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I went to Turkey so what I am going to write about here is lengthy, I wanted to have the surgery performed by Dr. ‘X’ (I don’t want to use his name for legal reasons). The doctor’s team seems very well trained but clearly they were not well organized. They failed to discuss the procedure with me, despite promises over the phone telling me what I was going to get. In the US, they have an informed consent process, this was missing in my pre-surgical meetings, They treat me like McDonald’s serves its hamburgers, not as a patient.

I has my first surgery when I was 29. A local doctors promised me between 2500-3000 grafts, started losing my hair at an early age. When I was 31 I had a FUT surgery with a local doctor who promised 2500-3000 grafts. After the surgery I had a great deal of pain and only received about 600 grafts even though I paid for many more. The experience was so bad, I started to weard a hair system.all of the time or if I took it off, I always had a hat on my head,

I first contacted Dr. X and told him of my terrible experience with my first surgery, I sent him pictures of me without the hair system system on so he could see what I looked like. He told me that I was a Class 7 patient and over the phone, he told me that I was an excellent candidate for the surgery. I thought I had an excellent donor area and told him that it might take two sessions.He told me that he should be able to get 5000 grafts in the first surgery as I have an excellent donor area. I was very skeptical about the number of grafts as many other clinics were telling me that I would get only around 3000 or so grafts. I read other patient reports about Dr. X and they were good. Dr. X was one of the more expensive doctors so I felt that paying a little more would get me a great experience. He also promised me more grafts than any other doctor had promised me.

I slowly worked out the days for the surgery. Someone told me to avoid a Sunday as the clinic often understaffed or closed on Sundays.

My wife and I were met at the airport by a driver. He was very friendly and provided some information about the area and some places to visit before the surgery. He didn’t know what time I would be picked up the next day for surgery but said the the doctor’s office would contact me at the hotel in the morning. Even though they knew that my wife was visiting with me, they only provided me with a single bed. After a few minutes, they corrected that.

Things started to get disorganized on Monday. I wasn’t contacted by anyone from the clinic qme by 11:30, still no word about my surgery. They finally called me and told me that they would pick me up at 2:30. I was already getting nervous about the surgery because of my last surgery in the US. Now I had to wait until the afternoon and I did not know ehnen they would actually come for me. They did tell me that they were very, very busy. The driver came an hour earlier than they told me to be ready. The clinic was close to the hotel.

 

When I arrived, I was asked for immediate payment, I wanted to have a consult with Dr. X first to review and make sure that everything was acceptable. I paid the fee and was then brought to see the doctor.

He told me that because some of his patients missed flight in, they were working hard to keep up with the surgery load that day. I was worried that the people performing the surgeries working for that many hours on so many patients in one day, might be too tired. Would I get their undivided attention? Should I move the surgery to another day when the staff was not so overworked? The doctor told me that his staff would be fine and that they do this many surgeries every day. He told that some patients were only getting smaller, 2000 graft procedures, and as mine would be a larger procedure, they would have more time to work on me. He then told me that my surgery would be for only 3000 grafts and would be very fast. When I reminded him that he said he should be able to do 5000 he said that my donor area wasn’t that good and that I had limits on the number of grafts. This is an exact opposite of what he said in emails to me. I pushed the point and he said he would have to see what he could do as I had short hair and it was hard to tell. “Don’t worry”, he said. most people require 2 surgeries anyway. He traced his standard hairline on my head and I did not like it. I wanted it narrower. I asked if it would not make more sense to narrow the hairline coming forward so we could provide thicker density and more coverage in the rear. He reassured me again that I would be ok, ignoring my ideas on my hairline. Dr. X seemed very rushed and didn’t seem interested in answering any more of my questions other than to say this is what he does. They put me into a gown that was too small for me (I take a large size) and I asked if they had something larger and was told that they didn’t. I was then instructed empty all my pockets into a bag that they gave me and that made me uncomfortable as it included my credit cards and Passport. They also focused in on my cell phone insisting that it must be given over. I said no as my wife was was there and I needed to keep in touch with her. Once I spoke to Dr. X he agreed to let me keep it as long as I didn’t use it during the donor extraction period. They next provided some drugs for me to take. I asked what they were for and they did not understand my question. A lady had to be called in to explain what the drugs were for. They then shaved my head and we moved to another room to see Dr. X. He looked atthe scar from my pervious surgery. When I asked what the story was or if there was any concerns, Dr. X said he was just consulting with his staff. I asked what about and I was told nothing to worry about. As the patient I felt very much like I was in a meat market just being moved from one room to another. I had no feedback to my questions and I felt like it was just going along for the ride.

The Surgery went well. The injections weren’t painful and the gentleman he who preforming them was very good at his job. The extraction team and the implant team (two different teams) were good at their job. Dr. X came near the end of the extractions he told me he was leaving my surgery room and that there wasn’t any issues I was in good hands.

I also had a cocern that there was a complete lack of privacy during the surgery. Even my driver came into the room looking over the results. I was bored through the entire procedure as the only thing I had was Turkish TV and even the position of my chair was such that I could barely see the TV

I didn’t sleep much that night because of the position I was told to stay in. I wasn’t in pain or any discomfort.

