Nine days to Surgery - Starting to get nervous

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Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 1/4/2010 9:03 AM (GMT -6)   
mostly at night Not sleeping well 
 
Has anyone cancelled or postponed their surgery? In my mind I know surgery is the right choice, however with no symptons its hard to cope with why i am putting myself through an operation.  (Answer is I don't want to be dying ten years from now saying if only I only I had the surgery back in 2010 - although I realize that surgery may not be a cure it it the best first treatment option for me) Ive never been knocked out and the fear of that is getting to me.
 
Has anyone ever had a surgeon prescribe some anxiety med in advance of surgery?
 
 
 
 
diag 9/09
 
age at diag 54
 
PSA 6/09 1.3
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/13 at UP with Dr David Lee
 
 


Ziggy9
Veteran Member


Date Joined Jul 2008
Total Posts : 981
   Posted 1/4/2010 9:15 AM (GMT -6)   
Burlcodad said...
mostly at night Not sleeping well


Has anyone cancelled or postponed their surgery? In my mind I know surgery is the right choice, however with no symptons its hard to cope with why i am putting myself through an operation. (Answer is I don't want to be dying ten years from now saying if only I only I had the surgery back in 2010 - although I realize that surgery may not be a cure it it the best first treatment option for me) Ive never been knocked out and the fear of that is getting to me.



Has anyone ever had a surgeon prescribe some anxiety med in advance of surgery?


Yes people have canceled or postponed surgery. If you're not comfortable with your decision I suggest you do cancel or at least delay it until you are. This is a major operation with possible long term quality of life effects to weigh in. Afterward there aren't any do overs. A delay of a few months won't change the outcome. There are other options you should check out and eliminate first. Then pick what you think is best for you. How long after your diagnosis did you decide on surgery? I understand how you feel facing such a choice when you have no symptoms. I felt the same like we're taking it all on faith. Believe me being sedated isn't that big a deal, haven't you ever had a colonoscopy? But I digress. If you're having second thoughts about major surgery then do postpone it. You can always reschedule it for later.
Diagnosed 11/08/07 - Age: 58 - 3 of 12 @5%
Psa: 2.3 - 3+3=6 - Size: 34g -T-2-A
 
2/22/08 - 3D Mapping Saturation Biopsy - 1 of 45 @2% - Psa:2.1 - 3+3=6 - 28g after taking Avodart - Catheter for 1 day -Good Candidate for TFT(Targeted Focal Therapy) Cryosurgery(Ice Balls) - Clinical Research Study
 
4/22/08 - TFT performed at University of Colorado Medical Center - Catheter for 4 days - Slight soreness for 2 weeks but afterward life returns as normal
 
7/30/08 - Psa: .32
11/10/08 - Psa.62 - Not unexpected bounce after the 80% drop the quarter earlier. Along with urine flow readings, an acceptable amount left in bladder measured by sonic. Results warrant skipping third quarter tests, and to return April, 2009 for final biopsy scheduled to
complete clinical research study 
 
April 2009 12 of 12 Negative biopsy
10/12/09 - Psa .30
 
 
 


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 1/4/2010 9:15 AM (GMT -6)   
Burlcodad,
It is very natural to be nervous prior to a major surgery. There are many things that can happen during and after but those risks are much less that doing nothing. Prostate surgery is one of the most common surgeries among men. As long as you have done your homework on all your options and have selected a reputable doctor with a lot of experience you should feel confident in your choice. Many of us here have been through that. Good luck to you and hope to see you on the other side.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 1/4/2010 9:22 AM (GMT -6)   
A case of the nerves is not new or unique when facing surgery. And the fear of the anesthesia is also common.

But how do you handle it is the question.

Think back to the discovery phase you have been through since your diagnosis. By now you know far more about PCa and the options for dealing with it than you ever wanted. You have done your research and made the decision that is right for you. You have found the doctor that you have confidence in and trust him to make things right for you. At this point you have to turn it over to the medical team you have assembled.

