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post op pain bleeding and anxiety

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Posted 8/24/2011 11:12 PM (GMT 0)
Hi my robotic surgery was 7/21/11 for prostate removal, gleason 3+4 and 6 of 12 cores showing cancer. I had a heart attack in the recovery room and was 7 days in the hospital. The heart attack has complicate things as I am on plavix, aspirin and a diueretic for blood pressure. I only have urinary control when laying down in bed. I will awake 3 to 4 times at night to pee; but leak and squirt urine all day while on my feet or active. I am using 4 to 5 diapers a day and the pads don't seem sufficient. I have perineum pain and rectal pain with blood in my urine and in my diaper. The pain is severe except when I awake in the morning. I am unable to do the kegels as the pain and bleeding get worse when I attempt them. I am taking vicoden and tylenol for the pain ;but, it still hurts. The Doctor says just wait but getting anxious and depressed. Any help or advice would be appreciated. I am now going to angroup anxiety class as I am really having a problem
Posted 8/25/2011 12:44 AM (GMT 0)
Holy cr*p, a heart attach in recovery? Did nt they do a pre-op cardiac test? What is your age?

I had open RRP on 8/5/11 and just like you, leaking constantly. A lot of us will for months, seems the average is 3 months. But everyone is different, some are dry the day the cath comes out and some are on years now. I also still have perinial pain, especially until I poop. So that is nothing to be worried about. However, my pain is not so bad I have to take narcs. I would suspect your heart attack meds may be blood thinners and that is why you are still bleeding, but we are not doctors here. Just patients like you. Also, vicoden can cause constipation, which is no joy after this surgery. So, did your Dr. prescribe you any stool softners?

Listen, welcome to the club no one really wants to join, but we are glad you are here. There are no stupid or wrong questions. We will try to answer as best as we can, but keep in mind that we are not Drs.

Also, if you feel your doc is not responding to your needs, then go to the ER.
Posted 8/25/2011 2:19 PM (GMT 0)
From my DaVinci experience -

Blood in urine, yes, had that, and it was coming from the healing where they reconnect the urethra, as well as irritation around the cath tube. A small drop of blood will make quite a show in water. This continued for several months.

Rectal bleeding, yes, a little, because I have had colo-rectal issues, and the scars get in the way of any stool that is hard, so use stool softeners if your doctor will allow (mine insisted on them). This is worsened because the prostate is so close to the rectum, and the surgery leaves it delicate at best. This will be a lifetime issue for me.

The various blood thinning effects only make it more complicated, as you already know.

Perineal pain was significant (had to use a doughnut cushion) for about 4 months, and is still present as an irritation more than pain 20 months later.

If you have a Walgreens, Kroger, or Target, they all have a common pad as a house brand (Target is Affirm). Their men's guards absorb the most, and were what I used at the start. But, don't get obsessed with "filling that pad" or saving money by waiting till the last second to change one. I used the "if it is uncomfortable, change it" rule. If you are always wet, the risks of urinary tract infections increase. I used 7-8 pads a day (in a single Depends pant - sometimes two, put the pad in the pant - double coverage) for about three months.

Posted 8/25/2011 4:24 PM (GMT 0)

Welcome to the website and congratulations on getting the surgery overwith. I had my open RP with wide cuts on April 27 of this year and still wearing Depends. I had very little progress of gaining control for the first two months and then started to see improvement in month three. For the first two months, I was soaking about 6-8 pads a day and gwoing three to four diapers a day. The urologists recommended I only do three sets of kegels in the late evening. The muscles are too weak and by the time you get to the afternoon and evening you have zero control.

By month three I started to see improvement, it was slow and frustrating but it was improvement. I am now on month four and down to no pads, and only two diapers a day. The urologists I was referred to after my RP was way too eager to operate to restore control. If you are like me, I was in no rush for another surgery. I wa told that wide cuts take longer to regain control, and know that every individual has their own unique timetable as they regain contenance.

