(No Subject)

Hello Everyone,

I want to thank everyone for their advice and support the last few months. On Wed. 1/9/13 I had the robotic prostatectomy procedure done by Dr. David Lee at the University of Pennsylvania Presbyterian Hospital in West Philadelphia.

What an experience, but not that bad. The team has an excellent record with Dr. Lee performing over 3,300 RRPs. I would recommend to everyone considering an RRP do get it done at a high volume center, such as UPENN. From what I have read this is a very tricky procedure, especially to spare the neurovascular bundle.

The whole thing was so surreal. I had to be there at 5:45 AM. Needless to say I was in a fog and by the time they had me all hooked up in pre-op, I found myself weeping a bit, thinking, there goes my manhood. I met Dr. Lee again (BTW, he is the NICEST guy you could ever meet - a mini psi - does RPP gangnam style) and was taken into the ER. The next thing I knew I was in recovery. Time is weird (and where the hell has it gone?)

That day and night I had pretty severe abdominal pain (at least it was for me). It was really hard to get up out or bed, lay on my side, etc. I had horrible gas pain in the abdomen. The CO2 used to inflate the peritoneal cavity must diffuse into the bowel. It felt like gerbils were running back and forth in my gut. I did not have the shoulder pain some mention. I kept getting up and walking. The gas wasn't coming. Finally it did - right before the nurses station - at which point I exclaimed "I farted." They all laughed and a couple clapped. The best things in life are free. Gotta love nurses. BTW, the Penn Presby nurses and aids were ACES.

My sister and girlfriend greeted me out of surgery. It is nice to see familiar faces - although the people at the hospital care and do their job well, it seems so impersonal. Now I know how the transgenic mice I worked with in my post-doc felt. At least I could not be put on the "sac rack."

I did not sleep well that night but took the torodol and percaset. Day 2 was not much better in terms of the belly pain but the headache from the anesthesia began to wear off. The gas was still there. They brought bacon with breakfast: I did not eat it, having been turned off to meat as I have become convinced meat metabolic by-products are a factor in this disease - I waved it at Dr. Lee when he came and he laughed "yes it is a problem." We are killing ourselves with the $hit we eat.

I was discharged from the hospital at 11:30 AM and came to my condo to sleep all afternoon. Thank God - hospitals are no place to get rest!

Day 3 at the condo was a little better but the belly pain and gurgling was still there. I kept walking. Day 4 (today) is much better - the belly pain is almost gone and I did not take peraset - just alleve. I await a #2. Milk of Magnesia.

Having a beer. I marvel at my 6 incisions. If I ever lose my GF I may tell people they are gun shot wounds just to make a story.

Well, I digress. Overall, the procedure in not that bad. The catheter is a pain but it is kind of neat to go for a walk in the park, go over by a tree, lift up your nylon sweats from the ankle, open a valve and "pea from your knee." The cats are quite fascinated by the tubing. One must be careful not to wear new sneakers. Catheter is due to be removed on day 6. I will be glad to get it out, but will miss it too.

So, I await the pathology report (confined, clean margins, downgrade of the Gleason), no urinary issues, and the potency of a 23 year old.

This whole ordeal sucks, but I have to remind myself that my brother died of metastatic pCA in 2004 at age 49. My other brother had RPP and is fine. "Little gland, big problem." No lie there, Dr. Walsh. Maybe one day they will remove it prophylactically on your 40th birthday.

Thanks for listening,

Christopher

PS - I now realize I posted little of value here! LOL

charendz said...
PS - I now realize I posted little of value here! LOL

Wrong!

I read these stories with a lot of interest. I'm facing the same thing. Not for sure yet, as I have a couple more consultations with doctors, my cardiologist (heart issues) and a medical oncologist.
The surgery and the recovery is of great importance to me, as I fear that more than the disease. So anything, or anyone, that will share with honest details I welcome. This forum is like a face to face meeting with people that have been through it.

Glad you're doing well and thank you for your story!

Hi there,

Sounds like the CO2 is causing you lots of problems. That is pretty typical. Actually it is quite ironic to go through such a major procedure and not have a lot of pain from the actual surgery -- only to be victimized by gas pains. Seems almost unfair, doesn't it?

I recall that I also had these pains, but not that bad and only for a couple days. You should begin feeling much better very quickly now.

Good luck!
Chuck

July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6. CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
mid posterior prostate. Right posterior apex margin involved by tumor over a 0.2 cm length,
doctor says this is insignificant.
Prostate 98 grams, tumor 2 grams.
Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
Post-op exams 2/13/12, 9/10/12 PSA <0.1
Only semi-erections so far, with continued improvement.

Christopher, Everything you said had value, so don't think otherwise. I likely am headed down the same road as you in a about a month and there is no detail too small that is not appreciated. Glad to know the procedure went well and hope the only news you get in the future is good news.

David, Buddy, Chuck and Everyone -

Thanks for the nice messages. I guess I poo-pooed my message as I was attempting to get some humor in there. Andrew: you are right – surgery is not for sissies (My dad used to say life is not for sissies and I think he was right!). Surgery is probably one of the biggest stresses a body must take. One thing I was not aware of is that one of the anesthetics is a paralytic and so you must go on a ventilator.

James: I hope you figure out the best way to go for your situation. These decisions are tough. I have found the book by Walsh to be a good resource.

Catheter due out on Tuesday (day 6) - then I have to re-learn how to pee. I doubt the path report will be done by then.

Take care,
Foggy day in Philly,
Chris

Hi James - I assume you come off the ventilator when they give the medications that reverse the anesthesia. I wish I had paid more attention to exactly what they were (there were 3 - propofol and two others) so that I could be more informed. I wonder why they used a paralytic in the first place and thought it might be due to fact that the robotic surgery is so precise and delicate that no movement can be tolerated.

At any rate, you wake up with a sore throat and dehydrated beyond belief. They push IV saline and you are so dry you drink water continuously. The best thing to do is to get up and walk ASAP. Flirting with the nurses takes the edge off....