Completed Pre-op appt, thanks for the heads up!

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Susan R
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Date Joined Dec 2010
Total Posts : 511
   Posted 1/21/2011 2:09 PM (GMT -6)   
My husband and I went to his pre-op appt today (posted on this topic yesterday) I wanted to say thank you to those who informed us of what they went through during their pre-op and then also wanted to give the details of what happened, maybe will help someone just about to having their appt!

This is how the appt went:
Urine test when we walked in the door

Cystoscopy - the nurse injected (not with needle but syringe) numbing gel into his penis. Waited about 7 minutes to numb and Dr came in, inserted the scope "tube with camera" and we were able to see what his bladder looks like. Once he passed into the prostate, this became slightly uncomfortable (the numbing gel doesnt make it that far). They then filled the bladder with water solution to see any abnormalities and to take a look at the bladder sphincter. All looked good. He then went to the bathroom, peed out the fluid and wiped up. He was still numb so peeing didnt hurt or burn.

Had a chat with Dr about what to expect with the surgery, asked questions. He stated he would do nerve sparing if possible but believes he will probably end up taking some lymph nodes. I asked about his recommendation about erection after the Cath is removed, he prescribes 20 mg Levitra to be used 2 times a week. Use the VAC and manual stimulation as often as possible "use it or lose it" Asked about the chest pain some men on here have reported after surgery....his answer....."we use carbon dioxide as the gas and it gets absorbed or leaves the body immediately, have never heard of anyone having pain" (I believe the men on here on this topic, so we will be cognizant of the issue) Michael asked him about ordering ED drugs offline and out of the country, he stated he would think it would be ok to order from Canada, but no where else (I think he is a bit loopy-what he doesnt know wont hurt him, we have an order from alldaychemist on its way)

Had an EKG

Chest x-ray

registered with the hospital for the surgery, went over medical history and medications. Cant call to find out time till 4-6 PM the day before. (on a personal note, this is crazy to me, we have kids we have to arrange someone to watch, would be nice to have some notice....)

We then began our drive home, stopped for lunch. When at Wendy's, Michael went to the bathroom. He said that this was a bit challenging and burned.

So.....that is how our (I guess I should say "HIS) pre-op appt went. Not nearly as bad as expected or anticipated. Michael wouldnt choose to do it again but he wouldnt be too worried about it, if needed to be done again. So, hopefully this info will help to calm another's fears!

Having Da Vinci on Feb 2, I will write an update after the surgery.


For reference purpose:
39 years old
Oct 2010 PSA 18.6
Nov 2010 PSA 12.4
Dec 2010 PSA 10.6
Dec 2010 Biopsy (1 core positive out of 10) T1c stage Gleason 6
Dec 2010 Chest x-ray, bone scan, abdominal CT
Jan 7 2011 PSA 2.47 (WHAT!!!!cancer trumps PSA)
Jan 21, 2011 pre-op

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 1/21/2011 2:42 PM (GMT -6)   
Susan, glad you guys had an uneventful trip. Now relax for a while...
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09, 01/11-.09
ED-total-Bimix 30cc

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 1/21/2011 3:08 PM (GMT -6)   
Susan:
- you are WONDERFUL - what a very good and supportive approach and report... I am sure it has calmed down some lurkers here at HW...

-very glad you asked about ED -
Susan said...
Cant call to find out time till 4-6 PM the day before. (on a personal note, this is crazy to me, we have kids we have to arrange someone to watch, would be nice to have some notice....)

I forgot all about that - we had to do the same to check the booking time of the operating room , in case it was booked for emergency surgery...

-fortunately, my RP surgery went on schedule.....
- mind you, my leg surgery back in 1998 had me on the waiting list ( and in traction) for a week !

hugs to you and your hubby ( you can hug him for me)
BRONSON
Age: 55 - gay with spouse of 14 years, Steve
location: Peterborough, Ontario, Canada
PSA: 10/06/09 - 3.86
Biopsy: 10/16/09- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/09
Pathology: pT3a -Gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
PSA: 04/08/10 -0.05 -Zero Club
PSA: 09/23/10 -0.05 -Zero Club
PSA: 03/12/11 - TBA

Post Edited (tatt2man) : 1/21/2011 1:11:32 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/21/2011 3:21 PM (GMT -6)   
susan, that is good news, glad you got that part behind you. one less thing to worry about.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

anxiety out the roof
Regular Member


Date Joined Aug 2010
Total Posts : 111
   Posted 1/22/2011 9:58 AM (GMT -6)   
My fear of the unknown was worse than the actual event. I'm 2 weeks out of open surgery and almost as good as new, except for being slightly incontinant and ED. But after only 2 weeks, I'm happy as a clam. lol remember the saying " THIS TO SHALL PASS".