I had a couple of times when I was back to work and in a long meeting when both my pad and diaper got soaked and unfortunatley so did my pants. It takes a little humor with alot of humility but people understand. I know wear dark navy blue or black slacks so if it ever happens again, it will be harder for a person to tell. I also have found that caffeine makes the urge to go that much more intense so I have cut back on my diet coke consumption.

I had blood in my urine for about three weeks, and blood in my stools as well for a couple of weeks.

I am sorry that you had to join the PCa fraternity and also sorry to hear that you had a heart attack in addition to this dreaded disease.

I am suffering from depression and just posted last night a thread on Depression and PCa and it sounds like it is very common for us to experience it. Words of encouragement that your contenance will improve as time goes on. On a positive note, when it does, your stream will be so powerful that you will have to worry about spray coming off the urinal. I have a good friend and we were both emptying our bladders, he has BPH and was stuggling with his output and was jealous of my strong flow from the adjacent urinal. So you have something to look forward to as you regain control. I look forward to the day I do not have to wear diapers, but find when I sneeze, cough, lift, stand up, bend, lift my leg, I continue to dribble and probably will for months to come but I have seen alot of progress over the last month.

We are all cheering you on for a complete recovery. Godspeed.

 

Posted 8/25/2011 10:42 PM (GMT 0)
Prohelp,
Pretty tough break having that heart attack but I guess if you are going to have one that would be the place for it to occur. I wouldn't get too down about the incontinence -------- you are only 4 weeks out. Incontinence following the op is the normal course of events and recovery from it varies widely from patient to patient. Very occasionally some are continent form the very early days while a few can struggle for years and can eventually need insertion of mechanical devices. But the great majority gradually recover over a few months. First you become more able to hold your water when laying down, then during the day and night the ability to hold it gradually improves. I wouldn't be doing any Kegals just yet if it is painful to do so -------- it's going to be at least 6-8 weeks for the healing of the wounds, both external and internal, to take place. Most of us here have been where you are now and we eventually got there. I know it is difficult to accept at these early days but it will get much better.
Bill
Posted 8/26/2011 12:41 AM (GMT 0)
Everyone , thank you for all your positive thoughts and encouragement on my problems. I know I have a long road ahead for recovery and I appreciate the advice and first hand information on getting through this.. The incontinence issue will hopefully settle down some. I agree not to wait until too wet but change diapers frequently. I also agree that the plavix and aspirin I am taking for my heart are probably causing the bleeding, although the pain is bad. I understand I would like to stop vicodin but the darn pain. I will try and ween myself off the vicoden onto tylenol, because I am having constipation problems.

I have been attending a group anxiety meeting to try and deal with the anxiety problems and the relaxation breathing and coping statements help; but facing one's mortality and dealing with the prostate recovery is difficult. I was a together 64 year old male who was in control of his life and WOW........has that changed. I do have positive news, my pathology came back clear . It is so easy to look back and say why did this happen. I had tests and was fit for surgery and yet a heart attack. We can't look back..........I have done some damage to my heart and the doc's say meds. should control some of these issues. My heart rate is very low and that saps my energy and I think leads to my anxiety and coping skills.

This is a tough road ahead and thank you all so much. I am going to call my doctor next week, 6 weeks post op. and discuss the pain and bleeding issue if it doesn't start to improve.
Posted 8/26/2011 4:41 AM (GMT 0)
I think I can fairly say that rule number 1 about concerns is to call the doc. Now, not later. This is not a contest to see who gets by longest without complaining. They took home a pretty penny for their work - it should be perfect.

I live on stool softeners because of colo-rectal issues (surgical artifacts) that will leave me in a world of hurt if I were to get constipated (that means 12 on a scale of 0-10). I take a docusate calcium 240mg (OTC) every evening, and probably will for life. Me, I would call my gp or surgeon first thing in the morning and ask if it, or another variety, was allowed. No reason to wait until next week. Better have an extra trip to the can in the morning than pain and bleeding. It takes away part of the concern about pain meds.

Great to hear that your path report is good. We will be waiting for that undetectable PSA and a Zero Club application.

Posted 8/26/2011 1:33 PM (GMT 0)
valium is a good medication for internal discomfort.
TTaylor
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