Posted 1/17/2007 4:00 AM (GMT -7)
The Pre-Surgery Prep and Actual Surgery
Now with the actual surgery date set and what seemed like along way off, by the way this time will pass quickly and you are there, I was set for the pre-surgery appointment to make sure I was a good candidate for surgery and the De Vinci etc. It turned out to be a 4 hour appointment on December 15th in which I met with doctors and nurses to cover some paperwork. Next was a meeting with a research nurse in which I agreed to provide a seamen sample prior to surgery, they are studying to see if they can find another way to diagnosis PC with out the need of a biopsy, of course I said yes because as stated earlier there must be a reason for me to get this and maybe I can help and turn this into a positive. Then it was time to meet the surgery coordinator and check me out physically and mentally. As we talked and another fact the made me feel better about the whole process was she made the statement that Dr. Jarrard wouldn’t even consider me for this surgery if I was not a good candidate. If there was any major doubt as to the chance of success he would direct me in another direction. Then on to blood work EKG and the anisthisougis. Again in meeting with them and as they reviewed the charts they all said the same thing, your having that procedure at your age, a little young but oh you have Dr. Jarrard, he’s excellent.
With this complete I now had about 4 weeks to get ready. I walked everyday that I had a chance and by the time of the surgery had close to 40 miles logged. I also started the Kegel exercises with the hope this too will make the incontinent issue better to deal with. So now get all things completed at home, Christmas shows to attend and all the other holiday events. This time passed real quick and the next thing I knew the day was upon me.
At 2PM on the January 8 th and one last walk completed I started the bowel cleansing process to ready myself for the next day. We left home on January 9 th for the 2 to 2 ½ hour trip to Madison . I checked in surgery prep at 9 AM and was wheeled into surgery at 11:06 AM, noticed the De Vinci across room, helped move myself onto the OR table and the next thing I remember is being awakened in the recovery room at 2:50 PM. In the time between I checked in and went to surgery I think I must have met every member of the surgery team who came in and explained what they would be doing what to expect, they were a great group and made me feel very comfortable.
But as the doctor told me just before they wheeled me in this is still major surgery and it hurts. I was out of recovery and to my room at 4 PM. I was pretty much out of it but not a lot of pain and the nurses made sure to take care of any discomfort I was feeling quickly. They had me up at 7:30 for my first walk which did not go very far. Out the door of the room and maybe 5 feet down the hall at which point I was ready to pass out but the nurse and my wife helped me back and now time for an hour nap. Don't give up if you think it wasn't very good, as the nurse told me many can only stand next to the bed and that's it, plus it had only been 5 hours since the surgery.
They kept me comfortable that evening with pain meds and it wasn't too bad. They pulled the drain the next morning at 6:30 am and I ordered and ate a little breakfast at 8 AM. Key here is a little breakfast, a little oatmeal and some Jell-O and then very little else. As stated the gas is the worst part. Up walking around at 9 am and passing a little gas. I was not able to walk all the much, a couple trips up and down the hall and then a nap. Again don't feel it's not enough.
about 2 PM after going over the instructions I was on my way home some 27 hours after the time they wheeled me in. But now it was a little bumpy 2 hour ride home, thank god during the pre-surgery appointment the surgery nurse told me to bring two pillows, one to sit on and one to hold over my belly that helped. The first 48 to 52 hours were the hardest part for me, a little pain and a lot of gas that was hard to find away to get moving. The rest of that night and the next day, Thursday I felt like that I had a good case of the flu, aching body, some pain, gas and no way to get comfortable no matter what I tried. This may just be normal or a little of my own fault too. I wasn't taking my pain meds any more then I had too and maybe should have taken a little more often. I now take one pill two to three times a day, morning, mid-afternoon and bedtime, things have been much better. In short it was at about the 52 hours removed from surgery that I all of a sudden felt better had an urge to eat and was able to get up and around much better. So in my case hang in there for the first 48 to 60 hours and it gets better. I find I now really love popsicles.
Friday January 12 th and my first allowed shower, I am feeling human again and tried attaching the leg bag for the day. I have noticed most here just like to keep the large bag on to capture urine around the house, but I have been much more comfortable with the leg bag for the daytime. Yes it does fill every 1 1/2 hours or so, but it makes me get up and around, which is good.
Saturday January 13 th and feeling real well, so good in fact I decide to do a little work on the tread mill seeing how Wisconsin finally got winter over the weekend and didn’t feel like trying walking in a cold wind chill, snow and ice. This however may have been a mistake, even through I took it extremely slow and did not walk more then a little over a ¼ mile I paid the price by not sleeping well Saturday and spend anther uncomfortable day on Sunday running slight fevers and just plain week. If I did this part over again I would just continue to walk around the house at a leisurely pace.
Monday and Tuesday the 15 th and 16th are better but if I have a problem I have a little constipation which is causing my slight lower stomach pains, nothing server however. My next appointment will be this Thursday the 18 th in which I will get the pathology report and hopefully the catheter removed and then the real test. But more important will be the results and hopefully the words we all look for, cancer 100% confined to the prostate. I will report back in late on the 18 th or the 19 th with the results and continue to up-date every once in a while on how the incontinence and ED issues are coming along.
