"Zen and the Art of Symphonic Continence"

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Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 4/28/2007 7:07 AM (GMT -7)   
Quick Summary:
As for the Kegel question, stopping the stream is one of the best ways to isolate the muscles for kegel exercises - Kegel exercises to be done while not urinating. (I still do them all the time....)
One of my favorites is to stand over the toilette with a full bladder and cough and see if you can keep from leaking.....
The argument against doing the "urine stream stop exercise," after you have isolated the muscles - is that this flexing confuses the unconsciously controlled valve at the base of the bladder that your kegel sphincter is supporting. The kegel muscles are not a vice-grip, but rather a "muscle tone" of many many pelvic floor muscles that are recruited in a coordinated effort/pattern/frequency - to avoid fatigue and jump in to close the urethra and aid the bladder valve that opens and closes - more by your suggestion than command........
It is an art, like riding a bike that cannot be learned theoretically!
CCedar

Bluebird Wrote:

This paragraph always jumps back to me when there's questions about kegels.

EXCERPT:…..On page 247 of Dr. Walsh’s book he states:
Exercises you can do: Every time you urinate, do it standing up. You can’t practice the following exercises, which strengthen the external sphincter and speed up your recovery of urinary control, while you’re sitting down. Start your stream, and once it’s in full force, stop the stream by contracting the muscles in your buttocks--- not your abdominal muscles, not the muscle “up in front” around the penis. Tighten your buttocks: imagine you’re trying to hold a quarter between your cheeks. Hold the urine back for 5 or 10 seconds, and repeat as many times as you can. Note: Only perform these exercises when you’re urinating; if you keep contracting these muscles throughout the day, you’ll overdo it—the sphincter tires easily—and you’ll end up wetter than you would otherwise.

Previous paragraphs address… things to speed up your urinary control. One is not using any artificial devices…… and certain high blood pressure medication relaxes this muscle so you may need to check with your doctor.


"Zen and the Art of Symphonic Continence."

I am starting this thread dedicated to what I have observed about post PC treatment continence.

First, it should be noted that all women are Zen-Shaolin Masters of this discipline.

This discipline is a symphony that is conducted, not just a 3-d vice-grip that is clamped at will.

The bladder is a smooth muscle and has a smooth muscle valve that - like your pulse, blood pressure, iris, etc. - over which a person generally has no conscious control. (cf., Sympathetic Nervous System).

Post-Prostrate Cancer Treatment, the "pelvic floor muscles" incorporated to control what shall be referred to here as the "Kegel Sphincter" around the urethra can stop the flow of urine after it has left the bladder.

My observation: The frequency, amplitude, and duration of the harmonic recruitment from the entire array of the pelvic floor muscles can be utilized to communicate with the smooth muscle valve of the bladder.

Of course this bladder valve is not very strong and must be braced with the Kegel Sphincter when standing up, walking, lifting, and running. However, this sphincter does not work alone. Constricting the Kegel muscles ("...feels like you are trying to suck up light through your penis...") with various intensity, frequency, duration, and recrutiment pattern - like a bee dancing in a hive to tell the location of nectar - harmnically constricting the Kegel muscles can communicate with the smooth muscle valve of the bladder to open and close it as needed.

You can make your eyes dialate by thinking of your eternal spouse.

You can be continent by learning to play the "pelvic floor muscle instrument" as an accompanist - not a Kegel soloist!

CCedar

(1-[the square root of five])/2

With this Ratio, Hiram built a ramp for the Cedar Choppers of Lebanon to build a temple for Solomon for the Presence of God. ICTHUS

kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 4/28/2007 8:03 PM (GMT -7)   

    Hey Cedar,

    I'm a welder.....can you explain all that to me????/....heheheh

    Catch you later....

    KW


    43
    PSA 5.7 - Discovered during Annual Physical with Family Practice Dr.
    Gleason 7
    Biopsy - 3 of 12 positive (up to 75%) all on left side of prostate
    RRP on Oct. 17, 2006 - Nerves on right side saved.
    All Lab's clear.  No Cancer outside prostate
    Cathiter in for 3 weeks due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00
    Office visit on Jan. 19th due to continued excessive urine leakage.
    Feb.20th Cystoscope and 2nd Post Op PSA. Another 0.00.....:)
    Dr. said everything looks fine.  Continue to work Kegeal's. Leaking appears to have improved  after Cystoscope?!?!?!  Down to 3-4 pads per day!
    March 1st  Leaking has crept back up to 6 - 8 pads a day ??????? 
    March 8th Started Detrol LA to see if it helps with the leaking?
    March 29th Collagen injection into sphincter / bladder neck area to control excessive leaking.  Worked for a couple of days then back to leaking.
    April 17th (Six Months Post Op) 2nd Collagen Injection to control excessive leaking.  Leaking started back next day at work!
    May 14th Second Opinion about my leaking and Options at OU Medical Center.
    May 30th Follow up and 3rd Post Op PSA
   


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 4/30/2007 3:00 AM (GMT -7)   

Good Morning KW,

Most Texans speak fluent Oklahoman  (Yeahup...and Cedar Chopese...)! 

