9 Days until Surgery, Any tips?

Hi Guys,

Is there a sticky with tips on how to prep for robotic surgery? I've been doing my kegels, bought several sweat pants, gone Vegan, got various lotions...What else should I be doing?

The first few days, how mobile are you? Do you lay in bed? Sit in a chair and watch TV? Zonked out on pain killers?

Thanks,

Nick

Thanks! That helps. I was trying to keep the nosy neighbors from finding out, so perhaps my wife can drive me to the park to walk.

If you have (or acquire) some baggy sweats or athletic pants, you can just wind the cath tube around your leg and drop the bag at the bottom of the leg (obviously, elastic cuffs work best, or maybe a small bungee cord or large rubber band) if you're out and about. At home, I just hooked the cath bag to my pocket when no one else was around. If I walked in the evening, I sometimes put it in a shopping bag. You'll figure it out.

I slept in a recliner, with the cath bag in a small wired-type bucket next to me. Wore oversized shorts with the cath tube running under the leg exit. That way, I could just take the entire thing to the bathroom to empty it. You can also just carry that type basket to the shower with you, and just set it on the floor while you're washing. I sometimes just hooked it to the shower door rail, or whatever i could find. My understanding is that you'll want to keep the bag below the level of your bladder at all times, as to not risk a 'backflow; and possible infection.

I only received a large bag, with a spare if needed in my 'goodie bag.' I could normally make it through the night with just an emptying in the morning---unless i was drinkin'! LOL!

Seriously, you'll figure it out. I think the first night was the most stressful, simply because I didn't know what to expect, exactly.

Just be careful of cabinet knobs! Don't ask.....

MD

Likely the first week (or until you're off the pain meds) you'll be a bit out of it and not able to do much. The pain meds can constipate you so have some stool softeners on hand just in case. Rest the first few days, but also do walk as you can - even if it's just laps around the living room. It really helps recovery.

Andrew

The most important thing is to make sure you can see the television from the recliner. There should also be a side table for a beverage and the remote. You won't be moving a lot of furniture during the first few weeks after surgery.
Walking helps you recover faster. Walk as much as you can. But once you've done that, recline and watch Netflix.

Hey Nick,

You have a good attitude and that's 80% of it. Keep it up!

Here are a few tips and some experiences from my operation.

There actually was no pain involved in my operation. I do not know if it was the pain medicine they gave me or what, but I actually had little to no pain.

This does not mean I was comfortable. I was not used to the catheter and it was uncomfortable. In fact, I did not like it the whole week it was in me. I counted the hours until it was removed. I hated it, but it seems everyone does.

The hospital did not give me any water or food for about twelve hours after the operation. Boy was I thirsty. I did talk the nurse into giving me some ice to munch on which helped.

I was up walking a little about eight hours after the operation with the nurses help. Walked a little every day and checked out of the hospital the day after the operation even though I was approved for three days. I wanted to get back home.

Don't worry if you see some ugly red blod clots and junk in the catheter tube. I hear it's normal from what the doctor told me.

To change clothes more easily with the catheter, I cut off some pajamas and made shorts out of them so I could easily slide them over the catheter bag and still be able to walk around the house.

The best advice I can give you is to walk a little often as long as it does not hurt. Every day, you will find you can walk a little more. Don't push it though.

When the catheter comes out, you may have trouble controlling your urinary control. Again, it's completely normal even though I was not used to it and made a mess of everything. Get some diapers and change as often as you need. Again, for most people it gets better. I got worried I would be one of the few that it does not get better, but it did with time.

Here's a tip the doctor never told me about. At first, even with exercise, it was next to impossible to keep from leaking so I started standing in the shower and tried to compress my muscles to see if I could stop the flow. In the shower, it made no difference if I was not successful. I could also see when I was successful and when control was lost. Doing this was the best thing I did to teach my muscles how to control things again.

Another tip is to walk longer and longer distances when the doctor says it is OK to walk. The first time I left the house to walk a couple weeks after the catheter was removed and the doctor said it was OK, I walked around the block once. I leaked everywhere the first few walks and was a mess because the walking seemed to cause me to lose complete control quicker. Despite the first few times, it seemed that the walking helped me regain control quicker than anything.

That's about all I can share Nick. Good luck and do what the doctor says. I'm sure you will be fine.

For me the pain was not important except when I tried to sit up in bed. Ouch! That didn't last very long, thankfully. The reality of the catheter is not as horrible as the thought of it. So don't think about it. As everyone says, walk. Don't overdo it, however. Remember that you will have had major surgery and it simply takes time to recover. Wearing yourself out won't help. Then, with some luck, this will all be in your rear view mirror.

OP here: Wow! Thanks all! I will buy some diapers (or have my wife do it), prune juice, stool softeners, make a Netflix list. It seems the cath bag is the biggest hindrance. I guess my job is to keep the catheter clean to prevent infection. That was a good tip: Keep the bladder above the bag to avoid back flow. I found a great YouTube prostatectomy guru for surgical advice:

https://www.youtube.com/watch?v=AHnfBWaG0-M

I wish I had more time to work on my core. Fortunately our master bedroom is on the main floor, I just have 3 steps to go down to get outside. I am racing to tidy up loose ends, just in case. I'm sure Bill Paxton had plans for the upcoming weekend!

Now I have to work on the mental part: I'm depressed that my status (4+3, Group 3) indicates I have a 35% chance of recurrence in 5 years, so I have been learning how to decipher everyone's history in their signature. I won't be able to finally relax until they tell me the post op biopsy is negative, since I am not a good candidate for hormone therapy due to diabetes and a cardiac condition.

