Dr. Just received my Rx for Xiaflex

[jc961]

Ok guys I'm extremely nervous now that this procedure is getting closer. My doctor is experienced in verapamil shots but not the xiaflex shots. I have an appointment in 2 weeks to go over the procedure and shots with him and then try to schedule a time to do it. I have spoken with my insurance and the company that makes Xiaflex to see about maybe switching over to a more skilled doctor, but was told that I would have to go back through the whole process of being approved again. My insurance company said that I probably would not get approved again and that the RX could not just be transferred over to another doctor. Any suggestions? Am I right to be so scared and rethinking this procedure, or do you guys that have had it done think it will be fine? It gives me some comfort reading some of the posts from people who have already had the shots, but at the same time scares the hell out of me seeing some of the side effects! Any info or reassurance would be greatly appreciated.    

[RoyHobbs]

In order for your doctor to administer the shots he would have had to been approved. So he must have received training, correct?

[LWillisjr]

Interesting comment. I'm not convinced that a doctor has to be trained or approved in order to administer a drug.

At most maybe would watch a video and then think he/she was ready to do it. I would be a little concerned about it if it was me.

[Mending the Bend]

I believe that doctors do need to undergo training specifically to administer Xiaflex. My doctor (Mulhall) trained several doctors in the NYC area before they could start treating patients with the drug. I'm not sure if it's an Auxilium thing or an insurance thing, but I'm fairly certain that both clinical efficacy and liability are major issues.

[RoyHobbs]

Yes that's what I was referring to. The FDA approval is conditional- the number of doctors ok'd is small. I'd ask what kind of training your doctor has undergone. I have to believe he feels confident enough to administer the drug otherwise he wouldn't have signed up to be one of the few.

[jc961]

From my understanding (mostly info from the company's website), all they have to do is watch a few video's and take a test. The doctor's assistant told me that the drug rep was bringing him a model to practice on before he could actually give the shots as well. He has done lots of the Verapamill shots which I have heard is pretty much the same technique. Still makes me nervous.

[RoyHobbs]

Yes the lack of experience would make me nervous as well. It's a tough call. I'm not sure I would go through with it if I were in your position. But you know your doctor better than we do. If you think he is competent enough then go through with it. You could also delay the appointment until he's practiced on more patients.

[jc961]

As of now I believe he has 10 patients total he will be performing this procedure on. I have requested to be the 10th! I also told his assistant that I would like the opportunity to speak with the other patients as well ( if they will agree to share their experience with me of course ) before being treated, and in exchange I would be glad to speak to any future patients. I trust his skills as he is one of the top urology surgeons in the SE (specializing in bladder and kidney cancers), I just don't want to be the first he tries a newly released medication on, even though as I said before he has a lot of experience with verapamill. Luckily I've been married for a very long time and my wife says she will stand behind whatever decision I make.