I'd probably just get out the Argon Machine manual and everywhere it says bead, insert Kegel Exercise.   Save the portable heli-arc for when you are lifting something..... 

Maybe make a Reggae steel barrel drum (or BBQ grill...) or two for the band?  :-)

I think those of us that take awhile to control incontinence are more sensitive to how our bladders were moved and the valve we can't control on the bladder is not happy in its new home and so has not returned to normal operation.  My physician and I also think that those of us that return to physical work increase the problems for this bladder valve as we add more than normal pressures on the newly stretched bladder from lifting and walking around (for me, 14 hours a day....). 

My point is that if you are fighting incontinence, work on the recruiting patterns for ALL the pelvic floor muscles (anus, kegel sphincter, pubic muscles above the penis, and even to a certain extent the muscles that attach to the area and run down the inside of the thighs)  - work on recruiting patterns of these muscles.  You can't keep them all flexed all the time.  Especially if you are walking for more than 30 minutes!

 If you do "elevator kegels" - half power for 5 seconds, full power for 5 seconds, and then (VERY IMPORTANT) half power for 5 seconds, then rest 10 seconds - it mimics the "harmonic" patterns of the muscles when you are continent and walking.  These muscles work with the unconsciously controlled valve on the bladder.  They don't replace it

The "medical art" is to get this valve (after it heals from surgery) to recognize your kegel work as a message to open or close.  This is how women pee or don't pee.

Keeping you in thoughts of perfect health (and a new welding machine....),

CCedar Chopper

1+...(((1/1+((1/(1+1/....)))...  =  (1+square Root of 5)/2  = "golden ratio"


~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*
2 Years of PSA between 4 and 5.5
Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.
Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.
Confined:)
***************
Texas Hill Country
FRESH Produce Department Manager
Have you had your 5 colors today?

Post Edited (Cedar Chopper) : 5/18/2007 7:47:33 AM (GMT-6)


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 5/1/2007 5:30 PM (GMT -7)   

Hi ~  CCedar,

You have given so much to this forum. 

Your expressive postings have so much information. 

It truly shows how much you care by all the special “gifts of sharing”…

Thank you ~ for you!!

Keeping you close in our thoughts and prayers.

In Friendship ~ Lee & Buddy


mama bluebird - Lee & Buddy… from North Carolina

J  We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy with "wide excision"

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 5/17/2007 7:21 AM (GMT -7)   
Senor/Herrn Doktor Martin :-) ,
 
This thread has a couple of descriptions of the "elevator kegals."
My bio-feedback therapist suggests doing them sitting or reclining twice daily - in addition to your other Kegal routines.  The idea is to practice the "blended" use of the pelvic floor muscles as this is what happens when you walk around.
 
THE MOST IMPORTANT ASPECT OF ELEVATOR KEGALS IS TO HOLD AT HALF-POWER AFTER HOLDING AT FULL POWER.  THIS IS ALSO THE MOST DIFFICULT.
 
I also recommend reading up on Bluebird's Kegal Disciplines.  Kegal while stair-mastering!
 
GruSS Gott!  Via con Dios!  (Jag tale inte Swenska, Rickard!)
 
CCedar
 
KW, I'm keeping your full recovery in my prayers.  CC
 
~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*
2 Years of PSA between 4 and 5.5
Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.
Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.
Confined:)
***************
Texas Hill Country
FRESH Produce Department Manager
Have you had your 5 colors today?


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 5/30/2007 9:55 AM (GMT -7)   

This is for Gene and Bill23 (Both quoted below),

The only time I reflexively feel I don't want to read someone's post is when I read something like:  "I had my prostatectomy yesterday and I never needed pads and my wife and I are enjoying sex today better than ever......"  I really do want to celebrate these victories....  It just requires setting aside my fight momentarily.

One Kegel exercise that was helpful to me was when I woke up in the morning with a full bladder: I would stand over the toilet and COUGH as hard as I could and try to hold it....  Like celebrating the blessings of others, it can be a real challenge! 

Aside from my point about confusing the smooth muscle valve, I do agree stopping the urine flow is an important execrise.  However, even that flexing does not incorporate all of the pelvic floor muscles involved in regaining continence.  I whole-heartedly encourage those with incontinence challenges after 8 weeks to look into bio-feedback therapy.

Below I am quoting three posts that Gene, Bill, and I wrote today.  I also want to add something about living with incontinence that I resolved to when in week seven I thought I would leak foreverHaving to "change diapers" is not a sentence to living the life of an aged invalid.  It's just another job - one usually reserved for parents and grand-parents.  You can discretely change out a  nineteen cent - 12 ounce pad every 2 hours.  There are worse "jobs."

