CO2 GAS was used to create a larger operating space. I AWOKE TO A WORLD OF INTENSE AGONY!!!

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Dennis Poitras
New Member


Date Joined Jun 2009
Total Posts : 4
   Posted 6/27/2009 4:05 PM (GMT -6)   
CO2 gas is used to create more operating space within a body that is being made ready for surgery. Was it bacause my 59 year old body was unusually skinny or that I had been an advid smoker most of my life that the CO2 gas caused so much insane pain? The robotic-assisted removal of my prostate was successful----with all the surrounding nerves being saved too. But, afterwards I awoke to the most physical agony imaginable! I was screaming and yelling and begging them to put me out immediately!! I felt like that guy in the movie Alien when , lying on his back on some lab table, he's screaming in horror as that ugly beast rips through this belly! It also felt like a miniature herd of wild horses were trapped in my gut and galloping frantically to get out!
I had prostate surgery this Monday morning, around 11:am. I was to spend the night then go home Tuesday morning around noon. But after I had several more brutal episodes with the very nature of agony itself, they kept me in the hospital until late Thursday afternoon.
No one could figure out why I had such a violent reaction to CO2. Does anyone out there have a clue?
Friday morning I was shocked to see that my ordinarily smallish-sized scrotum was staring back at me as if from a grocery shelf featuring purple soft-ball-sized watermelons for sale! My ankles and knees had also dissappeared and my bruised, stitched-up belly never stopped looking like I was ready to deliver an 8 to 10 lb. baby.
Other than all of the above, the surgery was a success. I never had any symptoms to begin with but, I'm assured, I'm cancer-free.
I do feel grateful and the doctors & nurses were terrific, especially in dealing with all my screaming, but I'm left feeling shocked & awed to say the least. Am I the only one on earth that this CO2 thing has happened to?
I hope that soon the medical establishment will be able to find out who may be a canidate for this kind of Co2 gas-torture. I wouldn't wish this experience upon my worst enemy!!!!

Post Edited (Dennis Poitras) : 6/27/2009 4:28:20 PM (GMT-6)


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 6/27/2009 4:56 PM (GMT -6)   
I was told to expect some pain from the gas, but your case is exceptional. It sounds like a totally awful experience and I'm sorry that you had to go through it.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
At 10 weeks: no pad at night -- slight unpredictable leakage day/1 pad.


TeddyG
Regular Member


Date Joined Apr 2009
Total Posts : 133
   Posted 6/27/2009 6:59 PM (GMT -6)   
Hello brother,
Of all the physical aspects of this journey, I too had a similar experience, and it was the worst part. It kept me in the hospital for 2 extra days. I am also small framed and pretty fit but my belly protruded like I was going to give birth to a basketball. I looked at my partially shaved belly, with the incisions , a small drainage tube and could hardly believe it was me from the chest down. I was never in so much pain in my life. The nurses were trying to be helpful but the situation with tubes going in and coming out of me from everywhere, darkness of night in a lightning concentrated thunderstorm, hospital bed that kept making noises to stay inflated and not being able to get around assured me that I was pretty darn close to hell. Alas, I was never so happy in all my life as when the gas finally started to find a natural way out.  It waswn't pretty, but I must say, it was fantastic. Everything else in the recovery pales in comaprison and now I have a new appreciation for those bodily functions that we don't really like to talk about much.
Ted
Background:
Age 55, two teens, very fit cyclist (avg 2000+ miles per year) and weight, diet, etc. consistent with good habits. Stressful job as attorney; very supporting wife who is helping me through every stage of this war.
Stats:
2006 PSA - 1.5
2007 PSA - 2.3
2008 PSA - 5.3 (18 mos.)
2009 Jan. 20 - Biopsy 12 samples
        Feb 3 Dx 2/12 samples positive, low volume  (5% and 7-10%)
Gleason 3+4, later downgraded by second opinion at Johns-Hopkins to 3+3, but "it's still PCa" as my Doc said.
Laproscopic surgery April 9,  University of KY Medical Center, Lexington, 3 days in hospital, catheter removal April 21.
Pathology: clear margins, no cancer in prostate: told that this is very rare and Doc has only seen it in 3 out of over 1400 cases; I rearched the concept of "vanishing cancer" and found a tumor classification of tP0 and asked Doc if it applied to me. He said that it was unlikely because if a pathologist had done a much more detailed analysis of the tissue, he would likely find more foci somewhere, and biopsy found "needle in the haystack as opposed to the tip of the iceberg"; Nevertheless, it is a blessing;
Regardless of the science, my family says "miracle."
Now working w/ post-surgery issues....
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 6/27/2009 9:32 PM (GMT -6)   
Another reason why I opted for open surgery, not an issue then, sorry you are having to go through all that pain, hope it abates soon.