I know that all of that seems easy to say, but we have all done that and found peace with our decisions.

Turn your thoughts to the positive. You found your cancer early. All of your reports indicate it is contained and removing the prostate will take it out. From that point forward you can live your life the way you choose it and not one dictated by PCa.

I am sure the regulars here are tired of me saying it, but my personal mantra for years has been, "Every Day is A Bonus". It has come to mean a whole lot more since my diagnosis in July 09.

So kick back and really enjoy life as it is now until your surgery. Take your wife out to a few more dinners. Enjoy the great glass of wine. Enjoy the romantic evenings. Keep your loved ones close and gain strength from their support, they are all in this with you.

Many of these things you may have to put on hold for a while after surgery, so don't take them for granted now. Just enjoy all of them to the fullest.

In your heart you know you have made the right decision for you. It's not in your hands any more, you have turned it over. Rest comfortably at night with these thoughts and look forward to the brighter day when you no longer can say you have Prostate Cancer.

Bless you and your family,

Sonny
61 years old
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
<5%, 90%, 40%
Gleason Score (3+4) 7 in all positive cores
CT Organ Scan - negative
Nuclear Bone Scan - Negative
da Vinci 9/17/09
Post Surgery Pathology:
Gleason: Changed to (4+3) = 7
Stage: T3a
Tumor Volume 12.5%
NERVES SPARED-positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT scheduled to begin Nov 30,2009 (74 days post surgery)


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 1/4/2010 10:23 AM (GMT -6)   
If you are getting cold feet from questioning your decision, that's one thing.

If you are getting cold feet from fear of the process and being put to sleep, then that's something else entirely. There's always good meds to ease the anxiety both before hand and during the initial contact the day of the surgery. Drug induced sleep is like throwing a light switch, one moment you're wake, the next it's hours later and you are waking up, with no recollection of the intervening period. The safety and success rate of general anestesia(SP) is so high, and the long history of successful cases should remove any fear of the procedure. Talk to your doctor about your concerns, remeber also at some point you will meet with the doc who will be coing the actual procedure of putting you to sleeep, so you will have a chance before hand to see and talk with them.

In summary, if you are still sure that surgery is your best approach to fighting this disease, and you have concerns that you may regret any last minute decisions- made out of fear of some part of the procedure- then it's time to discuss this with your health care team, and do something to relieve the anxiety you have of a procedure you are sure will offer the best odds of extending and improving your future life.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 1/4/2010 10:26 AM (GMT -6)   
Hi Ray..........all very natural to feel this way so close to surgery. The advice the guys have given for the runup to surgery is good advice: take the time to enjoy and live in the moment as much as possible between now and next week. I'll try to be your personal indian guide on this one, since you and I have the same surgeon. I used the 5 months between biopsy and surgery to not only educate myself with research, etc., but also to get into the best physical and emotional shape I could prior to surgery. Which, ironically, gave me the same feeling you describe----"why should I be having this if I feel so darn good with no symptoms"-----but each time I would come back to the realization that I had made this decision, and the only thing to do was go forward and get on with the next stage of the process. Trust me, you'll be in good hands at HUP, not only with Dr. Lee but with the whole pre-op and post-op team as well. That said, I still had anxiety, as we all do, before surgery. My GP had prescibed a very low dose of anti-anxiety meds in the runup to surgery, that I could take as needed. I asked ahead of time if it would be OK to take a dose the morning of surgery, just to take the edge off. I was told I could, as long as I informed preop as to what and how much, so they could account for it when administering anesthesia. Then, once in preop, and while being shaved, etc., they start you on a little cocktail of their own....from there it's some small talk with the anesthesiologist, a quick glimpse of the robot, and the next thing you know, you're being wheeled back to your room. I know how you're feeling, you wish the 13th could be tomorrow----or never! But you'll get there, and be on the other side with most of us real soon. I would ask your GP about a little anti-anxiety meds or sleeping aids on the lead up to surgery; you need to be as relaxed and well rested as possible.
 
