Fw: Prostatic massage and ANF protocol
Dr. A. N. Feliciano
empirically. For the past few weeks, we have included Trovan
(trovafloxacin) 400 mg once a day among the antibiotics we have prescribed
empirically. We are impress with the results obtained.
Antonio Novak Feliciano, M.D., F.P.C.S.
Visit my website
http://web.idirect.com/~ino
http://www.qinet.net.user/dr.anf/chronic.htm
----------
> From: dsho...@MY-DEJANEWS.COM
> To:
> Subject: Prostatic massage and ANF protocol
> Date: Tuesday, March 09, 1999 11:34 PM
>
> In article <B0002...@mail.qinet.net>,
> Prostatitis Discussion <PROST...@MAELSTROM.STJOHNS.EDU> wrote:
> >
> > Attach is the suggested protocol in Art. 12 found in my webpage, which
I do
> > not think any NA doctor have followed strictly to the letter.
>
> To be blunt, that is because much of what you have written in this
newsgroup
> and in your articles makes little or no sense to me or any other doctor
whom
> I have spoken to who has read them. I disagree with many of your
statements
> and disagree that much of the literature you quote actually supports your
> views. None of that would matter if your techniques worked in our
patients
> but they don't, as the soon to be published paper by Nickel on the
experience
> of several North Amercian urologists with antibiotics and massage will
show.
> When I tried YOUR EXACT protocol in a number of patients I did not
achieve a
> single cure or even symptomatic improvement. I applaud and commend you
for
> setting it out in sufficient detail for others to try and test;
> reproducibility by others is the cornerstone of scientific research. The
fact
> that it doesn't work means either that the technique is not what you
posted
> or that the patients are different. Your recent posts suggest that it is
> because the patients are different. Fine, great explanation, time to move
on
> to other things for my patients.
>
> >
> > . I feel that we are treating the same disease that you are trying to
> > treat, yet not achieving the same results as I have after more than 30
> > years of research. However your 20 to 40% cure rate is far better than
less
> > than 20% without the massage therapy which is the beginning. I am glad
that
> > at least you are trying your own experiment based on a semblance of my
> > method I was doing 10 years ago, which I have modified to the present
> > protocol.
> >
>
> If I had known your protocol didn't work in North American patients with
> chronic pelvic pain syndrome 3 years ago, it would have saved me a lot of
> wasted clinical time and research. There were lots of clues, including
the
> complete lack of any reputable peer reviewed publications but I tried
> nevertheless. So now we have had to start at square one and develop our
own
> protocols and approaches. We have been successful for a large number of
very
> difficult patients (roughly 67% cured or improved), but much more work
needs
> to be done. 99% of what I do clinically in Urology, Immunology and Organ
> Transplantation is based on the published research and experience of
others
> whom I gladly quote and reference, but in the case of our research in
> prostatitis and the protocols of the NIH study, your articles do not form
> that basis.
>
> >At least doctors are now
> > attempting to standardize the diagnosis during the NIH meeting last
> > November and remove the notorious "prostatodynia" from the
classification.
>
> Yes, it is now called chronic pelvic pain syndrome class IIIb.
>
> I don't mean to be aggressive or argumentative in this public forum, but
I
> feel it is important to once clearly state my position.
>
> Daniel Shoskes MD
> UCLA
> http://www.ben2.ucla.edu/~dshoskes
> Institute for Male Urology
> http://www.urol.com
>
> -----------== Posted via Deja News, The Discussion Network ==----------
> http://www.dejanews.com/ Search, Read, Discuss, or Start Your Own
>
Dr. A. N. Feliciano
----------
> From: Inspector Clouseau <Anonymous...@SEE.COMMENT.HEADER>
> To:
> Subject: Re: Prostatic massage and ANF protocol
> Date: Wednesday, March 10, 1999 12:40 AM
>
> I'm glad to see others are prepared to combat the Manila Microbe
> Monomaniac,
If I am not mistaken, Dr. Shoskes consider chronic prostatitis, bacterial,
based on growth in cultures OR PUS CELLS IN EPS alone to warrant
antibacterial therapy given empirically?. Would the anonymous writer
consider this "Microbe Monomaniac". While the rest of doctors are still
confused with the classification of CP?
