Incontinence/Depression

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Ehud
New Member


Date Joined Jun 2007
Total Posts : 14
   Posted 10/12/2007 5:14 AM (GMT -7)   
First, thanks for this forum and the many thoughts and prayers lifted up.  It has been such a help to me.  Our journey has been different from any I've seen posted here (see closing), but responses have always been appreciated.
 
We are 13.5 weeks from surgery, but this week the incontinence has been worse.  He had been doing better and then on Tuesday it's been like the gates have opened again.  I do think he tried to do more Kegals on Monday than he was use to doing.  Did not try to do any Kegals on Tuesday, Wednesday,  or Thursday - just other exercises bio nurse had him doing.  He is unable to stand to urinate because it seems to go everywhere.  Bio nurse said sitting is o.k. - now don't advocate the stopping/starting method.  Have too many that can't urinate.  Woke up during last night and everything was soaked (only once before right after catheter was out).  On two different occasions during the past two weeks have had some blood in urine but both times were after standing/walking more than usual.  None since last Saturday.  (Possible cause??? INR was high at 4.3 - should be between 2 and 3).  I called urologist office with questions (husband didn't want to) and nurse called me back after discussing with doctor.  May want to do cystogram at next appointment (October 23).  Also possible that Coumadin could be slowing his healing process.  Did I read somewhere that cystogram could cause scar tissue??  Does the above sound like a possible stricture? 
 
He is getting ready to retire.  This was in our plans before finding out about cancer and then surgery.  Now my concern is that he will stop trying.  Words yesterday were "I don't know how much longer I can handle this."  I feel as though I am the one doing all the research.  At this point, both of us are getting "down." 
 
This past Tuesday we saw neurologist for pain in upper thigh area.  Diagnosis is meralgia paresthetica.  Definition: (me-ral'-gee-a par-es-thet'-i-ka) is numbness or pain in the outer thigh not caused by injury to the thigh, but by injury to a nerve that extends from the thigh to the spinal column. This chronic neurological disorder involves a single peripheral nerve, namely the Lateral cutaneous nerve of thigh (also called the Lateral femoral cutaneous nerve). The term meralgia paraesthetica comprises four Greek roots, which together denote "thigh pain involving anomalous perception."
Pain on the outer side of the thigh, occasionally extending to the outer side of the knee
  • A burning sensation, tingling, or numbness in the same area
  • Occasionally, aching in the groin area or pain spreading across the buttocks
  • Usually only on one side of the body
  • Usually more sensitive to light touch than to firm pressure
Condition likely due to position he was in during surgery since the pain began the day after surgery.  Glad to finely get a diagnosis but one more thing to deal with.  Could go away eventually or could have it for the rest of his life. 
 
Guess right now I need as much info as possible on cystogram and if any complications could result from procedure.  We have a good relationship with urologist and his office, but I'm beginning to wonder if things got botched up.
 
There was interest on last email of his condition prior to surgery.  He is 6'2", weighs 208.  Never spent a night in the hospital until this surgery.  Was in good health until prostate cancer showed up.  Has had three previous outpatient sinus surgeries.  Probably didn't exercise as much as he should but walks 8 blocks each day from car to office.  Weather permitting, would walk at lunch time.  Definitely doesn't have a beer belly, maybe a little Mt. Dew belly (no caffeine since surgery) :-)    Never drank coffee, just a couple Mt. Dews a day and water. 
 
Robotic surgery 7/9/07
In hospital until 7/18/07 because of ileus after surgery
Home for three days, back in hospital with DVT/pulmonary embolism.  Home on 7/26.
Catheter in for 22 days due to all the complications
Age 58 (57 at surgery time)
3+3 (cancer in two cores of 12 core biopsy - 40% in one and 5% in other) T2c
Cancer contained, margins clear
Currently on Coumadin for 6 months. 
Recently diagnosed with Meralgia Paresthetica
Bone scan on October 4 - clear
MRI on October 7 - a little arthritis but otherwise clear.  Doctor said back discs looked like a 30 year old.

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 10/12/2007 8:10 AM (GMT -7)   
Dew Belly,
 
So thats what Paul has...a Dew Belly! Its nice to see a little tad of humor in the midst of a stressful time. The spirit still hangs in there in a strong person....you, are a strong person!
 
Wish we could collectively come up with a good answer for cases such as your DH's. Hang in there. Its taken him time to get through the surgery and he did have some serious complications (thankfully resolved successfuly). Perhaps it is the post-op issues delaying his recovery. We'll all hope for the best that soon he'll be on dry land again. If not, and things do not improve, good things can come of artificial sphincters.
 
