S.O.S.! WHAT QUESTIONS SHOULD I ASK IMMEDIATELY AFTER SURGERY?

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Paella
Regular Member


Date Joined May 2010
Total Posts : 52
   Posted 6/12/2010 8:49 PM (GMT -6)   

(48 hours until surgery.)

  

I’d love to get suggestions for specific questions for the surgeon post-RALP (while we’re still in the hospital).  I plan to use a tape recorder and have gotten some helpful tips from The Really Useful List Made by HW People for HW People…compiled by English Alf and found at the top of the forum site

 

However my list is still pretty short.  Can anyone add anything they asked or wished they’d asked? (Remember, this is for those right-after-surgery questions which I envision taking place either in the waiting room or in the recovery room or in the regular room.)

 

1.  Were you able to save the nerves?  Both sides?

 

2.  What can we know right now (prior to pathology report in a week) regarding:  Surgical margins positive?  Seminal Vesical involvement?  Lymph node involvement, Extra-capsular extension?

 

3.  How many lymph-nodes did you take?

 

4.     Will you send us home with an Rx for Pyridium…just in case?

 

5.     Will we see you again before we leave tomorrow?

 

Appreciate any thoughts on this subject.

 

Paella

  


DS Can
Regular Member


Date Joined May 2009
Total Posts : 195
   Posted 6/12/2010 9:18 PM (GMT -6)   

Paella,

I wish you all the best for a successful surgery and recovery.

The surgeon should be able to give you an opinion about how the surgery went.  You may want to ask what nodes/tissue was actually removed and why.  And why wasn't more stuff removed? 

You will be on the healing side of surgery and as the sedation wears off you will have some discomfort.  This is the day to focus on feeling better and having your pains taken care of.  I remember having a lot of upper body cavity pain.  They all said it was from the gas but I think it was more of a wrong placement of my arms during surgery.  My shoulder hurt worse than the surgery site.

I wouldn't rush a doc's opinion before the final pathology.  Just hang in there for the week and be hopeful.  Concentrate on taking good care of that catheter.  Make sure that you understand all of the instructions for cleaning and use before you leave the hospital.

Get some rest,

Dan

 


PSA Jan'07:1.2,  Jan'08:1.9,  Jan'09:2.5
BIOPSY Feb'09  PCa DX, age 52
Right: 3+3=6, 3/6 cores 10% involved,PNI-Y
Left:  3+3=6, 1/7 cores <5% involved,PNI-N
LARP April 9,2009 nerve sparing. Final pathology:
GS 3+4=7, Margins uninvolved, 2 lymph nodes negative
Catheter 8 days, Last pad May 2,2009
latest PSA: April 8,2010 <0.1
 
 


Paella
Regular Member


Date Joined May 2010
Total Posts : 52
   Posted 6/12/2010 9:29 PM (GMT -6)   
Thanks, DS Can!

Paella

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6898
   Posted 6/12/2010 9:30 PM (GMT -6)   
Although I'm pretty sure all of this is in Alf's list somewhere, I'll list additional things I asked the doc / nurses or was told before I was discharged:

-Catheter care?
-Extra big / night bag
-Leg bag (ask for an extension tube for the leg bag, they did not give me one, and it would have been fairly useless without it, although I just stayed on the big bag)
-Cap (a sort of stopper) for the catheter tube - the nurse brought it and said to use it if I was changing the bag and had any delay at all, so that the system could be closed to help prevent infection
-Wound care (what can get wet when) - I asked for some very large waterproof bandages to put over the incisions while taking a shower.
-When can bandages be removed?
-Weight limits and lifting / exercise restrictions
-Pain medication prescription and directions (I needed that, advil would not have done the job)
-Antibiotic prescription and directions (there will be one for several days after)
-Stool softener suggestions
-Contact info for the hopspital, physician, night numbers, etc.
-Diet suggestions
-Driving rules
-Symptoms that if seen, merit an immediate call to the doctor.

I'm sure there was something else, so I'll likely add some later.

