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  1. Melvin-Moderator

    Best Hairline Doctor

    There is no best, but there are several qualified doctors in New York, we recommend Dr. Wesley, Dr. Bernstein, Dr. Feller and Dr. Bloxham. I would at least have a consultation with the aforementioned doctors to gather some expert opinions. Warm regards-Melvin
  2. My partner had a brow lift last year that left him with three noticeable linear scars in his scalp that prevents him from cutting his hair short. He was looking to have this repaired with a FUE procedure, I'm assuming 200 grafts would suffice. Is anyone aware of FUE surgeons that perform small sessions, preferably on the west coast? The only ones I've come across are Dr. Lindsey and Dr. Feller, but that's quite a distance to travel. I had a very successfully surgery with Dr. Diep a few years ago, but he currently has an 8 month wait time for FUE and $5k minimum.
  3. JeanLDD

    What should I do?

    Pull the hair at the hairline back with your hand and take a close up shot, it's impossible to see what's going on even in that front on photo. I agree it doesn't look like a serious issue however. Shock loss is not a risk unless you're implanting into areas of existing hair, I haven't seen a single example of it anywhere and Dr. Feller for one has said the same in a video.
  4. jjsrader

    Dutasteride

    I also had a transplant w/Dr. Feller when I was 37 and began losing alot more hair about 6 years after at age 43. 16 year user of dutasteride here. I do use systemic oral rogaine and spiro (yea, I know - don't go there). As well as overmachogrande.com laser helmet 440 diode and 2X's weekly Nizoral. I think I RIVAL you for very very fine/straight hair. Guys like us literally need 7K in our frontal 1/3rd to have a natural hairline zone that 'appears' to be near normal. Not to mention (if you have the donor) another up to 5-8K for mid-vertex and near the crown. The crown you 'dust' lightly. Since you are new to dut (but an older guy) - I would stick with it even if you are losing ground. Think how much more you would be losing without dut? Sometimes us thin haired/fine hair guys w/very straight hair 'max' out our donor (fut/fue) and even then - we just have to work with what we have and accept it. I still have a couple surgeries left at nearly 9k of grafts done and will probably throw permanent SMP into the mix along w/PRP w/Acell in the next 2 years and that will probably be it for me. Good luck & you have had good surgeons thus far.
  5. It is simply a fact that FUT is still more popular than FUE...by far. In the Tom Hanks movie Apollo 13 Jim Lovell's wife asks why her husband's flight to the moon was not being televised live. The answer that was offered was that NASA "made going to the moon seem like a trip to Pittsburgh ". The same goes for FUT. The success and popularity of FUT has been so well established and proven over the past 20 years that it is taken for granted. There is no excitement in viewing the results of an FUT patient because we have already seen, literally, thousands of them online. Sure, there are variations from doctor to doctor, but by and large the results are predictably good. FUE SEEMS like the "next step", but it has been around for 14 years and it's safe to say that it has failed to launch. What has happened is that the pool of wishful thinkers and uninformed patients has grown and there has been no shortage of clinics willing to service these patients. So the number of patients has grown and thus the number of results online. But if you compare the ratio of successful to unsuccessful procedures FUT wins hands down. And this is for predictable reasons. FUE suffers from three detrimental forces that no doctor, clinic, or innovator has yet to overcome: Compression, Torsion, and Traction. You can add Skeletonization to that list as well. FUT does not suffer from these forces. This illusion of popularity is sparked by the interest of a FEW posters on websites like this one. But it is the very nature of this interest that betrays the weakness of FUE. We are all captivated by the man who walks along a tightrope a hundred stories off the ground. "Will he fall?" Same thing with FUE, but in this case it's "will it grow?" And if it grows "will it be as good as strip"? For all the distortion surrounding FUE one line has not been crossed, and that's the claim that FUE actually grows better than Strip surgery. Thankfully, that hasn't happened...yet. The best FUE can claim is that it grows AS WELL AS STRIP. So why not just get strip?! I'm in the business 20 years and that's what I did. You think I would pick an inferior procedure? Vehement FUE supporters, all of them lay non-doctors, say that FUE has improved over the past 14 years. This is simply NOT TRUE. It is wishful