Jerome Weiss, MD (San Francisco)

[kevin]

Here is a review of my visit to Dr. Jerome Weiss in San Francisco.

Overall, I was very impressed with Dr. Weiss. He is extremely knowledgeable about CPPS/IC. He was one of the earlier proponents of a neuromuscular approach to treating CPPS, and has published several articles on this topic:

http://www.jmweissmd.com/article.htm

(As others know more about, Dr. Wise used to work with him.) He knew what he was doing with his pelvic floor examination; although he didn't hit my tight spots as hard as Tim Sawyer, he knew his way around the pelvic floor and was able to pinpoint my tight spots. The thing that sets him apart, though, is that he is a urologist with a very strong medical/scientific understanding of CPPS/IC, meaning that he checked for and noticed things other physicians/physical therpists didn't. For example, he did a test to see in which areas of my skin the sensation of a pin prick was the strongest. This is actually a quite useful test, because it can tell where my central nervous system has been sensitized, and therefore where it should be treated. During my examination, we discussed not only my muscle function but also my nerve function, something that I have rarely experienced. He definitely understands very well how all the body systems -- nervous, muscular, and so on -- are involved together in CPPS.

We determined (as did the other physical therapists I saw) that I didn't have any tight spots that were significant enough to be causing my pain, so instead of having his physical therapist see me, he tried an anesthetic injection into the suprapubic area. I didn't notice any change in my symptoms after this, but he said that sometimes, and especially in people with bladder pain and frequency, this treatment is very successful. I think Dr. Weiss is the only person who does this treatment.

Afterward, he had me see a physical therapist who specializes in a technique called Feldenkrais. I didn't know what this was beforehand; I ended up unimpressed with my experience. It consists of light touching to different areas of the body that is supposed to heal somehow. It seemed to be very much in the realm of "alternative" medicine; I usually don't like these treatments.

We spoke about Botox in the pelvic floor, but since there wasn't a bad tight spot anywhere, he decided against it. There are a bunch of other treatments he does, outlined on his website: http://www.jmweissmd.com/

In sum, I was pleased with my visit to Dr. Weiss. He is extremely knowledgeable, sympathetic, and good with the manual exam. Even though I didn't improve from my visit, I do realize my case is an atypically tough nut to crack. By the way, here's a link to an interview with him:
viewtopic.php?f=37&t=248&p=1214

[ramana]

Thanks for the review. Other patients that I interacted with mentioned that he is very pricey. What are his recommendations then? Also I understand that he initially resisted the idea of Botox but later switched to it.

[neis]

I saw Dr. Weiss, and all I got was poorer. Could not replicate my symptoms through any trigger points, and then recommended months of PT with his very expensive therapists. I chose Stephanie Prendergast, his former PT at the suggestion of Dr. Wise, and made no improvement there. Again, she found no trigger point issues, but told me to "keep coming back". For what? If there's nothing tight, what's there for you to work on? I just say be careful with this PT business. It's a business, and some will milk it.
I've been interested in james-d's injection experience, who had no bacteria or pathogens(believes it was inflammation), yet has 2 years of relief from his last set of injections. I know two guys who are going to Dr. Bahn this month, and will report back on their experience. For me, the PT route was a dead end.

[kevin]

If there's nothing tight, what's there for you to work on? I just say be careful with this PT business. It's a business, and some will milk it.

This is true. It's important to realize when a treatment is not really necessary, but the therapist is just doing it because it wouldn't hurt, and would provide him/her with business. Also, I'm very skeptical now about the difference between what various PTs charge. I have seen a PT who charges $70 an hour, and one who charges more than $200. I really don't think there was a big difference in skill level. That's why a board like this, where we can compare our experiences and how much we're getting for our money, is crucial.

[neis]

Yes, cost really made me feel preyed upon. $200/session with Stephanie Prenderfast, and though I got no improvement after 6 or 8 sessions, and had no trigger points, she said it may take a year or more of work. $10,400 for something that's producing no results, and who know's what a years worth of work will do. Weiss charged me $550 just for the initial consultation. I feel like a fool for getting sucked into such a racket.

[webslave]

Hmm, Jerome Weiss and Stephanie. Out of the blue, a few years ago, they emailed me and asked me to completely redo their website for them. I looked at the job and gave them a quote, about half what I used to charge, very reasonable, because I wanted to help them. Guess what? They didn't even bother to reply. I emailed them several times, and eventually Stephanie said Dr Weiss is not interested at this time, or some such lame line. I guess he expected me to quote a hundred bucks or so, not the $1K - 2K I quoted (if I remember). He charges hundreds per hour, but he wanted me to charge hundreds per week.

I was left with a bad impression, sorry.