Take care,
Arnie in DE
Age 56 (biopsy & surgery)
PSA at Diagnosis-3.9
Biposy 8/19/08--4 of 12 cores positive; 5% involvement, Gleason 6 (3+3)
 
Surgery 1/26/09-DaVinci Robotic Prostatectomy at Presbyterian Medical Center/HUP-Phila, PA
Dr. David Lee
 
Pathology Report- Adenocarcinoma, no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, Gleason 7 (3+4), Stage T2C, NO MX, Prostate 61.8 grams, gland involvement 2-10%
 
Catheter removed after 8 days, totally dry at 3 months. ED issues continue, Viagra (via ADC) nightly (100mgs), VED use in earnest at 6 months. "Ball Park Frank" plumping at this point......ED at 10 months continues to improve, albeit slowly. Continued daily use of 100mg Viagra (ADC). Discontinued pump use; manual stimulation to varying states of erections; achieved penetratable erection on a couple of occasions
3 month PSA--<0.1
6 month PSA--<0.1
10 month PSA--<0.1


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 1/4/2010 10:31 AM (GMT -6)   
You bet it is frightening -- especially if you have never had surgery before. Having qualms about being cut open and having your insides rearranged seems like a pretty reasonable thing. One comfort is that you don't have to do anything -- a hospital is a well oiled machine for telling you what to do and when to do it.

Dr. Lee is among the most experienced PC surgeons in the country -- he doesn't need your business and you can have confidence that if he didn't think that surgery was appropriate in your case he wouldn't be doing it.

Some of us can just say "I gave it to God" if that doesn't suit you then consider that the die is cast. You might busy your mind by making preparations for your recovery -- baggy sweat pants? supply of pads? been doing your kegels? getting in some walks? giving the gland its final bit of exercise? bedside bucket for the catheter bag at night? KY for keeping the cath lubricated? Now these are worries that you can dig into and feel less out of control. If you want more suggestions just ask.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day


Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 1/4/2010 10:35 AM (GMT -6)   
Burlcodad,

Here is what I've been suggesting to people who have their surgery scheduled and are feeling nervous (or even if you are not nervous). Ask your doc for some samples of Levitra, Cialis and Viagra on a couple of pretenses. One is that you are having some performance anxiety due to nerves and need a little help. Two is that you can do a little homework and gauge which ones work OK for you now at pre-surgery (and thus know which ones to use post surgery). Your Doc might really like that second idea since everyone is always poking around post-surgery not knowing which ones to try next.

Even if you think you are are still like a studly 20 yr old, you may be surprised at how much longer you'll be able to go with a little help from your L, C and V friends.

Also if you have never used them before, there's the excitement there of trying them out. Kind fun to try them -- and that's what you need about now - more fun stuff.

Be sure to report back on your findings!
Age 58, 195lbs, 6'4", 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
Biopsy Nov2008 1 of 12 cores 5%, Gleason 3+3 - Sona showed size 140+ cc (110 grams post op).
02/03/09 open RRP surgery , Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
02/18/09 Cath out, passed a 1cm oblong STONE within hours.
03/06/09 Started Levitra@20mg / Viagra@100mg / (04/01) Cialis@20mg -- no real effect (thru 11/2009).
04/01/09, 07/07/09, 10/01/09 PSA <0.1 - Stone Was Oxalate stone -- X-ray no stones.
08/09 - started MUSE@1000mcg ... pump&plump - success(80-90%) (alpro ache).
09/09 @500mcg +pump&plump + 2 advil - success(80-90%) - (less Alpro ache).
10/09 TrimixGel (500/300/100mcg): 1st:60%, 2nd:(pump&plump) 60%, 3rd(added 500mcg muse):70-80% -- (no Alpro aches!) but none @ useful hardness!

