Prostate Surgery - Day Three

WARNING!  The following is a graphic update on the after effects of my prostate surgery:

Progress folks!  Finally.  No more razor blades and barbed wire pees.  

Before we go any further in this post I'll warn you this is a graphic update on my progress after my brachytherapy prostate surgery.  This may not interest you ladies and some of you guys.  But for those of you men who are of a certain age and will probably face prostate issues in the future, here is what is happening to me after my surgery on May 2nd, two days ago.

The first day urination was so painful that I almost passed out a few times.  I heard that it would be like peeing "razor blades."  Oh yes, and you might add a few barbed wires in with that.  Oh God, was it painful.  Picture this, you have to pee but you don't want to because you literally feel like razor blades are coming out of the head of your penis.  And I thought I had experienced the ultimate pain with passing kidney stones.  Peeing razor blades is another whole new plane of experience folks.

Well, last night when I made my nocturnal visit to the bathroom for my nightly pee, it burned but the razor blade extreme pain was gone.  Just a little bit here and there but for the most part gone.

Now I have a new development.  Normally I only have to get up once at night (if that) to take a pee.  Last night I stopped counting at five.  I think I got up seven times.  There was relief that I finally could take regular pees, although they were stop and start, not the steady stream I normally take. But at least I didn't have the extreme pain.  And, I found out when I had the urge to urinate I had to go then.  No holding back, which I was always able to do before.  I hope this is a temporary situation because I would hate to be saddled with this condition the rest of my life.  

The second "condition" I have is that I haven't had a bowel movement (I told you this would be graphic) since the enema I took before my procedure on the 2nd.  I am taking Doculax as prescribed by my doctor but still no "action" (so to speak).  I feel like there is activity "down there" so hopefully something will happened today.  For many years I was plagued by constipation until I had a sphincterotomy (surgery to repair an anal fissure) operation in 2001.  I've never had a problem with constipation since. I "go" at least once a day, usually twice or more....every day. In fact, I have to plan my day according to when I go, because when I have to go I have to go.  No holding it off.  Thank goodness this usually is in the morning before I start the day.  

So that's where I stand now folks.  Making progress after my prostate surgery.  Yesterday I asked my urologist's office about the "razor blades" pees and the bruising of my penis (caused by the catheterization not a radioactive seed stuck in the head of my penis) and they said "That is all normal."  Wow.  All I can say is I am SOO GLAD I am moving on and getting past the worst of it.  Our plumbing, we take so much for granted.  

Update:  Number Two just accomplished. Now I can breath.

Prostate Surgery Update

Me early this morning for my surgery at the outpatient center

Okay folks, let's see how much of this I can get through.  

I had my brachytherapy prostate surgery this morning.  My surgery was scheduled for 7:30 a.m.  Of course Bill and I were early risers, about 3:30 a.m.  We arrived at the surgery center about 6:45 a.m.  They took me right away.

Beyond this door - surgery (you can tell I was nervous when taking this iPhone photo, hands were shaking)

First of all I cannot praise the folks at the cancer surgery center enough.  They were friendly, welcoming, efficient and professional.  Couldn't be better.  But of course why I am there is for a very invasive procedure with the possibility of numerous, undesirable side effects.  

My short wait in the waiting room of the surgery center before the process started - sorry I'm not smiling, not a happy time

I won't go through the step by step procedure at this time (perhaps at a later posting) but I will say that I was given enough anesthesia that I don't even remember going out.  In fact, I don't even remember going through any of the humiliating procedures that led up to today's surgery.  Of course I did wake up with my first ever catheter which was very uncomfortable (I expected that). You feel like you have to pee all the time.  They didn't keep it in too long.  When they took it out......WHEE!  Wow, I don't want to experience that feeling ever again in my lifetime.  Thank goodness it only lasted less than a second.

My "bed" for the next few hours (after I took off all my clothes which is what the "Patient Belongings baggie is for - "strip down Ron" - something that I am NOT unfamiliar with but usually not under these circumstances)

Bill was with me most of the time, except for the surgery itself.  That was a big plus.  I am so glad the medical establishment recognizes the need for those undergoing surgery to have their loved one near them (including gay loved ones) during a scary time like this.  

We didn't get out of there until a little before noon.  I was groggy.  In fact they wheeled me out in a wheelchair.  No pictures of that.  In fact, I only asked Bill to take a few pictures.  I really wasn't in the mood for picture taking but did take a few to give you all an idea of what it was like this morning.

After the surgery - I wasn't in pain here but very uncomfortable with the catheter in - I felt like I had to pee real bad which I did - blood clots and all - this is the last photo - I wasn't in the mood for any more photos

So we left the cancer center.  I was armed with four prescriptions.  I usually get my prescriptions though the VA but my urologist told me these didn't cost that much and just to get them at my local pharmacy.  Well, that turned out to be wrong.  One of them cost $177.99 which I didn't get.  It was Roboflo which "relaxes" the prostate. And them to top it off the pharmacy didn't even have it in stock and was going to order it due in my Monday.  That's too late for me, I need it now. I told them that.  In fact, I guess my doctor could of ordered Roboflo or a generic equivalent from the VA before today but I digress.

The other prescriptions were for Advil (inflammation), Cipro (antibiotic) and Oxycodone (pain).  I don't like to take Oxycodone because it makes me nauseas and constipated.  