thinking. Nothing about the procedure has changed except for the hype and the number of clinics offering it because patients engage in either wishful thinking or are simply uninformed. NOT A SINGLE FUE DOCTOR HAS COME ONLINE ANYWHERE THAT HAS MADE A CLAIM THAT THEY USE NEW TECHNOLOGY. Only lay, non doctor, unaccountable FUE chest beaters who post anonymously have made this claim. Recently a poster on here made such a claim and I offered to host a three way call between him, me, and the doctor he said made the claim- and then post the call online. He did not take me up on the offer. Instead he made a limp-wristed attack on me and then disappeared. Nothing has changed in the world of FUE. A punch is used to score around a graft causing torsional damage. The graft is then grasped with a forceps causing compression damage, and then finally it is literally RIPPED out of the scalp causing traction damage. Sure, there are new machines to assist in taking out the grafts, but they either cause more damage doing it, or they only mimic (poorly) what an experienced FUE practitioner can do. I won't even go into the ridiculous extra costs these "technologies" involve. FUE has it's place, and in some cases it even has a place in megasessions. But I state without reserve that ANY time you see an FUE result, no matter how good or bad it looks, that same patient would have looked BETTER if he had a strip procedure. Furthermore his prospects for future surgery would be better and his donor area could be used more efficiently. FUE is the "have your cake and eat it to" procedure. And in some cases this may be the case. Such as in the hands of very dedicated and very experienced physician practitioners who carefully screen their patients. However, just scanning this website's chat forums alone I have seen more negative postings from patients who actually underwent FUE than I do positive ones, and precious few posts that involve actual FUE results from patients themselves. What you really see are posts by enthusiastic hopeful patients right after FUE surgery but no actual results posted- even years later. What happened to these FUE patients? While the same thing does happen with FUT from time to time, FUT already enjoys thousands of online megasession before/after photos, whereas FUE hasn't even made it to more than a hundred to two hundred yet...and that's after 14 years! If every doctor who performed a hair transplant surgery tomorrow were to check in on this forum and tell us what HT surgery they performed on that particular day you would find 99.9% would be FUT, not FUE. But you would not know that by reading forums because FUT is old news and unexciting. How many before/after pictures of a 2500 graft case can you look at before you become bored? And it is this very reality that demonstrates the reliability and strength of this procedure. FUE has it's place, but NOT first place, and it never will. Dr. Alan Feller
  6. Personally, I do agree that in average yield of strip is better with strip and in the best case FUE is close. I recommend strip regulary for big cases. But I have a hard time follow this post. What is your message exactly? Europe is bad, US is great? ;-) 1. Every (!) clinic has bad results independent of method (FUE or strip).. Just look at this horrible H&W case recently discussed in here. 2. Which role do Lorenzos hairlines play in this case? I think non and I also think it is not true. Why does Couto and Freitas decimate the Donor? Actually, Couto has a lot of cases online with a great result using low graft counts. Actually, he is praised a little to much for it, cause a lot of patients of his just have thick donor hair due to their heritage. 3. I though every elite Doc has bad results (your word)? So Konior is not elite? Or is he beyond elite? The truth is: Of course he has some bad cases, there are just so few online that you can see them. He himself admitted that every (!) clinic has bad results (explecitely not excluding himself). And yes, I have seen bad results of Keser like I did from everyone else. 4. Interesting point, but actually also the pro-strip brigade (or should I say Dr. Feller) has no scientific data to back up that strip is superior. We had this discussion on literally 300 pages. And even Feller and Bloxham did went down like a "led zeppeln" trying to back up their point with data ;-) 5. "The Europeans" again...of course Konior or Diep do not do this. Tell me: Do they just use lower density or are they just superior? What about Canada? Are their clinics Europe like (overhavesting) or US like (flawless) when performing FUE? Keser is actually known for doing more with less in german forums.
  7. I prefer manual. YouTube: "Dr. Feller rotary/suction machines." According to Dr. Feller and many others, motorized FUE may damage grafts.
  8. jjsrader

