Calypso Beacons, IGRT, treatment updates

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142
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Total Posts : 5859
   Posted 3/25/2010 6:56 PM (GMT -6)   
Sounds really exotic, seeing all the parts and equipment laid out on the table. There seemed to be altogether too much technology involved. But once on my back "assuming the position", I discovered that the three needles hurt a good bit more than the 12 from the biopsy, and I don't feel like any of my systems got an upgrade in the process.

I've felt worse, and still compare it to my "gold standard" - the dentist who didn't believe he had missed the nerve before he started cutting for a crown. I'm still convinced he remodeled the office because I tore part of the ceiling out. Today - the urologist's building is intact.

But now I have three markers implanted where my prostate used to be. The Dr. said it was more difficult due to all the internal scar tissue, and six hours later sitting is difficult (ok, painful - a solid 7). They did a verification xray, decided all was well (scary to think what would have happened if they wanted to move one smhair )
They issued me an id for anyone that ever does an MRI - seems my markers actually transmit a registered id - so much for fading away in to anonymity. I was offended that they didn't have set #142 available. Too late.

Now I will continue to take advantage of my three month pass. Three weeks before I go nuclear....

(update after 9 pm)
By the dinner hour, pain is a 3, I can sit, and I'll permit myself a glass of red wine. The crown remains the "gold standard" for pain.
 
=======
 
(I am adding this timeline for the entire IGRT process that I have used in another post, since this post started with the actual Beacon insertion, day 14 in the list below)
(Starting point is DaVinci surgery + 20 weeks)
 
Day 1) Uro / Surgeon consult, referral to RT (had met with them as part of my second opinions, so files had already been sent over).
Day 4) Radiation Consult, Appointment made with uro for Calypso beacon insertion.
Day 5) Blood drawn at Uro for tests.
Wait for appointment date (blood work had to come back first).
Day 14) Insertion appointment.
Minimum 15 day "healing" wait expected.
Day 33) Appointment for Planning CT scan.
Planning process - allow at least 1 week.
Day 41) Test walk-through with xrays and simulated radiation session.
Day 42) Next day started the 39 IGRT sessions.
 
After sessions were finished, there was a 6-week wait before the followup visit, with PSA test.
Handed back to the uro at that point.

Post Edited (142) : 9/27/2010 7:45:51 AM (GMT-6)


142
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Total Posts : 5859
   Posted 3/26/2010 8:41 AM (GMT -6)   
Update Friday morning -
Rectal bleeding is there, but not as bad as I was warned - about the same as the earlier 12 core biopsy.
Pain is gone - just annoyance now. Did not need pain meds.
My ultra-high deductible is met for the year.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24125
   Posted 3/26/2010 9:00 AM (GMT -6)   
142,

Geez, with all that going on, glad I just had regular tattoos in prep for my IMRT SRT. Hope you get to feeling better and end that bleeding.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


JB71
Regular Member


Date Joined Nov 2009
Total Posts : 201
   Posted 3/26/2010 9:41 AM (GMT -6)   
Wonder what and why the difference between your "Calypso" markings and my three tiny tattoos?

I'm also scheduled for IMRT later in April. (26)

Had no pain at all and only took 15 minutes, c/t scan included.
Age, only 71.
July 2009, PSA 9.1, free ratio 0.16
September GLEASON 4+4=8, T2A
Prostate 44cc.
Calcium: 2.46  (range: 2.20 - 2.65 mmol/L)
25 Hydroxy Vitamin D: 102 (range: sufficiency:
76 - 250 nmol/L)
Bone Scan: Negative
CT Scan scheduled for Dec. 1st. Negative.
Started Casodex 50mg. on Nov. 6, first pill of 30.
Got Lupron 22.5mg ( 90 day ) on  November 19.
No real side effects as of Dec. 15 except dry skin and hair but getting quite 'porky' in the belt area even though now I go to the gym, three times a week. Also I dont have a need to shave anymore so now I can save my 'shaving' allowance and direct it to my stash of Depends !
 
Christmas Day got my first hot flashes. Thanks Santa!
 
Open surgery done on Jan. 20th. by Dr. J. Chin at London's University Hospital.
 
Cath removel scheduled for Feb. 8th. Yes, I know,
that will be 19 days. Dr. is out of country until then.
====================================
Pathology Report:
 
Gleason Score: cannot be determined due to hormone therapy effects. ???????
Extraprostatic Extension:
present, left radial, multifocal
present, left basal, multifocal
Resection Margins:
Apical: involved by invasive carcinoma, multifocal
Bladder Neck: involved by invasive carcinoma, unifocal on left side.Other: non-tumoural prostatic present at resection margin.
Perineural Invasion: present.
Seminal Vesicle Invasion: absent
Lymphovascular Invasion: absent
Lymph Node Status: no malignancy in regional lymph nodes
Additional path. findings:
high grade prostatic intraepithelial neoplasia
 
Pathology Stage: yp T3a NO MX
==================================
Radialogist appointment was on Friday Feb. 26 with Dr. Glenn Bauman in London.
Got another Lupron 90 day shot today and he wants to start IMRT soon. CT Scan plus measure scheduled in about 3 weeks. ( march 15)
 
First PSA test since surgery on March 25th.
 
