UPDATED REPORT FROM DOCTOR'S VISIT MONDAY AFTERNOON:
Spent 30 minutes with the doctor, as usual, no rush on his part.
Decided I was too sore to change out the catheter tube (SP), he felt around and agreed. Been in 4 weeks, hes ok letting it go 4-7 weeks out if needed.
Put me on a new med for spasms, Enablex. Take it 1x in the morning, gave me tons of samples and a scropt, wants me to try for a few days to see if it works better than ditropan.
He is going to arrange day surgery this week or for next week depending on hopsital schedule. Wants to look with scope from below through the penis, and correct any new scarring, and wants to scope from the SP site, to see how much inflamation he's sees this time, as compared to his last look in March. Will mean coming out with both a SP cath and a foley at the same time. Which one stays after a few days depends on what he sees.
He has consulted with Dr. George Webster, a reknowned urological surgeon from Duke about my case. He can do advanced level surgeries. Unfortunately, he feels that there is too much radiation damage to my bladder neck/urethra area. He said I might as well had radiation as a primary treatment based on the 72 gys of salvage I had, because the damage is just about as exstenive. The logic is the same, if you have radiation first, then surgery as a salvage is usually a risk and bad idea. This Dr. Webster seemed to agree. Even without the radiation damage, the op considered is high risk to begin with, and was told that I would be certain of being 100% incontinent the rest of my life. My uro said he can arrange a personal consulation for me with Dr. Webster, but he said it wouldn't change the opinion or the outcome.
Our current thinking, is if this 6th corrective surgery bears no positive fruit by the end of August, will strongly consider Plan "B" surgery, which is a urinary by-pass op. In simplest terms, the bladder neck and urethra would be by-passed, and they would make a new tube out of a piece of my intestine (I believe), and exit it to the outside of my body. Don't have the name of the op handy. It would be no more catheters, and no more worries about bladder neck blockages. It would be a 4-5 hour surgery, and he said to expect 5 days min. in the hospital. So this would be no easy matter in itself.
He is still hoping for a natural solution, but realizes that since radiation did so much damage, it may not have that happy natural ending we both hoped would be there.
I did ask him about hyperbaric treatments (think I spelled correctly). He is not opposed to them, but in my case, he feels that the damage is too deep in the body for it to be effective, and that it would be an expensive waste of money. He does uses it in rare cases with other urinary matters, but didnt think it would be good for what ails me.
When I asked outright, he said that I was not medically fit to be working at all, let alone full time. So that still leaves me between a rock and a hard place about starting this new job in 2 weeks. But that is another matter.
Back home, resting, thinking, on meds. Over did things this morning with some painting prep work in my living room, and foolishly tried to mow some outside while waiting for my son to come over and mow. Big mistake, big pain. Just sick of feeling helpless and in pain, told the dr that too, that I was in a purgatory just circling around and around.
I went to that Yanow? site for the first time, and read some good things about this Dr. George Webster at Duke, and a case with a guy with a similar problem to mine.
As soon as they make the arrangements, will let you all know about the next hospital visit. Thrilled.
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