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4274
   Posted 1/22/2011 5:08 PM (GMT -6)   
Susan, I'm glad all went well with pre-op.  However, I just went back and re-read your last thread.  You got a TON of advice to have your hubby's pathology slides read by a real expert, e.g. Epstein or Bostwick.  I'm just curious if you followed through with that.  We are not docs here but the dropping PSA, the age and the one core would make me want to be VERY SURE that PCa was the proper diagnosis.
 
Do what you want, of course, but even for a 39 year old in great shape treatment will be a big deal.  Don't you want to be sure?  And, if you did get the slides read by one of the acknowledged experts or if I'm being too pushy I apologize.
 
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1305643

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3891
   Posted 1/22/2011 5:21 PM (GMT -6)   
Tud makes a good point...PSA drops from 18.6 to 2.46...It IS possible to have an infection and PC at the same time, but when it's just a single core of G-6 that all this hinges on, I would like to know FOR SURE it was really G-6 PC......It's not to late to check...
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT NOW

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/22/2011 5:24 PM (GMT -6)   
On a one-core positive for low grade Gleason, 6, I would want to know as sure as possible. Tud has given excellent advice.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Susan R
Veteran Member


Date Joined Dec 2010
Total Posts : 511
   Posted 1/22/2011 8:41 PM (GMT -6)   
I do appreciate the input about getting the slides read by one of the pathologists you all recommend. His slides have been read by several different people and then also the pathology specialists at the Armed Forces Pathology Institute, the big military people. But has also been read by a civilian pathologist (for those who will say "have it read by someone other than military) We are where we are, and at this point are moving forward. The decision has been made, and we need to have positive thoughts about how we are proceeding, no more second (or third, fourth opinions) questioning at this point. Thank you for taking the time to share your concerns, we do appreciate them!

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7082
   Posted 1/22/2011 10:31 PM (GMT -6)   
Susan,
 
I came here first a couple of months after my surgery was done, and there were a few suggestions as to what I might or might not have done correctly mixed in with the many welcomes and supportive comments. Not being one who believes in second guessing, I can only consider them in the context of how to evaluate my progress.
 
Once a decision has been made, I can only suggest that you use the links at the top of the site to help find information on how to prepare for and get through surgery and post-surgery. I have contributed more than a few suggestions . Search the site - James C. has posted a link to a site for wives that had a really good thread on getting the house ready for post-surgery - it helped me (I am single, so had to do everything alone). Please post any questions or concerns you might have, but remember, if there is something that concerns you, call the surgeon.
 
I am one of the experts in being wet - my journey did not include the word dry. If hubby suffers that indignity, I suspect I am one of the Depends experts. I hope I don't hear from you about that, but better to ask.
 
I wish the best to you.
 
DaVinci 10/2009
My IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3891
   Posted 1/22/2011 11:27 PM (GMT -6)   
As long as more than one pathologist agree it's cancer, that's what is important. Sometimes it's a close call between Gleason 2 and Gleason 3 cell structure. But when two different pathologists agree it's Gleason 3 (3+3=6) then chances of a mis-diagnosis is greatly reduced..

Some people feel there are only 3 or 4 people in the world qualified to read prostate biopsy slides. I am not one of those people.

It is a rare event indeed when a prostate is removed on the basis of a positive biopsy and found to be healthy....

Mackattack
Regular Member


Date Joined Jan 2011
Total Posts : 78
   Posted 1/23/2011 8:24 PM (GMT -6)   
I had my pre-op this past Thursday and it did not include a cystoscopy.  Not that I am a glutton for punishment, but should I be concerned about not having this?  If the results were different would it have changed a strategy with the surgery?
 
Matt

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7082
   Posted 1/23/2011 8:36 PM (GMT -6)   
Matt,
 
I did not have the cystoscopy. It was never mentioned. I suspect it is part of some surgeon's standard procedures and not others -

mr bill
Veteran Member


Date Joined Sep 2010
Total Posts : 709
   Posted 1/23/2011 9:29 PM (GMT -6)   
Matt,
I did not have cytoscopy pre-surgery either, that was at Cleveland. Had one when they took the cath out to make sure I hadn't sprung any leaks.  Noticed a bottle of radiator stop leak on the shelf, so I am glad I hadn't popped any cores (just kidding about stop leak obviously).

mr bill
Veteran Member


Date Joined Sep 2010
Total Posts : 709
   Posted 1/24/2011 4:58 AM (GMT -6)   
My mistake, that was not a cytoscopy I had post surgery.  It was merely to check for leaks. 
 
Sorry about that.
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