February 02, 2022
Learning that you need to undergo treatment for prostate cancer is a challenging issue. Do your homework and move foward as an excellent quality of life is possible after this diagnosis.
There are other treatment options that you should discuss with your surgical oncologist. Take notes and ask questions. Let your urologist work with you to choose the right option for your disease.
Caution with social media
Try and avoid "Facebook Medicine". Social media is great for support, but the medical opinions offered on posts are sketchy at best. Also private support groups on social media can lead you down too many " rabbit holes". I decided to get off off social media and the support groups.
I don't use the app or Facebook messenger. If you wish to contact me please use my website.
This is an excellent book. I highly recommend it.
Your urologist is your best source for info. Get a second opinion from another qualified urology doctor if you feel the need. Your doctor will not be offended.
The key to managing prostrate cancer is an early diagnosis and treatment before this spreads.
I am a 69 year old retired spine surgeon and artist. I also have a fellowship in integrative medicine.
My surgery was January 12, 2022. I did not have any radiation therapy. My cancer was caught early. Bone scans and 2 MRI scans were negative for spread outside the gland. Lynph nodes at surgery were clear of disease. I will need PSA exams for follow up the rest of my life. No treatment option has 100 percent results and every case is different.
Choose your surgeon carfefully
My urologist was Dr. Richard Goldfarb, and urologic oncology surgeon was Dr. Brian Miles, in Houston, Texas. I thank them for their excellent care. Great doctors are located all over the world. If you need help finding one contact the national prostate cancer website, or your local family doctor. I choose my surgeon based on a personal connection that developed after our visit. He also was a leader in his field on prostrate cancer and was teaching this technique to other physicians. You need someone you can talk to. Take notes and bring your questions.
In other blogs I have discussed my journey through diagnosis and early observation and treatment of my prostrate cancer.
Every man and case is different. Encourage your family and friends to have screening exams and regular PSA tests. Family history plays an important role. Get a good urologist and follow thier advice. Be careful with social media support groups.
About the surgery
Please follow your own doctor's orders.
I have shared my experience as it may be helpful to others going thru this. Every patient's course is different.
A walk to look at the ducks with Charlie, my grandson.
Remember that this care involves a team of caregivers. A thank you and a smile on your face helps them get through their days as well.
This surgery will put stress on your family and life partners. Take some time to thank them for being with you. You will do better post op when your partner is feeling appreciated. Having your family and friends around is vital for healing.
Some men go home the morning after surgery. Others require a bit more time. I went home the second day. Getting a shower before going home was therapeutic to me. It was easier, the first time, with the help at the hospital staff. Clear this with your doctor before doing it.
My surgery was robotically performed. I had several small incisions on my abdomen. Just because they are small incisions, don't be fooled into thinking this is minor surgery. It is not.
It is done by many skilled surgeons every day and it has excellent results. Expect at least 3 to 4 weeks before your energy is back. At 4 weeks post op, I am about 70 to 80 percent back and each day I am better. Depending on you age and medical conditions recovery can be faster or slower.
Take a nap if your tired. Avoid sitting in a straight chair for more than 15 minutes. A recliner provides a more comfortable position. I was told no lifting or bending over for the first 4 weeks. Do not drive if you are on narcotics. It took me 2 to 3 weeks before I was making short drives. Ask you doctor for their recommendations.
Exercise and a positive attitude are the key. Give yourself time to heal.
Post operative Shingles can raise it's head after any major stress or major surgery. Be sure you have gotten a shingles vaccination to lessen this risk. Talk to your doctor about timing.
Have an advocate with you
Having an advocate with you at the hospital is very helpful. Especially if you need a cather bag emptied, need to order your meals or need to be moved. The nurses are busy also caring for other patients.
Bring some extra face masks with you. They are mandatory during Covid 19 restrictions. Every hospital person, I came in contact with, was following the CDC guidelines. Wearing a mask that is covering you face and nose is necessary when you are walking in the halls. You do not need a mask in your room. I was allowed 1 visitor in my room.
Pre operative preperationGet yourself in the best shape possible pre-op It will help your recovery. I used a quality low sugar protein drink 2 times a day for a week pre op.
I rode 450 miles on my pedigo e-biike getting in the best cardiovascular shape I could be in, pre op.
Learn how to do Kegel exercises pre-op and practice. I met with a pelvic physical therapist pre op for instruction. Do not do them with the catheter in place. This book was helpful.
Tips for Sleep apnea
I was told to only bring my mask. I would recommend that you bring your machine as well, so that you have a machine with settings you are use to. Having my own ear plugs, made getting rest in a noisy room easier.
The return of bladder control is variable. Working with a pelvic physical therapist is very helpful. Some get it back early and others may take months to regain function. There are also some who need an additional procedure to get control.
I still am having issues with control. This is minor compared to the issues of advancing prostate cancer. I am confident it will return. If not, I will get it corrected.
You will find that your control will come back in stages. For some it's minimal loss but others it takes time. I am noticing that I can, at 5 weeks, make it thru the night with 1 or 2 depends. This is due to less stress from gravity on your bladder when you are supine.
At 10 weeks post op I am dry thru the night and improving during the day. Working with a pelvic pt.
Avoid alcohol post op until you have full control. it is a diuretic, and it will make urine control more difficult.
Post op Immediately after surgery go slow with your diet until you are passing gas. My bowels became active on the third day.
Avoid heavy foods and add a stool softer. Colace worked for me. Having a cup of hot coffee first thing in the morning helped to stimulate my bowels. Hot tea would also work. Adding a 1/4 cup of All Bran Buds cereal to my diet was helpful. I am now 3 weeks out and functions have returned to normal.