On the sore leg with nerve pain. Thigh/hip/buttock stretches help that sort of pain fairly well. Simply lying on a hard (floor) surface and bringing a leg up toward the chest and holding for a count of 10 (each leg) a couple of times will help. 2nd...Gently crossing each thigh across the abdomen toward the opposite leg a few inches (sitting, leg up / knee bent, extended opposite leg ). This is a gooood hip excersise for those who don't have bad joints already. If one cannot achieve these stretches them selves..lay on the floor and have a partner do them gently for you. They both (stretches) work to stretch the hip, outer thigh, lower back and buttock. opens up that area where nerves travel through the butt cheek. Feels pretty good! If he needs to, many patients find releif form using a low (.25mg) dose of Elavil for his kind of pain, Ehud. Good luck my dear. Hope something works in both arenas real soon.
 
Swim
 


Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 10/12/2007 9:07 AM (GMT -7)   

Ehud,

I have had stricture but my stricture was from the surgery itself.  I did have bleeding when I walked, etc. and the doc was very slow about taking it all seriously from me.

It is my understanding that cystoscope does not cause stricture but the surgery does... sometimes.  That's what happened to me.

I would for sure go ahead with the cysto so the doc can look in to see what the problem might be.

Gene


Age: 63
07/05 - Biopsy: Suspicious looking cells. 
12/27/06 - Biopsy
1/24/07 - Dignosed cancer: Gleasn Grade: 3+3=6
02-14-07 Radical Open Nerve-sparing surgery
Pathology Stage of cancer: T2c
4-18-07: First Post-Op psa = 0.011
05/31/07: Cystoscope reveals "Stricture"
06/12/07: Procedure to remove stone & dilate uretha at stricture: Successful procedure.
8/16/07: Start bleeding again in urine.  Get to see a new urologist same day.
8/20/07: Go back to dr. for cystoscope.  "No sign of stricture"!  Wonderful news! Still leaking.
8/31/07: Back to new urologist for regular check up & received 2nd post-op Psa.  It was 0.05
8/31/07:  First Bio Feedback session.
9/19/07: Finished 4 Bio Feedback sessions.  No imporovement with leaking. 
9/26/07 - Started injections   
 
 
 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 10/12/2007 9:40 AM (GMT -7)   
HI Ehud,

The exercises that Swim described are a part of those that I do each day for arthritis in hips and back. They decrease the pain and really feel good! (Payoff...) I got back into them again as soon as I could after surgery and it seemed to help with the recovery too.

Sometimes our recovery is one step forward and two steps back. But eventually we get it done. Patience and persistence, even when it seems hopeless, will eventually win out.

Good luck...

Jim
Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2C. Gleason 3+4. Cancer confined to prostate.
PSAs from  1/3/07 - 7/18/07 0.00. 
T level on 4/2/07 - 48     On 7/16/07 - 613
Started Tri-Mix on 8/7/07.  .02 ml and 50 mg Viagra.  It works!!!
Next PSA and T tests on 10/17/07
 
"Patience is essential, attitude is everything."
 


Irishman
Regular Member


Date Joined Oct 2007
Total Posts : 29
   Posted 10/12/2007 11:27 AM (GMT -7)   
Hi Guys
Had a radical prostate surgery early July, 47 years young, need help with exercises for incontenance, what are Kegals for Men and how do you do them????

biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 10/12/2007 4:46 PM (GMT -7)   
Hey Irishman,

There is lots of info in the second thread from the top on the main page. Bluebird is our archivist and has done a great job indexing our posts.

Please stay with us...

Jim
Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2C. Gleason 3+4. Cancer confined to prostate.
PSAs from  1/3/07 - 7/18/07 0.00. 
T level on 4/2/07 - 48     On 7/16/07 - 613
Started Tri-Mix on 8/7/07.  .02 ml and 50 mg Viagra.  It works!!!
Next PSA and T tests on 10/17/07
 
"Patience is essential, attitude is everything."
 


Irishman
Regular Member


Date Joined Oct 2007
Total Posts : 29
   Posted 10/13/2007 11:17 AM (GMT -7)   
Hi Biker90,

Thanks will have a good look around main page, what are Kegals for Men and how do you do them????
Just feel a little lost.

Cedar Chopper
Regular Member


Date Joined Mar 2007
Total Posts : 432
   Posted 10/13/2007 12:30 PM (GMT -7)   

Irishman,

Kegal exercises are flexing the pelvic floor muscles to contract around the urethra, that is the tube urine flows through from the bladder to the penis.
These muscles begin just above the penis and wrap around the crotch area and connect to the anus.

The best way to get a feel for these is - if you are retaining urine while sleeping, to rush to the toilette and try to stop the flow of urine.
When successful, tighten those muscles even a little more and cough.
Your goal is to have a very full bladder, cough, and don't leak....
Your goal is best described as a "muscle tone" as no one muscle can give you control all the time
My therapist describes this muscle tone as a "recruiting pattern."