Aimzee
Veteran Member


Date Joined May 2010
Total Posts : 1401
   Posted 6/13/2010 1:10 AM (GMT -6)   
Paella, I wish Mac the very best with his surgery and a speedy recovery!  May God bless you both.  Please come back and share some details with us.
 
Aimzee
Husband Ron, age 63
Had Progesterone shots for 6 months.  January PSA was .05. 
PSA 6.5
On Cipro (antibiotic) for 16 days
Bone Scan/CT Negative
Biopsy 4/20/10  12 samples... 3 positive on right side
one core left base (5% ` 0.5 mm)  two cores of left lateral mid
(20% ~ 2mm, 10%, 10% ~ 1mm)
Gleason 6 (3+3)
Surgery to be scheduled: THE DA VINCI ROBOTIC method
 
(I do the posting for both of us.)


English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2211
   Posted 6/13/2010 3:14 AM (GMT -6)   
Paella

It's not in the list, but I guess the very first question you need to ask is:

"Did everything go according to plan?" (ie did you find anything you had not expected to?"

Then perhaps:
"how long was he under?" (the longer you are under the longer the immediate recovery takes that first day.
and
Did he need a blood transfusion?

Mac may be connected to "tubes" if so, then ask what they are for (It wasn't a major issue for me or for my wife as a spectator, but when I came out of recovery to the ward I was on both a saline drip and had an oxygen tube in my nose as my blood pressure had dropped, but both were soon removed.
There will also be a drain attached to his belly probably on his right hand side, make sure this is comfortable and ask when they will remove it (probably about 24 hours after the op)
The catheter will also be emptying pee into the bag hanging from the bed, the pee will be full of blood at this stage so feel free to ask if this is normal both in terms of quantity and colour. The nurses should come and check it and empty it fairly frequently as part of the business of monitoring his recovery.

On the care front ask when he can have a drink. And when he can start drinking he should drink plenty, the catheter will take care of all the pee that results and it will speed up how quickly the bladder is flushed out.

The catheter itself may itch, tickle or just be plain annoying. modesty gets ignored for best results as you and he together with a nurse's help may want to adjust it. The thing is rubbery and can bounce and flex with a mind of its own if you don't tell it you're the boss. Even a slight adjustment of quarter of an inch can make the most important difference in the world. (and this is true for the next week as well)

The pain issue differs a lot per person. If Mac has any pain he must mention it. Pain relief is a must. But don't just think about pain in the area he has been operated on, include headache, back ache, leg ache whatever, it should not be ignored so mention it to someone. I felt nauseous and said nothing about it for ages and the nurse said I was naughty to have kept quite. She gave me a tablet and it went away. he may also have a sore throat from the tubes that get put down there. My throat didn't feel sore, but it felt different for a few days, and my voice was husky for a few hours till I was drinking plenty.

In the immediate coming round from general anaesthetic phase Mac may be half awake for an hour or so, so talk even if there is no response, hold his hand, give him a kiss etc. (I came round for real in my room with a view out the window and my wife there etc, but a few days later I had a memory of being pushed out of the lift and people talking as the bed was pushed along a corridor and we bumped into something. I also thought that that oxygen tube in my nose was the earpiece for my MP3 player as it had a spongy end so I pulled it out of my nose and stuck it in my ear.

I also only remember the surgeon coming to talk to me about the operation just once that afternoon whereas my wife says he came twice. So after a couple of hours (or even the next day) it might be helpful to give him a little account of everything you have seen and done etc as there may be bits that he can't recall 100%.

It may not feel like the thing to do in the first few hours after an op, but ask when he can sit up and get up too as moving about soon is important for the whole recovery process. To start with I just stood up and then sat again, but while walking round the bed seemed like it was going to be awful, and awfully difficult to do I felt a great deal better for doing it. BUT remember the catheter bag is attached to the bed, so don't let Mac move off without taking it with him. (Walking around connected to a bag of pee may feel like it's the most ghastly thing he's ever done, but the guy I shared my room with was doing it too, as were all the other men in the same corridor.

And don't fret during the time he is in theatre, try and eat, drink, rest, go for a walk, read a book, talk on your cell phone to someone. or if you do feel bad then just shut yourself away and tear a newspaper into small bits.

