Post-op RaRP - Day 2

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GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 3/5/2011 5:42 PM (GMT -6)   
I was asked to summarize my experiences.

I can't believe I'm doing this now, as I hurt.

DaVinci yesterday am at Yale in New Haven, along with a 2.5 inch hernia repair. Doc says the hernia was more complicated than the prostatectomy.

Did I mention I hurt??????

2mg dilaudid and a cathater that fills up hourly. Gotta switch to the big bag, take another pill and go to bed.

Doc says he will go over pathology next friday, but no detectable metatstasis. He spared all the nerves, I can tell, it HURTS!!.. 1 night in hospital and I got home 2 hrs ago.

The catheter tube is moving in and out over the penis tip about 1/4". Covered it with zinc oxide to prevent chafing. What fun!

I have 6 different incision points, all sealed with metal staples. The longest, about 2 inches just above the bb. There was a tube bleeding off internal blood to a small waste container. Doc pulled it out and I thought it was maybe 1-2 inches. darn thing was 8-10 inches and was placed around the newly re-sewn urethra. The removal was not fun, but it was fast.

Urine is clear and no blood. I feel the need to take a huge BM, but am terrified the stitches will burst. Ate mac and cheese last night and a decent breakfast today.

I did have to get a wee bit belligerent to make them let me go home. They promised noon, and by 3 pm I was annoyed. I was up, walking, making a pain in the ass of myself. I know it was for my own good......

Now....as I look up, every word is misspelled....gotta go edit and go to bed.

Update tomorrow pm (if anybody gives a hoot)

Aloha
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.

DaVinci prostatectomy scheduled for March 4 at Yale. Lets hope attempt 2 at this goes better than my first try.

davidg
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Date Joined Feb 2011
Total Posts : 4093
   Posted 3/5/2011 5:51 PM (GMT -6)   
hope you farted before eating those things.

Yeah, the drain was long and taking i out was funky.

I didn't know they used staples. They used a special glue for me on my smaller incisions and internal stitches on the BB one.

I remember it was tough to sleep that first night at home, good luck.

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 3/5/2011 6:14 PM (GMT -6)   
the nerves they spared were for mr. happy -

glad you got through it relatively ok...

all the best for a steady and boring recovery,

healing hugs,
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: 03/24/11 - TBA

wigged-out
Regular Member


Date Joined Dec 2009
Total Posts : 130
   Posted 3/5/2011 6:32 PM (GMT -6)   
GTO.

Start taking a stool softener right away. I take these little pills from Walgreens. Was taking 2 per day, now just one.

I was terrified before and during first poop, and it took 4 days for any urge. I also kept really well hydrated. Prune juice, water, and so on.

Avoid foods like cheese which can cause problems. Chew your food well. And get up and move around. I am heading into my fourth week post RP, and between eliptical trainer and walking, I'm up to 20 miles per week so far.

I had that drain thing too. It sucked, but behind us both now.

Watch what you left, especially with your hernia

Best wishes.

W-O
Age: 55- good health. Exercise regularly, 200#.
Needle Biopsy 11/09- 12 samples. 11 OK. Right Lateral Mid- Adenocarcinoma Gleason score 3+3=6 9 involving 5% of specimen.
PSA risingto 8.0 thru 2010.
2nd biopsy- 2 positive cores, one a 3+3=6, 3% and the other a 3+4=7, 20%
Very last PSA- 12
DaVinci 2/14/11 Cath out 2/21/11 Path=10%, Gleason6+7 No lymph, pca contained to organ. Lots of pads.

Mackattack
Regular Member


Date Joined Jan 2011
Total Posts : 78
   Posted 3/5/2011 6:33 PM (GMT -6)   
Welcome to the other side!
 
I was scared of that first bowel movement also.  Mine did not come until Day 6.  I am still taking Colace so I don't have anything to worry about.  Hopefully you are doing the same. 
 
Take more painkillers!  Surely they gave you a prescription.  No need to be a hero.
 
Rest up and you will be fine.
PSA 3.9 - October 2010 at annual physical
PSA 4.1 - November 2010 after a month of antibiotic, DRE Normal
Age 41 in December 2010 at Dx of 6 of 12 cores positive T1C and Gleason 3 + 3

open RP on 2/14/11 at Mass General

Post Surgery Pathology Report: Gleason 6, T2, Cancer in 35% of Prostate, All Margins Clear

wigged-out
Regular Member


Date Joined Dec 2009
Total Posts : 130
   Posted 3/5/2011 6:37 PM (GMT -6)   
Also don't strain when on the can. Be patient, sit there for a while and just let your body kinda push poop out. It will happen. For me it was like I had just given birth and I felt almost as overjoyed. But I digress.

W-O
Age: 55- good health. Exercise regularly, 200#.
Needle Biopsy 11/09- 12 samples. 11 OK. Right Lateral Mid- Adenocarcinoma Gleason score 3+3=6 9 involving 5% of specimen.
PSA risingto 8.0 thru 2010.
2nd biopsy- 2 positive cores, one a 3+3=6, 3% and the other a 3+4=7, 20%
Very last PSA- 12
DaVinci 2/14/11 Cath out 2/21/11 Path=10%, Gleason6+7 No lymph, pca contained to organ. Lots of pads.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/5/2011 6:41 PM (GMT -6)   
GTO, ouch, I remember those early days after my open surgery.