Dr. Shoskes wrote;
>I agree that chronic pelvic pain syndromes in men need first >to be
treated as
>due to chronic infection if there is any indication of infection
>(culture) or
>inflammation (white cells) and that using massage along >with antibiotics
>helps more men than do antibiotics alone.
Does he now consider the mere presence of pus cells in EPS a respond to
inflammation due to
infection? or as he stated in the past due to an inflammatory respond not
due to bacteria, if there is no growth in cultures?
Perhaps Dr. Shoskes could also clarify what he consider the number of pus
cell in EPS as significant to be pathological that warrant a
therapeutically trial with antibiotics. Does he still consider a certain
upper limit of pus cells indicating an inflammation due to factors other
than bacteria?
We have presented studies on patients (1 of them published in Digital
Urology Journal - http://duj.com/Article/Hennenfent2/Hennenfect2.html ) to
have an initial pus cell count of 7 on the first drainage, 4 on the
second, and 28 on the third drainage, done daily>.
A. Doble wrote; Prostatitis, 4 recent advances in STD and AIDS, 1991.
There is disagreement over the level at which the EPS leucocyte (pus cells)
count is deemed pathological. Normal individuals possess leucocytes in
their EPS and the range of upper limit of normal varies between 2 cell per
High power field (Andersen & Weller 1979) and 20 cells per high power field
(Drach et al 1978), with other authors suggesting values within this range
(Blacklock & Beavis 1974, Plau et al 1978, Stamey 1980, Schaeffer et al
1981).
Attached is Art. 9 -Diagnosis of Chronic Prostatitis Must be Standardized,
which is the source of confusion among doctors and patients in the
classification and treatment of
chronic prostatitis.
Dr. Shoskes wrote;
<To be blunt, that is because much of what you have written <in this
newsgroup
<and in your articles makes little or no sense to me or any <other doctor
whom
<I have spoken to who has read them. I disagree with many <of your
statements
<and disagree that much of the literature you quote actually <supports your
<views. None of that would matter if your techniques worked <in our
patients.
To be blunt, the protocol you are practicing is one I have replaced years
ago with the current protocol
To be blunt again, many patients and doctors have found sense and logic in
my website and my statements, that even you and some urologist have started
on the massage+antibiotic therapy. The E mail of new members indicates the
same confusion many old member are still suffering and this is because of
their doctor's inability to make sense. The majority of doctors still
cling to the old defunct method of diagnosis and classification, which you
as one of the researchers are making studies to improved and standardized
the classification. The Art. 6 Basic tests in the diagnosis of Genito
urinary Tract infection, which has been in my website for 2 years is now
part of the NIH diagnostic tests that they will conduct on patients. Why is
it that one or two urologists like yourself is so determined to discredit
my work. Is it because I am exposing your confusions at the expense of your
patients?
THIS IS WHAT I AM FIGHTING FOR !!! Once I have achieve this, then it is
time to say good bye, my friends.
dsho...@my-dejanews.com
Prostatitis Discussion <PROST...@MAELSTROM.STJOHNS.EDU> wrote:
> Does he now consider the mere presence of pus cells in EPS a respond to
> inflammation due to
> infection? or as he stated in the past due to an inflammatory respond not
> due to bacteria, if there is no growth in cultures?
You know, this is why I refrain from commenting on your newsgroup posts.
Debate is absolutely futile.
Here is the actual quote from my post of 12/23/1998:
Patients with "nonbacterial chronic prostatitits" have
increased levels of white blood cells in their prostate fluid but do not have
bacteria cultured from that fluid. The 2 possibilities are therefore
that the white cells are responding to a microbial infection that cannot be
cultured or that there is a non-infectious cause for the inflammation.