Post Edited (JimStars) : 1/4/2010 9:38:09 AM (GMT-7)


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7204
   Posted 1/4/2010 10:46 AM (GMT -6)   

You've gotten some good advice. But, let me put it this way. There is an emotional and an intellectual component to all of this. It is normal to be fearful. My surgery is set for 3 weeks. I have had previous surgeries (knee and inguinal hernia) and I was fearful a bit before those. This of course is much scarier. But that's just normal.

Listen to your intellectual component. Of course you feel okay. If you had PC symptoms now, that would be bad news. You KNOW you need to have treatment and I'm sure you considered various modalities. Assuming there is no intellectual/logical reason for changing your mind, then try to relax as best you can.

 

Mel

 


63 years old
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.  
History of BPH/prostatitis. PCA-3 test: 75.9 (bad news, guaranteeing I have to do....): Biopsy on 11/30/09. Result of biopsy:

5 out of 12 cores positive. Gleason 4+3. More specifically: 2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C

REVISED BIOPSY REPORT: The previous was read by Umich. Slides were then sent to Dr. Menon at Ford Hospital. Here is their report (much better) -- changes in bold print below:

5 out of 12 cores positive. Gleason 3+4. More specifically: 2 cores were 3+3 (one 5% and the other 20%) on one side. On the other side, 3 cores were 3+4 (5%, 5%, 20%)

 Latest: Surgery with Dr. Menon at Ford Hospital, set for 1/25/10

 


JB71
Regular Member


Date Joined Nov 2009
Total Posts : 206
   Posted 1/4/2010 11:18 AM (GMT -6)   
Burlcdad:
 
I was about to ask the same question. Never been in a hospital either so plenty scared. Trouble sleeping all thru the night likely caused by the Lupron and now associated hot flashes that wake me every 30 minutes or so.
 
Pre-op is for the 12th. followed by open surgery on the 20th, with the doctor I wanted and trust but there are still many worries. The hospital is a bit of over an hour away and yesterday the highway to there was closed because of snow, so if my schedule had been for yesterday, neither myself or the doc might not have made it and then what ? We may have a reasonable health system here but wait times are longer than they should be and a new appointment could take additional months.
 
As for postponing  or canceling, I think not since the doctor indicated that my current numbers indicate aggressive cancer, best treated by open surgery NOW.
 
Although I have done a fair bit of reading and resourcing ( and I love this board and the folks on it) I have to respect the advice from the experts.
 
Oddly, although I'm scared to death of any hospital, it's the catheder and it's sideshow that I think about most.
 
Lets keep in touch.
 
Jerry.
.
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. (not ordered
by first urologist)
 
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 !
 
Open surgery scheduled for Jan. 22 by Dr. J. Chen
at London (Ontario) Health Sciences Centre.
 
NOPE, that just changed to January 20th. (2 days earlier) and the venue for entertainment gets moved to the University Hospital.
 
Need to get this over with ASAP so next season
I can continue with motorcycling, sailing  and enjoying life, TOGETHER with my wife, Debbie.
.


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 1/4/2010 11:20 AM (GMT -6)   
I was very nervous about the surgery as I had never been operated on before but I was not questioning my decision for surgery. As James C. stated if you are doubtful about your treatment choice then cancel the surgery and go back through your decision making process again. With a Gleason of 6 your cancer is slow growing so you have time. If you are fearful of the surgery I can only relate to you my experience. I have now had two surgeries. One for the PCa and then the second for a penile implant which I had about three weeks ago. Being knocked out is not a big deal at all. The medications they use today leave little of no after effects. I had the Da Vinci and I had very little pain afterwards and never took a pain pill. My penile implant was a lot worse then the Da Vinci as to pain and recovery. Are you in good shape? In preparation for surgery I walked 3 to 4 miles a day every day. I feel that helped me a lot in recovering. The other treatment choice I considered was the proton beam. I chose surgery because it was the only way to know after treatment if the PCa was gone or if I would have to have further treatment.

The week before surgery I did not sleep well and the night before I did not sleep at all nor the night of the surgery so I went two days without any sleep but I slept well the next night.

Good luck!!