david in sc
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist
 
 


mspt98
Regular Member


Date Joined Dec 2008
Total Posts : 377
   Posted 6/27/2009 9:42 PM (GMT -6)   
Yeah,
      I too woke up to intense pain from having my belly bloated from CO2, but they gave me big time IV medicine almost instantly and I was put out for a couple of more hours, I then came to and it was much better then, good luck on your recovery
my age=52 when all this happened,
DRE=negative
PSA went from 1.9 to 2.85 in one year, urologist ordered biopsy,
First biopsy on 03/08, "suspicious for cancer but not diagnostic"
Second biopsy on 08/14/08, 2/12 cores positive for Prostate Cancer on R side, 1 core=5% Ca, other core = 25% Ca, Gleason Score= 3+3=6 both cores,
Clinical Stage T1C
 
Bilateral nerve sparing Robotic Surgery on 09/11/08, pathological stage T2A at surgery,
No signs of spread, organ contained,
3 0's in a row now, 7 months out
Incontinence gone in early December '08,
ED remains,  still taking daily viagra for penile rehab, uro said try oral meds and then trimix for sex only now, Peyronie's Disease a problem now


Recovering
New Member


Date Joined Jun 2009
Total Posts : 4
   Posted 6/27/2009 10:31 PM (GMT -6)   
I had surgery last Tuesday and was told that I had to be restrained when I was coming out of the anesthesia and I am not sure why but remember being in some pain in the recovery room. It is all a blur to me. By the time I was in my hospital room I just felt like I was bloated but not in pain.

I do remember having the urge to urinate due to the catheter in my bladder which no one told me was a common occurrence. It would have been better if I knew this was a possibility ahead of time because coming out of the anesthesia I was not able to communicate my discomfort very rationally.
Age 47
11/08 PSA 4.4, referred to Urologist
1/09 antibiotics 30 days, recheck PSA 4.1
2/09 Biopsy: 1 of 12 PCa, 4% involved, GS 3/3=6, T1c
6/16/09 Extraperitoneal laparoscopic surgery, Johns Hopkins
6/24/09 catheter out, Path Report: GS 3+3=6. T2c, margins clear
6/25 continence with some stress leakage


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 6/28/2009 6:25 AM (GMT -6)   
I too had to be restrained when I was coming out of the anesthesia due to the major urge to go pee pee...

Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
 
06/25/08 - Da Vinci robotic laparoscopy
Catheter in for five weeks.
Dry after 3 months.
 
10/03/08 - 1st Quarter PSA -> less then .01
01/16/09 - 2nd Quarter PSA -> less then .01
xx/xx/xx   - 3rd Quater skipped
05/14/09  - 4th Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.
 


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 6/28/2009 7:11 AM (GMT -6)   
No insult to the surgeons, but it sounds like someone did not finish the job before you were sewn up. Now it could entirely be that the surgeon left the room after he was done and an assisting Dr. did the closing. anyway, they have to make sure that the CO2 is vented out before closure - and depending on each patient, can take a while - and it takes time and work on the part of the team. It's not like you're a balloon and it will just whoosh out when they are done. Sounds like the team was sloppy.
Complain to your dr. Remember YOU paid him thousands of dollars and are an unhappy customer.
Paul
46 at Diagnosis.
Father died of Pca 4/07 at 86.
1/06 PSA 3.15
1/07 PSA 4.6 (Biopsy 3/07 just suspicious)
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC www.roboticoncology.com
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
-totally contained to prostate,
-10% involvement in L & R Mid lobes
PSA 0 at nine months.
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - Took 100mg viagra every night. for several months
Totally usable erections at 10 weeks, which disappeared over the course of a month or two.
ED bounce is what they call it. Now, at one year, ED is fine with viagra.
One year PSA - undectable!


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 6/28/2009 12:03 PM (GMT -6)   
I have to disagree. People are different and it may be that with any other surgeon Dennis would have had twice the pain for four times as long.

I would like to think that my surgery was the very best one my doctor ever did, and I would hate to think that it was his worst. In reality it was probably about average. Half of his patients get better operations, half get worse. That is all you get in this world.

There is the story of the baseball manager who decided that the secret of winning was to fire any player who did not get a hit in every game. He didn't make it to the world series, but he did set a record for forfeits.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
At 10 weeks: no pad at night -- slight unpredictable leakage day/1 pad.