    Dutasteride

    I have a big head; here's the gory details. Due to avodart, progressively stronger rogaine from 5% up to 30% 2X's per day, hair laser from overmachogrande.com and Nizoral 2% shampoo - I was able to do really well from age 38 w/my surgery w/Dr. Feller for about 6-8 years. Then, my genetics and family history and many years of taking fin, then dut, rogaine 2% then up to 30% 2X's per day and using Nizoral shampoo 2% for many years - my hairloss accelerated again after about 8 years from my strip surgery w/Dr. Feller. I don't have a bald spot nor any areas where hair is not growing - but I would like to maximize my results. At 18 months out from my last surgery I'll do another one and then a year or so after that I'll have my final surgeries, which will be FUE. At that point, w/permanent micropigment from Mark Weston somewhere in between these surgeries I'll be done. I always knew that I would do anything in my power to not be bald and from the outset I was prepared for many surgeries if necessary. Unfortunately, aggressive baldness w/a family history of almost everyone balding is not very good. This type of balding is a progressive illness and requires follow-up surgeries if you are committed to not being bald (and alot of medicine and treatments as well). Again - I don't even recommend surgery to anyone w/early balding or poor hair quality (thin/fine hair) or family history that is stacked against them; it's a truly personal decision. If I could go back and do it again knowing what I know now - I would have gone bald w/a bit of grace and dignity. Age 24 - two strips a month apart from Dr. Matt Leavitt (100 & 120 grafts respectively). This was the OLD days of strip removal. Small scars but they were micrografts of 2-8 hairs. Age 27 - One strip from Dr. Pomerantz 400 grafts. Again micrografts. Age 28 - Another strip from Dr. Pomerantz - 700 grafts. Again micrografts Age 38 - A strip from Dr. Feller - 2250 grafts. Follicular units dissected under microscopes. Age 50 - A strip from Dr. Soni - 4500 grafts. Follicular units dissected under microscopes. Age 50 - (same day from Dr. Soni) - 500 FUE
  9. Just over one year on the temple points/forelock/temple corners HT performed by Dr. Feller. The hair is still a bit unruly but I'm expecting it to calm down in the coming months. Overall I am very happy. I think one more strip would close to fully restore me, but I need to take a break from surgery for awhile. (SMP is in the future to address a few areas, though.)
  10. home1212

    Feller and Bloxham Posts

    My first in person HT consult was with Dr. Feller because of his reputation and the fact that he was in my backyard. I think he's a top notch surgeon and agree with most of his arguments in the FUT vs FUE debate. Unfortunately, I think he overly discounts patients' real choice and option in wanting to undergo a less invasive procedure with FUE. At least that was the case for me, I did not want a strip scar from ear to ear. I chose to undergo 3 smaller FUE procedures spread out over time that were less invasive and quicker healing time to get back to work and other activities. Hasson & Wong are now doing FUE if a patient so choses, I hope Feller & Bloxham embrace that option for patients as well.
  11. wylie

    Feller and Bloxham Posts

    I agree, I liked Dr. Feller, he is an honest, straightforward poster on here and he won't BS you. While most now disagree with his viewpoint on FUE, he is still a valuable contributor to the forum and always interesting to read. I would hope they decide to resume posting again.
  12. Gasthoerer

    Feller and Bloxham Posts

    There were several threads, cause some had to be closed by the forum supervisors. Feller and Bloxham dissappeared shortly after the results from Dr. Vories were presented with > 90 % growth rate for a small FUE test case (even FUE into scar tissue). Bloxham said that he expected this results as it was small procedure and by that totally contradicted the story of his partner Feller ("3 forced which cannot be overcome"). That was basically the start of the end of this debate... In general: I always like when clinics offer their advice in here. And I also gave F&B credit for that, but (and this is a big BUT) if you speak with superior authority (and this is what Feller always claimed for himself) you have also superior responsiblilty and have to care even more about the facts. Feller and Bloxham gave completely false numbers several times, they miscalculated numbers (inentionally or untinentionally) or used poor research as the only source. They also did not (!) answer questions which were asked by several users including other clinics. In my opinion, it is correct that people call them out for that. P.S. I still believe that F&B is a good clinic and even recommended people to have FUT there over FUE somewhere else.
  13. matt3480

