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radical retropubic prostatectomy on 4/10/2013

yankeefan
Posts: 69
Joined: Mar 2013

had procedure on Wed, morning. The surgeon stopped by the next morning. He said everything went well and added that he’d probably bought me an extra 20 years of life and that I shouldn’t sweat the potential impotence issues too much given that context. He’s right. I was fortunate to have such a surgeon. Now we just wait for the path report. Hopefully it will be good. I didn’t get much sleep the first (only) night in the hospital but wasn’t in that much pain, what with the pain meds pretty much on demand. I got up and walked about 100 feet total Wednesday night. That wasn’t much fun but wasn’t a big deal.  I walked multiple times for longer distances the next day. I was discharged from the hospital around 4:00 pm Thursday afternoon, the 11th. I was supposed to take a pain pill before I left but I forgot to ask and the nurse forgot to give it to me. That was a mistake as by then traffic was heavy and it took a fairly long time to get home, about an hour and a half to two hours. By then instead of being ahead of the pain, I was behind it…the first night was very rough. There is no way they should discharge patients who’ve had this procedure after only 1 night. 2 nights would have been much better, but 3 or 4 is probably the optimum. The patient can walk in the hospital and the hospital is much better prepared to handle the pain, getting in and out of bed, etc. Most of my pain was in the abdomen and appeared to be due, at least in part, from my stomach being distended from gas. I doubled up on the pain meds at home Thursday night and finally, by Friday morning, I caught up to the pain. Also, by Friday AM I started hearing gurgling sounds from my abdomen, which hopefully meant some of the gas was moving around and leaving.

 

It’s now Saturday morning and the gurgling continues. Doubled up on the meds again at midnight Friday and again at 5 AM on Saturday. Recovery is slow. Perhaps the robotic procedure would have involved less pain, but that wasn’t a good option for me. I was expecting the catheter to be the biggest pain and discomfort. It’s not. Next to the pain in my abdomen the catheter is small potatoes, though it is a nuisance having to trail that bag around everywhere and empty it routinely.

 

Bottom line, this is not a pleasant experience, made even less so by the unrealistic notion of discharging after only 1 night. Hopefully, things steadily improve and the path report comes back ok. I owe my surgeon a big round of thanks both for his skill and his reminder that this is a life and death struggle. I recommend keeping that perspective for those who have to contemplate this operation in their future.

 

More later.

VascodaGama's picture
VascodaGama
Posts: 1515
Joined: Nov 2010

Yankee

Unfortunately some chose to have a quicker fix than a secured healing. I think it better to stay longer at the hospital and keep moving to improve healing. Other body functions need also vigilance and the hospital is the right place to have it done.

Wishing you complete recovery and excellent outcome from the treatment.

VG

yankeefan
Posts: 69
Joined: Mar 2013

Yesterday (Saturday) still wasn't great but there was some improvement in the pain department. as the day went on my intestines continued to "wake up" and started to get rid of some of the gas that had been building up inside. By last night the distention had diminished such that i could climb into and out of bed by my self....we have a very high bed and that's not a trivial process, especially with this operation. pretty much slept through the night except to get up once to empty the catheter bag. Last night was also the first night I didn't double up on the pain meds. You are right about the whole body needing time to recover from this procedure and that a single night in the hospital isn't long enough....i'm sure the insurance companies push to get the patients out as soon as possibe, and i understand not over staying the hospital admitance, but i agree...one night just isn't enough to get over the hump on the pain and discomfort that accompanies this operation. In any event, the gurgling sounds from my abdomen have come less and less frequently, which hopefuly means my intestines have woken up. It's probably not a coincidence that as this process went on my pain diminished. This morning I still have pain, but not nearly so bad as Thursday or Friday. I am going to try to get by with tylenol today, vice the oxycodone (sp?). I've been drinking plenty of water and putting out a fair amount of urine, though it is still a definite pink color...haven't seen any large blood clots just getting blood in the urine...that will be the next thing to hopefully clear up.

