Had my hands full today. Back home now, wiped out but good. Met with my Uro/Surgeon this morning, we spent one full unterupted hour together. He went over the finer points of the upcoming surgery, sounded simple until you get into the details. He then went over, probably the top 10-15 complications that could happen, and then explained one by one, how he would deal with them if any of them happened.
The biggest decision, is whether he can use the easy to get to lower intestines to make the conduit out of, or have to use material from higher up in my digestive system. He said he can't know till he has me open, and then he can determine if the easier material is too radaition damaged to use or not. This is one time that you want that tactile feel of an experienced surgeons fingertips, he said he will be able to tell by touch if the material is damaged or not. For me, it will mean it will either be a 2 1/2 surgery or a 4 hour surgery, I will be knocked out so that part won't matter.
He said he has searched his soul, so to speak, and still feels this is the best long term solution by by-passing the damaged bladder and bladder neck for good, and ultimately, relieve me out of so much of this daily pain. He feels now, that I will probably be in the hospital a full 7 days, possibly more. The first 2 weeks at home will almost be the same as being in the hospital.
He will meet with my wife and I one more time before surgery, and he gave me a 24/7 number to call him anytime with any last minute questions or concern.
Then I went to St. Francis for the pre-op at the hospital. First hour, normal and routine for me, lots of questions, blood tests, etc. Its my 4th op there this year so far, so saw lots of familiar faces. Then spent a full hour with a full-time Stoma Nurse, a first for me. She was very good, 31 years experience, but the whole subject is expectedly creepy to me. She measured and marked the stoma locator, and I am wearing a test device just to see how it feels moving around, bending, sleeping, etc with one in place. She will be spending much time with my wife and I once I am in a hospital room, testing different devices, to see what will work best for me.
I threw her off being left handed, she said she hadn't thought about how all this would work for some one that essentially can't do a thing right handed. But in the end, I will have to adapt, as the stoma can not be located left sided.
This post is important, in that its just one more thing that a PC patient might have to face, another QOL issue, another "side effect". Yes this is rare, but its important to know that things can go wrong.
From the start, I had the stricture issues post surgery, but the surgeon was close to having that worked out. The radiation going wrong, took any natural solution out of the picture for good. My dr said, that even if by magic, he could keep me open, that I would always urinate in extreme pain from the radiation, and he suspects that I have gone from being 100% dry to being 100% incontinent. Its only the catheter at this point that is keeping me dry.
Am I afraid at all? Absolutely. Not from the op itself, but the recovery, and adapting to a whole new way of doing things. Do I have a better alternative? No. Can I stay in the world of extreme pain and endless painful cath changes? No way. So I will be doing this someone on a step of faith (for a better word), and hoping, like all of our decisions PC, that I am making the right choice. Status quo, is out of the question after nearly a year of steady suffering. Time to be brave, and hope for the best.
David in SC