Heal Well!   ICTHUS!   CCedar

***************************************

Gene Wrote:

Bill, I have followed your various comments and your first ones that I saw came at a time when I was pretty negative, too.  I hope I did not encourage you in negativity, because I know that is not the answer.  I have had to do what seems best for me at the time and that is using the Bard-Cunningham clamp, a devise that no one on the board recommends because Dr. Walse advises against it.  The only one I know promoting it at this time is my surgeon, whom I feel much like the way you feel about yours.  I wonder if he knows something he's not willing to talk about relative to my surgery.  I can contain absolutely nothing in my bladder and of course can pee absolutely nothing except in the mornings.  He tells me to have patience, too, which is what I (and you) must do at this point.  A close friend of mine said his continence returned to normal suddenly at six months, so that is my hope now, whether it is at six or twelve months, or whenever.  I too have been somewhat discouraged by all the testimonies of success, but I am trying to turn that discouragement into hope. I am glad these other guys are doing better than I.  I wish and pray the best for them. 

Like you, at first I felt I had made a terrible mistake by having the open radical instead of the robotic, but I have found jon this board just about as many with that surgery who has incontinence problems, too. 

Let's make a pact together to keep looking "up" through this.  Although you are a much younger man than I am (I'm now 64), let's get better together, while the people on this board watch us.  They are very supportive and concerned.  And perhaps we can encourage someone else.  By getting interested in someone else other than myself, I seem to do a lot better with my attitude. 

I am, after tomorrow, going to be limited on the computer until I get situated in my new location, but I will get back on this site as soon as possible.  I will see the surgeon tomorrow.  Maybe he will give some new data.  Also, I do want to remain annonomous, but there may be a point when you and I can communicate on a personal level.  If so, we'll have to figure out how we can get personal without the whole world knowing who we are.  In the meantime, do not dispair.  Do not dispair.  Look up to the Creator and Savior, the Lord Jesus Christ.

Gene

********************************

Bill23 Wrote

Gene:
 
It seems as if you and I are in the same boat.  I'm 2 months post-op,  and leak continuously during the day.  A lot of the guys on this board suffer from the "classic" form of stress incontinence.... which is leakage when coughing,  sneezing,  running,  etc.  While a real pain,  it is not as bad as the continuous leaking I have even when standing perfectly still.  This does not allow my bladder to accumulate any volume whatsoever during the day.... it all comes out in my pads,  which I change up to 15 times a day.
 
As far as your initial question,  I try to hold a kegel as long as I can,  but I must eventually let go,  and everything in my bladder just pours out.  It is truly ruining my life because I have seen zero progress in 2 months.... it is taking a huge toll on my well being because the total lack of any progress is so atypical from most people on this board.
 
Are you able to stop and start the flow in the morning?  I can only slow the flow briefly,   not stop it.  Since the morning is the only time I have a full bladder,  I can only practice this once a day.
 
My prostate was rather large at 60 grams,  so I am fearful that some damage was done to the sphincter or pelvic floor muscles upon removal.  The doc,  of course,  says no but I honestly feel he is feeding me a bunch of BS to cover his rear.  All he knows how to say is "patience and kegels"....  there has to be more to it than that after 2 months.  I started doing kegels weeks before surgery,  and have just started biofeedback lessons,  although the technician says that I have been doing the kegels properly.
 
I'm beginning to regret having the surgery at all.. I spent so much time researching all the procedures and doctors,  in order to make the right choice, only to face the prospect of being a guy in his early 50's living the life of a 90 year old in diapers.
 
Sorry to be so negative,  but this is becoming unbearable.  There are a lot of upbeat,  wonderful people on this board who have offered words of encouragement,  I'm sure you are better off listening to them!! Good luck to you!
 
Bill
 
***********************************
Cedar Wrote

Good Morning Gene,

I hope the move at work is going well.  I have a good feeling about your work there!

My understanding - from my bio-feedback therapist - is that you don't hold at maximum all the time.  However, there is a certain muscle tone that develops in all of the pelvic floor muscles that will seem somewhat flexed (Think half-power while doing elevator kegals.) all the time.  Also, she suggests, after a few weeks of scheduled kegal exercises, in addition to the scheduled routine, to just do a partial routine of kegal exercises whenever you think of them.  If you compare this work to conditioning other muscles in the body, you might exercise - say your legs or arms - for even hours at a time, but you would not just flex them all the time.  The muscles you want are dynamic.  Not static.

I personally do the warm-up (2 seconds on 2 seconds off) or elevator kegals (off 5 seconds, half-power 10 seconds, full-power 10 seconds, half-power 10 seconds,  - repeat) for as many times until I get bored - whenever I think of them.  For example, whenever I sense leaking.....  whenever I am driving...  whenever I am typing at the computer..  whenever I am doing some routine job on my feet.....

Your other post mentioned your using the clamp.  Even when I was leaking at full speed (at week 4 upon return to work), I could go 2 hours with the combination of the men's 8 oz. liner and women's 12 oz. incontinence pad at 90 degrees-  mostly just replacing the wonen's liner every two hours if I remembered.  My point:  I feel that using the clamp has to be a lot like doing kegals while urinating to stop the urine flow.  My bio-feedback therapist believes that doing this for any reason except to learn to isolate the muscles is counterproductive as it confuses the smooth muscle (no conscious control) valve of the bladder that is an integral part of your ultimate continence.