I did a lot of research as to who are the best uro surgeons in Chicago, interviewed the top two, and feel very confident with my choice, he has done 4000 robotic surgeries. Also has operated on 20 of his doctor associates, and this gave me confidence. The hospital building is just two years old and has the highest tech I have seen. There's even a gizmo on the wall that verifies if everyone entering the room has sanitized their hands! Plus a fold out bed for my wife. I forgot to ask if they have HBO. As to walking, I will have my wife drive me to a park because I don't want the neighbors to know I have the Big C. Bad for business!

I greatly appreciate your tips!

Nick

The guys are spot-on with advice. The big unknown (at least one major unknown) is your level of continence when the cath comes out. I was almost fully continent and all of the supplies my wife bought in anticipation of worst case scenario went unused. However better to prepare and not use the supplies.

Speaking of the cath, when it's time for it to egress, deflate the balloon and stand in a warm shower, mine practically fell out. Just needed a gentle tug to fully remove it.

I had no special diet and enjoyed all of the foods I usually eat. Don't punish yourself with a bean juice diet.

Nick-

You may want to read my story about surgery. It is in the link in my signature below.

Really try to walk. Start gradually, but walk as much as you can. You'll have plenty of time to rest that first week in between the relatively few minutes you spend moving. I ended up with blood clots, partly because I didn't walk enough.

The catheter was not that much an issue as I look back. It's only a week! With luck you'll have decent continence from the start. I think the surgeon's skill makes a difference.

A month after my surgery I was feeling pretty good, although the first 3 weeks were a struggle.

Nick

You will be fine. The one thing that was important for me, we went out and bought a recliner and that was where I was most comfortable after surgery. The bonus is that I still use the recliner four years later just to watch TV. I am most grateful that after everything my PSA is hovering around zero which ultimately is what is important.

Good luck!!

OP here. Uh oh. I can only sleep on my stomach! ugh

Others have recommended a lot of solid points.. and the davinci thread has good tips.

Here are others I found very useful.

of course, do the keggles a bit now, but I didn't over do it prior to surgery.. Surgeon actually said whatever you do in advance isn't really going to help too much after. He said try and drop some weight and keep core strong, abs and back.

I started to lighten up my diet prior to surgery about three days. Stopped with caffeine, high fats, limited meat, stopped alcohol (okay, I had a double scotch two nights prior) and walked about 4-5 miles a day for at least the few weeks up to the event (I know, you're what two days out)

I was lucky in that I could suspend work for several weeks and that was GREAT.. the actual recovery was really enjoyable in that fashion. I didn't worry about work, life etc, just recovery. It's sad to say but it was very liberating. I just loaded up netflix, my wife did all the food prep (god bless her) and all I had to do was sleep, eat, fill the bag, empty the bag and try and get back on my feet as soon as possible.

I only took the pain meds for about a day and a half dose at that. MANAGE the pain and stay ahead of it, but if you CAN move to the ibuprofen or something other than the narcotics quickly it is much better for many reasons. One very primary reason is that the real pain meds can be VERY constipating and you want to try and get your bowel working as best as manageable as quickly as possible. They will also give you stool softeners and things to make your bowel start working again (takes about 48 hours).

Keep a list of your meds and when you take them. Just make a grid on a piece of paper, and track it. Some you will take several times a day, tylenol and ibuprofen in various cycles, etc. a list to track it makes it much easier to remember and recall for your or a helper.

DRINK A ton if you can, it's all going in the bag and moving a lot of fluid is best. Mostly water, some juices and I would recommend non-caffeinated teas. I'd suggest staying away from coffee and of course alcohol (i didn't drink anything for about 45 days after surgery but I'm not a heavy drinker normally)

Eat healthfully. Avoiding things like fats, grease, too much dairy, too many cruciferous vegetables (can be upsetting to stomach and stomach acid and impair easy digestion) is better. Think chicken, light veggies, things like green beans, peas, easy breads, some fruits, bananas, oranges, etc.

Get up daily and often, but realize it's going to be for about 5-10 minutes at a time and then you are going to be tired and should sit and rest. People have the mis-conception that robotic surgery is less invasive than manual surgery - and in some ways it is, but in many ways there is MORE disruption that is going on and the five entry ports go a long way through a lot of tissue and spend a good deal of time inside the body and THAT is disruptive and painful.

My doctor gave me a simple corset to hold my mid section when getting up and walking. I used it, you'll feel more comfortable with it. you'll know if it works for you if you feel like you'd like to hold and clutch a pillow at night ;-).. try it it's VERY comforting.

Ask them for a leg bag when you leave. It makes walking and carrying the bag easier.. although, be SURE you understand how to change out the catheter, you don't want any errors. In the end, I only used the leg bag once. More so that I didn't really care what the neighbors thought and I just put a sasche on the bag and put it over my shoulder for walking.. worked fine and has much more volume than a leg bag.

Have your plan for penile rehabilitation. You doctor should have a plan for you which will include medications, exercises and other tactics. I employed an all of the above approach after significant research above even what my doctor recommended. I think its one of the reasons I recovered as quickly and confidently as I did.

I can go into more detail later, but this involved massaging the shaft even with the catheter in. do NOT try to do keggles with the catheter in though.

Get a penile pump. It really does work. Get the right size (more about diameter than length) you'll want to work to get blood pumped into the spongy tissue in the shaft long before your body wants to. This is all post catheter removal.

Try and keep stress low, so your body can spend all its available energy on recovery. Don't skimp on food just because you think you are sitting around. Eat healthfully, enough for normal and your body will find a way to move the nutrients to the healing areas.

More post surgery after you are through. good luck!