Input, please, for my 84 yo dad

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Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 7/31/2010 7:04 PM (GMT -6)   
Back in the early part of June, Dad hadn't urinated in 2 days so went to the ER, where they drained the bladder via catheter, and prescribed Flo-max.  Worked like a charm with the only underlying problem was that it made him dizzy to the point where he fell and needed another trip to the ER for a quick CT scan to see if there was a problem.  Nothing wrong.
 
After a few days he got a good blood level of the drug and had no further problems.  The only problem that ensued was that he took Lasix for ankle swelling.  Those two drugs caused him to dehydrate which lowered his blood pressure to the point where he got dizzy again and fell.  Another trip to the ER. Nothing wrong again.  Talked to his cardiologist who put him on a low dose of Lasix only when he felt he needed it (i.e., saw significant swelling of the ankles,etc. not an everyday dose.)
 
Pop has underlying health conditions,COPD, heart attack in '87, a bit overweight, etc.  Can't really exercise much due to the COPD, and is on oxygen at home as well as breathing treatments 4x a day. 
Last week I went to check on him at home at 9:30 AM and he seemed OK, my sister was there at noon and fixed him his lunch, went to work and was back again at 3:00.  He was unresponsive and still sitting where I saw him that morning.  I tried to rouse him be yelling, pinching, and (God forgive me) slapping him.  Called for the ambulance and went to the ER.  He has been hospitalized for the last week.  He has had one good day for every bad one, and Thursday the hospital called and told me he had been unresponsive  in the morning and thought he had a stroke or a TIA.  CT scan, MRI, EEG showed nothing.
 
Urologist he was referred to wants to do a TURP, thinking that he had a lot of urine retention went he went to the ER.  I figured that since he hadn't moved from the same chair since 9:30 on that morning a week ago that that was the cause for the retention.  Uro stopped the Flomax while he was in the hospital, so he hasn't been on it for a few days.  He has been on a catheter since the initial trip to the ER a week ago.
 
I think I know the answer to this one, but thought I'd put it out there for discussion.  I don't feel an 84 yo should have to go through this surgery when it seems to me that the Flomax did the trick for a few weeks before this all began.  I can see his health failing fast. We also lost my mother almost 2 years ago and I know that he is stilll blue about that.   On Wednesday he told my older brother, my sister, and me at different times that he was ready to give up.  But for the last 2 days he's been upbeat and feeling better, and ready to come home.  He lives a block away from me in case there's a problem.
 
I'm going to talk to the Uro Monday to get this mess sorted out.  My siblings and I are going to try and coordinate the different docs and see if there is some way to get the meds in agreement so that one doesn't foul up the other.
 
Thanks,  in advance, for the input.
 
Bob
 AGE:58
 Dx: October,27, 2008(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T2c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive
 Confined to prostate.
 DaVinci Jan. 19th, 2009. No lymph node involvement, all margins clear.
 8 week PSa <0.01
 Gleason downgraded to (3+4)7
 6 month Psa , 0.1 
 9 month Psa,  0.2  Doubled! Criminy!
 Started RT 10/28...one year since diagnosis.  RT over 12/22.
 3 month post RT Psa 0.1. 6month post RT Psa 0.1

Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 7/31/2010 7:15 PM (GMT -6)   
I forgot to mention that Uro wants to do the the TURP because he thinks the Flomax is the problem to all the difficulties.
Thanks,

Bob
 AGE:58
 Dx: October,27, 2008(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T2c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive
 Confined to prostate.
 DaVinci Jan. 19th, 2009. No lymph node involvement, all margins clear.
 8 week PSa <0.01
 Gleason downgraded to (3+4)7
 6 month Psa , 0.1 
 9 month Psa,  0.2  Doubled! Criminy!
 Started RT 10/28...one year since diagnosis.  RT over 12/22.
 3 month post RT Psa 0.1. 6month post RT Psa 0.1

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 7/31/2010 7:34 PM (GMT -6)   
Wow, thought I had problems.

What does dad say ? Is he able to call the shots ?

If this is up to you and siblings, i would certainly get a second opinion if it were me. Can't say whether a TURP is in order or not, but the odds of your dad surviving the surgery is not great from what you told us about his history.

I would probably go for a catheter before I would subject him to the pain and agaony of a TURP.

Good luck my friend.
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
15 month PSA <.01

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 7/31/2010 7:38 PM (GMT -6)   
Bob
- sorry to hear the problems your Dad is having - very upsetting to him, emotionally and physically, and to you and your siblings as well...
-quality of life affects our decisions at any age -

-the bottom line is - your dad has to void waste material on a regular basis to live - in this case - urine....
-it would be best to discuss with your Uro and dad in which, of all the options, is best for him -

-A turp may be painful but would open up the urethra again to allow him to pee -
-self cathetering does not sound like an uplifting experience for an 84 year old man who is questioning whether to continue this battle we call life or not...

- as we often say in the forum - we am not a doctors - I am just relaying and reacting to your posting - and what has affected other men in my life - my Dad had a TURP and a good buddy is trying to have that done so he doesn't have to self-catheter himself.

-other opinions are necessary at this stage as well as other options - and , since (we assume) your Dad is still lucid, what your Dad wants to do.

-all the best
BRONSON
.................
Age: 54 - gay - with common-law spouse of 13 years, Steve - 60
PSA: 04/2007- 1.68 - 08/2009 - 3.46 - 10/2009 - 3.86
Confirmation of Prostate Cancer: October 16, 2009 - 6 of 12 cancerous samples , Gleason 7 (4+3)
Doctor: Dr. Mohamed Elharram -Urologist / Surgeon - Peterborough Regional Health Centre
Radical Prostatectomy Operation: November 18, 2009 , home - November 21, 2009
Post Surgery Biopsy: pT3a- gleason 7 - extraprostatic extension - perineural invasion - prostate weight - 34.1gm -
ED Prescription: Jan 8/2010 - started daily 5mg cialis - girth back to normal -but not much length - June/2010 -have trimix - tried it twice - Aug 2010 -just lacking motivation right now
Incontinence: Feb 2010- 3-5 pads/1-2 clothes changes/day- March 3, 2010 - week 14 after surgery -finally seeing improvement - March 29- incontinence better - 1-2 pads a day - one pad at night - May 25 - 1 pad during day - 1 pad at night for security (barely needed at all) - stress incontinence at work - lifting trees and shrubs - August 2010 - still at one pad for day and one for night - primarily for hygiene and security - still having good and bad days due to stress and what I have consumed.
location: Peteborough, Ontario, Canada
Post Surgery-PSA: - April 8, 2010 - 0.05 - I am in the ZERO CLUB - hooorah!
Next PSA - October 8, 2010 - TBA -
............
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