And my very best wishes to both of you.

Alfred
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 of urine
Stopped wearing pads on 21st Sept 2009
Pre-op style intercourse on 24th Oct 2009 !! No use of tablets, jabs, VED etc. but...
Nov 17th 2009 PSA = 0.1
Can still get erections okay, and almost no leaking of urine, but since December 2009 I don't have orgasms, instead I just have intense pain in place where prostate used to be.
Mar 17th 2010 PSA = 0.4!!! referred to radiation therapist
April 13th 2010 CT scan.
April 28th 2010 Started Radiation Therapy (66Gy - 33 sessions)


April6th
Regular Member


Date Joined May 2010
Total Posts : 264
   Posted 6/13/2010 6:45 AM (GMT -6)   
Haven't seen these questions in the lists yet:

How long until the pathology report comes back?
Should I call your office to get it or will you call me?

BEST OF LUCK ON THE SURGERY!!!

Dan
Here are some of my stats:
Age:54
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean


RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1245
   Posted 6/13/2010 7:24 AM (GMT -6)   
At some point I would ask for a copy of the surgical report (what went on during surgery) as well as the path report.
PSA 2007 - 2.8
PSA 11/24/2008 - 7.6
Pc Dx 2/11/09; age at Dx 62
RLP 4/20/09
Biopsy -  Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex.
70 gram prostate.
Immediately continent after removal of cath.
ED - Trimix works well; viagra @ 60%
PSA - 7/31/09 <0.06
PSA - 12/1/09 <0.06
PSA - 3/29/10 <0.06
 
 
 


Paella
Regular Member


Date Joined May 2010
Total Posts : 52
   Posted 6/13/2010 8:12 AM (GMT -6)   
Waking up the day before surgery day was a little less stressful because I knew I'd hear from my forum friends. 
 
Thanks everyone.
 
Paella

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6898
   Posted 6/13/2010 8:54 AM (GMT -6)   
Looks like Alf covered most of the things I forgot.

One last thought - I have a small light shoulder pack - I put in the cellphone, phone charger, tape recorder, a notebook (so you can be keeping a diary), pen/pencil (2 so you won't be concerned if 1 goes missing) a "belongs to" card with your name and his just in case, snack and a bottle of water, etc.
I forgot the glasses case - the hosp. had one, but it would have been easier if I'd remembered it.
They will want you to keep watch, wallet, keys, etc., so he should take just what he needs.
You will have a bag for stuff for the hosp. stay and they will provide one for his shoes/clothes, but a small separate bag keeps all that stuff at hand and organized.

And add on top a bit of space for my best wishes and hopes for a totally uneventful recovery.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 6/13/2010 9:02 AM (GMT -6)   
Good luck on your surgery, and may you safely arrive on the other side, the Recovery side.
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 - 31 days, 5/24 put in Cath #17


DJBearGuy
Veteran Member


Date Joined Dec 2008
Total Posts : 714
   Posted 6/13/2010 12:45 PM (GMT -6)   
You might have already found this--it's nice to have a pillow to sit on for the drive home, preferably the donut type. I didn't have one myself, but it sure would have been nice. My surgical scars felt every bump on the road.

DJ
Diagnosis at age 53. PSA 2007 about 2; PSA 2008 4.3
Biopsy September 2008: 6 of 12 cores positive; Gleason 4+3 = 7
CT and Bone scan negative
Da Vinci surgery at City of Hope December 8, 2008
Radical prostatectomy and lymph node dissection
Catheter out on 7th day, replaced on 8th day, out again 14th day following negative cystogram
Pathology: pT2c; lymph nodes negative; margins involved; 41 grams, 8% involved by tumor; same Gleason 4+3=7
PSA 1/22/08 non-detectable! 8-)
4/23/09, 07/30/09, Oct 2009, Nov 09, Feb 10, June 10 still undetectable (<0.01)!