When you become continent again, four things:  your overall health, the muscle tone of the pelvic floor muscles, periodic conscious control of the kegel sphincter when lifting - etc., and this bladder valve all work together.

You will recover to full health.  You are "...fearfully and wonderfully made...!"
ihs
 
CCedar


 

~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*
2 Years of PSA between 4 and 5.5
Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.
Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.
Confined:)
***************
Texas Hill Country
FRESH Produce Department Manager
Have you had your 5 colors today?


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 6/2/2007 3:16 AM (GMT -7)   

I'm adding this in from Gene's thread:

Bill, Gene, & Ms. Bluebird Lee,  RE: WHAT ARE THE PELVIC FLOOR MUSCLES?

*******************************

Bluebird wrote:

... this paragraph always jumps back to me when there's questions about kegels.

EXCERPT:…..On page 247 of Dr. Walsh’s book he states:

Exercises you can do:  Every time you urinate, do it standing up.  You can’t practice the following exercises, which strengthen the external sphincter and speed up your recovery of urinary control, while you’re sitting down.  Start your stream, and once it’s in full force, stop the stream by contracting the muscles in your buttocks--- not your abdominal muscles, not the muscle “up in front” around the penis.  Tighten your buttocks: imagine you’re trying to hold a quarter between your cheeks.  Hold the urine back for 5 or 10 seconds, and repeat as many times as you can.  Note: Only perform these exercises when you’re urinating; if you keep contracting these muscles throughout the day, you’ll overdo it—the sphincter tires easily—and you’ll end up wetter than you would otherwise.

 

Previous paragraphs address… things to speed up your urinary control.  One is not using any artificial devices…… and certain high blood pressure medication relaxes this muscle so you may need to check with your doctor.

 
*************************************************
Gene asked Bluebird:
 
You recently wrote to me and Gene.....
 

EXCERPT:…..On page 247 of Dr. Walsh’s book he states:

Exercises you can do:  Every time you urinate, do it standing up.  You can’t practice the following exercises, which strengthen the external sphincter and speed up your recovery of urinary control, while you’re sitting down.  Start your stream, and once it’s in full force, stop the stream by contracting the muscles in your buttocks--- not your abdominal muscles, not the muscle “up in front” around the penis.  Tighten your buttocks: imagine you’re trying to hold a quarter between your cheeks."

 

Everything I've read specifically states that one should never use the muscles of the abdomen, thighs, or buttocks when kegeling.  Does Walsh differ from this?

 

**************************************

Cedar Writes:

My work with my bio-feedback therapist agrees with what Bill says.

However, If you think of the suggestion to "tighten the buttocks" as "contracting the muscles in your buttocks" - that is,  more as a description to get you to tighten the anus sphincter, this is what my bio-feedback therapist teaches as an integral component of the "Pelvic Floor Muscles."

The description she gave was: ".. like you are trying to hold back a fart..."

What I have found in my efforts to control the "kegel sphincter" that we who fight for continence are trying to develop, is that often when I control the passing of gas, I also leak.  This supports tightening the anus as well as the muscles immmediately surrounding the urethra for "Kegeling."

 

As the anus sphincter seems to be the more difficult to learn to control of the pelivc floor muscles, from the teaching point of view, Dr. Walsh's advice  "trying to hold a quarter between your cheeks" , is a helpful approach as it brings the focus of control away from the pelvic floor muscles we seem to think of first - those muscles that immediately surround the urethra that don't work for continence control so well while walking, lifting, coughing, or climbing stairs. 

Note: The last half-power portion of Elevator Kegel reps REALLY helps to learn this anus sphincter control - without tightening the actual buttock muscles.

 

My bio-feedback therapist showed me detailed musculature drawings of the pelvic floor muscles in both men and women.  They wrap around from the anus sphincter to the lower pubis (In women, this area surrounds the vagina.).  She said that another "feeling" that indicates that you are doing the Kegal Exercises correctly is that it feels like you are pulling your testicles up into the pubic cavity.  I only notice this sensation when I am at the peak of my elevator exercises.

 

ICTHUS

 

CCedar



~~*~~*~~*~~*~~*~~*~~*~~*~~*~~*
2 Years of PSA between 4 and 5.5
Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.
Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.
Confined:)
***************
Texas Hill Country
FRESH Produce Department Manager
Have you had your 5 colors today?

Post Edited (Cedar Chopper) : 6/2/2007 4:36:56 AM (GMT-6)


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 6/7/2007 3:08 AM (GMT -7)   

Written on the Fourth of July 2007:
To all the Freedom Fighter Members of this Forum on this 4th of July Independence Day-

  - Especially Vet, Tony, Susan, Gordy, and of course Ms. Blue,
 
A positive attitude? - Oh yes!  We have the freedom to have hope.
Hope for the cure, hope for our loved ones, hope for ourselves, hope for the world.
 
