Lingering pain in right lower abdomen, 2 months after RALP?

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denverSurvivor
New Member


Date Joined Oct 2009
Total Posts : 7
   Posted 1/23/2010 1:21 PM (GMT -6)   
 
Started about 2.5 weeks after surgery, Surgeon suggested that some sutures may have collapsed and re-adjusted themselves. Its right below the belt line in the soft tissue of the lower abdomen, the Surgeon reminds me that was the main working path and the prostate was taken out through there. A few weeks later they did a CT scan and everything looks fine, no hernia, kidney stones, etc. . . My family doctor put me on a course of antibiotics, because he thought it might be a bladder infection, but it didn't help.
 
Pain gradually getting better. I'm back to work, but I have to admit that it compresses and hurts when I sit in a chair, and also walking - each step with the right foot I can feel a little twinge of pain, not terrible, but just terribly annoying.  I start out the day feeling pretty good, but late afternoon it gets worse, and right now I need to lay on the couch for a while when I get home to let it ease up.  I can get to sleep just fine, but about 4am I sometimes can no longer sleep on my side without getting up and taking more ibuprofen, or 'trying' to sleep on my back, which is really hard for me to do - - - so this is really starting to drag on me - this is just taking so long to push through this pain.
 
 Anyone else go through something like this?
 
The surgeon just wants me to only use ibuprofen, but my family doctor is suggesting Tramadol or Vicodin. I'm not a big fan of narcotics, and have just stuck to the ibuprofen, but am wondering whether some pain management would help me? The surgeon suggests a Pain Management Clinic with maybe an steroid injection in the area, but I'm reluctant to let someone stick some needles all in there, especially when things are improving slowly but surely, plus now the exact area of the pain is rather vague, it just generally gets sore all inside there.
 
 


Age: 52 yrs old
PSA: 5.1 in Sept, 2009, last PSA was 2.6 over a year ago
Biopsy: Gleason 6 (3+3) in 1 of 12 cores, the Right Lateral Apex. 4 PINs, 1 Atypical
Robotic Assisted Laproscopic Prostatectomy: 11/16/2009
Pathology showed cancer completed contained in capsule, and Gleason 6.
First PSA test showed PSA undectable.
 
 

Post Edited (denverSurvivor) : 1/23/2010 12:24:38 PM (GMT-7)


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2215
   Posted 1/23/2010 1:32 PM (GMT -6)   
Denver,
I still ache in that area but it has improved, but took quite awhile. Had to put a pillow under that side at night as like you I am not a good back sleeper. Your a couple of months out of surgery and hopefully you will see some improvment shortly. Do you use a donut pillow? And what does the pain feel like and does it occur at any other site? I neded up with a condtion called radiculapathy which caused neuropathy type pains because it was mis diagnosed for so long. Took a CT,MRI and finally a Nerve conduction test to figure it out. about ten grand I guess. But if you only ache in that area it is likely from the surgery. good luck and hope it goes away quickly.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Starting IMRT on 1/18/10
Great family and friends
Michael


denverSurvivor
New Member


Date Joined Oct 2009
Total Posts : 7
   Posted 1/23/2010 2:12 PM (GMT -6)   
 
60Michael,
 
Thanks for your reply and your story, and i'm glad things have improved.
 
When it first began, around the first week of December, it was a very sharp, cutting pain, just like a razor blade cut internally. Ice seemed to help.
 
Nowdays, it is more of just a general ache, with maybe once or twice a day a little sharp bite of pain for just a second. It seems lately that a heating pad is helping a little.  Sometimes in the morning, especially after a hot shower, I hardly feel anything for a while, but towards the end of the day i can feel it for sure, sometimes worse than others.
 
Because of this pain, my recovery period lasted longer than the typical 4-5 weeks. It's a long story but basically I had an alergic reaction to the CT Scan contrast fluid, and then had a strong reaction to the steroids they gave me to fight the alergic reaction. So, it was more like 7 weeks before I had to go back to work and sitting at the desk - that was really hard, because by then I had lost so much weight and muscle, just found it hard holding myself up correctly in a chair for long periods of time, so I would tend to slump forward and compress the pain even more. But finally, I'm getting some core strength back, but very slowly, and this is helping with sitting. I'm just hoping that as I gain more strength, this thing will fade, but of course the pain slowly over the course of the day gets nerve racking, not to mention the worry.
 
Age: 52 yrs old
PSA: 5.1 in Sept, 2009, last PSA was 2.6 over a year ago
Biopsy: Gleason 6 (3+3) in 1 of 12 cores, the Right Lateral Apex. 4 PINs, 1 Atypical
Robotic Assisted Laproscopic Prostatectomy: 11/16/2009
Pathology showed cancer completed contained in capsule, and Gleason 6.
First PSA test showed PSA undectable.
 
