Thursday, January 8, 2009

Dec 31 2008 New Years Eve Day consult

Dec 31 2008 After spending the past five days on the beach in Cocoa me, my wife and children made the trip into Orlando for the visit with Dr. Patel. As we pulled into the Florida Hospital at Celebration I must ad the resort style appearance was quite appealing…

Florida Hospital was the first institution in Central Florida to offer the da Vinci® robotic radical prostatectomy in 2004. Dr. Vipul Patel is Medical Director of the Global Robotic Institute at Florida Hospital, and has personally performed the most robotic prostatectomies in the world. Dr. Patel leads one of the world's most experienced teams which is renowned for providing excellence in patient outcomes with respect to cancer control, urinary continence and maintenance of sexual function.

I should add that the anticipation of this consultation was much worse than the biopsy, although nothing was taking place today my anxiety level was maxed out. I am thankful that Kim was able to be with me, her presence was calming and reassuring. We were greeted very warmly and processed through admissions with much efficiency, although I did have everything organized and ready for processing. If Dr. Patel were to offer surgery tomorrow I was ready. We waited in the exam room for about 15 minutes which provided ample time for my A.D.D. to kick-in and I searched the entire room, the overhead cabinet was full of Depends, my mood quickly calmed.

Our first interaction was with Geoff Coughlin, MD a medical fellow of Dr. Patel’s that has been with him for over two years. Dr. Coughlin had reviewed my chart and had begun to explain the surgery, recovery and effects in detail. He answered a majority of our questions before we ever asked them. (I have provided his answers in red)

We had prepared a list of questions for our consult;

After reviewing my labs, family history, age and physical condition what is your recommendation for treatment? Surgery

Do you feel I am the right type of patient for a radical prostatectomy utilizing the daVicni robotic system? Absolutely, a prime candidate based on my physique, my age and the fact that I have a small prostate.

Do you believe with my cancer that by electing surgery we can successfully cure me from prostate cancer? Yes, after surgery you should have a PSA level of 0.

What are my chances of recurrence provided a successful surgery outcome? Would any chemotherapy or radiation be required? A minimal chance of recurrence, almost nil.

What is the success rate of surgery? The success is that you will forget you ever had cancer. For ages 55 and below we base it on the return of continence and erectile function.

Based on my age and physical condition what should I expect for the return of continence and erectile function? Continence within 3 weeks and erectile function within 3 months, we would be surprised if the rehab would be any longer for your situation.

How long should I expect to be out from; Work? Approx. 1 week Running? Approx. 4 weeks Biking? Approx. 12 weeks Lifting? 30 days no more than 10 lbs.

What determines the amount of time the catheter will be required? Approx 5 days. It will be removed following a cystogram. A cystogram is where contrast is injected into the bladder via the foley catheter then an x-ray of the bladder is taken in search of any leaks.

What would the timeline be for registration, surgery, release and returning to Panama City? We would require you stay for approx. 7 days following surgery, 24 hours after the removal of the foley catheter.

Would you require follow-up appointments or release me to my urologist? It is the choice of the patient, appointments at 30, 60, 90 days and then throughout the following year.

If you were diagnosed with prostate cancer tomorrow what treatment would you elect? I never asked this question, it was pretty apparent. Although I did ask Dr. Jenkins this question. Surgery.

Dr. Coughlin added that he has worked in various facilities across the world and that Dr. Patel is one the finest surgeons currently performing this procedure. Dr. Vipul Patel has personally performed the most robotic surgeries in the world, and is one of only two surgeons to have performed 2,000 robotic prostatectomies.

Next we met Dr. Patel; our first impression was what a humble and gentle man. He was more than willing to answer any remaining questions, concerns or hesitations.

1. We discussed the issues with early detection in men and how the PCP is handling PSA, more important he noted that any PSA is suspect, but over 1 is evident of some abnormality.

2. We discussed family history, I shared the Troia MD Anderson Cancer Tree, and he noted that with my brother’s prostate cancer and my diagnosis that most definitely my brothers, cousins and nephews would develop prostate cancer at some point.

3. Dr. Patel explained that all I am reading and researching doesn’t necessarily apply to me with my age and health considerations. There is not a lot of data available for men in their early forties. I personally used this website to gauge some of my information and an excellent book by Rabbi Ed Weisenberg called Conquer Prostate Cancer Now

4. We then discussed possible surgery scheduling; he noted that he will not operate within 8 weeks of biopsies due to the bleeding and trauma (so that pushes it to Feb 1.) Next his schedule is booked through March, so I asked him if he had any “live case” coming available. For those of you that don’t know, a live case is the live robotic radical prostatectomy performed by Vipul Patel, MD while being fed into the World Robotic Urological Symposium 2009 held in Orlando, FL April 6-9. He told us that he had one available April 6 2009. So we elected to secure that spot on his schedule.

5. We also discussed my past athletic venues, mainly the Athletes For A Cure Triathlon (2008 Orlando, FL) and my upcoming Disney 2009 Marathon (Orlando Jan 11 2009.) He was excited to hear of my involvement and even mentioned that maybe we might work together in unison with some future events. Lastly Dr. Patel shook our hands and said, “See you in three months and come back in good shape.” He doesn’t realize that I will use that as motivation to be in the best shape possible for me, I will treat this next 90 days as if I were training for another endurance event, my most important ever, one that could alter my life and my family’s lives forever.

6. So I guess that makes me a Prostate Model of sorts, either a model prostate or a prostate model.

Here is an excerpt from an email my wife sent her work associates…

“I can't begin to put it all into words, but let's just say, he will, without a doubt, be in the hands of the best the world has to offer! Long story short, his surgery is scheduled for April 6 - the Monday we return from spring break. The World Robotic Urology Symposium will he held in Orlando beginning April 6. Brett's surgery will be the "live case" for the symposium - telecast to the venue for hundreds to see. As it turns out, Dr. Jenkins will also be in attendance and was ecstatic when Brett told him that he was going to be the live case for the symposium. Our next mission will be for Dr. Jenkins to try to find a way for me to sit in on the telecast of Brett's surgery! How darn cool would that be! Patients usually are released from the hospital 24 hours after surgery but are asked to remain in town for at least a week post-op..” Kim Troia Jan 1 2009


  1. Hey there. My surgery with Dr Patel is the 24th March at 0900. Great guy, great team. He was also born in Bradford in the UK and I am a brit who lives in Florida, so we had a lot in common. He said I could attend the conference as I would be a "da vinci" person by then.
    Good luck
    Tim Kingaby (

  2. Brett, Thanks for doing this blog to help fellow friends out. We just found out and had no idea what to do with so many options. A nurse told me that the best is Dr. Patel so we have our first appt on April 15th. Good luck and prayers and positive thoughts to you and your lovely family. Your questions really helped us. T&L

  3. Brett--Ever since you stopped by Publix last week you have been in my thoughts and prayers constantly. You have definately touched my life with a renewed relationship with God. I ask that God's blessing surround you, Kim and the girls.

  4. Thanks for sharing this. I admire your strength and character. Not all men will admit this but you took it as a means of informing others. Good for you.

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