Tamu
Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06, 6/25/07, 1/8/08
No more pads as of 1/13/07
Began injections in April '07
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/4/2010 11:30 AM (GMT -6)   
Burl, you have been given a boatload of good advice to your question.

If you are just nervous nervous about the upcoming surgery, 100%, and if needed, even your GP or surgeon could put you on something mild to help you chill between now and then.

If you are worried about being put under, I may be the odd one but I enjoy being put under. It is total and utter bliss, you dont know anything dont feel anything. Some people have trouble coming out from being put under, but its usually related to nausea, and they usually give you something for that to prevent it.

If you are 2nd guessing your decision, only you and you alone know in your heart of hearts what you want to do. I had some doubts even on the gurney waiting to leave for the OR, but I thought through an outline in my head why I was doing what I was doing, and remembering all the knowledge I had learned along the way that led me to that decision.

Like I told my darling daughter as I was walking her down the ailse 5 years ago, if you even have 1% doubt, we can just turn around and walk right out of here. It would be better to do that then to enter a wrong marriage. Same kind of thinking, dont worry about what the hospital or surgeon will think. Make sure this is what you want, no instant replays, no rewinds.

We are here for you either way. But its most assuredly normal to have moments of fear, panic, doubt when I is about to have a major and complex surgery. If it didn't bother you at all, I would be more concerned for you.

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
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA:
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 in place


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 1/4/2010 11:45 AM (GMT -6)   
Thanks everyone for your respones.  I really appreciate  the kindness of everyone here.  You are all great human beings to be here for each other.  I am so lucky to have found this place.
 
My apprehension really boils down to the fear of being put out.  I'm certain that I have chosen the right procedure for me and the right doctor. 
 
I suppose that they are use to people being very stressed out and do have things mapped out to help minimize the anxiety once you get there.  If I can't get some sleep tonight I am definently calling tomorrow for some meds to help. 
 
Thanks everyone
 
Ray
diag 9/09
 
age at diag 54
 
PSA 6/09 1.3
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/13 at UP with Dr David Lee
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/4/2010 11:53 AM (GMT -6)   
Ray, sounds like you are coming up with a plan to dealing with it. Happy to hear that. Let your doctor help you get through this, it's stressful enough without adding to it. In the end, sure you will do fine, we have all been there done that, with us surgery guys.

If you are certain, as you are saying about your decision of procedure, then the rest of it is just normal human nature and common fears.

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
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 in place


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 1/4/2010 11:58 AM (GMT -6)   
I had undergone surgeries before robotic, Ray, but I can understand the apprehension of someone who has never gone under before. The moment of truth will happen and you won't be aware of it. Next thing you know, you're done! Of course, our individual constitutions are very different, but all things being equal, my experience coming out of recovery was that I found myself in the same elevator as my wife going back to my room to her shock at how alert and conversational i was, even on the gurney! (and so was I).........I certainly lapsed in and out of naps once back in the room, but I had total recall of all conversations that were happening in my room. Not much in the pain area either. Incisions were sore, but no real internal pain. (Might have something to do with the morphine drip) :-) If you do, they'll be at your beckoned call for meds or anything else you need.
Don't try to be a hero if you do have discomfort. Ask and ye shall receive!
 
Arnie

Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 1/4/2010 12:33 PM (GMT -6)   

Arnie

Do you remember how long your operation took?

 

Ray

 

Arnie said...
I had undergone surgeries before robotic, Ray, but I can understand the apprehension of someone who has never gone under before. The moment of truth will happen and you won't be aware of it. Next thing you know, you're done! Of course, our individual constitutions are very different, but all things being equal, my experience coming out of recovery was that I found myself in the same elevator as my wife going back to my room to her shock at how alert and conversational i was, even on the gurney! (and so was I).........I certainly lapsed in and out of naps once back in the room, but I had total recall of all conversations that were happening in my room. Not much in the pain area either. Incisions were sore, but no real internal pain. (Might have something to do with the morphine drip) :-) If you do, they'll be at your beckoned call for meds or anything else you need.
Don't try to be a hero if you do have discomfort. Ask and ye shall receive!
 