This hope is firmly grounded on our ability to believe in something we can't see -
  -(I think JFK called it on the money: "I dream of things .... and ask why not?").
This vision of something better, something perfect - 
  -this is the best move or investment any of us can make
               with our life or resources.
We are challenged to live free in optimistic, radically imaginative, positive thinking!
 
I am honored to be here with all of you Freedom Fighters, fighting for "independence."
Your friendship is a powerful uplink to help keep my smile on straight!
 
ICTHUS!
 
CCedar
***********************************
ADB,

Some of my posts here are unnecessarily wordy - but there are several quotes from others and they might help you understand the nature of your kegel work.

Try to spend some time reading some of the threads in Bluebird's Journey if you have time.  Listen for technical advice from Swimom.  Listen for encouragement from others such as Susan, Courtney, Biker, KW, PCDAVE, El Tigre, and a dozen others....

Sonrise, Surprized, "Civilized" man.  Heal Well!

CCedar

*************************
A post to ADB from another thread:

ADB,         RE:  A PATIENT PATIENT 

Remaining optimistic (Important!) while managing incontinence was/is very challenging for me.  Your bladder was moved, stretched, and re-attached to the urethra.  The bladder still has an unconsciously controlled valve that must be supported by your kegel activity.
 

It takes some of us more time than others to learn this new form of control.  Developing the kegel muscles and your recruiting patterns for utilizing these muscles 24/7 seems ominous, right up to that point where you find your pad only has some minor spotting after a day of full activity.  For some, it happens immediately.  For most - somewhere in the 2 to 3 month time-frame.  Others take even longer.
 
Discretely changing pads is annoying but not an impossible task.  Don't let the annoyance keep you from (realistic) optimism that you will regain control.
 
ICTHUS!
 
CCedar
 
The following was posted 08JUN07
&&&&&&&&&&&&&&&&&&&&&&&&&&

Bird6,

...For those of us that do not achieve immediate continence, the "elevator kegels" discussed there seem especially helpful.

I also STRONGLY recommend that you look at the direct links on Bluebirds "Helpful Hints" thread and read about doing kegels on the stairmaster!  Bluebird is famous for helping all of us here in this community find what we need - and to use our talents and knowledge to join in helping others where we can.
 
I myself have regained most continence (I drip a little each day - as I unload trucks....) as I approach the 4 month-post-surgery mark.  Now I look toward E.D. (erectile dysfunction) rehabilitation.  While it may be a little soon for you to work on this area, I heartily recommend you follow all of the threads on E.D. as well.  A few weeks after surgery, it's all about keeping the circulation going to the nerves.
 
Social comparison can lead to unrealistic expectations about how long it takes an individual to heal.  Physicians are not only very busy - I feel they also have to be "oh-so-careful" what they say - or even what they appear to agree to if we make a statement in front of them.  They know that we must stay positive about our futures.  Hope for the best but don't lose your joy if some healing process takes a little longer for you than it does for another. 
 
Your new friends here can each share their stories!  We are all healing.  Be patient.  You will regain continence.  Stay with us!
 
ICTHUS!
 
CCedar



2 Years of PSA between 4 and 5.5  + Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.  +  Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.  + Confined:)
Texas Hill Country FRESH Produce Department Manager
Have you had your 5 colors today?

Post Edited (Cedar Chopper) : 7/26/2007 4:16:01 PM (GMT-6)


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 6/24/2007 4:34 PM (GMT -7)   

Hey ~ CCedar,

 

Thinking of you and wanted you to know!!!    yeah  

 

I’m going to link this thread with the one we started for you back in February 2007!

 

As each of us move in different directions ~ please know that we continue to keep you close.

Hugs from Lee & Buddy

 

(Direct Link ~ just click on the title below and a new window will open!  

Reminder … click on the REFRESH icon once you get there)

Cedar Chopper's Page & Updates ~ Radical Prostatectomy ~ Feb '07  Thread started by: bluebird :)

 


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 7/26/2007 4:01 PM (GMT -7)   
kw said...

    Hey Cedar,

    I'm a welder.....can you explain all that to me????/....heheheh

    Catch you later....

    KW

Gene,

Incontinence:
I wasn't sure you could find this thread on incontinence, so I'm continuing my email discussion on that topic with you here.  Bluebird has this thread and so many more catalogued in Helpful Hints at the top of the page.
My slow return to continence is likely the result of both my long work days and my blood pressure medication.
Bluebird's link to My Journey will remind you how many weeks I was completely incontinent while standing - 14 hours a day.
I still think that those that don't return to mostly continent within 8 weeks should find a bio-feedback therapist and learn elevator kegels.
Reviewing this thread has a lot of kegel tips.  
I am sorry I'm so wordy!  (Did I tell you - or was it KW -that I really do have a "B.S. in Speech?") smurf
Reviewing this thread you will also find a place I quoted your dialogue with Bill23 - a different time and place - but still helpful to many.

