Artficial Urinary Sphincter installed Friday 4/11 Activated, now dry!!!!

Well, things didn't go well yesterday when I had the AUS activated.

My doctor activated it then I drank 64 ounces of water. I went back and he showed me how to squeeze the button. It took me about 3 tries then a stream came out. He sent me on my way and I drove the 1 hour trip back home. By that time I arrived home, I had a lot more water to release but all I could get out was about a shot glass worth.

I went on to work and it felt good to not be leaking only I continued the ritual of having to go to the bathroom every 15-20 minutes and only being able to get a small amount out. I tried every way I could think of to push the button. If I tried to urinate without pushing, nothing came out but after pushing the button, very little was released. I didn't think the cuff would just open partially but I believe that is what was happening.

As the evening progressed, a pain started developing like a urinary tract infection. I knew my urine was just checked that morning when in the doctor's office so it had to be caused by a full bladder trying to empty.

By 11:00 P.M., the pain had gotten so severe that I had my wife take me to the emergency room to have someone deactivate the AUS. I wasn't sure I could do it if I couldn't get the AUS to work all day as it was designed.

The doctor in ER had never heard of an AUS but I had brought the instructions with me. He said he would try if I wanted to. He deactivated it on the first attempt and then I went to the bathroom with the strongest stream in 40 years.

My biggest fear of having an AUS had come true, not being able to open it to pee. Now I am back to where I have been for the past 22 months, using pads.

Since my surgeon is 60 mile away, I am going to have my local urologist activate it again on my day off so I could go back to him the same day if a have any problems. The thought of driving 1 hour back to my surgeon with that pain was a nightmare.

I am sure it is my stupid self that caused all this discomfort. I guess I will have to brush up on my technique before attempting it again.

Since I am leaving town in 2 days, I will delay the 2nd attempt until after I return. Hey, using pads has been the new normal for sometime now so what's another 10 days.

Regarding the incisions, everything feels great now. I guess they know from experience that it will take at least 6 weeks before they should activate. He did say it would take up to 3 months for me to heal completely. No restrictions, lift and walk all I want.

I was hoping to complete this thread yesterday on a positive note but it looks like the saga will continue.

Bill from Florida

Bill:

Hopefully this is a very minor blip (ie: very TEMPORARY setback).

Mel

Hey BigMac,

I hope you didn't have to replace a toilet destroyed with the "strongest stream in 40 years" you released on top of everything else, lol.

I do wish you had different news to share. No matter how used to the saga you are, I'm sure you were/ are looking forward to its end. Hopefully this is just a matter of you getting the hang of your new device. I'm rooting for and keeping you in my thoughts.

But did you call? Busy surgeons have hard working nurses who can answer that sort of question much of the time and can usually catch the ear of the surgeon as he rushes by.

Maybe at this point you should just wait and not try anything yourself. It is very possible that the ER guy did just what you said, give the bulb a couple of squeezes an just pushed the lock button in which case it might be difficult, even for an experienced person, to re- activate it. Re-activation should just be a small quick bulb squeeze ,making a small "pop" when the lock button opens.
If he read and understood the AMS instructions, he should have squeezed it several times till the bulb was completely flat then waited >20seconds for the bulb to refill , then he should have pushed the lock button. So, if he or someone does not wait the 20 seconds then the pump bulb will be partially flat without enough fluid in it to "pop" the valve.
So, if you decide to try and activate again your self, if you squeeze the bulb but it seems flat, just leave it alone till you see your guy. He will have to coax more fluid into the bulb, but this point we should not talk about now. Wait till you can at least pee then go from there.

One more thought, since you couldn't pee at all, even when you needed to, I take that as a positive, it worked. And, since as Neo said, the ER guy opened it an presumably locked it open, that more good news. Taken together, it works! Now you just need some time with your uro, rather then being rushed out the door, still not familiar enough with the device. Your surgeon should have had a nurse or a PA, spent some time with you, maybe?

My doctor called me this evening and said I must not have pushed it hard enough. He said it worked fine in his office. He said since I was pushing and it was dribbling, the cuff was still closed and had not opened. He reminded me of the importance of not using a catheter with an AUS. He told me the day I set the appointment for the AUS surgery that I needed to wear a medical alert tag telling medical personnel that I have an AUS and not to use a catheter. I wear a "dog tag" style necklace.

He suggested seeing my urologist near me who he happened to have taught at the Univ. of Miami. I told him that is what I had arranged already.

The lightest moment at the ER was when I explained to the doctor what I wanted him to do. I handed him the directions, he read them and said "well, it doesn't sound that hard, let's give it a try". When he succeeded he said, "That is why I like working in ER, you never know what is going to come through the door".

Yes knotreel, I am convinced it does work and must have been pilot error on my part. It was hard and embarrassing to update this thread but I have been upfront all along about my AUS adventure and this is just another chapter. Hey, Peyton Manning practiced hard to become a star and he still throws interceptions.

Thanks titlewave for the encouragement. If this didn't happen, this thread would be over by now. I kind of wish it were but it will continue until the job gets done. I guess Peter will have to make a part 2 out of this, it is 9 pages long already. That is about 5 pages longer than I expected it to be.


Bill from Florida

Neo,
Every time I pee now I have that fear it won't come out like the other day, even though it does since the AUS is deactivated. I guess I will have to prepare to try it again. I can feel the bottom of the AUS where you have to push. I will just have to practice locating the botton of the AUS until I reactivate it in about 10 days.

knotreel,
The ER doc read the directions, pumped it several times, waited 20 seconds then pushed the button. Worked like it was suppose to with him.

Thanks to you AUS vets for your support. I am convinced it will work like it is suppose to.

Bill from Florida

Canuck 66: Congrats on getting through the surgery !!!!!

I have a question for the guys who have been activated for a while.

My activation was April 22nd and I have a an uncomfortable feeling where the uretha is shut off by the cuff, it feels like a lot of pressure is building up. I thought over time it would or will get better but it hasn't.

Does this feeling go away, do you get used to it ?

I don't leak at all, could the cuff be too tight ?

David

Sorry guys for not answering my thread. I am on vacation at a beach condo on the coast of South Carolina and haven't spent my usual time on HW.

Canuck66,
My pain from the lower incision went away right at the 6 weeks time. It must be why they wait until then before activation. My doctor said it will take 3 months to heal completely.
I hope yours goes well the first time, not like mine. Ending up in the emergency room the night of activation was not how I wanted this adventure to end.

Knotreel,
Because I had this vacation planned after my activation, I elected to wait until I get back to have it reactivated. I chose a day when I would not have to go into work after activation and my personal uro is going to do it. He is not as busy as my surgeon and is very soft spoken so I feel he will be good at showing me without rushing through it. His office is 3 miles from home so if I have any problems, I could run back to his office later the same day. I am having it done first thing in the morning.

My surgeon is 1 hour away near Miami and it would be a hard drive in heavy traffic if something happened again. I was in so much pain by the end of the day the first time, I was screaming. I took a pain pill I didn't use after surgery to help me get by.

I can feel the controller perfectly. I don't understand what I did wrong the first time. I went straight to work and feel maybe I had a lot on my mind with customers and activation and wasn't squeezing the right spot. I can feel the bottom of the device so there should be no problem this next time.

Bill from Florida

I been off for a while and just saw your posts. As you say, it sounds like a simple pilot error. Once you get the squeeze right and your fingers and "feel" educated all should be well. All the signals are good.

Jhuno,
I was just going to make my latest update and saw your post. Thank you for the words of encouragement. That is exactly what I needed to hear.

Bill from Florida