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Post-RP

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3186
Joined: May 2012

I'm starting a new thread, since I am now post-surgical removal, and any future discussion will be of different matters from those when I was figuring out which First-Line therapy to go with.

I got the cath out this morning. They filled my bladder with fresh water first, to see how much bladder control I had, and I was twice able to stop the flow on command, which the RN said was very good. I have since urinated once at home, with little leakage, but I know bladder control will take at least a few weeks. 

The doc discussed the pathology report, which was almost identical to the original biopsy, and a quantity still of <5%.  Said no positive margins, but "tumor present within .1  CM of blue inked left prostate."

Staging changed a little:  pT2A NO.  Digital exam was T1.

The six incisions for the daVinci maching are healing very well, and no longer hurt.

I'll share anything significant. And I'm thankful that this went so well. I am in spirit with all of you guys who are in tougher battles, believe me.

 

max

Old-timer's picture
Old-timer
Posts: 196
Joined: Apr 2011

Hi Max,

The toughest steps are behind you. I wish you smooth sailing during the healing stages and beyond.

I understand that the Di Vinci process is eons better than the old-fashioned radical prostatectomy, which I went through 23 years ago.

Your post reminds me of my experience when my catheter was removed. The urologist pulled it out while he had me sitting in a chair in his office; I promptly put a puddle in the middle of the floor! The nurse and I had a good laugh. The urologist took it stoically; he didn't see the humor in the situation.

Thankfully, my ability to control it got much better within a short time.

Old-timer (Jerry)

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3186
Joined: May 2012

I appreciate the memory Jerry. It is impossible to directly compare one pain to another I suppose, but I was struck by how bad it hurt the first day or two following surgery. I have no doubt that open proceedure whould have been worse.  My entry incisions are pretty well healed already. I still have pain which I believe is along the urethera, which makes sense.

I do not know if you were a fan of the old Seinfeld comedy, but there was an episode in which George discusses what happens to guys when they get in cold water at the beach..... That is what the RN and I talked about when he was getting my cath removed, the scene where George asks Jerry, "Do women understand about shrinkageUrology must be the specialty that former plumbers who go to med school choose.

We all had a good laugh.

max

 

 

VascodaGama's picture
VascodaGama
Posts: 2932
Joined: Nov 2010

Yes, we may laugh. My RP was open and within the caring team of physicians (5 doctors and 4 nurses)  one was a specialist in sexiology (urologist). The day after widrawing the catheetr he come to meet me to explain about "requirements". The first was to teach me on how to use a pump and instructions for active massages. Interestingly, in the morning after RP a nurse come to bath me and did it with a special touch and care on the "aparatus", infront of my dazing wife.

It was a relief to me to know that even with a shrinkage I had not loosed the feeling.

Best wishes for fast improvments.

VG

 

 

Old Salt
Posts: 720
Joined: Aug 2014

you will continue on the road to recovery.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3186
Joined: May 2012

Thank you, Old Salt.  First post-op PSA in about a month.  Praying for that "0.0," or whatever the value for "indectable" is.  Surgeon and radiation oncologist both told me that there is very, very little possibility of "micro-metastatic" escape, so the odds are with me.

max

VascodaGama's picture
VascodaGama
Posts: 2932
Joined: Nov 2010

Max

I wonder about the basis of your physicians to comment on the possibility of micro metastases "escape". What did they found in the diagnosis? Was there any positive image study?

Such way of thinking would never be part in a recomendation for AS, which option was initialy suggested to you.

I would try getting details on the above to have peace of mind.

Best wishes in your journey.

VG

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3186
Joined: May 2012

As you can see, I had DaVinci RP in January of this year.  My PSAs continue to come back undetectable, and I'm thankful.

 

My incisions healed normally -- no issues with the surgeon on follow ups.  About a month or so ago my main incision (above the naval) started to buldge a little, and has been increasing. It is now significant and feels slightly sore.  It is slightly visible through a dress shirt. I called the surgeon's RN and he said it sounds herniated, and added that this occurs occasionally and usually is not cause for concern. He also said that there is no need to come in prior to my next routine app, which is several months away. One last thing: he said urologists do not fix these hernias; I would be sent to a general surgeon if necessary.

Has anyone had herniation months after DaVinci ? Does the nurse's answers seem reasonable ? I am not a whiner, and understand that surgery is not sculpture, cause I am sure not looking like anything Michelangelo would produce at present.

VascodaGama's picture
VascodaGama
Posts: 2932
Joined: Nov 2010

Max,

Congratulations for the undetectable PSA. My best wishes for continuing successes.

Regarding the abnormal protrusion, I would disregard the urologist answer and have it checked properly. In particular because of the symptoms comment by you “It is now significant and feels slightly sore”.

Most probably it is an incisional hernia. At surgery they cut the abdominal muscle for the openings and these incisions may become weak if not clamped properly, even if they have healed normally.
The cause for its increasing could be due to an intra-abdominal pressure because of extreme exertion activities or forces or obesity, etc, or it could be due to a localized vascular disorder, acquired during the surgery. The worse would be if the local blood flow is cut off because the bulged tissue.
Surely, you cannot disregard other type f hernia (such as inguinal hernia, ? ?) which could develop at the area of the existing protrusion.
Repairing such hernias is difficult and may cause additional health problems. I think it better you consult a specialist surgeon of hernias. You may find a good one within gastrointestinal doctors.

Please read this;
http://www.herniasolutions.com/about-hernias/types-of-hernias

 

In any case, your post is informative of a successful result on your 8th month post op and we shall celebrate. How about a glass of red wine or raise a pint.

Salut.

VGama  

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3186
Joined: May 2012

Vasco,

Red wine, definitely.

I have had a massive hiatial hernia for years, verified by a surgeon who scoped my entire upper GI a few years ago.  It even makes a "grunting" nosie at times, which the doc said is it rubbing through the diaphram, but the doctor recommended against doing surgery at that time.  I have a bit of a pouch (gut), but am not obese.  Evcept for my waist, I am thin all over. That is, I have the classic 60 year old male look. I would exercise more to stay fit , but was run over by a car decades ago, and have very little flexibility. I do walk a lot on hilly terrain at work.

The 'noise' is not very far away from my current buldge; I hope these are not in fact related, but that you for mentioning the possibility. 

Enough wine cures most ills, at least for a few hours !

 

max

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3186
Joined: May 2012

This seemingly sound academic study in the US suggests an increase in metastatic cases of PCa.

My family doctor has been telling me for years that insurance companies are pushing to reduce PCa biopsies, and for the doctors to obsess less with static PSA numbers (according to him , vectoring PSAs are still cause for attention). I have read reports confirming this trend.

He suggested I not get a biopsy 2.5 years ago, but I went to a urologist on my own, who scheduled a biopsy, for what was learned after surgical removal to be t2a.

I know there are studies available that conclude virtually anything, but this is most likely of interest to many readers here, especially newcomers.

max

http://www.foxnews.com/health/2016/07/18/metastatic-prostate-cancer-cases-rising-study-finds.html

 

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