Shadow of the EMpire State

I didn't intend to make another post on this subject, but I recently got a private message from a poster who reminded me that this forum has been rather uncritical of finasteride and its various trade names. It's true: by and large, people here seem to repeat the company line, to wit, that the incidence of sexual dysfunction is very low and that any dysfunction will always abate quickly upon discontinuing the drug. In short, they believe the drug companies. But an ever-increasing amount of evidence suggests that the sexual side effects of this drug are likely greater than admitted and that the resulting dysfunction is often chronic or even permanent. I know that speculation about the safety of finasteride has been around for a while, but there have been two noteworthy changes in recent months. First, the number of reports is growing apace. Second, the stories are now being published by first-rate media outlets including Time Magazine, the Los Angeles Times, CBS, msnbc, etc. Go to google news, type in "propecia" or "finasteride." See what you get. It's not a pretty picture. Of course, I reserve the possibility that this could all be much ado about little, but given the increasing number and quality of these reports, I tend to think not. In fact, I think that we could very well be on the precipice of learning some very disturbing truths about the drug. But in any event, I think people should be aware of these reports when deciding whether to take it. The idea that this is a low-risk medication might not be exactly true. Propecia for Treating Hair Loss: Is it Worth the Risk?

But the proffered explanation here was that the doctor does not return phone call from patients 15 months later because there's no time. There's no excuse for that. No, because the doctor admitted the behavior. Had he denied it, then we'd be left to wonder whether it was true, and contrary experiences like yours might well have made JAG's story less credible. But the doctor admitted--rather defiantly--that he doesn't have time to take phone calls from patients 15 months after the surgery. So credibility isn't an issue here. This is not debatable. When a patient calls you, you call him back. Period. If you found the time to take his money, you can find the time to take his call.

Well, if that's the way you feel, then it seems as if it's less like an "agenda" than an ordinary response to that sort of behavior.

Are you actually suggesting that a patient doesn't have a legitimate expectation of having a phone call returned or that it's appropriate to dismiss the poster's gripe as "internet nonsense"?

OK, but your personal experience really doesn't have anything to do with this particular issue. It's important to isolate the real issue here. The issue is not surgical quality. Nor, contrary to popular opinion, is it the reliability and consistency of communication. After all, sometimes, a person intends to handle a patient/client the right way but instead hires the wrong office people or experiences a personal problem or just plain doesn't know how to run a business very well. Those would all have been relatively benign failings----valid criticisms, yes, but also understandable and malleable. And had he come on here and said, "Look, I really blew it by not taking your call, and I'm sorry," this wouldn't be a big deal. In fact, had he apologized and admitted blame, then this whole matter would be an ordinary quality-control issue, and your personal experience would have had some bearing on things. The problem is that he doesn't appear to see anything wrong with his behavior. In fact, rather than apologize, he gave us a fresh helping of peremptory arrogance. Thus, this isn't a quality-control issue at all. Rather, the whole thing seems to be a product of a deliberate philosophy, and that's the problem.

Click to see the writing on the wall. http://www.google.com/search?hl=en&rlz=1G1GGLQ_ENUS304&=&q=propecia&um=1&ie=UTF-8&tbo=u&tbs=nws:1&source=og&sa=N&tab=wn

It's always disturbing to see this kind of behavior from a doctor because the world still regards medicine as the preeminent patrician calling, and people have come to expect doctors to comport themselves with the social graces befitting their rarefied station in life. Doctors are supposed to be pillars of society and, by extension, above the fray. So when you come across a doctor who engages in puerile, ad hominem bickering with patients, it's very disconcerting.

Good Lord. This response is so manifestly ridiculous and disingenuous that it ought to send off alarm bells in the head of anyone considering Feller. He can't find 15 minutes a month to take a phone call from a patient who's put thousands of dollars in his pocket, but he somehow can find the time to meet with that patient for an extended period if the patient were only to . . . fly across the country to meet him at his office. The needle on the gauge just did a 720.

He's no longer approved here. sic semper hackeris

I think the responses here are a bit misleading. It isn't "just" a matter of Bernstein's price; it's his philosophy and results. He's very, very conservative and circumspect when it comes to hairline design, and in my opinion, his graft estimates are usually way too low. Why pay all that money to go in as a NW4 and come out as a NW 3?

This video is funny. First, he begins by saying, "The redness has gone away" when it obviously hasn't. Then he says that there's "a 'little' scar in the back," which he then reveals to be the width of his head.

It's tough to see how much loss is actually there because the flash emphasizes your scalp. But to answer your question, of course there's hope for you. You have the benefit of time, which is far more valuable than hair. You may have to suffer with the problem for a while, but I think it'll be temporary. Given the ever-improving research on the issue, you'll most likely die with a full head of hair.

Only the very most insecure among them.

Yes, you should. Here's the inference: when you make $2 million a year, hair starts to take a backseat.

Well, I think we can make very educated guesses as to what the final baldness pattern will be. There are no guarantees, of course, but if you're 35-40 and a NW 3A or less, the chances that you'll progress to the upper Norwood levels are actually very small. Should we live our lives to avoid "any" possibility of a negative outcome? I don't think so.

In my experience those are really the only people who should be getting a hair transplant. Once you go beyond NW 3, the chances of achieving a good result decline precipitously.

Take it as a cue.

What's the difference?

His results look amazing in some part because he tends to operate on people without substantial hair loss. If you're a NW 6, there's a 99-percent chance that a hair transplant will make you look ridiculous. Really, if you're anything more than a 3A, you should hold off and wait for the cure.

Here's my suggestion: have your head examined. You are buying SURGERY, not a car or a lamp or a pair of shoes. You DO NOT want a "good deal" when it comes to medical services. You want the best people you can get. Going to a third-world country to have any medical procedure is idiotic. First, you have no idea what their licensure and oversight standards are. Second, if anything goes wrong, you will have almost no recourse.

Why does everyone chit their shorts at the threat of "legal action"? First, a doctor is highly unlikely to sue you---especially if he's being advised by competent counsel. Second, if you're not from his state, he's even less likely to sue you because he's not going to want to appear in your state. Third, if I were a doctor, the last thing I'd want is my testimony and medical records out in public.

That should be the least of your worries. What if your penis doesn't work?

With due respect, this is really irresponsible advice. There have been myriad cases in which the effects did not subside. Just recently, there was a slew of reports indicating that Propecia's sexual side effects may be both far underreported and permanent. Go to google news and type in finasteride. See what you get.

Something stinks here. I just don't know where the smell is coming from.

Medicine and pharmacology move at a glacial pace. Progress is certainly happening, but these things take decades. Baldness is certainly curable, and in time, there will be a cure. But it's not going to be "in the next five years." Or ten. The smallest unit of medical/pharmacological advancement is probably about 20 years.