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Going for Tulsa Pro
I've posted here a few times over the last year and have read most of the posts from others. I was diagnosed in January 2024 through an ultrasound biopsy (it should have been MRI guided), followed by a PSA test CT scan, MRI, and Decipher test. My cancer is not aggressive, but there are three growths in my prostate. My doctors recommended a full ablation, and I’ve decided to go with the Tulsa Procedure at UCLA with Dr. Steven Raman.
I’ve waited until now because I believe Medicare will begin covering the procedure on the 1st. of 2025. Earlier this year, I switched from a Medicare HMO plan (Blue Shield) to Original Medicare with a supplemental plan, where Medicare covers 80% and the supplemental plan pays the remaining 20%. It’s been incredibly difficult to determine whether Medicare will actually cover the procedure, as I’ve received conflicting information. However, I think they will.
I considered going back to an HMO with United Health Plans, which includes UCLA physicians as in-network, but no one could guarantee that they’d cover the procedure either.
Anyway, I thought I’d document this journey. It begins on January 5th, when I’ll check into an Airbnb hotel near the procedure location. This is two days before the procedure. I’ll have to fast those 2 days and completely empty my stomach (I’ll spare you the details). In the best-case scenario, I’ll wake up with a catheter and a “burned out” prostate. I’ll need to wear the catheter for at least two weeks. Hopefully, they'll get it all 🙂
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I agree with Phil. Get another opinion on those lesions. I hope it was a fusion guided biopsy where they targeted those lesions with extra emphasis.
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2 ReactionsThat MRI report is anything BUT negative!! It shows 2 diffuse lesions PIRADS 5 abutting the capsule - you need this looked at and addressed quickly by someone else.
Not to raise the alarm, but the interpretive read of the MRI at the bottom says it all.
Phil
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2 ReactionsSo had my biopsy last week. Urologist office called today. Said results were negative and have another psa in 6 months. Wife is freaking out and I’m feeling like we are being blown off. I don’t want to be a pest or hypochondriac but I’m scared maybe he missed the masses with biopsy gun. MRI showed 2 masses that were PI-RADS 5. I’m gonna load my mri results on here. What do you guys think?
MRI report 4:15:25 (MRI-report-41525-1.pdf)
Contacted HealthChoice today. Said if procedure was not available in state, I can petition them to see if they would cover out of state. Said it is possible they would maybe cover. We will see what happens. Thanks!
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1 ReactionWell, look at HIFU then, that is a possibility and depending on your case, may be far better than surgery. HIFU is similar to TULSA, but a different approach. You really should contact HealthChoice and see if you can do a out of State procedure.
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1 ReactionI managed to come up with the $33k. I sold a couple of cars and am fortunate enough to be able to pay for the procedure.
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1 ReactionThanks. That is what I was afraid of. I have already contacted Oklahoma Proton Center. They will not accept any insurance. Private pay only. We have Healthchoice insurance. I don't think they will pay out of state. Looks like I may be stuck with surgery. Can't come up with the 33k that Oklahoma Proton Center says they need. Thanks again for your input.
If you are Medicare, be certain to understand that most private providers do not accept Medicare due to the reduced coverage paid by Medicare. Private providers also often do not provide a pre-authorization to your insurance either. Be very careful or you may be surprised by the bill. If insurance is an issue, and you are in OKC or close, you could drive to Dallas and use UTSouthwestern.
Well, probably not so much tie the MRI up for four hours as it is the bore on the TULSA PRO MRI is larger than the standard bore of an MRI machine. Most hospitals will not have a MRI with a bore this large. This is necessary due to body position, the UA probe and other devices.
I had the local urologist to refer me to OU. Dr. Stratton is an OU doctor but the procedure was done at Oklahoma Proton Center in Edmund. Everything except the actual procedure is at OU. I'm assuming that the TULSA equipment is located at Ok. Proton Center. The dr. told me that most hospitals don't want to tie up their MRI for 4 hours which was how long the procedure took for me.