Next appointment with the surgery Doc is April 13.
 
Started a Facebook page for bikers with prostate issues at:
 
IMRT to start approx. April 26.
 
.


142
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Date Joined Jan 2010
Total Posts : 5859
   Posted 3/26/2010 10:14 AM (GMT -6)   
Difference they explained -
First I incorrectly called this IMRT, it should be called IGRT.
Tattos are markers to use for entry points, and based on the known angle and entry points, the multiple beams converge to hit an expected point. The idea behind the calypso beacon is that the organ being irradiated moves (in this case the prostate - they also are apparently using it for other cancers as well), and may not be where the original CT scan placed it. So in theory, that little bit of shift leaves something else unexpectedly getting that moments radiation. I was skeptical, but have read all their literature (at least what I can comprehend) and it makes sense for people having their primary treatment as radiation.
Now, the question I also asked was "why use it after the prostate is gone?". Pretty much the same logic. They plant them in the scar tissue mass that is left after the surgery. It is about the same idea, as the mass (which has the edges where the cancer came through the capsule) moves as well.

So the big plus should be that the computer recognizes my beacons, and uses the programmed / known relationship between the three to target the beams. In theory I get better use of the radiation. We won't really know that for years, I guess.

142
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Date Joined Jan 2010
Total Posts : 5859
   Posted 3/29/2010 2:25 PM (GMT -6)   
Update - On Monday, no more bleeding noticed, no pain - seems, overall, less invasive than the biopsy.
Just wondering if I'll ever be able to trust a GPS receiver again - nono

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 588
   Posted 3/29/2010 2:49 PM (GMT -6)   
I wonder if you could set yourself up as a geocache...

:)
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1
http://pcabefore50.blogspot.com


142
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Date Joined Jan 2010
Total Posts : 5859
   Posted 3/29/2010 2:54 PM (GMT -6)   
shudder

Post Edited (142) : 3/29/2010 2:17:56 PM (GMT-6)


142
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Date Joined Jan 2010
Total Posts : 5859
   Posted 4/13/2010 1:28 PM (GMT -6)   
CT scans planning scans are done, three tattoos, each hip and my gut. Even after drinking all the water they wanted me to, the bladder did not blow up enough for them, so it seems that might not be a good thing.
Radiation starts next week.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24125
   Posted 4/13/2010 2:58 PM (GMT -6)   
142,

Good luck with the radiation,hope you have an easier time than I did with it. Please keep us posted of your rad journey too.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29


142
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Date Joined Jan 2010
Total Posts : 5859
   Posted 4/22/2010 5:57 PM (GMT -6)   
Yesterday they did a so-called dry run, but as I mentioned in a post on David's thread, I had a blowout, and did the dry run in wet jeans.

For today, I reevaluated a bit (with the Rad. Therapist), and we changed the timing of drinking that bomb of water. So, today I made it through. Still had some issues, but at least it was after.
Today was the first real radiation experience. The machine seemed something out of Star Trek, moving around me, stopping at seven points to do its thing. They tell me we will have it down to a five minute visit before the last visit. Not being in a hurry, I'll say seven.

I asked about what levels of radiation I was getting, since everybody else here seems up to date on theirs. I guess it did not seem to make a lot of difference, but for the statistics fanatics, it is 39 treatments, 70.2 GY total, 1.8 GY per day.

38 more. Very literally one day at a time.

Post Edited (142) : 9/27/2010 7:48:44 AM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24125
   Posted 4/22/2010 6:41 PM (GMT -6)   
142,

Your treatment is similar to what I had. I had 39 treatments, but 72 gy, instead of your 70.2. Glad you got the water issue settled with them. Yeah, my machine indexed around me 7 times. Despite having 7 tattoos, my treatments were plagued with constant alignment issues, hopefully they will be able to get yours down to what they said.

Radiation, my friend, is an endurance contest. Getting there the same time everyday, whether you want to or if you feel like it ,is half the battle. Sometimes, you will feel like you are in a time warp, like everytime you open your eyes, you are back in the machine, day after day. That part will pass of course.