I hope this helps someone and thanks for all the good support from this site.
Friday January 19th up-date . Well here is the up-date form Thursday's post op and pathology report and this day turned in to one crazy day. First my buddy the catheter was removed and my voiding wsa a sucess, althrough it was a little redder then normal the nurse told me to keep pushing the fluids, step one covered and it felt great to be free. Now into the meeting with the doctor and go over the reports. Original PSA 6.22, Gleason 3+3 = 6, Stage T1, 2 of the 13 core samples positive 10% each Actual Gleason 3+4=7 with a couple agressive cells at 5 alone, 20% of the prostate canerous. I didn't happen to get a new staging. Cancer contained with in the capsule. Bottom line the doctor said it was a good thing I decided to have this done now vs. not finding or taking care of this in 2 or 3 years. With that agressive cell it could have been much worse by then. The one kind of disclaimer he had was the fact that my cancer begain right at the Lower Apex and there is always a little doubt about the joining of the two organ capsuls and if some might have been shared. But he did not seem overly worried becasue he said if there were any right there they typically would be killed during the process in which they are buring the cells with the instruments to separatem them at the point. Don't know if anyone would have more info on that. Anyway all is good lets go home. about an hour up the road I notice it's time for my first attemp to urinate so a stop at the first fast mart store we see. I know the meaning of planning in advance, when you need to go, you need to go. So out of the car and notice the first 3 drops down the pants, the good news was I was able to hold the rest until I got to the restroom. This is where it all fell apart, unpon finishing yet more red urinie I begain to have an extense burning in the penis that grew into the stomach area and having intense pain and spasms like I have ever had. I later learned I was a lucky one to experience bladder spasms. Better yet and long story short I got to experience this two more times last night, thank god the third time as we were on our way to our local ER because the third one never let up. Well I have some muscle relexers and my buddy the catheter back. While disapointing and I am being one of the unlucky ones to experiece some of the problems, I just think back to the doctors words had I not found this for 2 or 3 years and the shape I might have been in, so I continue to have faith. I have heard of bladder spasms right after surgery but has anyone else experienced this 9 days later. For now this is the up-date. Thursday January 24th 2007
Well try number two at having the catheter removed, it's now been 6 more days and 15 days total for the catheter hopefully everything is healed better and no more bladder spasms, never want that feeling again. No wonder I was much more uncomfortable these past 6 days, the new catheter was much larger and less flexable than the previous, in fact the hospital in Madison does not even carry any this big. If the object was to keep me less active, it worked. We joked that the hosptial that reattached the second catheter got even with me for not having the surgery there. Anyway the voiding trial went well and worked as planned. I hung around drinking fluids to insure there would be no further problems. Try number two worked fine and a quick ultrasound showed I emptied well. Still hung around for a third try and started to feel discomfort but turned out to be the need to urinate was causing the discomfort. The urine is still rather bloody and red but did clear a little with each time I went. Well the two hour trip home and two stops to use the bathroom and home I am. I find I need to use the bathroom about every 40 to 45 minutes becasue I begin to fell the discomfort and when urinating I do feel a certain amount of discomfort and I am sure this is due to the blood in the urine and the fact that this is the first real day of trying to get things working again. It's too early to judge my continence situation but if I concentrate really hard when I stand up I can usually hold my urine or just dibble a drop. So far I can get by with one pad for the day as long as I get to the bathroom in those 45 minutes. Overnight I had to get up 5 times and had a little more leakage but not total loss of control and of course much redder from blood from not drinking over night. Things are clearing up as the day goes on but I do have a certain amount of dicomfort each time I urinate. I feel hopeful that as the urine clears and I continue with the kegel exercises each day, my doctor has me doing 20 sets each hour, that I will be fine and will report in a few days after I have time to continue to heal and get stronger. As someone said on the board, this is a journey and once you clear one hurdle you encounter a new one but with each and everyday a hurdle is cleared. Aside from this my next big hurdle is my first post op PSA test scheduled for March 12th.
February 3, 2007
Well I am now 25 days post surgery and 10 days post catheter removal, the second try. Once past the bladder spasms and with the catheter gone for the second time I keep getting a little better everyday. This past week has seen dramatic improvements in these last 6 days getting stronger and feeling more normal. I have found out that I will tire easily and it will take time to get the same ole energy back but I am up out and around. I also found that even though I feel good, going to my daughters basketball game the other night, that I tired easily and the bleachers are not really made for me and comfort in the mid section, it must just bend me in the right way to make it uncomfortable. As for incontinence issues I feel very fortunate although I can not take anything for granted. I have been able to get by with 1 pad per 24 hour period with just small leaks, I just have to concentrate very hard prior to every time I am going to get up and move and once in a while I will feel a drop slip. I do find that I have the urge to urinate quite frequently and as of today I cannot wait for more then an hour, no matter how much I have built up. The same urge is there if I have a bottle full or a thimble full and sometimes it feels as I could go again after just going, but at least I am able to control things for the most part. I have to keep up on the kegels and get stronger and I am sure I will get there in due time. A lot of the time the pad is there more for confidence I feel. I do know as I move around more it takes more concentration to make sure things are in check. I plan on going into the office for some limited hours starting next week at 27 days post surgery and see how things go.