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 6/13/2010 1:13 PM (GMT -6)   
Paella, when the surgeon came out to speak with me after John's surgery, the first question I asked him was "did you see anything you didn't expect?" Fortunately, his answer was "no" and he told me straight off that he was able to spare both external nerve bundles. He had no plans to test lymph nodes and did not change his mind during the surgery. We got the results of the surgical path report about 7 days later and the surgeon called to give us a quick synopsis of what the report said. A print out of the actual report was given to us when John went in to have the catheter and staples removed a few days later.

John was sent home with a script for oxycondin (which he never used due to the fact that it constipates) and did not have any medication for bladder spasms. The surgeon preferred that he avoid using them (unless there was pain, of course) since it also contributes to constipation which delays introducing "normal foods" to the diet.

Hope the surgery goes well.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5682
   Posted 6/13/2010 2:28 PM (GMT -6)   
My 2 cents worth is take as few drugs as is required. They had me on a morphine drip,{ I was informed }, being a love child of the 60's I couldn't refuse. BIG mistake, my second nite in hospital, the last, I totally freaked out, depression,sadness, despair and that was with the good news that they felt they got it all. Path report confirmed, at least to the extent ,they can. Glad I didn't have bad news. Surgery, catheter, all the post op stuff, I"m 8 mos out, reallywasnt as bad as you think it will be. Being human, you will have a roller coaster ride. Recovery is not a straight line, but as compiler knows, the shortest distance, may not be. Aloha!
age 66 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of W Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
Dec 14,2009 psa 0.0 May 10 2010, psa 0.0

" Hypocrisy is vice's homage to Virtue " read it in Bartlet's book of quotation years ago stuck with me, can't remember who said it.


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5682
   Posted 6/13/2010 2:30 PM (GMT -6)   
A caveat, If you really need the drugs, by all means take them, just don't do it for the experience.
age 66 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of W Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
Dec 14,2009 psa 0.0 May 10 2010, psa 0.0

" Hypocrisy is vice's homage to Virtue " read it in Bartlet's book of quotation years ago stuck with me, can't remember who said it.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 6/13/2010 3:31 PM (GMT -6)   
Pain management is a crucial part of any surgical procedure. There are men that somehow feel that they are to tough it out, or to endure pain. Some pain meds can cause short term constipation with some patients, but not all. Those made with synthetic opiads are less prone to do that. It's a trade off though, pain that is not being controlled, just slows and retards the general recovery process. Each person's pain tolerance and level is certainly different, but if it hurts, then don't hide it. Take your pain meds as prescribed and as directed, and you will find your overall recovery from surgery a whole lot more tolerable. That's my take on it.

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, 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 - 31 days, 5/24 put in Cath #17


daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 6/13/2010 3:42 PM (GMT -6)   
Amen Purgatory,
One of my nurses got really pissed at me for toughing it out, turns out the pain was causing an increase in my BP and vitals which made her nervous. After she found out I hadn't been asking for my morphine (I'm in recovery 20+ years) I got a scolding and some relief.
Diagnosed 12-09 age 55
07-06 PSA 2.5
01-08 PSA 5.5 (PCP did not tell me of increase or schedule follow-up!!!!)
09-09 PSA 6.5 Sent for consult with Urologist
11-09 Consult, scheduled for biopsy, found out about PSA from '08 (yes I was pissed)
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5, ain't much but I'll take it.
01-10 Bone Scan, "appears negative"
03-01-10 RRP in Durango CO by Dr Sejal Quale and Shandra Wilson, no naked eye evidence of spread, Vesicles and lymph nodes taken for microscopic exam.

03-16-10 Removal of cath' and pathology results of samples.
Multifocal carcinoma with areas of Gleason pattern 3, 4 and 5, Overall Gleason grade 4+4 with tertiary 5, Bilateral involving 21% of left lobe, 3% of right lobe, Invasion of left Seminal vesicle, Tumor focally present at left resection margin, 9 lymph nodes removed all negative, Tumor staging pT3b NO MX

04-23-10 PSA <0.04
05-03-10 1 week without pads
06-07-10 PSA <0.04


Paella
Regular Member


Date Joined May 2010
Total Posts : 52
   Posted 6/13/2010 4:04 PM (GMT -6)   
It's now 16 hours until surgery and I can't thank everyone enough for all the good thoughts and the help. We're doing well. Our son (he's 25 and lives about 1.5 hours away) is much more stressed out than we are since we've been able to talk together about everything (EVERYTHING!)and become as well informed as can reasonably be expected. Phone calls with him have helped but we asked that neither he nor anyone come to visit during the week pre-surgery just to make no new germs than usual come to visit, too.