Erectile Dysfunction:
I think you should look for both el Tigre's (Dr. Martin's) and Tamu's threads about fighting erectile dysfunction.  Lee, IzzyBlizzy (Courtney), Myman (Susan), Mkat, Creed_One and other women here can probably give you some terrific pointers on the woman's perspective.  I also believe all patients that have erectile dysfunction should be using the pump daily (not necessarily with the rings) by week nine.

Your Friend,

CCedar  ICTHUS!
##################################

THE FOLLOWING IS AN EXCERPT FROM SWIM about

swimom said...
Simple answer Puget..Yes, please take one of the PDE5's at least 3 times a week IF you have no contraindications preventing you from doing do...

swim PS: Ron...I'm a female. Paul is the better half.

PSSSS Everyone : That is Captain Paul as of last week!!! :>)

Swim,

You asked how I knew you liked conversation?
I think I've read over half of your posts!  (The coffee was an educated guess....)
What branch is Paul's Captain Commission in?   Congratulations!

I really believe that your following post - repeated here - needs to be put into someone's Helpful Hints Thread - for easier access to the newby.  I wouldn't even think to ask my physician these questions!

Swim Wrote:
Let me explain my version of why a man should begin to stimulate erections as soon after surgery as he feels up to the idea.

In the first 24 hours post-op, most of the damage is already done to the tissues. They (surgeons) don't just leave the penis alone during surgery. The whole mechanism is messed with from messing with nerves and vessels to manipulating the urtehra with a cath. In the next few weeks to few months there is more damage occuring to the penile tissues simply due to the nerve pathway disruptions, preventing normal signaling/oxygenation. The surgery has disrupted natural (nocturnal and otherwise) erections which in turn disrupts tissues from getting much needed fresh oxygenated blood. Atrpohy begins immediately and continues on until healing slows/reverses the process.

Looking for a clear path, the nerves begin to rebuild the damaged bridge, providing there was nerve sparing surgery done. The nerve pathways need help as they regenerate (rebuild) the bridge. Viagra releases nitrus oxide (essential to nerve/tissue health). Stimulation promotes nitrus into action (we all need a little hlep sometimes). It takes a while for the nerves to say..hey, look Nitrus is back! Oxygen says hey, my old friend is back! Together, they work toward regenerating lost functon and revitalizing atrophied tissues. Giving poor physical stimulation a much needed break, Viagra will eventually take on a stronger role until nitrus and oxygen are able to (if they are able to be indenpendent) take over their job completely again. Shots, Muse, a pump, Levitra, LArginine, Cialis, Viagra....all support! Stimulation...vital support! Why? Somebody has to operate the crane. It's the only part of the healing process that isn't automated.

Non nerve sparing candidates have to take a slightly diffeent rehab route. Shots and a pump are considered first line therapy. Unlateral nerve sparing may be in a similar rehab situation and of course, not evey man who has had sparing surgery will recover function on his own. The one thing men should be relaxed about is, unless he's is being overly agressive (via any method) with his rehab, the process is not dangerous to the body. Maybe frustrating to the mind but not to the penis.

PS: Jim, your Doc is a really hopeful man!!!! I agree though. Paul's surgeon wrote on the RX to "attempt" 3-5 times a week.
###########################################

CCedar
ICTHUS!

P.S.
A description of Elevator Kegels:
I'm working on a "third floor" to my elevator kegels.  My bio-feedback therapist insists there is no such place......  and her bio-feedback screen seemed to only indicate two "floors" as well!  That is, a half power contraction and a full power contraction.  Still, I find that after reaching a full power contraction and holding it for 5 or 10 seconds, I can increase the sensation of contraction to an additional level before attempting to reduce to half power ("first floor"). 

Post Edited (Cedar Chopper) : 9/17/2007 12:09:07 PM (GMT-6)


StrictlyInc
Regular Member


Date Joined Dec 2006
Total Posts : 353
   Posted 7/27/2007 10:23 AM (GMT -7)   
Interesting, I never heard that some high blood pressure medicines affect continence. Which would those be? I take felodipine for high blood pressure (in addition to simvastatin for cholesterol).
____________________

Prostate cancer diagnosed: May 15, 2006 (age 40)
Gleason score: pre-surgery 3+3=6; post-surgery 3+4=7
daVinci radical prostatectomy: July 25, 2006
size of tumor: approx 1.1 inches; negative margins from surgery

- number of pads/day at 3 months after surgery: 3 to 5
- number of pads/day at 4 months after surgery: 1 to 2
- number of pads/day at 6-12 months after surgery: 0 to 1

- 1st post-surgery PSA: 0 (Nov 2006); 2nd post-surgery PSA: 0 (Feb 2007)
- 3rd post-surgery PSA: 0 (May 2007); 4th post-surgery PSA: 0 (June 2007)

The search for timber: took Viagra/Cialis approx. every other day, ErecAid once a day, injections. Peyronie's diagnosed 7/5/07. Now on Cialis, L-arginine and pentoxyfylline, ordered to be celibate for 6 weeks.

