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Bigben
Sorry to hear about this.  Is it possible to have a tiny piece of the white section biopsied and examined by a pathologist.  Perhaps it is melted pmma and needs to be excised ?  But if not, it seems like it would be better off to leave it be longer in hopes it will heal.  I hope it is not painful.
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Skeptical One
@Restoration

Sorry about your ordeal but don't let that prevent you from attending social functions. You can always politely turn down sex, or at the very least, exchange numbers in hopes of a future hook up when all is well. And social interaction shouldn't be solely for the pursuit of hookups... you could also make some new friends & network as you go. You can do all of this and address your situation in your downtime. The sex-is-everything attitude isn't a healthy one, try not dismissing your summer, fall & winter over it. With patience & informed decision making, I'm confident you'll have this seen through. Till then, find things to occupy your mind with, including social outings, etc.


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Restoration
Yeah I probably overstated that a little. I am not in some orgy lifestyle or something, but it just sucks that I always feel like I can't be 100% at a lot of things.  I have plenty of boring social events that I can go to - but I just feel like the summer is going by fast.

They didn't want to biopsy anything.  My urologist just wants to redo it, in the surgery center, with IV sedation - which I thought was nuts... so I talked them out of sedation, but they can use local. 

The next opening isn't for a while- though they have a very long cancellation policy.  I was hoping I could wait and see how it healed and then cancel if it healed...though i can't with the cancellation policy.  Also, the tissue is rock hard - worse than the nodule ever was...so maybe if he cuts that part out - that's the only way it can become normal.  I'm not sure.  The other areas are slightly firm like new scars are, but not like this.

I need to ask him if he's going to cauterize it - I totally forgot.  I think that is part of what led to this problem, though it's just a guess.  He really thinks it is the pmma in the skin that is preventing it from closing.

Oh it's not painful at all.  It's sort of lacks any sensation in that yellow area...the border is a little sore. 

Part 1:  The first year - recovering 1/2" girth lost to Peyronie's Disease (Round 1 & 2 Metacrill PMMA)
Part 2:  Things starting to go bad (I had nodules removed and excisions wouldn't heal)  (After Round 3)
Part 3: Resolving Round 3 problems caused entirely by USA doctors.
Part 4: All PMMA (from all 3 rounds) hardened 6-12 months after round 3.

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coolhandluke
General anesthesia is crazy, just so they could bill your insurance company! Lido & Epi the min. for a localized procedure or Fentanyl or versed for conscious sedation (not together) if need be.
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hoddle10
Surely the PMMA would aid the healing and closure. Isn't that how they discovered it's cosmetic application in the first place?
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Restoration
They were saying versed... but I was like no way.  When I was at the derm a 25 year old nurse injected the lidocaine before the doctor even came in. And, they didn't even know how to do a ring block.  They just injected the nodule. It was perfectly fine.  Besides, am the one who cut out the other nodule (that healed already) and I injected it on my damn sofa.  I stole some sterile drapes and various surgical tools, but there's not really much pain involved.  I used a tiny amount of lido/epi.  Tiny.

I think surgeons like unconscious patients, so you can't move or bother them or talk.  And, it's very rote - he can do 5 cases in a day - all are prepped, shaved, cleaned, sedated, and the tools are laid out.  He just comes in - does his thing - walks out. 

I've got a week to see if it will continue to heal...though - and I just really want to avoid it.  The only thing is that if it never healed in 7 weeks, maybe it just can't.  And I could wait until November to have some weird scar there - but then I'll probably want that revised.