    Feller and Bloxham Posts

    Agreed, extremely poor marketing on Feller’s part.....and not so much even for the lack of professionalism but rather the blatant disregard of current trends in FUE. I’ve had 5,000 or so grafts removed via FUE at this point and you just simply can’t tell in the donor....so it just makes Feller seem like an absolute nut job when I read that stuff. Jury is still out on Dr. Bloxham.....and I think Dr. Nadimi is head and shoulders the best younger surgeon right now. Looking at who each studied under says a lot, too. I am hoping Dr. Bloxham is just getting some experience from Feller and then going out on his own because I don’t believe being associated with Feller is ultimately going to be good for his reputation.
  14. Over the past few years that Dr. Steve Gabel has been recommended on the Hair Transplant Network, I have gotten to know him and his ultra refined work. I have come to regard him as being highly ethical and a likable straight shooter who works hard to provide his patients with excellent results at modest cost. So I was not surprised to find while visiting his clinic that he and his staffs' truly ultra refined hair transplant procedure was outstanding from start to finish. I also had the opportunity to see a few of his patient in person and their results were very natural. These patients were very pleased with their results and their entire experience. To view their before and after photos visit http://hair-restoration-info.com/eve/forums?a=albumtopi...1037353&f=2091043751 I was very impressed with the great attention to detail and care that Dr. Gabel and his staff showed at every step of the procedure. Dr. Gabel took ample time to carefully remove the donor strip in sections in order to avoid follicle transection (severing follicles) and any damage to the underlying tissue, blood vessels and nerves. He adopted this careful donor strip removal from the expert surgeon Dr. Ray Konior of Chicago. Dr. Gabel then performed a trichophytic closure that included using subcutaneous sutures (internal sutures in the tissue under the skin). These internal sutures pull the underlying tissues beneath the skin together so that the second external running suture simply closes the skin with minimal tension. Since tension is a leading factor in scarring, the low tension on the scalp's skin consistently produces pencil thin donor scars. His donor removal and closure on average takes almost a full hour. Dr. Gabel's strong prior surgical background is evident in his skilled donor removal and closure. In my opinion, the combination of internal and external sutures is optimal for both minimizing scarring and potential patient discomfort. On the day of my visit the patient had very good donor laxity and Dr. Gabel was able to remove a strip from ear to ear that was as wide as 1.75 centimeter at the back of the head and tapering to 1.3cm on the sides. This donor tissue was carefully trimmed by Dr. Gabel's experienced staff under microscopes. The quality and refinement of the grafts appeared to be excellent. His staff is capable of trimming and placing over 4,000 follicular unit grafts during a single session. Patient did not want to shave his recipient area so the hairs in this area where left long. Dr. Gabel chose to make the graft incisions in and around this existing hair sagitally (parallel to the underlying hair follicles) so as to minimize trauma and transection of these existing follicles. Dr. Gable credits much of minimally invasive incision technique and careful graft orientation to Dr. Alan Feller, who mentored and encouraged him to perform a truly cutting edge procedure from day one of his career. However in the areas without pre-existing hair he made lateral incisions (incisions perpendicular to the angle of the hairs normal growth) using tiny custom cut blades. In general Dr. Gabel prefers to make lateral (perpendicular) incisions. He is very meticulous about controlling the angle and direction of the incisions so that they replicate the natural direction and pattern of the hairs. He used blades as small as 0.70 to create incisions for the single hair grafts and 0.90 for the three and four hair grafts. Dr. Gabel is very hands on and typically places many of the grafts along with his staff. In the surgery I observed the patient received 3,203 grafts in both his frontal hairline area, temporal points and crown for a total of 6,519 FUs (594 singles, 2274 doubles, 323 triples and 12 four hair grafts). The surgery began at 7:30 am and was completed at 7:00 Pm. In my opinion, this surgery exemplified high quality ultra refined follicular unit hair transplantation. To learn more about Dr. Gabel view his recommendation page at http://www.hairtransplantnetwork.com/Consult-a-Physician/Doctors.asp?DrID=633
  15. We know people are busy; we also know people like to view hair transplant results. To try and help, we started a video series called "Quick Vids." And it is exactly what it sounds like: a quick run through of a hair transplant result, only requiring a minute or less of your finite time. Here is a "Quick Vid" of a 2,500 graft hair transplant I performed on a patient 9 months prior: Thanks for viewing and commenting, Dr. Blake Bloxham Feller & Bloxham Medical, PC