As for any erection action, I have had some good sensation in the furnace room area and a couple mini enlargements. I haven’t started any drugs yet or tried any more activity with my wife as the doctor wants me to hold off till I am a little more healed.
So in short I am doing pretty good, can’t take nothing for granted and must really concentrate but no major dam breaks in the incontinence issues. I still will take a Tylenol or two a day to help tweak of pain here or there on occasion. The biggest problem is on some nights I don’t sleep well, getting up 5 and 6 times to go to the bathroom. Then on other nights have been able to get by with only a couple trips. As everyone says on this board, time is the great healer, keep up the kegels and you will get there, just don’t try and do too much too soon.
March 11, 2007
Well I am now 8 ½ weeks past surgery and everything overall is pretty good, no major issues and as everyday goes by things generally get better.
I ncontinence continues to be minor with a little dribble here and there just enough to be aggravating. I use ½ of 1 small pad every 24 hours and most times it’s not catching a lot. I probably ware if more for confidence right now. I can go for a period of time like I used to feel before surgery and then it must be when I get tired I have more of the urge or at least the feeling I have to go. It makes a difference to keep doing the keggels and I hope to get out and do more walking now that winter is starting to let up here in the upper Midwest . I generally only have to get up once during the night now.
Sexual functions has also been very promising, I have not and currently do not take any medication to help produce an erection, I have been lucky in the fact with just a little work I can get an erection that is probably about 90% of what it was before surgery and can produce penetration without to much trouble. We have only tried a couple times as I have not been back for my follow-up with my doctor and my last appointment he had not wanted me to try yet, plus the one real fact is I just don’t have the same urge just yet but the plumbing works.
In general I just completed my 5 th week back at work and the one thing I am still adjusting to is my energy level. I get tired by late afternoon and by the end of the week I am pretty done in. Also getting started in the morning is more of a challenge for me; I just can’t seem to get the energy back. I only have an occasional pain or feeling in the area of the incisions it sometime feels like I have a muscle pull mostly in my right side.
Overall I feel very lucky and really have appreciated the information from this web site has provided me and the caring folks that respond. Right now I am just waiting for my first post surgery PSA test and follow up appointment and hopefully I will be a “0”. One of the few times a 0 is the preferred number. My appointment is on March 22 nd and will check back at that time to report my results.
March 22, 2007
Well I am now 10½ weeks past surgery and everything remains overall pretty well and I continue to get a little better all the time.
First Post PSA Test was done on 3/22/07, results < .01 or undetectable.
I ncontinence continues to be minor probably more frustrating than anything that I just can’t seem to completely shut off the faucet and a drip comes every now and then. It’s was real good last Sunday but each day this week has been more of a challenge. Making sure to keep doing the kegels and walking as much as I can. The doctor said as my bladder continues to adjust to the prostate being removed and looking how to properly fit, I might be having small bladder spasms on some days due to this and it is trying to empty the bladder when there really isn’t much there, thus the urgency I feel sometimes. I will need to just keep working on it and it could be another 6 months or so. I continue to ware ½ of 1 small pad every day for protection, hey at least it’s a nice warm feeling once in a while; remember to keep sense of humor also.
Sexual functions continue to go well, I don’t have the same urge as before but when I do things are working at about 90 to 95% of the way it was prior to surgery with no medication, so very lucky. As for the lack of desire that is pretty normal at this time and should return also as time goes on according to the doctor.
In general all is pretty well this is the 7th week back at work and the energy level is getting better slowly but I am getting by. With a 9 year old and a 12 year old at home they make sure to at least get me moving and a loving wife that has many plans for me, that says it all. She has been great through all this and in fact told me to get out of here a few days with my good buddy that called last week and said lets go to Augusta and visit the Masters and have a little fun, so I am gong. The price to pay her back for all she has helped me through just went up. My doctor is setting up an appointment with a dietician which he feels is the most important thing for continued success and I will see how bad I am. We try and eat and stay pretty healthy but I am sure we can improve.
So I have been blessed this week with a good PSA report and now wait for my next test in 3 months. I can only wish and pray all who read my journey to have as good of results as I have had to date. Thanks to all on the board who add support and advice daily, this is a great place.
July 5, 2007
I am now 6 months post surgery and things are pretty darn good, my latest PSA came back at < .1 or undetectable. I have now gone pad free for the past month and half and only have minor ED problems; for the most part everything works as advertised. I am very fortunate on all fronts, the first being the cancer appears to be under check, I have control of continence and very little ED problems and I don’t have the need for any medication for erections etc.