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Ehud
New Member


Date Joined Jun 2007
Total Posts : 14
   Posted 8/3/2007 8:58 AM (GMT -7)   
For those of you not familiar with our story, I'll give a quick update and then I have a few questions.  Larry had robotic surgery on July 9.  Surgery went all right but the afternoon following surgery, his body decided it did not like all that was going on.  He had what is called an "ileus" which means bowels/colon stopped working, etc.  He had never had any major surgery before.  To make a long story short, he was in the hospital until July 18.  While in the hospital, they gave him Heparin shots every 12 hours and used the stockings somewhat.  There were a few days when he was so sick he just could not tolerate the stockings most of the day/night. We were home three days and back to ER/hospital with blood clot in leg.  Stayed in the hospital for six days taking Novenox shots and Coumadin. Had his first PT/INR (since leaving the hospital) on Monday (July 30) and level is at 3.  Next blood testing on Monday, August 6.
 
He had the catheter removed this past Tuesday :-) (been in for three weeks).  We feel as though we are finally making some steps forward.  However, when he gets up from sitting, he has no control of bladder.  He knows he has to go and is fine as long as he is standing, but he just can't get up without going.  I've been reading where control takes a while.  I'm just wondering if anyone has had the catheter in this long and if control results took longer, etc.  He is hesitate about going out among people.  He has started doing the Kegels and is walking some.  He still has some pain issues with leg so our walking has to be somewhat limited.  We are walking a little more/farther each day.
 
We go back to Urologist on Tuesday and to PCP on Wednesday.  The PCP is monitoring the Coumadin but has been on vacation this week (his associate monitored Coumadin this week). 
 
Thanks again to all who have been praying.  We still have a ways to go, but I know HE is faithful. 
 
Wife
 
 
Robotic Surgery on 7/9/07
58 years old (as of 7/26/07)
3+3
T2b
Cancer contained
Margins clear :)

Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 8/3/2007 10:00 AM (GMT -7)   
Ehud and wife:
 
Can't answer your question about cathater, as I didn't have one, but do want to extend my thoughts to both of you while you are going over this bump in your journey.
 
Take care,  Dutch
Diagnosed Feb 2001  (Age 65)  Currently 72
PSA 4.8      Gleason 3+3=6      Stage   T2b
Completed Proton Therapy @ Loma Linda - Aug 2001
Have had no side effects.
6yr PSA - 0.19
 
Our responsibility now is to educate men about Pca, PSA and the importance of early detection. 
 
 


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 8/3/2007 10:44 AM (GMT -7)   
ehud,
 
I had my catheter for 10 days so I cannot relate direct experience but I know the first week after catheter removal my control was up and down.  Kegels and as much walking as possible will make a lot of difference in a couple of weeks.  Be careful not to overdo the kegels as it will just make the leaking worse.  There are threads on the forum about what kegel routine should be employed.  In my case I was kegeling too much at first.  When I changed to doing a set of 10 kegels in the morning holding each one for a count of 5 and then repeating this in the evening then I had improvement.  Also, be sure that he is doing the kegels correctly.  The easiest way to learn how to do them is stopping the stream.  If he does not have a stream yet then, as it was described by one of the forum contributors, visualize the penis as a straw and tense the pelvic muscles as if you were sucking up liquid through the penis.  If you tighten the abdomenal muscles then you are doing them wrong.
 
Hopefullly you will see considerable improvement shortly although full continence will most likely take a few months but it will come.
 
Tamu
Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07
Began injections in April '07
Undetectable PSA on 6/25/07


Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 8/3/2007 11:42 AM (GMT -7)   

Mrs. Ehud,

My physician team almost always keeps the catheter in for three weeks.
(I suspect it keeps the patients from getting too active....)
I had mine in for 21 days, also.  I also had very little control upon catheter removal - while standing - for some time.

Your husband has control while sitting.  THIS IS GOOD NEWS!
The unconsciously controlled (smooth muscle) valve of the bladder is still working.

Your husband needs to walk a lot (with liner pads) and be patient as the stretched bladder and shortened urethra both get accustomed to their new positions.  For now, try holding ever-increasing amounts of urine in the bladder as you are sitting.

Kegel exercises:  Your husband should be doing at least three 20 to 30 minute sets a day. 
After a few weeks and the muscles get stronger, he can do more.  As many as he feels like without getting exhausted.

It takes awhile to develop the necessary muscle tone of the pelvic floor muscles.
This flexing - supports and works with - the remaining bladder valve.

Tamu's suggestion about contracting the muscles to stop the stream flow is good. 

In Bluebird's Journey (Lee & Buddy's Journey), Buddy starts and stops the flow over the toilet.
He practices kegel exercises on the stairmaster.  This is good as walking stairs without leaking is one of the early challenges in gaining control.

If after week 8, you don't see at least some improvement in control while walking, I agree with KW that you will likely benefit from working with a bio-feedback therapist that will make certain you are exercising all of the pelvic floor muscles.  I talk a lot about my work with my bio-feedback therapist in my thread "Zen and the Art of Symphonic Continence"
If you have time to look and want some encouragement, this thread is linked in Helpful Links at the top of the page under Other Topics. 
I also talk about walking around the garage nude with a styrofoam cup to learn how to flex while walking.  Again, all of this is about muscle tone and coordination, not just a constant 24/7 flex.