  16. Almost daily, I see patients with thinning in both the "back" and "front" of the scalp. And while many of these patients tell me the back bothers them the most and they would prefer to do "everything" in one shot or focus on restoring the back first, I almost universally advise them to focus on the front "half" of the scalp first. This is for a few reasons: 1) Because it is a more visible and cosmetically significant region. 2) A full front with a thinning back is a pattern found in nature and, therefore, looks natural regardless of whether the patient has a second procedure to address the "back." 3) Because the back frequently appears fuller and the overall appearance of the ENTIRE scalp looks fuller when the front is done. And reason 3 is where today's patient comes into play: The patient is a male in his 30's with NW VI patterned hair loss. The front is more pronounced than the back, and he's consistent with daily minoxidil usage in the "back" region. I had the above conversation with him and despite reservations about not addressing the back during the first surgery, he understood "point 3" and trusted that everything would look thicker. Here is how he looked 6 months after a 3,000 graft transplant. Now, these are not the best "apples to apples" comparison pictures here. Obviously his hair is combed back in the befores and down in the afters. But this is the point of the presentation: he was unable to comb his hair how he wanted before (down) because there was a lack of hair in the front and the thinner hair in the back looked like a "comb over" when he tried to swoop everything down. Now with 3,000 grafts in the front, he's able to "bring it all together" and create a thicker, fuller look in the entire scalp despite having no transplants in the back whatsoever. So, if you have thinning throughout the whole scalp and are somewhat worried about the doctor's recommendation to start with the front first, remember the thickening effect that a single transplant in the frontal half can have. This patient will continue to see how the back holds up on minoxidil and possibly do a second procedure to address the mid-scalp and crown thinning in the future. He will return at 12 months for a fully matured evaluation. Thanks for viewing, Dr Blake Bloxham Feller & Bloxham Medical, PC
  17. Dr. Feller ?hh Dr. Lindsey, this is not (!) a good case to promote FUT vs. FUE. This is just a case of a repair from a butcher clinic. To give the impression that this is a FUE "Problem" you sell yourself cheap. Sorry, I like your work, but this needs to be said.
  18. Today's patient is a male with fairly classic thinning in the hairline/frontal band and "fronto-temporal corners" regions. Based upon his hair type, pattern and likely progression, I agreed with his request for a strong, defined hairline, a thick rebuild of the frontal band region, and some "corner closure" -- not something I do on everyone. Presented are the 7 month results of his surgery. While I shared a few key images here, I highly recommend watching the video. The video contains more pre-op, immediate post-op, and "after" images, and it also includes dry hair video and wet comb-through video. The wet comb-through is my favorite because if a hair transplant looks good wet and slicked back, it will look dense and full with pretty much any style. Video: Comparison Pictures (wet and dry): Thanks for viewing and commenting. Dr. Blake Bloxham Feller & Bloxham Medical, PC Hair Transplant & Hair Restoration Services in New York
  19. From time to time, we see a disconnect between hair transplant "expectations" and the "reality" of modern hair transplant surgery. Most of the time online, it seems like patient expectations were outside or above the -- excellent -- reality of hair transplant surgery. However, sometimes in practice, I actually see the opposite; an instance where a patient actually had lower expectations and accepted a less than satisfactory outcome because they thought this was the reality of modern hair transplantation. And I think it is just as important to discuss this because it helps patients understand what they can expect in general. When expectations match reality, patients tend to be happy and achieve good cosmetic outcomes. What's more, by knowing what they should expect from a transplant, otherwise unsuspecting patients reading this thread will hopefully avoid being taken advantage of. The case today is a patient with advanced hair loss -- essentially a NW VI -- who underwent an FUT procedure in India. The doctor recommended doing a 2,600 graft "mega session" to rebuild a "dense pack" frontal band and do some fill behind to create a smooth transition in the mid-scalp. The patient liked the plan and moved forward. Here's how he looked 12 months after that procedure: As members of this forum know, this result is not an accurate representation of the reality of a modern mega session with dense packing. But when the patient presented for the consultation, he was under the impression that this type of result was the norm. I informed him that his expectations did not match the reality of what hair transplant surgery can offer. And I recommended proving this to him by essentially doing precisely what the first clinic claimed: a 2,600 graft mega session with a dense packed frontal band and a strategic mid-scalp fill that transitioned into his open crown. Here's how he looked 12 months after the surgery at our clinic: Now I believe this is a realistic representation of what a modern hair transplant mega session with dense packing via FUT should look like. And