I know this isn't all that exciting news but I thought for someone about to go through this themselves, it might be useful to get a first hand report on the progress. I think I underestimated the amount of pain/discomfort there would be...this is a proetty major operation...especially the open procedure. 

thanks for the good wishes.

yankeefan
Posts: 69
Joined: Mar 2013

still have pain and tenderness in the abdomen but can do more each day...that's good.

still have some blood in urine, but other than that, everything there seems to be going as expected.

looking forward to the catheter and the staples coming out on Friday.....

 

yankeefan
Posts: 69
Joined: Mar 2013

urine is finally almost completely yellow....very litle sign of blood.....hopefully stays this way.

less pain than yesterday, that's good too.

Catheter and staples come out on Friday.

 

yankeefan
Posts: 69
Joined: Mar 2013

10 days post surgery (counting the day of surgery):

i took the cathether out this morning. turned out to not be a big deal. I didn't get much sleep last night thinking about takig that thig out, but it took less than a minute...i went very slowly..and not really any pain...just the normal funny sensation.

went to my local urologist to have the staples removed...that also was a non-event...not really any pain.....

received the path report today as well...appears that the report was negative in all regards....no tumor cells found in any lymph nodes...seminal vessale invasion, none..lymphatic (small vessel) invasion, absent...gleason score, dominant module was 3+3=6 (which was better than the biopsy, which showed one core with gleason 7). Bottom line, the tumor was organ confined throughout (stage pT2). While it's not impossible to find prostate cancer some time in the future with this report, my sense is that it is not likely.

the real bottom line to me is the vindication of the psa test. i am now 68 and have been having them for years....it was only in the last 12 months or so that the numbers started to rise, which led ultimately to the biopsy and the surgery. if I had stopped having the psa test (as many are advising) I would have never found the cancer this soon...I had bph which caused significant urinary difficulties, (which would have masked any symptoms due to cancer), even though they were some what improved by taking flomax everyday. If I'd waited another year or more before finally having surgery I am not sure the pathology report then would be so promising. 

as far as i'm concerned, men should continue to have psa test regularly, at least till they're 80 or more. As I may have mentioned before, my surgeon said he added 15 -20 years to my life, as without surgery, I was looking at real trouble in 5 years.

so far continence is not an issue. have used the same pad all day and it's still dry. When I feel the urge to go, I go to the bathroom and go....stream much improved over pre-surgery case with the bph, so that has been an improvement due to the prostate removal. hopefully the ed will resolve in the next 6 months or so, and that will be back to normal too....but only time will tell there....

no one likes having a radical prostatectomy, but the ulternative of ignoring psa tests and doing nothing is way worse, at least it seems that way to me.... 

 

VascodaGama's picture
VascodaGama
Posts: 1515
Joined: Nov 2010

Congratulations on the results. Best wishes for complete recovery.

I do not know about your chronology of PSAs but as you say the test is important and it will continue to be the mark to judge your advents. Typically we get to levels of remission (<0.06 ng/ml) at the two weeks mark post surgery. 

VG

yankeefan
Posts: 69
Joined: Mar 2013

Never had real bad incontinence. But still leaking a little, especially after getting up from sitting. I suppose I shouldn't complain after reading some of the posts here, but it would be nice to be completely dry with no leaking at all. Re ED....I'm completely dysfunctional at this stage. I'm hoping this will improve, but so far haven't seen many positive signs.

Bottom line, it seems like the improvement curve has a real small slope. I just hope it is positive. I could survive with what I have but would like to get total continence and my erections back.

For a person who hardly ever gets sick, cancer seems like a total incongruency. It's like, who ordered this!

i am pleased that it appears my cancer is gone for the time being. The path report was great and my first post op psa was zero. So I guess everything is relative.

hope everyone else is doing well.

DFR_99's picture
DFR_99
Posts: 2
Joined: May 2013

Hello Yankeefan,

Congratulations on your 6.5 week anniversary.  I just joined the network today, and one of the first things I noticed was your surgery date was 1 day after mine.  On Tuesday April 9, I had a 5.5 hour long DaVinci robotic.  Been quite a trip hasn't it?

 

I was told going in that I had Gleason 7 (3+4) with tumor in 1 lobe.  They gave me most of the pathology report a week later ... negative margins, lyphmnodes clear, vesicles clear.  Last week my PSA came in at <0.1, I was happy.  Then at my 6 week visit, doc told me I had dodged a bullet...apparently I also had a tumor in both lobes, tertiary Gleason grade 5 (1%) and initial perineural invasion... effectively giving me a Gleason 8.  Fortunately I had opted for surgery, radiation would not have done the job.  Good thing my GP did not listen to the "don't do the PSA anymore" crowd.

