9th day of R.T and bursting!

Talk to the RO about timing. I was orginally told to down 500ml of water 45 minutes before treatment time. After a couple of incidents and trips to get the seat washed at the detail shop, they negotiated back to 35 minutes, which had me flying to the toilet as soon as the door opened, often without time to tie my shoes, but did avoid the 'puddle on the robot' syndrome.

Developed the habit of stopping on the way home as well.

Seems I have a small bladder.

See my IGRT thread, linked in my sig. 

I was told after each treatment how full my bladder was....90% of the time it was too full but had no problems holding it in. When they said it was just right...I barely had the urge to go. I guess everybodys bladder is different but I suspect you are drinking more than is needed.

CJD,

This is very common and very much part of the routine. I was so happy be to done with the early morning water drinking routine. More than once I trotted to the bathroom after treatment, shoes in hand, not wanting to wait to put my shoes on.

They declined to give me a specific amount to drink. They just said have a relatively full bladder, not bursting. I figured out the water drinking timing the best I could but I had some close calls if they ran behind. Once I "had" to go just before treatment because of an equipment delay. They told me to let "just a little" out -- tough, but I did it! I knew my kegel exercises had paid off at that point. One part of the challenge is your bladder begins to react to the radiation so your capacity/urgency starts to change during the treatment course. (I started getting up 2-3 times a night to go.) If you are struggling you should cut back until you are full but can reliably make it through your session. Your bladder should be full but not bursting. 

If you are having imaging done prior to each session, they can give you feedback on how full your bladder is. One time they told me my bladder was "huge" after imaging. They were impressed. So, I knew I was getting the job done.

The good news: my bladder was back to normal within 2 weeks after the treatments were done.

 

Some mention has been made of daily CT scans - those are specific to a certain type of hardware, so don't presume that it applies to you unless the RO or technicians verify that.

I had only one CT scan, a week before the process started. My clinic uses Caylpso markers to see that everything is where it should be. The objective of the water is to ensure that your bladder is in the same place it was when the planning CT was done, thus the need to verify anything you will change with the RO.

I was told to maintain, with the most extreme severity, the same daily routine throughout the treatments. No "new" or extraordinary food, drink, or activity. Period. Anything that caused change could be dangerous.

When I started to find it difficult to manage my bladder during SRT I asked the doc during one of my routine check-ups. He said the key was to have the same amount of pee in my bladder each time. They took extra x-rays every three days or so throughout my SRT to check whether things inside me were still the same as they had been during the CT scan when they did my set up, and when things had moved a little they adjusted the targetting. Niote that they also put me on a specail diet that started 10 days before the first CT SCan, this was to keep my bowels calm so they they did not move much either.

I used to travel to my SRT sessions by train. I always caught an earlier train (rather than be late if the other train was delayed); this meant I nearly always had 30-45 minutes in the RT waiting room. I thus peed when I arrived at the hospital and then drank the water (about half a pint); I then sat quietly in the waiting room. I found that taking it slowly like this helped. (Took my reading glasses and a newspaper).
On one occasion the guy before me didn't show up and they offered me his slot, but I had to decline as I knew my bladder would not be full. On another occasion there was a delay when the whole computer system shut down and they came out to tell any PCa guys that they could go retime themselves, ie go pee and then have another drink.
The RT technicians/nurses were very clued up regarding bladder control and I soon got used to warning them if I felt like I was close to bursting and they often offered to have a bucket standing by. The techs said they had had to clean up a lot worse than a bit of pee.
Once I was on the RT table I just had to go into "meditation mode" as it were. I had to do that to some extent in order to be able to lie still for ten minutes, but it also helped my bladder. The trick seemed to be to relax rather than tense up. And it was also important to get off the table in a calm manner. Dressing quickly afterwards helped too, I didn't waste time packing my towel etc neatly into the bag. I also made sure when I undressed that my clothes were laid out in the changing cubicle so I could dress very quickly, I thus wore slip-on shoes the whole time so as not to need to bend down to tie laces; if I had a coat or jacket I put it on after I'd had a pee. There was luckily a WC just across the hall from the changing cubicles. I was usually able to get to the WC within less than a minute of getting off the table!)
I didn't have any accidents or even small leaks. I was also pleased to note that every day when i went for my post RT pee it looked like the same amount of pee came out, so somehow I must have got it right.

So I hope you get things under control, even if it means having a bucket in the treatment room, or needing to clean a few car seats. Grim as it may feel some days, if like me, the SRT gets you into the zero club, then I don't think you'll care if you get a bit damp in the process

Alf

This is pretty normal. I had to drink 32 oz of water before every treatment. The RO drew me a picture of a full bladder and shows how it pulls away from the prostate and out of the radiation beam. If your bladder is not full it will get more radiation. I came close a couple of times, but never peed on the table. I always kept a empty bottle in my car for the ride home and used it on a few occasions.

Ut.Greg,

Best to start a new thread - that way the answers are for you - less confusing that way.

this is very interesting. Are we talking about radiation other than IMRT? I had 42 rounds of IMRT and I was never ask to drink water prior to treatment. WOW I feel lucky.

peace to all
Dale

Dale,

I asked my Rad Oncologist about the water in the bladder, since I've always kept my bladder empty.  I think he said they only use that when they have to concentrate in the area of the rectum.  I am 19 into 26 IMRT treatments with gold seeds and Xrays to position me for every session.  Then I'll finish up with a 36 hour HDR.  I'll get about half my total dose in those 36 hours.  I am using Flomax to help me flow better, especially when I have to get up at night.  So, the full bladder apparently isn't used everywhere.  The key here is to try to be the same every treatment.