Arnie


diag 9/09
 
age at diag 54
 
PSA 6/09 1.3
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/13 at UP with Dr David Lee
 
 


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 1/4/2010 12:43 PM (GMT -6)   
Right around 2-2 1/4 hours, Ray it'll be that for anybody in the waiting room; for you it'll seem like 2 minutes........Lee came back to the room after to say that there were no surprises, that he felt he got it all, and that the nerves were spared. You won't know for sure until you get the pathology report, but those words were comforting right after surgery
Do you know what time of day your surgery is scheduled? Mine was first thing in the AM. Lee's right on schedule at that point, especially with no complications.  Feel free to ask any and all questions..........I didn't know anybody, personally or on a forum, who had Lee prior to my surgery. Just a lot of very good references form medical sources---------A friend of mine followed me about a month later. He had similar stats but was 5 years older. He was, and is, as pleased as I am with the outcome. 
 
Arnie
 
Age 56 (biopsy & surgery)
PSA at Diagnosis-3.9
Biposy 8/19/08--4 of 12 cores positive; 5% involvement, Gleason 6 (3+3)
 
Surgery 1/26/09-DaVinci Robotic Prostatectomy at Presbyterian Medical Center/HUP-Phila, PA
Dr. David Lee
 
Pathology Report- Adenocarcinoma, no capsular involvement, seminal vesicles clear, lymph nodes clear, negative margins, Gleason 7 (3+4), Stage T2C, NO MX, Prostate 61.8 grams, gland involvement 2-10%
 
Catheter removed after 8 days, totally dry at 3 months. ED issues continue, Viagra (via ADC) nightly (100mgs), VED use in earnest at 6 months. "Ball Park Frank" plumping at this point......ED at 10 months continues to improve, albeit slowly. Continued daily use of 100mg Viagra (ADC). Discontinued pump use; manual stimulation to varying states of erections; achieved penetratable erection on a couple of occasions
3 month PSA--<0.1
6 month PSA--<0.1
10 month PSA--<0.1


Burlcodad
Regular Member


Date Joined Nov 2009
Total Posts : 254
   Posted 1/4/2010 1:00 PM (GMT -6)   

As of now i dont know what time it is scheduled for - I have to call next Tuesday afternoon.   I am going to call now and make sure they have all my pre op reports.  My GP had them when she wrote the clearance letter so I assume that they do because they called me last Monday and asked if I wanted to move the surgery up to today because they had a cancellation.  I have plans to go to AC with my wife and daughter for a dance clinic my daughter is in this weekend so I didnt change the date.

confused I don't know why I have these questions about incline position and length of surgery - its not like I'm gonna be aware of it or have much to do with it at that point.

Ray


diag 9/09
 
age at diag 54
 
PSA 6/09 1.3
 
stage 2b (biopsy done because of firmness felt on right side)
 
3 positive cores out of 12 (all less than 25%)
 
Gleason 6
 
Surgery scheduled 1/13 at UP with Dr David Lee
 
 


Arnie
Regular Member


Date Joined Aug 2009
Total Posts : 372
   Posted 1/4/2010 1:08 PM (GMT -6)   
If you have a choice, and you might at this point, ask if you can be the first time slot of the day. That way, there's less of the day to pass getting even more anxious. Get it done and over with, and the sooner you get back and start recovery, the sooner the clock starts ticking to go home the next day, barring complications.
All the questions about positions and length of surgery are common. You've seen other similar question and concerns on this forum...........again, you'll be just fine.
 
Arnie

MaxBuck
Regular Member


Date Joined Jan 2010
Total Posts : 75
   Posted 1/4/2010 5:59 PM (GMT -6)   
I'm no good at addressing the emotional component, since I'm a pretty callous SOB. But with respect to anxiety over anesthesia, it may be worthwhile to discuss with your surgeon the possibility of having the surgery done with a spinal block - in which case you'll be pretty much awake and aware during the procedure. No pain or sensation, but you can see and hear what's going on.