KeyWestPirate
Regular Member


Date Joined May 2009
Total Posts : 60
   Posted 6/28/2009 12:09 PM (GMT -6)   
Shelley told me that CO2 is routinely introduced to create more room in the abdomen during a laparoscopic procedure -which includes the Da Vinci robot . Unlike the carefully organized pics and diagrams you see on the brochures, the organs are tightly packed in the available space and the CO2 give the surgeon a bit more room for the camera and instruments.

The C02 is considered harmless, and is evacuated at the end of the procedure by gently pressing down on the extended abdomen.

She thinks what happened, which is very rare, is you developed an embolite, or gas bubble, similar to the bends that divers get from expanding nitrogen gas in muscle tissue. She has actually never seen this herself.

Sorry to hear about this unpleasantness you had to endure. Coupled with this is probably the surgeon's desire to get you up on your feet and walking immediately after the surgery, and the expectation of very minor discomfort post surgery.

Someone had to push the reset button, and that always takes a while.

Everyone is beginning to take the low impact of the robotic RP for granted. I had a friend get an open RP about forty years ago. He was about 45 at the time. He spent two weeks on his back after he got out of the hospital, and didn't come back to work for another month after that. This post is a sobering reminder that there is serious risk with any surgical procedure.

On the open RP a frame called the football is fitted to the incision to maintain the access for the surgeon. There is still a question in my mind as to the quality of access to the sides, underside of the prostate and bladder for the procedure, and other areas of the abdomen for careful inspection with the open RP, but I am not a professional, and this is speculation.

Dennis Poitras
New Member


Date Joined Jun 2009
Total Posts : 4
   Posted 6/28/2009 12:43 PM (GMT -6)   
Thanks sincerely everyone for the feedback. I am getting better, at a turtle's crawl, but it's better than none at all. Last night was terrible! Doctors keep telling me to walk, which I do, and they say I should have as much protein as possible. But what's holding back everything is the co2 swelling that now seems to be just about everywhere. It makes me feel like I've just finished a Thanksgiving meal and I've got my belt unbuckled sitting on the sofa watching a football game. (Don't I wish!)
I've also got this acid, heartburn cloud rising up from my stomach and spreading up into my chest and stopping somewhere in my throat near where that ol' automatic puke button resides. Finally, around 3:am, after walking and walking, round and round in my bathroom, with my belly about to burst, as usual, while carrying my sorry looking pee-bag, I bent over the toilet and forced myself to throwup. The protein drink I had put down around 7:pm came back up looking almost exactly like it did going down.
This perpetual bloating prevents me from wanting to eat and/or digesting it. However, my scrotum has shrunk from a softball to a baseball. And I'm starting to see my ankles again.
I've also starting taking Maalox which is giving me some release from the gas and acid.
All in all, I've very grateful to have had my decaying prostate removed (though I had no symptoms at all) but the experience has been nothing but an unwilling and prolonged visit to hell. I still hope that in the future people like me who will suffer to the extreme because of CO2 or it's improper use, will be recognized and set aside for other alturnatives.
I've still only scratched the surface on my experience and on this subject as a whole. Stay tuned for more descriptions from Dante's Inferno. (Or since my name is Dennis, why don't we call it Dente's Inferno.) 
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 6/28/2009 1:46 PM (GMT -6)   
Dennis,

Glad you are getting some relief at last, it should continue to improve for you. I would have to say, your reaction to this is not normal or regular, but in the wonderful world of PC, one never knows what straw they will draw. Good luck to you.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist
 
 


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 686
   Posted 6/28/2009 1:52 PM (GMT -6)   
I am a pretty fit bike rider and had no post op pain trouble other than the usual healing and catheter stuff.  I wasn't even aware that they had injected me with CO2 until much later.  There was some minor bloating, but I guessed that was just post surgery trauma.
 