while the final result may have benefited slightly from the existing grafts (which, for whatever reason, did not amount of what 2,600 grafts should look like), I still think this is about right. Always keep in mind that results will vary, but this is something I would feel comfortable showing to the average patient to help create realistic expectations. I'm happy to report that this patient is very pleased with where he is at now. I recently did 1 more FUT (this is when the "after" pictures were taken) to fill a little more in the posterior mid-scalp and anterior crown (which is what the patient actually thought he wanted to do originally before understanding how much thicker the front could look). He's likely stripped out now and will probably return in the future for some FUE to finish up. Hope this presentation is helpful to those researching HTs and wondering what they can expect. Here are some comparison shots: Dr. Blake Bloxham Feller & Bloxham Medical, PC
  20. One of the most common requests I receive at the office is: "Doc, I want to cover 'everything.'" In other words, patients want to try and cover from hairline to full crown in one procedure. And while this is possible for some patients -- and I have done it before -- it's usually not the best/most realistic approach for most. Instead, I usually tell patients the best way to really knock "everything" out is in two procedures: one FUT mega-session to rebuild the hairline, densely pack the frontal scalp, and strategically fill the mid-scalp (past the "horizon"); and a second FUT to really do the crown correctly and feather up into the mid-scalp. I particularly like doing this method because a true "crown surgery" really deserves it's own day and a good graft number. I've also found that the FUT scar usually heals roughly the same between surgery 1 and 2, so you get total coverage with very minimal damage in the back and lots of donor left to address any issues in the future -- including some non-strip surgery to camouflage the scar further if the patient wants to go shorter on the sides later on. And that's precisely what this patient did: The patient is a male in his 50's with advanced NW level V-VI hair loss. We planned for two FUT procedures as described above. The first was a 3,200 graft HT aimed at the frontal and mid-scalp. Here are his results from that surgery: And here are his immediate post-operate results from the second surgery -- 2,000 grafts to the crown: And here is a video with more pictures, explanations, and some detailed "comb-through" footage. I highly encourage all members to watch: Thanks for reading. Look forward to comments and questions. Dr. Blake Bloxham Feller & Bloxham Medical, PC
  21. had an FUT with Bloxham (Dr. Feller's partner) 4 months ago and i'm seeing solid growth so far, couldn't be happier. I echo the other guys, from what i've seen of Huebner it ain't pretty.
  22. Read and look at what HTSoon posted to you. It's already been stated why he's a bad choice. He's a highly competent marketer but he isn't performing follicular unit transplantation in the sense that hairs naturally occur in the scalp like all modern hair transplant surgeons should be doing to achieve natural results. People with experience are telling you to avoid him for a reason, this isn't the time to blindly follow your impulses or fall for marketing and pathetic TV advertising like on Dr. Oz (who you yourself admit doesn't have a great reputation). And yes Dr. Feller would be a much better choice, or Dr. Bloxham at his clinic.
  23. C'mon dude! If you do in-depth investigations into hair transplant history you will NOT let him operate on you. I can't be any clearer. Dr. Feller is top notch and in the biz for over 20 years. Frankly, you seem resistant to other suggestions of top USA FUT surgeons except for Huebner. Man oh man - can some other posters get in here and show him the light? Frankly, if this is your last 'strip' surgery - consult w/Hasson and Wong. They are known for great yield and consistently have the largest sessions of FUT surgery docs in N. America. Their techs are consistently rated A+.
  24. Click my profile pic to see my present condition. I'll check out Feller more carefully, but it seems like there's some real dissatisfaction with his results and demeanor. This concerns me. I still don't understand why you object to Dr. Huebner. I've been researching him and so far he's looking like an excellent practioner. His density pix seem impressive, and his reviews from past patient reviews are extremely high.
  25. Hi, Please cross Huebner from your list. Don't go down that path. I had 2250 FUT/FUSS transplant from Dr. Feller in 2004. He is a bit conservative w/his strip size; completely competent & his staff is excellent. He's a top- tier strip surgeon in the USA. Down to earth, modest office complex in Great Neck & doesn't put on airs. A doctor who treats each patient w/care and attention to detail. Good pre-op discussion and realistic expectations. He's had work done so he also knows what it is like to be a hairloss sufferer as well. I don't care for flying into Long Island and the traffic - other than that. No problems. He has alot of older videos on youtube he posted from his car and house and basically discusses all kinds of stuff I found pretty interesting - even though I'm older and had my first surgery in '91.
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