Your pain med, dilaudid, is a good choice for serious pain, use it as needed.

On the cath, I would reccomend staying on the large night bag all the time, unless you have to be outside or go somewhere,
less comfortable, the big bag tends to equalize the pressure and generally more comfortable to deal with, and it should
hold at least 2 liters or more. I spent 1 1/2 years on 21 caths, so this is my little area of expertise, lol.

Rest of advice is good: walk when you can, lots and lots of water, stool softeners as long as need, pain meds as needed,
and rest as much as you can. Robotic or not, you still have been through a major and complex surgery.

I had real staples from my open surgery, think there were 21 if I remember, taking a BM is not going to make you split open like a ripe melon, even though it feels that way.

Good luck in your recovery, you are now, on the other side.

David in Sc
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

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 3/5/2011 7:02 PM (GMT -6)   
pain killers, serious ones, will constipate you. So calculate that. I kept to Tylenol and was fine.

I also always kept the large catheter bag. I was afraid of screwing something up if I changed. I just stayed home the first week anyway.

I also used colace two weeks straight out of surgery.

Hardest thing about BM was the positioning with the catheters. It would point upwards when seated on toilet and cause spasms whenever some pee was being drained as it just went back down. Didn't bother getting a raised toilet but it would have helped probably.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/5/2011 7:18 PM (GMT -6)   
I think the constipation risk of using the pain killers is an overkill sometimes. Every body is different of course. For the short time that most men are on prescription pain meds, anywhere from a few days to a week or so, in most cases they will not cause any serious constipation problems. Not taking pain meds when you need them, is counterproductive to good healing, any nurse or surgeon will tell you that.

I was on Loratab 10/500 for 51 weeks straight, after all the radiation damage, and per my surgeon's supervision for dealing with severe level constant pain, and I can honestly say that I never had a day of constipation as the result (will add, that constipation has never been an issue in my life, its a rare event). During that period of time, I consumed over 1,000 pain pills and it never cause an issue. Then after I had the ileal conduit surgery, to bypass the damaged bladder, I was on the same pain meds for about another month, and then stopped using them cold turkey. Never cause an addition problem or a constipation problem.

David in SC
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

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 3/5/2011 7:32 PM (GMT -6)   
all my nurses ( 3 shifts ) told me the tylenol would provide good results and that the pain meds would cause constipation. Each and everyone of them. I did as they suggested and everythign worked out great for me.

Of course I do not know the level of pain GTO is in. I only felt like Mike Tyson worked my mid section over and even that lasted only 2-3 days. Passing gas and having a BM were my first two objectives when i got home.


# Increase your fiber. Since constipation is usually a result of long-term dietary issues, first make sure you're enjoying a high-fiber diet, heavy on a variety of fruits and vegetables. High proportions of breads, potatoes, greasy foods, and meats can encourage constipation. Treat vegetables as an entrée instead of a side-dish. Try going vegetarian, or better maybe, vegan, for a week and see if the problem clears itself up.

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#
2
Increase the intensity of fiber. If a week-long vegetarian diet doesn't fix the problem, a three-day fast of some high-fiber vegetable like cabbage is recommended. Cabbage is particularly good because it's not only high in fiber but it has enzymes which encourage the entire digestive tract to "flush." This is also a good liver cleanse for a build-up of liver toxins. Cabbage can be prepared in a number of ways, including skillet frying if the oil used is grape-seed oil or olive oil. Spices can be used, to taste. Vary your recipes so the three-day fast doesn't become three days of hell.
#
3
Hydrate well. Constipation can also be caused by insufficient hydration. Generally drink a minimum of 1.5 - 2 litres per day, or more depending on your size, hot weather, or exercise. If trying to relieve a bout of constipation, increase your water consumption for 3-4 days, starting with a big glass in the morning and drinking regularly throughout the day.
#
4
Exercise. Exercise is a good way to restore rhythm. Not exercising because you are feeling constipated will only make things worse.
#
5
Read the labels carefully. Most over-the-counter laxatives are effective to a certain degree but none should be taken except as indicated or for longer than indicated in their directions.
#
6
Try the banana cure for mild occasional constipation. This requires that you eat a banana with a glass of warm milk, chewing the banana carefully.
#
7
Be very careful of painkillers. Painkillers, especially narcotic ones such as hydrocodone (Vicodin, Lorcet, Norco) and oxycodone (Percocet and Oxycontin), can cause constipation. In this case consult your doctor/pharmacist (though the previously mentioned steps should be ok) to make sure that your meds don't need to be adjusted.
#
8
Be aware that some anti-depressants can cause constipation. Prozac, for instance, is known as being a source of constipation problems for a number of its users.

Post Edited (davidg) : 3/5/2011 5:38:04 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 3/5/2011 9:07 PM (GMT -6)   
Pain tolerance is a very personal and subjective thing. No right or wrong, what might be a 2-3 on the pain scale for one patient, might be a 4-6 for another. The important thing is the right pain management during the most crucial periods of healing from a surgery. Again, if you as the patient, properly tell your medical team exactly how you are feeling, and don't try to be Mr. Tough Guy, they can dial it in just right for you on the meds.