In the three years of being a part of this forum this is the first time that I recall anyone having as much pain as you described.  You should have a long talk with your surgeon.
PSA up to 4.7 July 2006 , nodule noted during DRE
Biopsy 10/16/06 ,stageT2A
Very Aggressive Gleason 4+4=8  right side
DaVinci Surgery  January 2007
Post op confirms gleason 4+4=8 with no extension or invasion
no long term continence problems
Post surgery PSA continues to be "undetectable"
One side nerves spared
Bi-Mix for ED 
born in 1941


TeddyG
Regular Member


Date Joined Apr 2009
Total Posts : 133
   Posted 6/28/2009 9:06 PM (GMT -6)   

Upon further consideration of my similar experience (for 2 days) I now recall from my supressed memory that the nurses and residents kept asking "have you passed gas yet?" they kept encouraging me to walk, which I did, though it was more like 'shuffling" around the halls pushing my IV pole and carrying my bag. What a sight I thought, but did not care. getting one's digestive system moving is the key and it sounds like you are taking more time than most. I did get some relief finally in getting the system moving and relieving the gas pressure when I would bend forward. Try this: get near a table and bend over it resting your arms on the table so that you are bent over at a 90 degree angle. (Kind of like you are going to moon someone.) It apparently changed the angles of the lower instestines enough to allow some gas to escape. I would do it routinely and it started with a little gas, then eventually a bit more. The next day there was an explosive release while trying to go to the bathroom (sitting down.) I was also only eating soup and fruit following surgery as the hospital food was horrible and I really had no appetite.

Good luck. For the rest of our lives we will appreciate flatulence.

Ted


Background:
Age 55, two teens, very fit cyclist (avg 2000+ miles per year) and weight, diet, etc. consistent with good habits. Stressful job as attorney; very supporting wife who is helping me through every stage of this war.
Stats:
2006 PSA - 1.5
2007 PSA - 2.3
2008 PSA - 5.3 (18 mos.)
2009 Jan. 20 - Biopsy 12 samples
        Feb 3 Dx 2/12 samples positive, low volume  (5% and 7-10%)
Gleason 3+4, later downgraded by second opinion at Johns-Hopkins to 3+3, but "it's still PCa" as my Doc said.
Laproscopic surgery April 9,  University of KY Medical Center, Lexington, 3 days in hospital, catheter removal April 21.
Pathology: clear margins, no cancer in prostate: told that this is very rare and Doc has only seen it in 3 out of over 1400 cases; I rearched the concept of "vanishing cancer" and found a tumor classification of tP0 and asked Doc if it applied to me. He said that it was unlikely because if a pathologist had done a much more detailed analysis of the tissue, he would likely find more foci somewhere, and biopsy found "needle in the haystack as opposed to the tip of the iceberg"; Nevertheless, it is a blessing;
Regardless of the science, my family says "miracle."
Now working w/ post-surgery issues....
 


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 6/29/2009 5:29 PM (GMT -6)   
Please remember that the gas we are talking about is two different gasses. The CO2 used during surgery does NOT pass through your rectum. Any leftover CO2 is slowly absorbed into your blood stream.

The gas that they talk about walking off and passing is the gas that quickly builds up in your intestines when the systolic action of your digestive tract is halted by the anesthesia. The goal of passing gas is proof that all things are working again in the digestive tract and you will be fine.
46 at Diagnosis.
Father died of Pca 4/07 at 86.
1/06 PSA 3.15
1/07 PSA 4.6 (Biopsy 3/07 just suspicious)
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC www.roboticoncology.com
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
-totally contained to prostate,
-10% involvement in L & R Mid lobes
PSA 0 at nine months.
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - Took 100mg viagra every night. for several months
Totally usable erections at 10 weeks, which disappeared over the course of a month or two.
ED bounce is what they call it. Now, at one year, ED is fine with viagra.
One year PSA - undectable!


Recovering
New Member


Date Joined Jun 2009
Total Posts : 4
   Posted 7/1/2009 10:16 PM (GMT -6)   
Since Research is my job, I tend to read a lot of Journal articles. I avoided this before having my surgery as some of the details given in research papers would only serve to increase my anxiety over having the surgery. After my surgery, I did start to read some research articles and remembered this one that has some mention of the CO2 issues. Here is the reference if anyone is interested.

UROLOGY 72 (2), 2008
Laparoscopy and Robotics
Intraperitoneal Effects of Extraperitoneal
Laparoscopic Radical Prostatectomy
Trinity J. Bivalacqua, Edward M. Schaeffer, Hannah Alphs, Lynda Mettee,
Andrew A. Wagner, Li-Ming Su, and Christian P. Pavlovich
Age 47
11/08 PSA 4.4, referred to Urologist
1/09 antibiotics 30 days, recheck PSA 4.1
2/09 Biopsy: 1 of 12 PCa, 4% involved, GS 3/3=6, T1c
6/16/09 Extraperitoneal LRP, Johns Hopkins
6/24/09 catheter out, Path Report: GS 3+3=6. T2c, margins clear
6/25 continence with some stress leakage

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