Cleveland Clinic

[elitynski]

I was just reading that Cleveland Clinic was ranked as the #2 hospital for UROLOGY according to US NEWS & WORLD REPORT>

I know that Dr. Shoskes practices there.

Does anyone have any experience or recommendations for this? I am working with a Neuro-Urologist in Chicago but would be willing to look at this clinic down the line - I am particularly pleased with what I read from Dr. Shoskes website.

[webslave]

Dr Shoskes posts here and is welcome to answer this himself. However, I do not believe he treats pelvic muscles and is more likely to put you on conventional treatments (a-blockers, Elavil etc) or perhaps give you his Nanobac Labs anti-"nanobacteria" treatment. It's not sensible to refer people with CP/CPPS, who have failed conventional treatments (antibiotics, a-blockers etc), for further urological investigations without good cause. You in particular would be better off spending the money on something like lap band surgery to reduce your life-shortening 350lbs mass.

[elitynski]

I am actually starting with a bariatric internist this week and will talk to him about lapband surgery. I'm not wild about it - but if it helps with the weight loss then I should pursue this.

[dshoskes]

Dr Shoskes posts here and is welcome to answer this himself. However, I do not believe he treats pelvic muscles and is more likely to put you on conventional treatments (a-blockers, Elavil etc) or perhaps give you his Nanobac Labs anti-"nanobacteria" treatment. It's not sensible to refer people with CP/CPPS, who have failed conventional treatments (antibiotics, a-blockers etc), for further urological investigations without good cause. You in particular would be better off spending the money on something like lap band surgery to reduce your life-shortening 350lbs mass.

That's a very bizarre comment given everything I have published about therapy, including my recent textbook, the information on my web page and my new clinical classification system which for the first time includes pelvic muscle tenderness as a separate diagnostic domain (it is now accepted for publication and as soon as it appears on the Journal's website I will post the details). I don't treat pelvic muscles exclusively because not everyone who comes to see me with a diagnosis of "prostatitis" a) has chronic prostatitis / chronic pelvic pain syndrome and b) has pelvic muscle spasm as a contributing factor. For those that do, we have one of the most experienced group of pelvic physical therapists in the country. I do see many patients who have failed multiple therapies, INCLUDING pelvic PT and we are always looking for novel therapies with evidence of efficacy.

BTW, the US News rankings takes many things into account including reputation, surgical mortality and outcomes.We are very proud of our Urology program which has top experts in every subspecialty of Urology (except acute trauma, which the hospital doesn't treat). I guarantee that US News doesn't take the care of chronic prostatitis / chronic pelvic pain syndrome into account! The program that edged ours out by a few points for #1 (Hopkins) doesn't even have a faculty member with an interest in prostatitis. OTOH, centers with expertise in chronic prostatitis / chronic pelvic pain syndrome don't appear in the top rankings.

[webslave]

I stand corrected, and pleasantly surprised :happy:

[elitynski]

I met with the bariatric internist today and he told me that he would not recommend nor do surgery on me due to my urinary issues. He felt that the weight loss surgery coupled with what I am going through currently would be too traumatic / painful.

On the other hand I've lost another 3 lbs and so that's good. I guess I'll put my efforts into the chronic prostatitis / chronic pelvic pain syndrome realm.

[davioj]

Dr Shoskes, in your view and experience in what percentage of "CPPS" patients that you see pelvic floor muscular issues are the culprit?

[dshoskes]

In my experience, a bit over 50% have pelvic muscle tenderness.

[elitynski]

So is it possible to be a chronic prostatitis / chronic pelvic pain syndrome patient and still not have the pelvic muscle tenderness and simply have LUTS for instance?? I'm a little confused - sorry??

[webslave]

Eric, please read this
viewtopic.php?f=34&t=1778

[timberdoodle]

I've been off this board for quite some time as I had been doing extremely well. Of course the condition struck back about three months ago, and so here I am reading the latest posts.

As far as Cleveland Clinic goes, I saw Dr. Jeannette Potts in Cleveland a couple of years back. She handles chronic prostatitis / chronic pelvic pain syndrome very much the same was as those associated with the Stanford/Wise-Anderson Protocol. I was treated by two PTs at the time who worked on internal and external trigger points. One was named Betsy, who had been to CA and trained with the Stanford team.

I once spoke on the phone to Dr. Wise and told him I was being treated by Dr. Potts, and he spoke very warmly about her.

I agree with Dr. Shoskes that Cleveland Clinic is one of the best places to go for treatment of chronic prostatitis / chronic pelvic pain syndrome in ways consistent with the philosophy of this board.

[superuse]

I'm not sure how important weight loss is for chronic prostatitis / chronic pelvic pain syndrome or luts symptoms. Many will report little correlation between skinny/med/large and problems. (at least maybe for chronic prostatitis / chronic pelvic pain syndrome Luts I don't know). The main factor in chronic prostatitis / chronic pelvic pain syndrome (with all urinary test exclusion) seems to be largely correlated to exercise.

Its hard to lose weight without weighttraining (build calorie eating muscles), Fairly long cardio sessions, (heartbeat >120 beats/min) and gradual caloric restriction, eventually to about 1800-2200 or a bit more. CPPS'sers may have to avoid the exercise, perhaps making for a calorie restriction solely approach which is tough.

Almost all the lapband folks have/may not have a slow metabolism but nothing abnormal. They fail the muscle mass,proper cardio and especially caloric restriction. (many report trouble getting below 3000-3900) a day for lengthly periods, much less down to 2400--1900. This surgery seems wasteful and all sugeries seem to have risk. Some even gain the weight back (although I don't know how with a stomach the size of an egg) Tonsa soda pop and stuff at 20 intervals instead of 3? I don't know.

Proper cardio (about 90mins/day h>120), weighttraining and caloric restriction (enforced) from 3000s to 2000s etc will drop 2-3 pounds/week initially with 1-1/12 after that. For someone very heavy this is obviously a 18-36+ month affair of getting it right. Most can't do it or don't understand the concepts and want it off in 4 months. (with smaller effort and thus the surgery) Failing to even hold below 3000 cal/day with everything else right is a waste of time for most.

Losing weight may not even be your problem (in the case of pain) . Proper diet/fats intake may be much more important at this stage for health.

Good luck
--jjf

So is it possible to be a chronic prostatitis / chronic pelvic pain syndrome patient and still not have the pelvic muscle tenderness and simply have LUTS for instance?? I'm a little confused - sorry??

[timberdoodle]

Just a follow-up to my post recently about Dr. Potts. Just yesterday I received a letter from Cleveland Clinic saying she no longer practices there. The letter said to give Dr. Shoskes a call if you were being treated for prostatitis by Dr. Potts.

I'm sorry to see her go. She was very interesting and compassionate. I came across this website, which is somewhat hilarious documenting what she's up to now:

http://www.doctortango.net/

[webslave]

I don't find the site hilarious, but quite interesting. I think I'd be more inclined to see her as a patient than less after seeing that. I refer you to this page http://www.ercnet.org/speaker/speakers/potts.asp — and especially to the final section "Surrender to Win - Tango Lessons for Stress Management". Pretty profound insights there, and would be useful to most members of this forum.