Advil, aspirin, tylenol doesn't always provide enough pain relief, so its not uncommon to start with a script med and taper off when no longer needed.

David in SC
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

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7270
   Posted 3/5/2011 9:13 PM (GMT -6)   
David:
 
Maybe your body just adjusted to the pain pills. Glad constipation was not a problem. But it is well-known that even 1 or 2 of them can cause significant constipation problems.
 
I had a hernia repair in 1988 and took 1 or 2 vicodin and had major problems in that area for 10 days. (But keep in mind I seem to be suseptible to that).
 
For my RP, I think I took a few regular tylenol.
 
I toughed it out. I did not want constipation at that time!
 
Mel

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7087
   Posted 3/5/2011 9:19 PM (GMT -6)   
I was sent home with some real serious pain killers, and used them when needed - mostly at night so I could sleep. I kept track of them, as that sort of pill is on the list that keeps you from being allowed to drive.
 
The stool softener was a must for me. My colo-rectal guy swears by docusate calcium (comes under a lot of house brand names). Not the most common, but can be had at any pharmacy. My Big Moment was three days out.
Worst case, get some mineral oil - that works every time (for me), and makes it stress-less.
 
Straining is not allowed.
 
I also used the big/night bag the whole time.
 
Welcome to the other side!

Post Edited (142) : 3/5/2011 8:15:42 PM (GMT-7)


daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 3/5/2011 9:25 PM (GMT -6)   
Welcome to the other side, Here's to a speedy recovery.

You've got great advice already so I'll just add

Good luck!
Dave in Durango CO
07-06 PSA 2.5
01-08 PSA 5.5
09-09 PSA 6.5
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5
03-01-10 Age 55 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson
03-16-10 Path' G-8 (4+4+5) Bilateral involving 21% of left lobe, 3% of right lobe, SVI, Focal positive margin, pT3b NO MX

All PSA as of 1-25-11 <0.04

GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 3/6/2011 3:57 AM (GMT -6)   
here it is 3:53 am and I'm up waiting for meds to set in.

Since 7:30 last night, the only water I've taken was just enough for two pain pils. I emptied a half-full large bag twice ***?????

Passed a wee bit of gas....gonna try the mineral oil, but I am on scrip stool softners.

I forgot to mention, I have no "bruising" of the testes or penis. They look normal. I read in a sticky here that they would be black and blue. My doc said they work to squeeze the the trapped gas out of the scrotum, and that would account for them looking fine and adding a bit of ouch to the procedure
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.

DaVinci prostatectomy scheduled for March 4 at Yale. Lets hope attempt 2 at this goes better than my first try.

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 3/6/2011 6:55 AM (GMT -6)   
you can expect a range of colours - or maybe none at all - while the remaints of the surgery - blood and such start moving around to disperse in the body .

.. I started turning black and blue and swollen a few days after coming home from hospital ... the balls went three times their normal size - had to rest and have legs up on pillows to help drainage..

-another easy fix if really constipated and bloated feeling - in one regular 10oz glass - 1/2 milk -1/2 prune juice - microwave for 30 seconds- warm not too hot though ... drink right down - chug it... and in 20 minutes , you will ( most likely) have a effective b.m.

-that trick was relayed to me by a big black nurse in my rehab after leg surgery -had noted pooped for 7 days - worked like a charm - very scary to see what you can hold inside of you ....

all the best,
hugs
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: 03/24/11 - TBA

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 3/6/2011 7:33 AM (GMT -6)   
i had no bruising or swelling down there, just around the incisions. you should definitely drink more water.

anxiety out the roof
Regular Member


Date Joined Aug 2010
Total Posts : 111
   Posted 3/6/2011 7:48 AM (GMT -6)   
I used milk of magnesia with great success along with citricel and lots of water.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 3/6/2011 9:11 AM (GMT -6)   
GTOdave, you need to start drinking water now, lots of water, as much as you can stand. And walk, start walking, just a few steps at first, if that's all your able to do, but often. Add more to it as you go. Activity and water is needed now to get your systems kick started and to flush out toxins, debris, and trash from your body. Expect all kinds of gunk and junk to show, blood in any color or tint will be the norm for a while. This can go on for several weeks, even after catheter removal. But it's the water and walking that will do you more good than anything else you can do.
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, 12/10-.09, 02/11-.08
ED-total-Bimix 30cc

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7087
   Posted 3/6/2011 10:55 AM (GMT -6)   
Dave,
 
Swelling - you may or may not see it - mine was about 5 days out - I was swollen to the size of grapefruit, and couldn't find where the catheter went in - shocked
 
Stayed that way 3 days or so. Called the doc in panic. They said it was normal, but I couldn't imagine it was. Looking back, that was before I knew about HW, and I did search/find some comments on the net about it happening, but the scale was really scary.
 
When I went to have the cath removed (7 days out) they were still swollen, and the nurse said it wasn't the least bit abnormal.
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