Hoddle - PMMA was used on bones, as a paste - to keep bones together after fractures.  I know of a cosmetic use where it was placed in the temples before we had all these fillers that we have now.  The surgeon I know used to do a full coronal incision - ear to ear -  (usually this was during a brow lift) and lift the brows and then fill in the temples with PMMA (100%) - and he mentioned he's used it in a number of applications because the off-the-shelf implants don't always solve the cosmetic issue.  PMMA in its bone-paste form has been very popular for a long time.  When it gets in the soft tissue, I think it's perfectly safe - but the cautery was not good. That's my thought & someone else agreed who I work with...I have to find that article from Italy that says the temperature the doctor uses to melt pmma.  I think it's below the cautery temp.  I actually might send that doctor an email because he uses pmma so much (from its original days), he might know a little more... ooo good idea...

Part 1:  The first year - recovering 1/2" girth lost to Peyronie's Disease (Round 1 & 2 Metacrill PMMA)
Part 2:  Things starting to go bad (I had nodules removed and excisions wouldn't heal)  (After Round 3)
Part 3: Resolving Round 3 problems caused entirely by USA doctors.
Part 4: All PMMA (from all 3 rounds) hardened 6-12 months after round 3.

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hoddle10
Restoration wrote:


Hoddle - PMMA was used on bones, as a paste - to keep bones together after fractures.  I know of a cosmetic use where it was placed in the temples before we had all these fillers that we have now.  The surgeon I know used to do a full coronal incision - ear to ear -  (usually this was during a brow lift) and lift the brows and then fill in the temples with PMMA (100%) - and he mentioned he's used it in a number of applications because the off-the-shelf implants don't always solve the cosmetic issue.  PMMA in its bone-paste form has been very popular for a long time.  When it gets in the soft tissue, I think it's perfectly safe - but the cautery was not good. That's my thought & someone else agreed who I work with...I have to find that article from Italy that says the temperature the doctor uses to melt pmma.  I think it's below the cautery temp.  I actually might send that doctor an email because he uses pmma so much (from its original days), he might know a little more... ooo good idea...


I was referring to the fighter pilots in WW2 and how their wounds healed so well when shattered plexi-glass, from the cockpit windows cut up their faces. That's where the idea of it having potential as a cosmetic filler comes from. 
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Restoration
Oh - did it actually help wound healing?  All I could find is that the doctor who discovered it noticed it didn't cause the same adverse immune reactions as glass... so it was basically considered safe as an implant.  This is what I could find on that:

https://en.wikipedia.org/wiki/Harold_Ridley_(ophthalmologist)

They may send the excised tissue again to pathology and I'll have an opportunity to learn if there was pmma in there or if my body just won't close the wound. I've never had anything like this anywhere on my body before though. It's just really odd. 

Part 1:  The first year - recovering 1/2" girth lost to Peyronie's Disease (Round 1 & 2 Metacrill PMMA)
Part 2:  Things starting to go bad (I had nodules removed and excisions wouldn't heal)  (After Round 3)
Part 3: Resolving Round 3 problems caused entirely by USA doctors.
Part 4: All PMMA (from all 3 rounds) hardened 6-12 months after round 3.

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Bigben
There was a dr in Italy who used a laser to melt the pmma and remove it from ladies who had it their butts and suffered from complications.   There are also is one in Colombia South America who claimed he could use a laser to heat and suction to remove.  However the reports people posted were not good.  They said the pmma did melt however it formed globs that could only be removed by open surgery.  This was on one of the spanish forums and I read it several years ago so my memory is not too clear on details.   So I could see how the cautery could easily do the same thing and is best avoided.   I guess the good news is that is this white section is pmma you should heal fine once it is excised.  Why don't you contact Dr Lemperle in San Diego ?  He knows more about pmma complications than anyone.  It is a small area right at the surface.  He might know of  a solution that would avoid surgery.
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Restoration
Thanks.  That's a good idea.   In the meantime, I emailed that plastic surgeon who used PMMA forever as bone paste... he might not have any idea what I'm talking about - but it was worth a shot.

I definitely don't want to go through this if it is unnecessary and will cause more scarring and delayed healing... BUT if it is the only way to close the thing - then I'm totally on board.   Other incisions are looking better every day.  Celacyn really flattened them out fast. So, that's good at least...but this open one is just nuts.