Talk to you on the flip side

Best!

Paella

Aimzee
Veteran Member


Date Joined May 2010
Total Posts : 1401
   Posted 6/13/2010 5:50 PM (GMT -6)   

That is good advice Paella, about the germs.  There are so many things I have not thought of.  As I mentioned, we watch our Grandbabies (ages 2 and 3) and I have asked my daughter to try to find someone else to take care of them for a week.  After that, maybe I can go to her house?

Please let me know how Mac weill be feeling as these days go by.  May he have a very successful surgery!


Husband Ron, age 63
Had Progesterone shots for 6 months.  January PSA was .05. 
4/1/10 PSA 6.5
On Cipro (antibiotic) for 16 days
Bone Scan/CT Negative
Biopsy 4/20/10  12 samples... Adenocarcinoma:  3 positive on right side,
one core left base (5% ` 0.5 mm) -  two cores of left lateral mid
(20% ~ 2mm, 10%, 10% ~ 1mm) - No Perineural Invasion
Gleason 6 (3+3)
Surgery to be scheduled: da Vinci Prostatectomy
 
(I do the posting for both of us.)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 6/13/2010 6:35 PM (GMT -6)   
dave, you are quite right in your reply of my pain med advice. any good nurse would agree in a heartbeat. one reason i needed all 4 days post op after my open surgery, was strictly dealing with severe post op pain, and the drugs they administered could only be done in a hopsital setting. when i needed them, and i was almost out of my mind with pain at times, they were so good at the hospital to keep close tabs on my pain levels. i never had to beg
to have the meds, they knew. once i was sent home, my wife (a very qualified nurse, aside from being a great wife) had one of our spare bedrooms set up like a mini-hospital suite, with eveyrthing close by. she took a full week off of work to nurse her one and only patient, so that when she returned to work, she didnt have to worry as much about me. after my 10 day point, they removed my staples, and i was ok during the day to be by myself.

perhaps i am an exception to the consitpating rule, but long term use of pain meds, i.e. loratabs and even longer term use of ditropan for spasms, has never caused me any kind of consitpation problem. but in fairness, i have always had a nervous constitution, and so consitpation isnt anything i have had much experience with in my life. again, everyone different there.

post surgery, the single best advice i think we all agree on: is walk as much as you can comfortably, drink loads and loads of plain water, use stool softeners often - until that part of your returns to normal, and take pain meds as prescribed and needed.

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, 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 - 31 days, 5/24 put in Cath #17


Paella
Regular Member


Date Joined May 2010
Total Posts : 52
   Posted 6/13/2010 6:43 PM (GMT -6)   

Aimzee - if you'd like, I can e-mail you my list of "THINGS TO COVER".  A whole lot of this stuff has come from the hw forums but I've got it all in one place...or at least a bunch of it in one place:

List A. Things to cover when we get to the hospital prior to surgery (like making sure there's something in writing that our surgeon will perform the entire procedure...not one of the residents...)

List B.  Things to cover with the surgeon immediately post-surgery

List C.  Things to cover with the nursing staff (like making sure we go home with a topical lydocaine ointment for where the cath comes out of the penis)

I'm not really sure how you should get your email address to me.  I'm a little hesitant to put my email address here and imagine you are, too.  I guess I could just post my lists here and you could then cut and paste 'em onto a word document or whatever.  Oh what the heck - here it is:

Questions pre surgery (when we get to hospital)

 

Who will we see immediately post-op?

 

When will we see our surgeon?

 

If the doctor sees a hernia, will he fix it at the same time?

 

I don’t think Mac’s “free PSA” was ever measured.  Could I get that measurement?

 

We want to be assured in writing that only the surgeon we choose will be the one to do the entire surgery.