- PGE1 batting average: .364 (4 for 11)
- Bimix batting average: .200 (2 for 6)
- Trimix batting average: .500 (1 for 2)

"Lost in the valley without my horses, no one can tell me what my remorse is..."


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 7/27/2007 11:28 AM (GMT -7)   
  tongue    EXCERPT:…..On page 246 of Dr. Walsh’s book he states:
 
(Note: If you are being treated for high blood pressure with an alpha-adrenergic antagonist such as Cardura, ask your doctor to put you on a different kind of drug.  Cardura makes the sphincter relax, and can make incontinence worse.)

StrictlyInc
Regular Member


Date Joined Dec 2006
Total Posts : 353
   Posted 7/27/2007 3:42 PM (GMT -7)   
Thanks, bluebird.
____________________

Prostate cancer diagnosed: May 15, 2006 (age 40)
Gleason score: pre-surgery 3+3=6; post-surgery 3+4=7
daVinci radical prostatectomy: July 25, 2006
size of tumor: approx 1.1 inches; negative margins from surgery

- number of pads/day at 3 months after surgery: 3 to 5
- number of pads/day at 4 months after surgery: 1 to 2
- number of pads/day at 6-12 months after surgery: 0 to 1

- 1st post-surgery PSA: 0 (Nov 2006); 2nd post-surgery PSA: 0 (Feb 2007)
- 3rd post-surgery PSA: 0 (May 2007); 4th post-surgery PSA: 0 (June 2007)

The search for timber: took Viagra/Cialis approx. every other day, ErecAid once a day, injections. Peyronie's diagnosed 7/5/07. Now on Cialis, L-arginine and pentoxyfylline, ordered to be celibate for 6 weeks.

- PGE1 batting average: .364 (4 for 11)
- Bimix batting average: .200 (2 for 6)
- Trimix batting average: .500 (1 for 2)

"Lost in the valley without my horses, no one can tell me what my remorse is..."


NewJourney
Regular Member


Date Joined Jun 2007
Total Posts : 30
   Posted 7/28/2007 6:51 PM (GMT -7)   
A question about other exercises. The kegal exercise I get, but wondering if doing these exercises:(http://www.exrx.net/WeightExercises/HipAbductor/LVSeatedHipAbduction.html and http://www.exrx.net/WeightExercises/HipAdductors/LVSeatedHipAdduction.html) at the gym have any additional benefit related to this subject. Thanks
Age: 52
PSA: 4.8
Stage: T1C
Prostate, right base, core biopsies:
Adenocarcinoma.
Gleason’s grade 3+3=6.
Carcinoma involving two core biopsies and 50% of sampled tissue with a linear measurement ofapproximately 3 mm.
Perineural infiltration present.


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 7/28/2007 7:36 PM (GMT -7)   
  tongue Hi ~ New Journey, 

Looking back at the last postings on your threads…  Treatment Choice and CAT Scan   and your signature…. Have you decided on your treatment yet?

 

The following is our personal opinion:

 

Before surgery…. Any exercise is beneficial.

And yes ~ your link is a good exercise before surgery….

Stairs and the stair master are very helpful in strengthening the sphincter muscle (before and *after surgery)

 

*After surgery….  Be very selective as to how much strain you put on your surgical area and the sphincter muscle.

(Start out slow…. and gradually add time and strength to your routine)  We did not go back to the Y for 8 weeks after surgery…..  We walked, walked, walked, and walked some more during the 1st 8 weeks. 

 

In our personal thread (near the bottom of the posting…) we’ve given information about Buddy’s routine at the Y…. beginning just after Mr. Hang was “sent packing”….  Actually ~ we made friends with him pretty quick because we know he was allowing us to heal…  We had no issues with “him”… J

 

I hope you can pull something from “Our Journey”….

(direct link located in our signature below)

 

Congratulations on the loss of weight and the preparations you are making for your next step!!!

 

Our thoughts are with you as you continue to move forward.

Thank you for staying close!

In Friendship ~ Lee & Buddy


mama bluebird - Lee & Buddy… from North Carolina

J  We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)

 


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 8/4/2007 3:42 AM (GMT -7)   
Ms. Ehud,

This thread might help you.
Don't forget Buddy's suggestion to practice kegels and use the stairmaster!

All my best!

CCedar
ICTHUS!

2 Years of PSA between 4 and 5.5  + Biopsy 23DEC06 
Only 5 percent cancer in one of 8 samples.  +  Gleeson 3+3=6
Radical Prostatectomy 16FEB07 at age 54.
1+" tumor - touching inside edge of gland.  + Confined:)
Pad Free @ 14 weeks.  Six Month PSA <.003  :)
At 6 months, ED treated with Pump Exercises & 50mg Viagra Daily
Texas Hill Country FRESH Produce Department Manager
Have you had your 5 colors today?