Part 1:  The first year - recovering 1/2" girth lost to Peyronie's Disease (Round 1 & 2 Metacrill PMMA)
Part 2:  Things starting to go bad (I had nodules removed and excisions wouldn't heal)  (After Round 3)
Part 3: Resolving Round 3 problems caused entirely by USA doctors.
Part 4: All PMMA (from all 3 rounds) hardened 6-12 months after round 3.

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Restoration
Dr. Lemperle thinks it is a biofilm infection.  The other plastic surgeon who used PMMA also thought there was an infection.  The biofilm makes more sense due to the lack of swelling and pain...and the fact the PMMA was melted with the cautery and was just sitting there waiting to be colonized.  Biofilms are extremely hard to treat since they are usually made up of many bacteria and they are resistant to oral antibiotics (usually).  They also prevent wounds from closing - and a few pics I found online look pretty much the same as this.  

Part 1:  The first year - recovering 1/2" girth lost to Peyronie's Disease (Round 1 & 2 Metacrill PMMA)
Part 2:  Things starting to go bad (I had nodules removed and excisions wouldn't heal)  (After Round 3)
Part 3: Resolving Round 3 problems caused entirely by USA doctors.
Part 4: All PMMA (from all 3 rounds) hardened 6-12 months after round 3.

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brunoxxx
Did he have a suggestion for treatment?
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Restoration
Yeah, he said to biopsy some of it and then see what antibiotic would work against it.  Then, take it out surgically, and administer the right antibiotic locally - not orally.

The only problem is that I don't know who can do that.  The doctor I asked said it takes up to 3 weeks to get the results...and I'd probably get a dozen bacteria that aren't even the problem.  It's almost academic to do something like that.  I have to contact a wound care specialist, because I just don't think my derm does this.  Wound care people do. Also, it's not done by culture. It's done by DNA analysis.  Dr. Lemperle said, also, it cannot be done by culture.  

So...given the hurdles, it may make more sense to take it out and saturate the area with betadine or something that is known to destroy biofilm structures...and oral zithromax disrupts internal signaling within biofilms.   There are no drugs specifically for biofilms because they are basically colonies of multiple bacteria working together.  

Then, if the area is left open for a day or two while it drains, it can be closed again with deep, buried sutures so there's no space for anything else to colonize...last time it was closed with superficial simple sutures which didn't hold the wound and allowed it to reopen.  This last part isn't Lemperle's thought - just mine.  He also said that the cautery would melt the PMMA into a hard spot since it melts at 150c.

He was very helpful and optimistic & friendly.  I really appreciate his reply.

Part 1:  The first year - recovering 1/2" girth lost to Peyronie's Disease (Round 1 & 2 Metacrill PMMA)
Part 2:  Things starting to go bad (I had nodules removed and excisions wouldn't heal)  (After Round 3)
Part 3: Resolving Round 3 problems caused entirely by USA doctors.
Part 4: All PMMA (from all 3 rounds) hardened 6-12 months after round 3.

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Bigben
I am glad you were able to contact Dr Lemperle.  Not sure if this will help but guys who get internal penis pumps sometimes develop biofilm infections.  You might want to check one of those forums to see if they have any advice.    Is it possible the pmma became contaminated with bacteria before or during injection and this is what caused the other nodules you had as well ?   Hope you find a speedy resolution.
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Thinthin
I must say its just pure irresponsibility from dr c and its really unethical why he refuse to treat you ? And im sure you not the only one its seems that once a patient begins to develop problems they are trying to avoid responsibility and they also trying to put the blame on you i think everyone here should do something about it and to let dr c know and peoples not need to afraid to ask questions and to complain the dr about how his runnig things in his clinic and how is allegedly refuse to service a "problematic " patient .. For all of those that have a good relationship with the doctor and care about others please let him know its just not possible
He continue like that only because he had kind of monopoly on this market and we all just keep quiet to his " mercy"
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