> To be blunt, the protocol you are practicing is one I have replaced years
> ago with the current protocol
You have no idea what my current protocol is.
>Why is
> it that one or two urologists like yourself is so determined to discredit
> my work. Is it because I am exposing your confusions at the expense of your
> patients?
>
I am not interested in discrediting your work on your patients. I will point
out that I have not found your protocol to work on my patients as you say it
does on your patients. I have also seen American patients who have seen you
at your clinic, were treated, told they were cured and sent home despite
their symptoms being unchanged. Therefore, I also have a different definition
of "cure". I will also point out that I disagree with most of your
conjectures on pathophysiology of symptoms and mechanism of disease. If a
SINGLE North American urologist follows your protocol on the type of patient
I see with long standing prostatitis that has failed multiple previous
therapies and is able to achieve a higher cure rate, I'll be interested.
I want to help my patients with this horrible condition. I don't care whose
protocol I follow or who gets the credit. If you come up with something new
that works, I will be glad to try it.
John Garst
...
> protocol I follow or who gets the credit. If you come up with something new
> that works, I will be glad to try it.
Bravo! Cooperation works best.
John Garst ga...@sunchem.chem.uga.edu
Inspector Clouseau
> If I am not mistaken, Dr. Shoskes considers chronic
> prostatitis, bacterial, based on growth in cultures
> OR PUS CELLS IN EPS alone to warrant antibacterial
> therapy given empirically?. Would the anonymous writer
No, I wouldn't, because Dr Shoskes has acknowledged that Abx have
multiple effects, not only an antimicrobial action. In other words
antibiotics may be helpful whether there is, *OR ISN'T* an ongoing
infection of the prostate. This was clearly demonstrated in patients
with Crohn's disease, where many had huge improvements, better than they
had with steroids, from Abx therapy. And we all know now that Crohn's is
not a microbial disease. You seem to find this a very difficult point
to understand, Dr Feliciano. Secondly, it is probably wise to treat ALL
men presenting with a prostate pain syndrome and negative cultures with
a broad spectrum antibiotic (e.g.. quinolones) as an *initial* strategy.
This eliminates the small chance of an undetected infection, and may
even provide real assistance through anti-inflammatory side-effect.
> Why is it that one or two urologists like yourself
> is so determined to discredit my work.
If I may speak for Dr Shoskes here: I don't believe this is his aim, Dr
Feliciano. Neither is it mine, in all honesty. I'm still not entirely
sure what your motivations are, and what really drives your interest in
this newsgroup and in chronic prostatitis. I simply oppose you for a few
simple reasons:
1) No-one has visited you and then reported to
this forum that they are cured.
2) Many have reported the opposite.
3) I have read too many stories of men who have
taken every antibiotic under the sun, tried all
sorts of massage, and yet are no better. They are
like dogs chasing their own tails.
4) My own experience has convinced me that while CP
*may* have bacterial origins (I'm not convinced
of this yet), it is almost certainly not an
active infection.
> THIS IS WHAT I AM FIGHTING FOR !!! Once I have
> achieve this, then it is time to say good bye,
> my friends.
I think you have achieved your aim. Everybody knows what you believe and
everyone knows that you, and not your son, initiated your own protocol,
which is unique. Although 'massage + antibiotics' is the oldest CP
treatment in the book, let's be frank about your contribution:
1) You revived it and brought it back into the limelight,
forcing the medical profession to take another look
at it. I think they are going to give it the "thumbs
down", but at least you did bring it to their
attention again. For that you deserve credit.
2) You took an old treatment method and added the
one original twist: multiple empirical antibiotics.
I don't think anyone had done this before. Perhaps
because your location in the Philippines, where
there is almost no control over antibiotics, made
it easier for you to implement such a protocol.
I think it really is time to say "good bye", Dr Feliciano. Enjoy your
retirement.