So here I am about twelve hours after my surgery. I do have a problem.  I'm going to get graphic so if there are children in the room, please ask them to leave.  Ready?

When I pee (urinate) it feels like razor blades.  Man it hurts!  I have a fairly high pain threshold but this hurts like a (pardon the expression) MF.  

Here is the second problem, I have a discoloration which looks like bruising below the head of my penis.  I'm wondering if this is a normal side effect of catheterization or has something to do with the painful burning during urination.  It looks like burns.  I hate to think it but it looks like radiation burns, whatever THAT looks like.  

Of course by the time I got back from the pharmacy the outpatient cancer center was closed as well as my urologist's office.  I'll call tomorrow.  

I am concerned because I went on a website for prostate brachytherapy surgery for side effects and the "burning, razor blade urination" is experienced by quite a few men who undergo this surgery.  Some for days, some for weeks, and some for months!  God, I hope that's not me.  I've always had good urination.  Now I'm dreading it.  

I envy those few who said they had no side effects after their brachytherapy. At least one side effect I don't have is the soreness in my scrotum where my doctors stuck all those needles to implant the radioactive seeds.  I've read quite a few comments from others who underwent this procedure that they have pain.  I am very thankful that it appears that I will miss this side effect.

Today was an absolutely beautiful day.  I wanted to work outside but my post-operative instructions instruct me to "not exert a great deal of physical activity."  I can do that.  In fact I'm very good at that.  Also, the post-operative instructions advise me not to drive for two days. I can understand that because I am still groggy.  That was some kind of anesthesia they put my under, I still feel the effects.  Sort of like a two martini high.

Now, if you'll excuse me I have to take a pee.

Prostate Cancer - Seed Implants

As I mentioned in my last prostate cancer update blog posting, after my "volume" procedure earlier this week, I qualified for radioactive seed implants.

That comes as a great relief to me because I don't have to go through hormone therapy to reduce the size of my prostate glad to qualify for seed implant.  While I was at the cancer center I talked to one man who just finished four months of hormone therapy and was in pretty bad shape.  I heard my doctor informing another patient that his prostate did not reduce in size after his hormone therapy.  So of course I was very apprehensive, so much so that I decided not to go through hormone therapy is that was the only option left to me.  Thankfully, I didn't have to make that decision.

My doctor's office called me and informed me that my seed implant procedure will take place May 2nd.  That is good timing because it permits me to attend next week's Bloggerpalooza.  

Bill and I can still take our annual spring vacation trip South to his hometown of Toccoa, Georgia and I can visit my roots in western North Carolina and my brother in Greenville, South Carolina.  Bill and I have been taking these trips for the past three years and look forward to them very much.

The following (for those of you interested) is what will happen to me during my seed implant medical procedure on May 2nd:

What Happens During The Procedure?

The entire procedure takes approximately 90 minutes. Most patients go home the same day.

A radiation oncologist and urologist perform the procedure. Both physicians are actively involved in all aspects of the implantation, from the planning to the post-operative care. During the procedure, the urologist provides ultrasound guidance and the radiation oncologist places the radioactive seeds.

The procedure is performed as follows:

• After general or spinal anesthesia, the legs are elevated and padded very carefully.
• The ultrasound probe is inserted into the rectum and is used to take pictures of the prostate. The probe remains in place throughout the procedure.
• The radioactive seeds are loaded into the designated number of needles.
• In a specific order, each needle is inserted through the skin in the perineum (the area between the base of the scrotum and the anus) and into the prostate using continuous ultrasound guidance. Once accurate needle placement is confirmed, the seeds in that needle are released. This process is continued until all of the radioactive seeds have been implanted. No surgical incision or cutting is necessary. For HDR, once the needle placements are confirmed, they are filled with a radioactive material. After a period of minutes both the needles and the radioactive material are removed.
• The urologist inserts a tube with a camera called a cystoscope through the penis and into the bladder. If he or she detects any loose radioactive seeds within the urethra or bladder, they are removed.
• If some blood is in the urine, the urologist may place a catheter into the bladder for a short period of time to ensure proper drainage. All patients are instructed how to drain urine from the bladder, if necessary.

What Are The Results?

Although it is a relatively newer treatment, results show that, in patients with similar types of prostate cancer, brachytherapy alone or in combination with external beam radiation therapy appears as effective as a radical prostatectomy and regular external radiation in 10-year follow-up studies.

What Are The Side Effects?

Urinary symptoms are the most common. These include frequent urination and a need to get to the bathroom quickly. Some men have a burning with urination and, in a few cases, an inability to empty the bladder completely.

These symptoms can usually be managed with medicine, and they improve over time. Temporary self-catheterization may be necessary to help drain the bladder

Urinary incontinence is rare in general. The risk may be somewhat increased in patients who have undergone a previous surgical procedure to remove a part of the prostate called a TURP (transurethral resection of the prostate). A doctor can minimize this risk by doing a careful prostate ultrasound before the procedure to determine how much prostate tissue is still present to implant the seeds.

Rectal bleeding occurs in less than 1% of patients. Diarrhea is rare.

The impotence rate at five years after the procedure is about 25% using brachytherapy alone. If hormone therapy is added, the impotence rate rises to 50%.

Special Considerations

Close, prolonged contact (such as sitting them in your lap) with young children and pregnant women should be limited for the first two months after the procedure.