you know how rapidly they reproduce,  I now have 1000 rabbits searching for lettuce.    They can’t find much.   Every day when I run / walk, and when I go to bed,  I visualize melting ice and rabbits cleaning up the debris.    Like any engineer, the rabbits travel in large groups,  traveling in  spirals from my head to toe so they don’t miss a thing.

There are many options, all with advantages and disadvantages.    Several types of radiation, several types of surgery.   All have a realatively high cure rate.  90% plus.  Radiation can be seeds, 3 axis radiation, 4 axis radiation, and proton radiation.   Types  of Radiation have advantages and disadvantages.    Seeds are quick, a few days of discomfort, little incontinence and little impotency,  but you must be healthy enough to withstand the procedure.  Could get back to running and biking earlier.    3 axis and 4 axis radiation is 5 days a week for 6 to 8 weeks.    The disadvantage of Radiation is that surgery is difficult should the cancer reoccur due to the scar tissue,  and the incidence of bladder and colon cancer is higher in 15 to 20 years.    

The types of surgery are traditional and Davinci Robotic.   Other older surgery processes that are seldom used today.    Lot of discussion if traditional or Robotic are equally successful.  But,  I think it is more the surgeon than the process.   Today, both types of surgery use nerve sparing and blood vessel sparing procedures to reduce probability of incontinence or impotency.    The advantages of surgery is long term cure is slightly higher, very small,  less chance or reoccurance, less chance of bladder or colon cancer down stream, and while they are in there they can see if cancer has spread and remove what they can.  Disadvantage is 3 to 5% incontency and 20% + impotency. 

I am really leaning towards Davinci Robotic Surgery, I plan to live a long time.