Perhaps our moderators, Ms. Blue or Mr. Idaho, will move all of this to a thread for you?
Perhaps start a thread of your own journey/questions/joys/concerns/etc and
(while logged on) go to the control panel in the top left corner of the page
and personalize your signature so that we chatting with you can help you best.
(For example, so you won't have to repeat that you had surgery in July every other time you post.)

If you click on Bluebirds Helpful Hints thread (# 2 at the top of the page)
and scroll down past personal journeys to "Other Topics" you will find my thread
"Zen and the Art of Symphonic Continence"
It has over a dozen entries with ideas & descriptions about Kegal exercises.

Ehud, it also has several entries on overcoming depression!

Work on "elevator Kegals" to help with the idea of developing a "muscle tone"
- not a vice grip.

MOST of us here seem to gain some kind of control between weeks 12 and 16.
a very few had no problems.  Others have shared inspirational long-term battles.
(Berb, KW, Gene, and more.)

Luck of the Irish to you!

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) : 10/13/2007 1:44:08 PM (GMT-6)


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1463
   Posted 10/13/2007 12:33 PM (GMT -7)   
Hey Irishman,

Kegels are meant to strengthen the external sphincter which is all we have left to control pee after a prostatectomy. The exercises involve squeezing like you are holding your pee and holding for a period of time, release for a period of time then repeating the sequence. I hold for 5 secs, release for 5 secs and repeat the routine 5 times. Before surgery and for 4 months after, I did this routine 10 times each day.

I had an excellent surgeon and the Kegels helped a lot because I was dry and pad free on the day after the catheter came out.

Good luck and please stay with us...

Jim


Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Pathological stage: T2C. Gleason 3+4. Cancer confined to prostate.
PSAs from  1/3/07 - 7/18/07 0.00. 
T level on 4/2/07 - 48     On 7/16/07 - 613
Started Tri-Mix on 8/7/07.  .02 ml and 50 mg Viagra.  It works!!!
Next PSA and T tests on 10/17/07
 
"Patience is essential, attitude is everything."
 


Hagrid
Regular Member


Date Joined Sep 2007
Total Posts : 60
   Posted 10/13/2007 12:34 PM (GMT -7)   
Irishman, here's some links to info about Kegal exercises:

http://www.healthtouch.com/bin/EContent_HT/cnoteShowLfts.asp?fname=07195&title=KEGEL+EXERCISES+FOR+MEN+&cid=HTHLTH

http://www.depend.com/learn/kegel_exercises.asp

http://www.drrajmd.com/resources/selfhelp/kegal.htm

http://www.coolnurse.com/kegel_exercises.htm

http://www.urologychannel.com/education/
Age: 57 (49 when diagnosed)
PSA 100+ 3/1999
Biopsy -positive, both nodes 03/1999
Bone Scan and CAT scan negative 4/1999
Radical prostatectomy and bladder neck removed 04/19/1999
HT - 05/1999 (Lupron every 3 months for 9 months)
RT - 6/1999
PSA 0.0-0.2 until 2001
Casodex 150mg 2001 until 2006
Casodex 100mg 2006-present
PSA 0.4-0.6 2001-2007
 


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 10/13/2007 3:15 PM (GMT -7)   
Ehud and Irish, Hang in there. I know things will wear you down from time to time. Just have to keep doing your exercises. If you have not tried a physical therapist that uses Bio-Feedback for the pelvic floor muscles you might want to do that. Also, when you do have a full bladder try to start and stop your flow while standing. I seems to help isolate the muscles.

Good Luck,
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.  After reviewing my records the Dr. feels I will probably need some surgical intervention to stop my leaking.  But did agree to try Bio-Feedback and work hard on the Kegeal's first!
    May 30th Follow up with my Dr. and 3rd Post Op PSA 0.00 agian!!!
    June 1st Start Bio-Feedback to try to control my leaking.
   


Irishman
Regular Member


Date Joined Oct 2007
Total Posts : 29
   Posted 10/14/2007 12:16 PM (GMT -7)   
Thanks a mill everyone, great to get all that info, will use it well.
Still got lots of problems but one thing at a time, not great on computer dont know how to set up a tread!
Irishman

Hagrid
Regular Member


Date Joined Sep 2007
Total Posts : 60
   Posted 10/14/2007 9:16 PM (GMT -7)   
To start a new "thread", click on the "New Topic" button near the top-right of the page, fill in an appropriate Subject, and just start typing in the box.
Age: 57 (49 when diagnosed)
PSA 100+ 3/1999
Biopsy -positive, both nodes 03/1999
Bone Scan and CAT scan negative 4/1999
Radical prostatectomy and bladder neck removed 04/19/1999
HT - 05/1999 (Lupron every 3 months for 9 months)
RT - 6/1999
PSA 0.0-0.2 until 2001
Casodex 150mg 2001 until 2006
Casodex 100mg 2006-present
PSA 0.4-0.6 2001-2007
 

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