That's what was done with me, and since my surgeon had a particularly rockin' choice of OR music (Aerosmith, the Stones, Thorogood, etc.) I had a blast. They also shot me full of morphine, which is its own little freakshow if you're awake to experience it. Was even able to confirm with the doc as he was stapling me shut that he found no unpleasant surprises. My open surgery lasted maybe 2 hours total.
Dx at age 56: Oct 09; PSA 5.8, followed up by 9.9 two weeks later (reproducibility of test - ?)
Biopsy ind cancer in 8/12 cores: Gleason 8 (4+4)
open radical retropubic prostatectomy Dec 4 09
Post-op pathology: 56 g weight, cancer in 21%, Gleason 7 (4+3, tert 5); margins clear, lymph node involvement 0/9, perineural invasion, T2c N0Mx (but showed clear from distant metastasis in pre-op bone scan and CT scan)
Continence data: 1 maxipad/day, with minor leakage when I get up from long seated position; ED pretty complete: some erection possible but current non-functional


NewspaperLover
Regular Member


Date Joined Sep 2009
Total Posts : 311
   Posted 1/4/2010 6:00 PM (GMT -6)   
I have a friend who had surgery six years ago.  He swears by LexiPro, both before and after for anxiety.  I know how you feel.  A few days before my surgery I told my wife I just wanted to run away from home.  She asked me "Can I come too."  Best wishes
 

Age 66

PSA:  6.0  on 07/31/09 having risen from 4.2 on 12/02/08.  Free PSA 23.5%.Other PSA History: 4.3 on 05/01/08; 3.3 on 11/15/07; 3.1 on 05/20/07; 4.0 on 11/30/06; 3.40 on 09/01/05.

 

Biopsy:  09/04/09  13 snips;  two positive.  Right Mid  4+3 = 7 and 15% of the total volume.   Right Lateral Mid 4+3 = 7 and 20% of the total volume.

 

DaVinci robotic surgery:  11/05/09.  Post surgery pathology:  margins clean, no invasion of seminal vessels, no upgrade of the Gleason scores, no evidence of cancer outside the prostate capsule.

 

Cathether removed one week later:  11/12/09.  No incontinence.   Stopped using pads on day three.  No pads or incontinence at night. 


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 1/4/2010 11:43 PM (GMT -6)   
Hey Ray, there's a reason my "handle" is Sleepless. Welcome to the club.

It wasn't being knocked out, per se, that worried me, it was dying on the table. So I called my surgeon and told him of my concern. He told me that with modern anesthetics and monitoring etc. the most danger my life was in on the day of surgery was the drive to the hospital first thing in the morning. "Once I get you in my OR --- you've never been safer." I forget the exact statistic on OR anesthetic problems, including dying, but it was like one in many many thousands and what really settled me down was his saying that the stats weren't about people of my age, in my condition, having a daVinci operation. They included all sorts of people in bad shape having lengthy major, major surgery. I left that conversation totally convinced the most danger I'd be in all day really was the car ride to the hospital in the morning. I came to the realization that the reason it was scary was it was new to me. Every day in hundreds if not thousands of ORs around the world people were being knocked out, waking up, and not long afterwards resuming their lives cancer free. That sounded good to me.

On the morning of my surgery when I met the anesthetist I told him I was glad he was on my case as my surgeon had said he'd trust him to put him to sleep and wake him up again, anytime. I told him it was the waking up part I really liked about the endorsement. The anesthetist said not to worry, "If I don't wake you up, I don't get paid."

No matter what we say Ray, you're going to worry. You wouldn't be normal if you didn't. And, in a few weeks, you'll be here writing guys about to head into the OR saying, "don't worry ---- you'll be fine," just as I'm saying to you now.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9, so far, so good
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
Oct 1st 09 -- dry at night, during day some stress issues, but better every week. 
Feel free to email me at:  sheldonprostate@yahoo.com    


skeener
Regular Member


Date Joined Dec 2009
Total Posts : 214
   Posted 1/5/2010 12:03 AM (GMT -6)   
Sleepless gives you some very sound advice.
 