The next day at breakfast I ran into several other patients. At 9:30am I was called to say the driver was there for me. I came down and there was 5 of us there. The driver brought us to a midsize car and wanted us all to get in. The driver noticed that it was going to be very tight and said he would be right back for me. I went back into the hotel and ran into another patient who was late getting down. Not sure how the driver planned to fit 6 grown men into a 5 seat midsize car. The driver was back and we were taken back to the clinic. All six of us were gathered in the reception area and this is where they took the dressings of us. We were then all huddled up to Dr. Maral’s office as a group and he provided instructions for post care. Several questions were asked of him and he quickly dismissed them with the statement “he hasn’t seen any need for it and that it was a waste of time”. Again it felt like we were just meat being processed instead of patients.

I asked about the timing for the transfer to the airport and I was told to speak with the driver as he would arrange everything. I spoke with him and he said I would be going with another gentleman as our flights were an hour apart. He was also traveling with his wife and I raised a concern about fitting 4 people plus driver and all their luggage into a midsize vehicle. I was told not to worry about it that it would all fit. I tried to explain that my wife and I had larger size baggage as we were going on to another destination from there. The other gentleman said his wife and him were in the same situation. We were told not to worry about it that it would all be taken care of. I did call the clinic back at the hotel and was told that I needed to send an email. I sent an email explaining my concern. Dr. Maral responded and told me he would arrange separate transfers for us and then went on to say “but please do me a favor and prefer another clinic if you go more sessions? or your price will be 1000000 euro”.

That night I spoke with several of the other patients and they all were promised more grafts then they received and were very unhappy with the communication. One of the gentleman said he was supposed to have his surgery on Saturday but they rescheduled it to Monday and they need to give their staff some time off. Of the 4 other patients I spoke with, all were promised above the 4000 and all received around 3000.

I’m not sure of the end results yet but I’m hoping for the best. I will be looking at a second session in the fall but I can guarantee I will be going with another clinic.

Maybe this was the perfect storm for the clinic and they were overwhelmed but I suspect this was not the case.

PFS patients often don’t follow up with their original doctors (as was the case here). There’s not much of a point really other than to inform the doctor what happened. Sometimes they do and the original doctors downplay the situation, tell the patient it will go away, and when it doesn’t they don’t bother following up. The doctor will often assume the problem went away even though it didn’t. Even worse they say the problems weren’t caused by finasteride and they should seek help from a specialist. Here are just some of the dynamics that play out when patients get PFS. It is getting better now that people are more aware but it is taking far too long and it is all because Merck lied to doctors, the public, and maybe the FDA over 20 years ago.

I never followed up with my original doctor beyond an initial email because he didn’t know any more than what was on the product label. This was over a decade and he probably thinks I’ve recovered. Merck’s warning label basically encouraged doctors to keep patients on the drug because it said side effects discontinued in “most” cases for men who continued the drug and “men who discontinued”. They just lead you to believe it was “all men”.

I make sure to bond with my patients. For example, I will often spend 30-60 minutes with each patient who comes in and it is always free. That establishes a bond between doctor/patient and I believe almost every patient follows up with me because they know that I listen to them.

You used to be a dairy farmer, correct? Is there a difference between dairy cattle and beef cattle? I always assumed they got milk from the females and meat from both males and females.

Can you clarify this? I’m asking b/c if they only use steroid hormones in beef cattle, then drinking milk would presumably be clear from any steroid hormones.

If you are worried about hormones in your milk, you can start with organic food stores and inquire about where they get their milk. I believe you are the same reader that sent me the earlier posted email about how steroids in milk (when used) get broken down by the acid in the stomach so it does not get absorbed into the body (see Growth Hormones in Milk).

From the Wikipedia entry for “cattle” —
Cattle raised for human consumption are called “beef cattle”. Within the beef cattle industry in parts of the United States, the term “beef” (plural “beeves”) is still used in its archaic sense to refer to an animal of either gender. Cows of certain breeds that are kept for the milk they give are called “dairy cows” or “milking cows” (formerly “milch cows” – “milch” was pronounced as “milk”) and their genetics are such that they produce high milk outputs whereas beef cattle are genetically created for their muscle mass.

Male bovine are called bulls (or steers if they are castrated) — and they do not have udders, nor do they produce dairy milk.

He actually may be close to bald, but his cover-up, whatever he used, doesn’t show his reality.

This bald stop, if only 2 weeks old, should be examined by a dermatologist. The dermatologist will look for Exclamation Mark Hairs, which might point to alopecia areata as a diagnosis. Maybe it is possible that you have had this for some time and just noticed it which then could be male pattern balding’s first presentation

I have a question regarding the mechanism of action behind androgenetic alopecia. I see some people saying that we lose hair as males with pattern hair loss because the scalp hairs are more sensitive to DHT in the area of balding (pattern). I also read that some people say that the conversion from test to DHT (via. 5AR) is greater in the scalp tissue than in other body parts. This begs the question: why would you ever need to block DHT in the whole body by using oral meds like fin and dut If the “problematic” test conversion happens in the scalp tissue, then topical dut/fin or a topical anti-androgen should be enough ? Anything I am missing something? Thank you!

Hair loss occurs in males because we carry the genes for hair loss, and our DHT hormones trigger hair loss. The genes are programmed to determine when hair loss starts, but most men get it before age 26. I have seen men develop hair loss as late as in their early 50s, but this is an exception to the rule. If we decided to cut off your testicles, I doubt that you would have hair loss, but that is an extreme approach to reduce the impact of DHT. Topical finasteride goes through the skin and into your body as it gets absorbed through the skin/scalp. You might as well take the oral finasteride. There is a type of liposomal topical finasteride where most of it stays in the scalp, but this is expensive and only covers part of the scalp. If you spread it around the scalp, it raises the cost considerably.