 

So I am glad all that bad stuff is out. However, at the moment ... I am not really sure what to think.  Hey, but what else is new.

 

Anyway, have a Happy Memorial Day.

 

 

 

yankeefan
Posts: 69
Joined: Mar 2013

But I didn't have a robotic surgery, I understand they take longer. Hope your recovery goes well...I walk for a couple of hours just about every day. I think that helps. I've started lifting some dumbells, lightweight, only 25 lbs, to get some muscle tone back in my arms...everything seems to atrophy a little when u just sit around for a month or so. My surgeon had advised not lifting anything more than 10 lbs for the first 5 weeks. Glad to see your path report was so good. I was lucky that I had my operation in time where my report was good too.

how long were you in the hospital? I was there only one night. In retrospect I would have much preferred to have stayed 2 or 3 nights. My first night at home was the pits. I had open surgery, don't know if that's more painful than robotic, but it was difficult for the first 48 hours at home. After that it was just the nuisance of having that catheter in for 10 days, although I have to say the catheter itself wasn't as uncomfortable as I thought it was going to be. That was my main worry going into the surgery. It was mostly the nuisance of having to carry that bag around everywhere.

here's to a speedy and full recovery...and happy Memorial Day to you too...

DFR_99's picture
DFR_99
Posts: 2
Joined: May 2013

>>how long were you in the hospital? I was there only one night. In retrospect I would have much preferred to have stayed 2 or 3 nights.

They told me that my surgery started at 2:30, and I was out of recovery and in my room by 10pm.   When I woke up and heard how long the surgery took, I asked if anything bad happened, they told me no ... just took a lot of time on the lymph nodes.  After that I never asked why it took so long.   All I know is that my wife was told I was out of surgery by 8.  Apparently, my doc is partial to taking extra care on those lymph node guys.  Hey, if the end result is good, I am all for it.  Also, I am a Cubs fan, and could be they tried some exploratory surgery on what might be responsible that dangerous and debilitating condition.  I was on my way home by 2:30 the next afternoon.  I had the idea that open surgery involved at least 2 days in the hospital.  I know that I would have felt more comfortable staying one more day myself.

>>My first night at home was the pits. I had open surgery, don't know if that's more painful than robotic, but it was difficult for the first 48 hours at home.

One of the reasons I opted for Robotic was that I had the idea that open surgery was much tougher ... so I salute you sir.  I heard open sometimes requires a blood transfusion.  Did you need one?  Did they ask you to donate your own blood just in case?

As for the hospital stay, I was uncomfortable the first few nights, but not too bad. 

>>it was just the nuisance of having that catheter in for 10 days,

That catheter, boy I was a happy guy when that thing came out on Day 7. Likewise, I dreaded that thing.

Mostly I have just been bumbling through one new thing after the other.  I guess I just have to prepared for one surprise after another.

Have a good one.

 

 

yankeefan
Posts: 69
Joined: Mar 2013

the short answer is no, I didn't need a blood transfusion. I had read that one benefit to the robotic procedure was less loss of blood and less risk of needing a transfusion and was concerned about that. When I disussed this with my surgeon he said that i would only loose a small amount of blood, like maybe half a cup (I can't remember exactly what amount he said but it was a small amount). He said they don't even ask patients to donate their own blood in advance any more (though I do believe that was the norm years ago). He also said that back in the day they would keep patients in the hospital for something like 8 or more days....but now it's only one night....He offered that they learned that getting the patients up and about and out of the hospital more quickly was found to reduce the likelihood of blood clots. I'm sure that's true, but I was walking in the halls of the hospital the same night I had surgery and could have continued to walk all I needed there....even if I stayed an extra night or two. My sense is that for retropubic prostatectomy (i.e. open) 3 nights in the hospital would be the best, vice only 1 night. I'm sure the insurance companies like patients getting out as soon as possible as it saves them a ton of money. I'm glad your doc took all the time he needed ...this is one operation you want to go well.....

stay well and keep healing.....

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