Don't get discouraged!  While a very few have almost instant continence when the catheter is removed, most don't gain almost complete control between months 4 and 6.  
I feel a positive attutude will help speed this healing. 
Many of us felt we would never really gain control.  Then, one day after week 16 and before week 24, most just suddenly don't need pads. It is that sudden.

Sincerely,

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:)
Texas Hill Country FRESH Produce Department Manager
Have you had your 5 colors today?


Ehud
New Member


Date Joined Jun 2007
Total Posts : 14
   Posted 8/3/2007 6:15 PM (GMT -7)   
Thanks for your encouragement. However, I don't see Other Topics at the top of my page. I would like to read the info "Zen and the the Art of Symphonic Continence" but can't find it???

Rufus
Regular Member


Date Joined May 2006
Total Posts : 31
   Posted 8/3/2007 6:23 PM (GMT -7)   
Ehud and Wife

I had my catheter 14 days - When it came out I had no control for about a month and then it started to improve - took over five months before I was basically padless and only had a few minnor stress leaks.
I too would have no control when I stood up if i sat too long. It was a matter of practice for me to get to learn when time sitting was just about right. I found the kegels helped me and still do them even though RRP was in Dec 05. The radiation I had to have in 06 has made the continuation of the kegels important.

I hope that Ehud recovers quickly.

Rufus
Diagnosed: August 05 T1c 1 of 10 cores positive 5% vol no palpable on DRE Gleason 3+4 or 7
Surgury: RRP Dec 05
Pathology: Jan 06 PT3 20% PCa total volume bilateral 4 positive margins Gleason 3+4 seminal vesicles clear LN not checked extraprostatic extension positive right base and right central anterior no perineural invasion HG PIN present both nerve bundles saved
PSA: Mar 06 0.87 referred to radiation oncologist
PSA: May 06 1.1 June 06 Began 36 treatments EBRT 64 Gy ending July 06
HT: 2 weeks casodex 50 mg, then Lupron Depot 7.5 monthly for 18 to 24 months - monotherapy
PSA: Sept 06 <0.1 (lowest reading on assay) Testosterone (T) <0.4 (lowest on assay)
PSA: Mar 07 <0.1  T <0.4  PSA: July 07 <0.1 T <0.4  :) :)
 


Dutch
Regular Member


Date Joined Feb 2007
Total Posts : 400
   Posted 8/3/2007 6:33 PM (GMT -7)   
Mrs Ehud:
To find the Zen thread - it is the 2nd topic at top of page "Prostate Cancer Resources, Helpful Hints & Topic Thread" -  they are alphabetized, so scroll down to the "Z's".
Dutch

bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 8/6/2007 7:43 AM (GMT -7)   

Here's a few direct links taken from 

 

 Prostate Cancer Resources, Helpful Hints, and Topic Thread Links

 

Listed under *Urinary...Kegel Help? started by KW

Listed under *Other Topic Threads... 

"Zen and the Art of Symphonic Continence" started by Cedar Chopper

 

Pull from all ~ what works best for you!!

 

Quotes & Partial Quotes…

 

 ** Excerpts taken from a wonderful book called “Dr. Patrick C. Walsh’s “Guide to Surviving Prostate Cancer” by: Patrick C. Walsh, M.D. and Janet Farrar Worthington.  Copyright 2001….. 

 

 Excerpt: Page 246

**After the catheter is removed….

     > Until your urinary control has returned to an acceptable level, don’t force fluids. 

 

>Once the catheter is out, you’ve got to slow the pace considerably.  Avoid drinking excessive amounts of fluids, and stay away from caffeine in all forms---coffee, tea, even soft drinks.  Caffeine, especially, is a powerful pharmacological agent that increases the frequency and urgency with which you need to urinate.

 

 

 

**Urinary continence: The return of urinary control:

 

 

**Phase One is when a man can remain dry when lying down.

 

**Phase Two,  you’re dry when you’re walking around.

 

**If you can walk to the bathroom and not urinate until you get there, that’s a

 

    GREAT SIGN!!!…

    ---it means that the sphincter is intact.

 

**Phase Three, you are dry when you stand up (using muscles that put pressure on the sphincter)  after sitting.

 

**Remember, the recovery of urinary control is a slow process.

 

The most important thing you can do during this time

is not to get discouraged.

 

 

 

Excerpt: Page 244

**It’s hard to believe, but urinary control does continue to improve over two years and, in an occasional patient, even longer than that.

 

**Can you do anything to speed things along, and improve your urinary control?  First, whatever you do, do not wear an incontinence device with an attached bag, a condom catheter, or clamp!  If you use any artificial device, you will hurt yourself in the long run.  You won’t be able to recover your urinary control, because you won’t develop the muscle control you need.

 

 

Excerpt: Page 247

**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.

END Quote...

 

 

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.

 

 

*Thanks Dutch ~ for your support in sending members to the thread above!!! 


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 :)

 

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