Dr. A. N. Feliciano
know very well that it is unethical for any doctor to divulge or give any
information regarding his patients without the approval of the patient.
Most, if not all my NA and other foreign patients have come to consult me
after reading my website or my book and have no idea of the existence of
the Prostatitis Foundation website. So, how can you claim that you have
seen patients who have been treated by me and not cured or improved.
I have never had any patient from NA that consulted me as a result of the
Prostatitis Digest. As a matter of fact I have discourage these patients
from consulting me, because I cannot guarantee a cure. No doctor can.
But it is encouraging that you are willing to try new protocol that works.
But I must repeat that you are not following my protocol to the letter and
your answer to what your criteria for the number of pus cells you consider
excessive is evasive and vague.
I wish our exchanges could be more professional and personal, but you have
prohibited me from E mailing you directly after our confrontation on what
is normal pus cells in the EPS more than a year ago. .
My main interest is for doctors to try TO THE LETTER the protocol I
suggested in Art. 12 and find out for themselves the results.
You wrote;
>If you come up with something new
> that works, I will be glad to try it.
Good, then either come to my clinic to see for yourself the results of my
treatment, but I think you are too busy to spare the time, or follow my
protocol to the letter, and I shall be glad to guide you. No one can deny,
that after seeing thousands of patients since 1981, when I retired from
surgery, to devote full time to this disease, must be worth something.
The reason I am participating in this forum is to correct the results of a
doctor who claimed to have done the research I have done since 1983 and
claim 100% cure in 16 days, which has compromised the results of my life
long research.
Perhaps it would be better if we settle our difference in private.
Antonio Novak Feliciano, M.D., F.P.C.S.
Visit my website
http://web.idirect.com/~ino
http://www.qinet.net.user/dr.anf/chronic.htm
----------
> From: dsho...@MY-DEJANEWS.COM
> To:
> Subject: Re: Fw: Prostatic massage and ANF protocol
> Date: Wednesday, March 10, 1999 11:16 PM
>
> In article <B0002...@mail.qinet.net>,
> Prostatitis Discussion <PROST...@MAELSTROM.STJOHNS.EDU> wrote:
>
> > Does he now consider the mere presence of pus cells in EPS a respond to
> > inflammation due to
> > infection? or as he stated in the past due to an inflammatory respond
not
> > due to bacteria, if there is no growth in cultures?
>
> You know, this is why I refrain from commenting on your newsgroup posts.
> Debate is absolutely futile.
>
> Here is the actual quote from my post of 12/23/1998:
>
> Patients with "nonbacterial chronic prostatitits" have
> increased levels of white blood cells in their prostate fluid but do not
have
> bacteria cultured from that fluid. The 2 possibilities are therefore
> that the white cells are responding to a microbial infection that cannot
be
> cultured or that there is a non-infectious cause for the inflammation.
>
>
> > To be blunt, the protocol you are practicing is one I have replaced
years
> > ago with the current protocol
> You have no idea what my current protocol is.
>
> >Why is
> > it that one or two urologists like yourself is so determined to
discredit
> > my work. Is it because I am exposing your confusions at the expense of
your
> > patients?
> >
>
> I am not interested in discrediting your work on your patients. I will
point
> out that I have not found your protocol to work on my patients as you say
it
> does on your patients. I have also seen American patients who have seen
you
> at your clinic, were treated, told they were cured and sent home despite
> their symptoms being unchanged. Therefore, I also have a different
definition
> of "cure". I will also point out that I disagree with most of your
> conjectures on pathophysiology of symptoms and mechanism of disease. If a
> SINGLE North American urologist follows your protocol on the type of
patient
> I see with long standing prostatitis that has failed multiple previous
> therapies and is able to achieve a higher cure rate, I'll be interested.
>
> I want to help my patients with this horrible condition. I don't care
whose
> protocol I follow or who gets the credit. If you come up with something
new
> that works, I will be glad to try it.
>