Nutrition and supplements
I added a nutritional supplement at week 3 to help with wound healing. I also restarted 5000 units if Vitamin D3 that I take once a day with a meal. Check your Vitamin D level and ask your doctor before adding this. As soon as I started these, my energy has improved.
During my integrative medicine fellowship, I met a dynamic woman, Rebecca Katz. She is a artist, nutritionist, and writes great cook books. She has a great website and as well.
We have had this cancer fighting cookbook in our kitchen for a long time. We first started using this to help my wife's mom thru glioblastoma brain cancer treatment. We love the recipes. I have also sent copies to friends during their recovery. I highly recommend it.
Post op suggestions
Have some Male Depends around. The sizing is different so make sure you get ones that fit. They can contain a lot of urine, so don't worry about leaking. For me, I use about 10 to 15 a day. I am positive that will get better with time.
I am a tall and only needed the large size. The label goes in the back and they work really well. I had a lot of discharge around the catheter for a few days and they kept it from dripping on the floor and kept my clothes clean. Catheter care is essential. I used soap and water to keep it clean. A warm wash cloth applied to my testicles was very comforting the first week.
Some men use a pad and a pair of supportive underwear rather than Depends. Use old fashion jockey briefs. Everyone needs to find what works for them.
I went home with the catheter and a 2000 cc urine bag. I had an elastic leg strap that kept tension off the catheter. I purchased an extra one on Amazon so I could have a dry one to use after showering. Be sure and keep slack in the catheter. The straps worked well for that.
I was also given a leg bag as an option at the hospital, but I found it was pain to keep it from slipping down my leg as it filled up.
Be sure to wash your hands with soap and water before changing catheter bags.
I used a new 2000 cc bag I got on Amazon every 3 days. They were cheap and it was easier than cleaning old bags. Be sure the catheter is firmly pushed onto the bag hose. This bag did not need to be drained during the night.
It will feel great to get in your own bed after leaving the hospital. I got up several times a night to change the depends the first few weeks. By week three, I was able to sleep thru the night with only 1 awakening. Take a nap if your tired during the day.
Post op follow up
I returned for a cystogram prior to having my catheter removed. They checked my voiding residuals 3 times with a painless abdominal ultrasound before I went home. I will return back about 8 weeks after the surgery for a PSA and exam.
Getting up and walking is key. Get dressed and shower daily as soon as you can. I walked at least 4 times a day. Just a little at first but you must keep moving. Take a phone with you if walking outside.
Helpful hints Have a tube of A and D ointment around to help keep a rash away. My kids, who had little ones gave me a bum brush to put it on as it's tough to get off your hands. It works better when applied to dry skin.
Mind preperationI used a mindfulness program to get my brain ready. It was excellent pre op and I still use it post op.
Post op lessonsTake a picture of your post op wounds with your phone. That way you can follow it if you are having issues.
I had a severe reaction to the glue (Dermabond) and comparing the pictures helped me get the help I needed. This is a very rare reaction, but, I also have a severe latex allergy.
The concern for a life threatening post op bacterial skin infection necessitated a trip to the ER and a 10 hour er visit and waiting in the hall for a bed.
Initially solumedrol iv followed by a medrol dose pack was tried. It was some better, but rapidly come back after finishing the medrol My skin was on fire and itching like crazy.
After seeing an excellent dermatologist it was diagnosed as an "ID" reaction and this is commonly seen after incomplete treatment of severe poison ivy with a medrol dosepack. . Luckily are a second round of intense steroids for 15 days and topical steroids this has resolved.
If your Dr is willing, ask for their cell number, pager number, or know what the emergency contact number is for their answering service. This will allow you to cut thru the red tape of getting in touch in case of an emergency and avoid an unnecessary visit to the overwhelmed emergency rooms.
Medicine in 2022 is different. Many practices use phone apps as a way of communication. Relying on this form of communication is not acceptable in the acute post operative period. Waiting a day for a text message response is not what you need.
Ask about a regional blockCheck with your Anesthesia team about a regional block. I had bilateral quadratus lumborum blocks and they gave me great relief for several days. I managed discomfort with no narcotics and Tylenol. I had a few Toradol ( which is like an iv form of Motrin) shots in the hospital. Narcotics will slow your bowel recovery. Avoid them if possible.
Some Doctors start a daily low dose of Cialis after surgery to help with healing and to improve the return of sexual function. Mine recommended this. Discuss this with your Dr.
You will get thru this, and excellent days are ahead.
If you wish to contact me, please use my web page. I do not use Facebook or facebook messenger. I have other blogs about nutrition and my course.
I am now 8 months from surgery. My bladder function is still improving and working with pelvic pt has helped.
My psa never dropped to neglable following my surgery. After a pmsa scan a solitary 3 mm node was seen. Following many consults moving forward with limited xrt as I await my bladder function to normalize. May need more extensive xrt if this doesn't turn psa off.
If I did full pelvic radiation and changes of full control of my bladder would end.
I am encouraged with the current plan but careful followup will be part of the new normal the rest of my life.
I am thankful for a great partner and excellent physicians.
May 13, 2023
My uncle was thinking about getting prostate surgery from a robot and we all want to help him recover after so I did the research. Thanks for explaining that working with a pelvic physical therapist is particularly beneficial since the recovery of bladder control is unpredictable. We can see that some people regain function quickly, while others may need many months to do so. Some people additionally require a further operation to restore control. Thanks. http://www.urobriz.com.au/Prostate/RoboticNerveSparingRadicalProstatectomy
March 11, 2022
Al great to read your story and good to hear how well you have done. I am a current IM student half way through and have been diagnosed with
Stage 1 prostate cancer- psa 5 and clear MRI 2 years ago.
Just wondering I am being actively monitored and was wondering when to make the decision to have surgery?
I would love to hear your views.
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