I wish you all the best on yours, and hope the Side Effect Gods are kind to you, and you can get through this.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14 out - 27 days, Cath #15 - 3/29


142
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Date Joined Jan 2010
Total Posts : 5859
   Posted 4/24/2010 1:43 PM (GMT -6)   
Friday was treatment 2. Again, the water bomb timing was off, so lots of laundry days this week. At least this time it was after the treatment, so the bladder was fuller than the day before.

No side effects to notice yet, but I did discover that the low back pain from the daily cialis is a real killer while they are moving you around, so will stop that until this is over.

This time, from in the door to dressed and out was 17 minutes. They did what they told me would be a weekly set of extra xrays plus the RT.

First bill has posted to my insurance. Pretty scary, but we will see what the "agreed" price is before I panic.

keysailfisher
Regular Member


Date Joined Dec 2009
Total Posts : 332
   Posted 4/24/2010 6:57 PM (GMT -6)   
Hope all goes well for ya, with no side effects.
 
Neal
age 45
psa 3.09
Biopsy results 12/9
Left side base 3+3=6 21% 2/2 cores positive
Left side mid  3+3=6 100% 2/2 cores positive
Left side apex 3+4=7 88% 2/2 cores positive
Right side - 0/6
CT & Bone scan negative
Davinci Feb. 5th 2010/ cath removal 2/16
 
Gleason-3+4=7
Extent of tumor-Bilateral
Extraprostatic Extension-Absent
Seminal Vesicles-Negative for tumor
Surgical Margins-Rt apical margin focally positive
lymphovascular invasion-Suspicious in areas of capsular involvement
Regional lymph nodes-One node negative
Stage-T2c NO Mx
Incontinence-yes/ Down to 1 pad at 6 weeks out
11 weeks pad free
PSA 3/29/10 <0.01


142
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Date Joined Jan 2010
Total Posts : 5859
   Posted 4/27/2010 1:38 PM (GMT -6)   
#4 today, we are down to 12 minutes. It was a near miss on the water front, had to make an extra stop on the way home, but got there dry.
No apparent side effects yet, other than all this water.

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2077
   Posted 4/27/2010 2:42 PM (GMT -6)   
Wow, you are having a more complex thing than me.

Pee shouldn't be a problem. I'm naked from the waist down during my RT, well from the nipples down in fact as I have to pull my shirt up too, so if I leak/blow then my skin and the equipment get wet but my clothes stay dry. (They said beforehand not to worry or feel embarrassed if I do wet myself as they have seen everything when it comes to such things)

One of my tattoos is so small and feint it had to be marked with marker pen today as well.

The tattoos are the reference points for the computer and humans to work out where things are for the plan (During the CT scan lead balls were stuck on my skin exactly on the tattoos to show up on the images)
My planning stage was thus about working out the position of the prostate bed in relation to these three reference points, plus which angles to aim the beams from so as to avoid collateral damage.

I asked if they would do any additional CT scans during the treatment to check if things were still in the same place and they said no as they are only working to the nearest centimetre anyway.

There are some RT machines that have a built-in CT scanner and these are used for things like throat or brain cancers when they are working to the nearest millimetre and they may want to recheck positions before each session.

Regarding the target moving between the CT scan and irradiating it, this was what they said my strange diet was for. The idea is to slow down the guts but also have them empty so everything will be the same if it is empty, hence the diet started 5 days before the CT scan and will continue till the last session.
The state of the bladder is thus also relevant and why I have to pee and drink a specific amount of water a specific time before the session. (and why today I asked if it was okay that they were running ahead of schedule and about to treat me 25 minutes early as by bladder was not exactly full - the response was to take me off the machine and tell me to get dressed and go back to the waiting room! They slipped up there. And were very glad I had mentioned it.)

I have also decided to make sure I hang around at the hospital afterwards to calmly go to the wc and really empty things as not all the water I've drunk gets processed till about an hour later, so it is of course an advantage that for most of the journey home I am in a train with a WC about twenty feet away from my seat.

I'd better stop counting your sessions to avoid losing count of my own. (It's bad enough that I had it all worked out as five each week so Fridays would be 5,10,15,20 ect and now in the the first week the Friday is a national holiday so RT is shut and it's just 4 this week and the Fridays are now going to be 9,14,19,24 etc.

It's bed time in Holland so...
zzzzzzzzzzzzzzz

Alf
Age at Dx 48 No Family history of Prostate Cancer
Married 25 years, and I cannot thank my wife enough for her support.
April 2009: PSA 8.6 DRE: negative. Tumour in 2 out of 12 cores. Gleason 3+3.
RALP (nerve-sparing) at AVL-NKI Hospital Amsterdam on 29th July 2009. Stay 1 night.
Partial erections on while catheter still in. Catheter out on 6th Aug 2009.
Dry at night after catheter came out
Post-op Gleason 3+4. Tumour mainly in left near neck of bladder.
Left Seminal Vesicle invaded, (=T3b!)
no perineraul invasion, no vascular invasion. clear margins,
Erection 100% on 15th Aug 2009, but lots of leaking
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc.
Nov 17th 2009 PSA = 0.1
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist


aspen4
Regular Member


Date Joined Dec 2008
Total Posts : 59
   Posted 4/27/2010 3:54 PM (GMT -6)   
Sounds like quite an adventure. I am pulling for you though.

