Disaster

Sorry Barb.....what i meant was that if there is urethral involment at the time of cystecomy the surgeon if he's capable can do an Indiana Pouch on the patient or of course, the ileal conduit(anytime there is urethral involvement the urethra comes out and things change on the OR table..the urethra always comes out with the Indiana anyway)......but once the neo is made i don't know of anyone that can then do the Indiana after the fact..it would use up to much intestine. You really need a Top Notch surgeon to do any correction here and certainly a consult since the cancer is still in the urethra.
Yes the docs i gave you at City of Hope and USC/Norris i thought were within the Kaiser system..just not convenient to San Diego...tho i've actually driven it at 3 in the morning and made it in 2 hrs!!!..can't do that during the day..LOL... I could be wrong...i thought i pulled up a list of sytems within the Kaiser network in California...but my brain is a bit fuzzy. You might call them.
I'll send you those papers in a PM....try to reply again...just answer with anything and then i've got you on my PM list. Sometimes it will kick back but try again and it might work. Thats happened to me a few times.
Pat

I have no words to this disater. My goodness, what a mess. I can only give you my shoulder to lean on Barb and send prayers for your sister.

Dear Pat,
Oh my gosh you are so wonderful! I got your email but when I tried to respond it kicked it back. Yes, I would love you to tell me about papers on diversions and why a neo should never be done when the urethra is involved. If there is any way I can convince Kaiser to pay for an outside specialist I will need all the help I can get. Did I understand you to say that an Indiana CAN be done after a neo? A list of doctors who do that proceedure would be very helpful. I searched out one of your old messages and you mentioned the two Skinner doctors at USC/Norris and about Dr. Wilson at City of Hope. Are these the doctors you thought could do the Indiana after a neo? Thanks to you I'm not feeling so alone anymore. Now, if I can just convince my sister to go for a second opinion. My mind is filled with nothing but trying to help my sweet sister. Even though I am home in Sacramento, if I hear a noise at night, I sometimes call out her name wondering if she is OK. Looks like I may be going back to San Diego. It's a good thing I have such a wonderful and understanding husband. Thanks again, you dear sweet lady, Barb

Barb..here's an excellent article by the late Great Dr. John Stein at USC/Norris.......you'll have to go about 3/4 down to urethral recurrance in a neobladder....
www.cme-ce-summaries.com/urology/ur3105.html
Pat

Pat, All I know is Calif. has so many regulations and doesn't allow it. Go figure. Barb

Gee Barb...whats with second opinions from Cleveland in California?....explain that one to me. Pat