I am not too proud to say that I took sleeping medication for two nights before the surgery to ensure that I would be well rested.  Having been in the hospital before 25 years ago for hernia repair, I recall getting little or no sleep while in the hospital.
 
I just made sure I let them know that I had taken some medication the evening before which caused no problem.
 
In the end I was very glad I was well rested before I went into the hospital because they did not have a bed for me with the PCa guys.  I was in a private room in the thoracic surgery recovery area.  With all the bells and whistles going off the two nights I was there, PCa surgery seemed no where as bad.
 
I other thing I noticed is that the anaesthetic has really improved over the years.  I recall a long recovery from that when I was younger.   This time I was feeling myself the day after surgery.
 
Carl

Age:  63 
Biopsy: May 09 showed 2 of 12 cores positive for prostate cancer -- 1 at 5% and 1 at 25%.  Cancer indicated as non aggressive.  Gleason Score: 3+3.
RRP on Oct 23/09 in London, Ontario.  Excellent surgeon. 
7 Weeks Post Op -  The fears I had about bad things about the operation and recovery did not materialise except of course ED!!.  Otherwise, everything went very smoothly.  Incontinence not a problem.  Wear a pad when out just in case. Pain was never a problem.
Pathology:  Unremarkable 
First followup PSA and Visit: Feb 07/10.      


LenB
Regular Member


Date Joined Jul 2009
Total Posts : 102
   Posted 1/5/2010 9:09 AM (GMT -6)   

Burlcodad,

 

Like you, I had never had surgery or even been in the hospital prior to my DaVinci surgery.  What you are feeling is natural. DO NOT BACK OUT!!!

Dr. Lee is one of the best in the Philadelphia area.  I had no pain after the proceedure at all. Just some slight discomfort.  I could have had morphine or oxycodone for the pain but, the only thing I needed was a couple of tylenol.

Surgery is the best option. If you have radiation and the cancer comes back then it will be difficult to have surgery because it will be more complicated. 

Hang it there, you'll be fine.  You sound like me 4 months ago.  Now I am glad I had the surgery and I know I am cancer free.

Best of luck and feel free to email meif you want to talk person to person.

Len


Age: 65
DX: 7/10/09
Gleason: 7
Biopsey: 2 chips with some cancer cells out of 30.
Robotic Surgery: 9/10/09
Cath out: 9/23/09
1st post op PSA: 10/20/09: <0.0
 
 


brainsurgeon
Regular Member


Date Joined Jul 2009
Total Posts : 137
   Posted 1/5/2010 9:53 AM (GMT -6)   
I had not had a general anesthetic since the third grade with open drop ether (tonsils). Nowadays, under general anesthesia, your body parameters such as, blood pressure, oxygen levels, etc. are better than if you are up walking around. After seven hours under, I did not have a sore lip or tongue, no sore throat, etc. One minute you are awake and the next you are awakening like no time has passed.

Try to relax. Things will go well.
70 years old (1939) USA citizen
Prostatic carcinoma dxed June 2009 by PSA (7.0) and then Bx
PSAs yearly since 2001 ranged 1.52 to 7.0
Neg. CT and Bone Scan
4 of 8 biopsies positive (all right side) Gleason Score 3+4=7
Robotic assisted total prostatectomy and node excision July 2009 in Luzern, Switzerland by Dr. A. Mattei in the Kantonsspital
pT2c G3 pN0 (0/14)
Catheter out in 5 days (home in 3 days)
No incontinence
Positional neurpraxia resolved in 5 months.
Potency: beginning tumescence??? at 3 weeks post-op. Still happens at 3 months PO. Nearly usable one month later. At 5 mo. with 100 mg Vitamin V, pretty good.
3month PSA less than 0.01

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