Dear William:
Who can blame you for being scared? It's a dreadful thing to hear this news. My husband who is 57 years of age got diagnosed, after having a rising PSA, and biopsy, with prostate cancer (detected early, as he kept an eye on the psa) and my world felt like it was falling apart. After the biopsy his semen was very, very bloody and his urine had some blood in it. The biopsy itself did not give him much discomfort--the doc explained it was a stinging that would last all of about 3 seconds, and that was exactly right. You need to take the antibiotics, strictly as a precautionary measure against infection. That is a smart thing to do, so don't fret about that. Every thing, even the most minimally invasive, presents the possibility of infection, so this is a healthy recommendation, don't be concerned.
We opted to go for a 2nd opinion, as I was not thrilled with this first doctor's bedside manner (the one who did the biopsy). First of all, we had to wait 2 wks for the result of the biopsy and those were the longest weeks of our lives. Apparently they send the test out to another state, so the results were not instantaneous. When we got the word he had low level cancer, the doc was a bit too matter of fact and clinical. After all, he may have delivered that news to lots of men, but it was the first time we had heard those words and we were devastated and frightened. Then he gave my husband a big book to read. The book was given to all the patients, and I noted that it was printed about 5 years ago. It was a turn off to me, regardless of how much good info was in the book. It was like "read this so I don't have to answer any of your dumb questions.'' Plus, he was young. If you are opting for surgery YOU MUST ASK THE SURGEON HOW MANY OF THESE PROCEDURES HE HAS DONE. I cannot stress enough the importance of finding a doctor who knows the intricacies of the robot and everything I've read says the skill of the surgeon COUNTS. Do not allow yourself to be intimidated by any surgeon. This is your health, and you must be your own advocate. A good surgeon will not make you feel anything except comforted and important. If you do NOT feel that you are being treated that way, then find another surgeon who does.
William, I will tell you that once you meet with a surgeon with whom you feel comfortable, much of your fear will be allayed. We realized that much of the sick feeling we had was because we were relatively new in the state in which we live (5 years) and did not know where to turn, when we wanted to find a different surgeon. Only the Lord knows why we were at a relative's home the same weekend we got this diagnosis and one of their friends who was also there had the same diagnosis as my husband, same age, same psa level, almost identical in every way to our situation. He recommended his surgeon, of whom he could not speak highly enough. He did have to also have cystoscopy prior to his surgery date, to rule out any kind of problems in the urinary tract, as the surgeon mentioned that if there were any growths or problems in the tract, they would need to be addressed prior to the robotic surgery. Following the cystoscopy, my husband had some extreme soreness, burning, stinging upon urination--but that was mainly because he had not taken the drug that the doctor had sent him home with (Pyridium--excellent drug, makes you pee bright orange, but will clear up any discomfort you have following cystoscopy, if you must have one).
Just last Monday (3/16/09) my husband underwent his prostatectomy, by way of the daVinci robot. He has a series of 6 incisions--5 of them very tiny, the one above the navel about 1 1/2". They have posed no problem for him and are healing beautifully. He originally did not think he would need to fill the Rx for pain med, and could get by with just Extra Strength tylenol. Everything we read said the discomfort is minimal and manageable with over the counter tylenol. I do not recommend this. Get your Rx filled. During the day, the first 2 days, he was ok, but in the evening, he developed some soreness in his back, and the catheter began to bother him. We got the doctor to write him a script for Vicodin, which immediately gave him the comfort he needed. He had a slight fever one of the days, which we immediately treated with the Vicodin, and it went away for good. Low grade fever is normal, but above 101 required a phone call to the surgeon (never happened, his was 99.8 at the highest, and short lived). He is still catheterized and will be until Tuesday, the 24th of March. He had virtually no appetite for the 3 days post surgery--but on the 4th day, that evening, he seemed to turn the corner. He was able to shower the day after the surgery, the incisions are closed by a surgical glue, which has been wonderful--no stitches or sutures to deal with, and the ability to take a warm shower has been a blessing. Our surgeon, in addition to the script for the pain med, said he had to take two Senna (natural laxatives) and two colace (stool softeners) each day. when we went for our pre-op meeting, the nurse practitioner said that without a bowel movement (in the course of the one week, post op) they would not remove the catheter. I was incredulous--a whole week with no bowel movement? But she said you'd be surprised how many men do not move their bowels the whole week, post op! No way was this going to happen and we stuck to the recommendations rigidly --she even suggested milk of magnesia, along with the other two items, which I did purchase for him. By the 4th day, he did move his bowels, but there can be NO straining--that is why you need to take the stool softener and the laxative. No stress at all on the bowels while you are healing. It literally must just kind of ''fall out'' of you (and it will!). Ironically, after the bowel function got going, he started to feel better, eat like a champ, and has been taking neighborhood walks since Friday, increasing the distance a little each day.
As far as the incontinence part, we are not there yet--don't have any concrete predictions until after he loses that darn catheter--but he was given the instructions about the Kegel exercises and the meeting with the nurse practitioner, about 10 days pre-surgery, also included a machine being hooked up to him (not invasive and no pain, just contacts stuck to his rear end cheeks!) measured how well he could contract his pelvic muscles. She instructed him on how to isolate the muscles themselves, and this would be a huge aid in his controlling his urine stream.
William, I know you said you live alone, with no significant other, but you are going to need to have some help with your meals, shopping, medication and catheter and getting around for the first few days. You cannot drive while the catheter is in, and someone will have to drive you to and from hospital and back to your first check up/catheter removal. You need about 2-3 weeks recovery time before going back to work (if you still work). You will not be able to do this alone, so make the necessary arrangements beforehand. Please ask a health care professional how you can acquire the help you will need, or if you may spend a few days in a facility as you will not be able to be alone for minimally the first 3 days. I truly wish you the very best and know that I will be praying for you through this trying time, but believe me, this too shall pass and you WILL get through this. Please feel free to reply to this as I am being notified of postings/replies and will be happy to answer anything I can to help you through this. God bless you, William--hang in there, buddy--this too shall pass.