 

During the surgery, who will insert the catheter?

 

Will he be given Viagra immediately after surgery?  (with cath in place?)

 

Will he be given Viagra at any time while the cath is in place?

 

 

 

For Surgeon (immediately after or shortly after surgery)

 

How long was he under?

 

Did everything go according to plan?

 

How many lymph nodes did you take at the beginning of surgery (to send to lab while he’d on table?)  Why did you take that number?

 

How many lymph nodes did you take before you closed him up?

Why did you take that number?

 

What else did you take to send to pathology?

 

How long until the pathology report comes back?

Did you see anything you didn’t expect?

 

Was there any evidence of extra-prostatic disease?  Is there anything you can tell us now  (prior to pathology report in a week) regarding:  Surgical margins positive?  Seminal Vesical involvement?  Lymph node involvement, Extra-capsular extension?

 

Were you able to save the nerves?  Both sides?

 

We’d like to be sent home with an Rx for Pyridium…just in case of bladder spasms that persists without relief? (we live in a semi-rural place with a drug store that frequently has to order stuff)

 

Will we see you again today?

 

Will we see you before we leave tomorrow? 

 

Will he be given morphine today and tomorrow?  In a drip?  Can we have more if he wants it?

 

What Rx for pain? (ie- tylenol/paracetamol if it’s relatively mild)

 

What Rx for more severe pain (Mac’s allergic to codeine so may some kind of  Hydromorphone  ie - Palladone, Palladone SR, Dilaudid?  What about oxycondin?)

 

Regarding the cath removal in a week – we’d like Mac to definitely have a cystogram first

 

 

 

For nursing staff (prior to leaving the hospital)

 

Can you provide a good lubricating gel for the catheter?

 

Can you provide topical lydocaine to use around the catheter? 

 

Can you provide an antibiotic cream?

 

Cap (a sort of stopper) for the catheter tube – so system can be closed to prevent infection

Wound care (what can wounds get wet?)

 

Can you provide some very large waterproof bandages to put over the incisions while taking a shower?

When can bandages be removed?

Weight limits and lifting / exercise restrictions

Stool softener suggestions

Contact info for the hospital, physician, night numbers, etc.

Diet suggestions

Driving rules

Symptoms that if seen, merit an immediate call to the doctor

 

A large and small catheter bag.

 

Extra bags?

 

Learn how to clean everything.

 

 

 


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 6/13/2010 7:12 PM (GMT -6)   
On the other hand, just take a few moments, maybe a day to just relax and go with the flow. I think sometimes we are so overprepared that it becomes too stressful. Just see how the surgery was tolerated, how the pain is, and how his bowels are working. I found that Flowmax was a nice med to take along woth the pain meds, because the assault on the bladdder and urethra will cause spasms.

You most likely won't have quality time with the doctor. After surgery is usually a few minutes, and when he visits during his tounds, he is not able to spend an hour with you. He won't have pathology for a while, most likley after ypu are discharged.

Good luck.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01


DJBearGuy
Veteran Member


Date Joined Dec 2008
Total Posts : 714
   Posted 6/13/2010 8:52 PM (GMT -6)   
Paella,

If you're still reading, I can answer a couple of your questions. Since you're at City of Hope, I can tell you that they use a catheter kit. The kit includes the catheter and bag, as well as a tube of lidocaine gel. So that is likely what you will get. The lidocaine gel works very well.

Good luck,

DJ
Diagnosis at age 53. PSA 2007 about 2; PSA 2008 4.3
Biopsy September 2008: 6 of 12 cores positive; Gleason 4+3 = 7
CT and Bone scan negative
Da Vinci surgery at City of Hope December 8, 2008
Radical prostatectomy and lymph node dissection
Catheter out on 7th day, replaced on 8th day, out again 14th day following negative cystogram
Pathology: pT2c; lymph nodes negative; margins involved; 41 grams, 8% involved by tumor; same Gleason 4+3=7
PSA 1/22/08 non-detectable! 8-)
4/23/09, 07/30/09, Oct 2009, Nov 09, Feb 10, June 10 still undetectable (<0.01)!

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