142
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Date Joined Jan 2010
Total Posts : 5859
   Posted 4/27/2010 5:13 PM (GMT -6)   
Alf,

I suspect that my Calypso markers, which are implanted in my prostate bed scar tissue, provide the same target that you would see from the CT scan. There is a panel above and one below me that track the three markers, a sort of mini GPS. The machine got upset today, and had to briefly reposition. The girls tell me that is why I spent extra money on the Calypso.
They do still have to recheck the tattoos each day, because the Calypso can not fix my position, but just tell them if it is wrong.

They make sure the WC is clear when I get through, because full bladder does not describe it.

This is a small clinic, so you just empty the pockets, lose the shoes, get positioned with pants down to the knees and a light cloth over the waist. They have a mold of where my legs were when they did the planning CT, so I get into that, and leave them to do the rest of the positioning.
They position the Calypso panels, which find and identify my markers (they have a unique ID), and the computer makes sure that the program plan is really mine before it allows them to start. Then off to the races (i.e. the race to see if they finish before I have to pee too desperately).

They do run a steady stream of patients, and have changing areas, but I've never seen anyone use them.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5859
   Posted 4/28/2010 4:34 PM (GMT -6)   
#5 is done. Made it there and back dry. Did have to stop an use the facilities of my favorite grocery store chain half way home, though.

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2077
   Posted 4/29/2010 10:27 AM (GMT -6)   
RT had to deal with a complication with another patient this afternoon so there was a queue and there were five of us in the waiting area for about 15 minutes

Two of the guys (who were both over 70) had had gold markers and both were having 39 sessions and I was interested that they both said that they had been in severe pain for about 24 hours after the markers have been placed, enough for both to seek help. They said they would not recommend gold markers to anyone else because of the pain.

Alf

142
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Date Joined Jan 2010
Total Posts : 5859
   Posted 4/29/2010 10:17 PM (GMT -6)   
Today was #6 for me. I am beginning to have some intestinal issues, but can't say what the cause is. Maybe just work stress -

Alf - I imagine planting the gold markers is the same as the Calypso markers - like a 3 core biopsy, but without any local pain killer - I hurt a lot more than after the 12 core biopsy, but did not consider it dramatic pain (maybe 7 on a scale of 10). However, if I were 70, it could be a completely different story (I am 56).

Post Edited (142) : 4/29/2010 9:24:03 PM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24125
   Posted 4/29/2010 10:20 PM (GMT -6)   
keep hanging in there, 142, you are doing well, one treatment at a time.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 4/23 put in


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5859
   Posted 4/30/2010 8:18 PM (GMT -6)   
#7 done. Today was the first time the Calypso stopped the treatment. Apparently my "gastric distress" caused the markers to move during the session, at which point everything came to a grinding halt. They realigned and reset that step, and went on. Still only about 12 minutes total elapsed.

I have a bit of the old loose bowel, and am getting tired earlier, so I suspect either the treatment or the stress of a daily routine and altogether too much water.

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2077
   Posted 5/1/2010 1:56 AM (GMT -6)   
(I had a day off on Friday as it is a National Holiday in Holland)
Interesting that you mention loose bowel I have had that already too, still at the normal time of day and just one BM per day, but now also had sudden pain insdie me after BM, lasted for about 10 seconds in area where prostate used to be, then had a dull ache in that area for about an hour, similar to how it felt down there about two weeks aftyer the robot.
I also have a mild undefinable sensation in some areas of my skin around my pelvis as though something in a pocket is pressing against me. So making a point of not sitting too long in same position.

Anyway the job today is to go and buy some pants that fit as it has been too hot for jeans and my wardrobe is full of stuff that fitted before the robot but is now too tight at the waist.

Roll on Monday (when I've also got my next chat with the doc)

Alf

142
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Date Joined Jan 2010
Total Posts : 5859
   Posted 5/1/2010 8:52 AM (GMT -6)   
Thought I would take the 5mg Cialis over the weekend, and sure enough, this morning the minor back pain has returned, so it looks like that was the cause of my pain during the first sessions. That which is a very tolerable bother normally becomes quite an issue when you shouldn't move.

I have not noticed any skin irritation or sensitivity yet, and have not seen any urinary function impact.

Post Edited (142) : 5/1/2010 7:56:57 AM (GMT-6)

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