From Lee M.
"There's cancer." The words reverberated in our ears before we had even come to a complete rest in the chairs across the desk from the doctor who had 8 years earlier connected my wife's kidney to my bladder. There is no easy way for a doctor to give bad news and perhaps the direct way is best, but it sure left us wondering about many things. He proceeded to tell us about the four options for newly diagnosed prostate cancer victims. Do nothing, hormone therapy, radiation and surgical removal. The first he dismissed categorically because, even though it was found to be the slowly progressing kind and only in a small portion of the gland, he felt at 59 years old I was too young to let nature take its course. Hormone therapy was also rejected because it's usually prescribed as a last resort when other treatment modalities fail. That left radiation or surgery. Neither sounded like something I wanted to undergo. The surgery option has several sub-options of its own: 2 routes of entry with an open incision or something relatively new that he referred to as robotic. Initially I thought that simply meant laparoscopic, but found out later it was much more than that. In any event he did not recommend the robotic approach because, as a kidney transplant patient, my new kidney sits in my lower abdomen and would probably be in the way of the surgical tools used. This technique, known as da Vinci surgery was also not performed by him or at the hospital where he was affiliated. After answering our many questions he sent us on our way with booklets about prostate surgery and how to treat it and to digest the prognosis and decide on a path forward.

As it was determined to be a slow-growing cancer there was no frantic rush to make any decisions too rapidly and for that I was very grateful. It gave me time to consult the Internet, friends, friends of friends, relatives, my other doctors and anyone else who had some knowledge of the disease or knew someone who had undergone the various treatments. During the course of my Internet searching I found out more about the robotic surgery and was very impressed by its accompanying lack of complications, the shorter hospital stay and recovery time and overall appeal. If only it could be done on a kidney transplant recipient like me.

In addition I contacted a second urologist to get another opinion. A long-time friend of mine recommended Dr. Marc Coulton since he had been written up for several years as the top urologist in NJ in New Jersey Monthly Magazine. No! It’s not your most prestigious medical journal, but if that many patients say he's the best, why not give him a try? I called for an appointment, but was told he was away but his partner could see me. I said OK. Dr. Gregg Zimmerman is a young, thorough and extremely understanding physician. He took more time than I would have expected to discuss my case with my wife and me. He gave us the much needed comfort that this was, indeed, nothing that we had to rush into and gave us more information to consider.

During a routine visit to my endocrinologist, I told to him about my situation and he suggested I contact Henry Ford Hospital in Detroit where they had performed more robotic prostatectomy surgeries than any where else and there would be the highest likelihood that they had seen a kidney transplant recipient in the process. Upon returning home that evening I looked them up on the Internet and sent an e-mail to them via their online consult form. I asked if they, in all of robotic surgeries they had performed, had ever done one on a kidney transplant patient. A week or so later I got a response from Dr. Mani Menon saying they had done 3 or 4 such patients and all were successful. My hopes were stirred beyond my wildest expectations and I immediately contacted Dr. Zimmerman. During several additional appointments with him, I observed a keen sense of excitement from him and once even remarked that he seemed a bit of a "cowboy." He very quickly set me straight on that and said he was being extremely careful about the prospect of doing this procedure and was covering all aspects in the best way possible. He again took considerable time to explain everything of what he would be doing and said that the plan would be to insert the camera first and see if my wife's former kidney was in the way or not. If it was, he would immediately stop the robotic procedure and revert to an open one. If not, he would proceed as planned. At no time did I ever get the feeling that my well-being and or quality of life afterwards was not of utmost importance to him.

The procedure was scheduled but I had to have some extra scans done at Saint Claire's Hospital to ensure that everything looked good for the procedure to continue as planned. Again, before the surgery, I met with Dr. Zimmerman who went over those scans very thoroughly with me and explained everything one more time. We were ready.

When I arrived at the hospital on the day of surgery, I was remarkably calm and peaceful. I knew that everything had been done with purpose and was as well thought out and planned as possible. All contingencies were considered and there was a plan for each of them. As I lay on the gurney in the hallway waiting to be wheeled into the surgical suite I was greeted by Dr. Coulton, who was standing by in case the robotic procedure was halted and he would have to perform the open one. He, too, reassured me that everything was well in hand and that I would be well cared for. After a brief visit with the anesthesiologist I was taken to the operating room where one of the nurses made a point to show me all of the equipment that was there. I'm not sure how they got me in there, how they were going to move about during the procedure or what happened in what order, but the next thing I knew Dr. Zimmerman said, "Let’s go." I was out.

Several hours later, I see my wife was standing over my bed greeting me with a smile. What a wonderful sight. She tells me that everything went according to the original plan and that the robotic procedure was an unqualified success. The next day Dr. Zimmerman comes in beaming and tells me that there were no issues at all and that everything went fine. He is very pleased and excited. Then Dr. Coulton is seeing a patient in the bed next to me and mentions how well everything went as well. Later that day I get the news that I can go home. That is just remarkable. A mere 24 hours earlier I was being operated on and now I'm going home.

Follow up with Dr. Zimmerman has been fantastic and I feel a bit like a celebrity with both Dr. Coulton and he going over and over how well everything went. My nephrologist was also very excited to hear the news because this now opens the door for other kidney transplant recipients for a better treatment.

The staff at Saint Claire's is first rate and I have to recommend the facility to anyone needing medical treatment. I was always treated with respect and never felt like I was afterthought.

No one ever wants to hear the "C" word mentioned, but I have to say, in this case, it was met with kindness and understanding by a top team of professionals who went the extra inch and turned a bad situation into remarkable outcome.