Post Edited (Cedar Chopper) : 9/15/2007 6:55:04 PM (GMT-6)


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 8/4/2007 5:28 PM (GMT -7)   
Hey ~ Cedar....
Buddy doesn't do kegels on the stairmaster.... He uses the stairmaster to strengthen the sphincter muscle.
Let me know if I've written it wrong somewhere..... so I can go in an correct it!!
Hugs from us!!!! to you!!!

mama bluebird - Lee & Buddy… from North Carolina

J  We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

2nd PSA 02-06-2007 Less than 0.1 Non-Detectable :)

 


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 8/20/2007 10:56 AM (GMT -7)   
Berb, KW, & Gene,

I copied Berb's post here about the urodynamic study and his patient attitude toward artificial methods. What a remarkable attitude and thoughtful sharing!

Thanks! Sincerely,

CCedar

Berb Wrote on August 19th 2007: Hi KW

Sorry to hear that you have not seen any improvement. My current situation: I use about 8 pads a day; am relatively dry at nights (couple of spoonfuls into the pad); and after sitting or lying down I can usually make it to the toilet with a 10-20% loss of urine along the way, provided it is not too far. Like you, I find my control better if the bladder has some liquid in it before I start movement if I start moving with an empty bladder, I have zero retention.

The urologist who conducted a urodynamic study on me recently said that my continence is unlikely to come good on its own, and I'll need either the artificial surgery or the sling. I'm not prepared to accept that point of view at this time. It may well be that he is eventually proven right, but once the artificial sphincter surgery is done, I kiss goodbye to any chance of the incontinence coming good on its own. The stats show that some people still come good in the period from 6 to 24 months, so why could I not be one of them?

The sling does not sound a good option from what I have read, with only about 70% of respondents expressing satisfaction. I've only read a couple of actual reports of men who have had the artificial sphincter operation, and they still use pads, although at a lower rate. Personally, I have concerns about more damage being done during surgery, so this for me is a last resort. My plan therefore is to do nothing until 2 years are up. I'll keep working on the exercises. I'll do the bio-feedback as you have done, and keep alert to any other sort of non-invasive approach that might have some merit.

In a strange way, having the urodynamic study done was a bit of a mental turning point for me, despite the outcome being pessimistic about my eventual recovery. Until I had that done, I had been looking for improvement on a week by week basis. Of course, I was disappointed as it never came. However, the results of the study have had the effect of shifting my focus out to 2 years, and I am no longer worrying about the short term. When I do the kegals now, instead of looking for improvements week on week, I simply view them as tiny additions to the strength and bulk of the sphincter which hopefully will still come good.

And if in 2 years I am not continent, there are still options to surgery. One is the clamp (I would not use this now because it appears to impede natural recovery). And of course, there's no reason why I can't continue to use pads indefinitely. 3 months ago, I could not contemplate such a thought. Today, I think it's not the end of the world.

Berb


Berb Wrote on August 19th 2007: Hi KW

Sorry to hear that you have not seen any improvement. My current situation: I use about 8 pads a day; am relatively dry at nights (couple of spoonfuls into the pad); and after sitting or lying down I can usually make it to the toilet with a 10-20% loss of urine along the way, provided it is not too far. Like you, I find my control better if the bladder has some liquid in it before I start movement if I start moving with an empty bladder, I have zero retention.

The urologist who conducted a urodynamic study on me recently said that my continence is unlikely to come good on its own, and I'll need either the artificial surgery or the sling. I'm not prepared to accept that point of view at this time. It may well be that he is eventually proven right, but once the artificial sphincter surgery is done, I kiss goodbye to any chance of the incontinence coming good on its own. The stats show that some people still come good in the period from 6 to 24 months, so why could I not be one of them?

The sling does not sound a good option from what I have read, with only about 70% of respondents expressing satisfaction. I've only read a couple of actual reports of men who have had the artificial sphincter operation, and they still use pads, although at a lower rate. Personally, I have concerns about more damage being done during surgery, so this for me is a last resort. My plan therefore is to do nothing until 2 years are up. I'll keep working on the exercises. I'll do the bio-feedback as you have done, and keep alert to any other sort of non-invasive approach that might have some merit.

In a strange way, having the urodynamic study done was a bit of a mental turning point for me, despite the outcome being pessimistic about my eventual recovery. Until I had that done, I had been looking for improvement on a week by week basis. Of course, I was disappointed as it never came. However, the results of the study have had the effect of shifting my focus out to 2 years, and I am no longer worrying about the short term. When I do the kegals now, instead of looking for improvements week on week, I simply view them as tiny additions to the strength and bulk of the sphincter which hopefully will still come good.

And if in 2 years I am not continent, there are still options to surgery. One is the clamp (I would not use this now because it appears to impede natural recovery). And of course, there's no reason why I can't continue to use pads indefinitely. 3 months ago, I could not contemplate such a thought. Today, I think it's not the end of the world.

Berb
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