 


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2215
   Posted 1/23/2010 3:22 PM (GMT -6)   
Denver,
Thanks, that explains it in more detail. Hate those things have happened and certainly my surgery and recovery has been hampered by side effects and medical errors. I still work and travel via vehicle so I use a donut pillow to help with the compression problems. Use one here at the computer and the last staff meeting I went to I just decided to take the donut pillow in with me. Didnt care what others thought, but they are supportive and know about surgery and post op problems. But the $13.00 I spent on the donut pillow was well worth the price. Hang in there, better days are ahead.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Starting IMRT on 1/18/10
Great family and friends
Michael


Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 1/23/2010 5:44 PM (GMT -6)   
Can't guarantee anything, of course, but my experience may give you hope.

Came out of surgery feeling bad all over. After a few days felt much better - except for a serious, doubling-over type pain on my right side just about or slightly below the belt line, right where the scar from the surgery was although the exact area would wander a little from time to time. The doctor told me that this is where my prostate had been taken out of my body during surgery and where some of the "heavy lifting" had occurred.

But the baffling thing was that I was pretty much pain free once I got moving, but getting moving from a stationary position (sitting, standing in one place, lying down) was very, very painful. And you can't walk around 24/7, although I thought about trying it ....

As usual, the doctor was worthless and the PA a jerk.

I can't remember exactly, but this pain lasted 6 - 8 weeks. I didn't take anything for it - just toughed it out. But I knew I couldn't hold out for much longer.

And then ... without warning ... within about 36 hours it went away. Totally, completely went away. And never came back.

Zen9
No family history of PC.  PSA reading in 2000 was around 3.0 .  Annual PSA readings gradually rose; no one said anything to me until my PSA reached 4.0 in September 2007, at which point my internist advised me to see a urologist.   
Urologist advised a repeat PSA reading in six months = 4.0 .  Diagnosed May 2008 at age 56 as a result of 12 core biopsy.  Biopsy report by Bostwick Laboratories = Gleason 3 + 3. 
Interviewed two urologists - the one who did the biopsy and another - the latter had the biopsy slides re-examined = Gleason 3 + 3. 
Then went to M. D. Anderson Cancer Center in Houston in July 2008 and met with a urologist and a radiologist.  Biopsy slides re-examined yet again, this time by MDA's internal pathology department = Gleason 3 + 4.   
Chose da Vinci surgery over proton beam therapy; surgery performed at M. D. Anderson Cancer Center on August 15, 2008.  Post-operative pathology report = four tumors, carcinoma contained in prostate, clean (negative) margins, lymph nodes clear, seminal vesicles clear.  Gleason = 4 + 3. 
Minor temporary incontinence; current extent of ED uncertain due to lack of sexual partner; refused treatments for ED as being pointless under the circumstances. 
PSA readings: 
November 2008 = <0.1 ["undetectable"]
June 2009 = <0.1   
December 2009 = <0.1
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 1/23/2010 5:59 PM (GMT -6)   
Hey there, I had experienced a lot of pain let that after my open surgery. I heeded all my doctor's warnings at the time about weight restrictions, no sexual attempts, etc, being very compliant.

The Advil class OTC mets you were told to take would be best to reduce the swelling in the areas affected, but there is a risk of that causing bleeding, which I had an issue with.

A lower class pain med (prescription) is the classic Loratab, either the 7.5 or 10 mg, depending on pain level and body weight. But you have to be careful about not injesting too much in a 24 hr period, because of the amount of the Tylenol ingredient, which I believe is 500 mg on each tablet, and that can cause liver problems or damage for some.

Hopefully it will continue to heal naturally, and then the pains should keep abating. Good luck, listen to your body, and mind your doctor!

Please keep us posted

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 43 days, 1/10 - Corrective Surgery #4, and Caths #11 and #12 in at the same time


Im_Patient
Veteran Member


Date Joined Aug 2009
Total Posts : 659
   Posted 1/23/2010 11:24 PM (GMT -6)   
My problem post-surgery (although we are talking only 1 week) was in that general area. After a trip to the ER, it ended up being an ileus. That was a result of too much pain medication for too much pain. At some point, I suppose I will relate my "worst case" experience, as my surgeon described it, of my surgery. However, no regrets. I'd do it all over again. However, the ileus was a result of the digestive system completely stopping from the pain medication. I ended up on a trip to the ER via ambulance for excessive pain as a result of that ileus. After management of the pain, and another visit to the ER for dehydration as a result, I stopped all pain management in favor of getting the digestive system back on track. After that, it was all about recovering from the surgery, albeit a slow recovery.

My point: don't take any more pain medication than you have to, and sometimes it is unavoidable, you just deal with it. You get past that phase of the process as quickly as you can, and then you move on with the next phase. I was past this phase of the troubles at 1 1/2 weeks. You are well past this, denversurvivor, so this may not have a lot to do with your troubles, but my $0.02.
Gleason, 3+4; PSA, 7
Robotic Prostatectomy, March 2008 (Age 48 then), nerves both sides spared, post surgery analysis confirmed 3+4 Gleason,
cancer contained, no penetration, lymph nodes clear
PSA consistently <0.1 since surgery

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