Took the Plunge

Dear Friends:

Dear Friends:

When we last "talked," I was heading towards a decision point:
"Nearing Decision Point" (Posted 12/10/2017 4:16 PM (GMT -7)
and sought your advice.

Subsequently I met with my MSKCC URO surgeon and an MSKCC RO. The surgeon recommended RALP (naturally) and the RO stated that she would do BT followed by EXBT. She would not recommend radiation over surgery saying that the outcomes are generally the same and it was up to me.

I bit the bullet and immediately scheduled the RALP at MSKCC in NYC and it was performed on 12/27/17 (hey, why not get it over before a new deductible kicks in). Surgery went well with a one night stay in a
lovely new facility (private room, staff tripping over each-other to help and my wife able to sleep on a pull-out sofa in the room.) I was discharged the next day (Thursday). I had minimal pain and purposely avoided painkillers as previous use caused 5 days of constipation. Took two Tylenol over the next 24 hours and was fine. Usual stiffness, soreness, stomach bloating, and dragging around that miserable leash (CATH). Worst part was the 1 1/2 days of constipation. Every hour I felt pressure to go and ran-and-sat-and-prayed constantly. Relief came three days after surgery. The other problem I had was leakage at one of the incisions. That went on for three days and was really annoying. I wept through gauze and multiple layers of clothing... but it stopped by day three. Nonetheless, I was out doing at least a mile of walking every day at an indoor track or the mall.

Yesterday I returned to MSKCC and had the CATH removed. What a relief!!! So far minimal PPI. I think that doing the Kegels for three weeks prior to surgery may have helped. So here's my current condition:

Soreness in the rump. I feel like I fell and bruised my coccyx (tailbone) so I sit on a pillow
Minimal soreness around the incision sites
Swelling going down
Occasional stress PPI
Some penis shortening (unfortunately, I didn't have much to spare)
Total ED... but here's the weird thing. I tried manual stimulation and achieved an orgasm without
getting hard. That was really strange. URO said that was normal.
My energy level is very good but am limited to picking up no more than 10 pounds for 6 weeks.
This morning I got the pathology results:
I was downgraded from 4+3 to 3+4
Nothing at the margins
Lymph nodes and surrounding tissue clear. Whoppee!!

Gentlemen... I feel like a new man! Relieved and ready to get back on track.

I want to thank:
Saipan Paradise, halbert, three 5's and a jack, Fauntleroy, ASAdvocate, Michael_T,
ddyss, oldbeek, jmadrid, Subdenis, Dogdays, Tudpock18...
but particularly Tall Allen for such thoughtful and comprehensive answers and recommendations.
YOU GUYS ARE AMAZING!!!!

My best wishes for a Happy and Healthy New Year to All.

--------------------------------------------------
LeonardR
Age: 64, 64 at DX
PSA: 2.1 12/12, 3.1 12/13, 3.4 7/14, 3.2 11/14, 3.7 11/15, 3.86 10/16, 4.0 9/17
Gleason 4+3
Stage T2a
6 out of 12 cores positive
12/27/17 RALP
Downgraded to 3+4 post surgery
20mg sildenafil daily
Minimal PPI

Leonard...congrats and welcome to the other side! Thanks for reporting in and all the best for your continued recovery!

My thoughts are with you for a good recovery. May I ask, how did you decide which surgeon to go with? I'm newly diagnosed and have been referred to the surgeon in the Urology Associates Group that my urologist belongs to. He seems to have a good reputation, but as I have read on this forum and other websites-the skill of the surgeon is very important.

That was a good summation of your surgery. I'm glad things have gone fairly well for you.

My brother had prostate surgery at MSKCC in October, and his story mirrors yours.

You should feel good as new in about 6-8 weeks.

Good news Leonard. Your results similar to mine. That facility at MSKCC is great — might have wanted to stay longer because it was so comfortable. Wish my psa was undetectable at 6 weeks but maybe it will be at 12.

SteveSR, lots of evidence that the surgeon’s skill is the most important factor. There’s enough information on the web if ypu search by doctor’s name to find reviews and statistics. Dr. Karim Touijer at MSKCC did my surgery. Not sure who Leonard had there.

I would recommend Dr. Touijer very highly — he does 200 prostatectomies per year, more than 2500 lifetime. Excellent work — although I had extra-prostatic extension on one side, he excised fat on that side that was not cancerous, all margins were negative, he had a pathologist check on lymph nodes during surgery, and he spared the nerves on the left non-cancerous side. He’s also pleasant to talk with, and his team are very good as well.

Thank you progressing for your response. I just started my own post. Also I live in California, so traveling across country may not be possible.