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POST RALP DEPRESSION

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Posted 9/16/2019 5:37 PM (GMT 0)
So here I am at 7 months post RALP and am having major depression issues. I was not prepared for the repercussions and loss of my sexual functions. I know you guys don't like talking about this stuff but I needed to vent a bit. I am only 58 years old and I am not ready to give up that part of my life. Yes I know it is common to take a year or two to fully recover, but I am not seeing any improvement at all. The good news is my PSA in below one, with my second 3 month check up a month away. Today is just a bad day and I am feeling sorry for myself I guess. Vent over.
Posted 9/16/2019 5:50 PM (GMT 0)
It's a lot to process FP. Vents are welcome. Hopefully you're rehabbing your junk with a vacuum pump and Cialis.
Posted 9/16/2019 6:20 PM (GMT 0)
FranPro
I just got my RP 08/19/19 and I could imagine what you are going though. All I could say is PUSH THE BEAST BACK, don't quit take it day by day. Are you doing your Therapy's?

This is what I'm doing:
20 mg Viagra Daily
VED 15-20 Minuets every day
100 mg Viagra (once a week) instead of the 20 mg
Walk. Walk. Walk.
Try to eat healthy

I'm still dealing with the incontinence stuff but today seems to be a good day, its 2:25PM est, I'm at work still on pad 2.

You must be stronger than the beast, fight back.

S/F
Posted 9/16/2019 6:28 PM (GMT 0)
FranPro,

Let me start by correcting one misconception, that we don't like to listen to you complain about your side effects. That's what we do here. It's most of what we are about. You can get better advice on treatments other places but this forum is one of the best venues on the planet for complaining about the side effects. So complain away; we can take it.

In a previous post I think you mentioned that you are using a pump. That's good -- they are somewhat helpful -- but if you are not getting any response from pills at 7 months it might be time to think about trimix. If you haven't tried them injections are easier than you think -- but they'd have to be, wouldn't they? Like you said, it is not uncommon for it to take a year or two for the nerves to recover (if they recover, of which there is no guarantee) but it's important to keep the tissues in good shape while you wait and trimix can help with that.

If you haven't already watched Dr. Mulhall's videos this might be a good time. Gedman has a recent post and he has a link to the videos in his signature. ( See Ready for a new home: ED pump and Peyronie's book ) The links to the videos are in his signature as "( I, II, III )". The takeaway for you should be that 1) ED often gets worse before it gets better, and 2) it's best to keep working the problem while you wait for your hydraulics to come back online.
Posted 9/16/2019 6:30 PM (GMT 0)
Fran, it took me quite a while to get over the whole concept of having cancer. You have every right to have a bad day, to vent, and this is the place to do that (and also you should be able to vent to your loved ones, but we are here for that.
Everybody is different, and there is still a good chance you may get your junk working well again, try to be patient. Keep taking your Cialis or Viagra (if you are taking one, and its not helping, maybe ask your Dr if you should try the other?
I'm guessing you are a fighter, and will get through this, but are just, as you said, having a bad day.
Posted 9/16/2019 6:45 PM (GMT 0)
For a lot of us treatment for PCa is a life changing event, even if treatment is successful and PSA drops to undetectable. The SEs can be severe and may last forever; those effects can be a very good reason to be bummed out.
Posted 9/16/2019 7:01 PM (GMT 0)
Fran there's not a person on this forum who hasn't experienced what your going through right now regardless of surgery or radiation. The fact that you were able to talk about it is great and I hope that a person always feels comfortable coming on here and talking about things like what you are going thru. I think a lot of times the SE's are worse than the actual treatment. Like the other guys have said hang in there it takes some time. I like what one of our members posted a couple of months ago when talking about the difficulties of Cancer and SE's. BY THE YARD IS HARD BUT BY THE INCH IS A CINCH.

Larry
Posted 9/16/2019 7:16 PM (GMT 0)
Thanks guys. Not the best day of my life but at least I am alive and I have hope.
Posted 9/16/2019 7:35 PM (GMT 0)

FranPro said...
Thanks guys. Not the best day of my life but at least I am alive and I have hope.

Hope springs eternal, as does venting, complaining, bytching, crying, worrying, obsessing, and being pi$$ed off.

Not that I agree it's what we do best, but we sure have a couple of world champions at it. So vent away ;-)
Posted 9/16/2019 8:09 PM (GMT 0)

garyi said...
... venting, complaining, bytching, crying, worrying, obsessing, and being pi$$ed off...

Not that I agree it's what we do best, but we sure have a couple of world champions at it.

While we do indeed have some contenders in the venting/complaining/obsessing* category, it was sympathetic listening I was claiming as our standout feature.

*You forgot "whining"
Posted 9/17/2019 1:56 PM (GMT 0)

PeterDisAbelard. said...

garyi said...
......it was sympathetic listening I was claiming as our standout feature.

*You forgot "whining"

LOL, and so true about compassionate, well reasoned, listening!
Posted 9/17/2019 3:13 PM (GMT 0)
FranPro, You gotta hang in there. I was the same as you, then about 7 months out, I started to see some life. My surgeon told me that I should see incremental improvements over time. He was right. The ED improvements were incremental and small, but it just kept getting better. At about a year out or so, things got to about 75% with daily 5mg cialis. about 18 months, I was at 90% with meds, which is pretty good. Now at 3 plus years, it's at about 100%, but still using 5mg daily cialis. I tried about 6 months ago without the meds, but only got to about 75%, so, I just accept the fact that I need some meds to be fully functional, ED-wise. I may have needed that anyway, even without PCa. Oh, use the pump. It does help with maintaining size and shape! J
Posted 9/17/2019 10:18 PM (GMT 0)
Fran,
I was in your shoes 2+ years ago and can totally relate to your situation.
I don’t see in your signature if your RALP was nerve sparing, but most likely it was not because of 4+3 and +margins. As others mentioned, it would be good timing to try penile injections which no one likes but for some, they are working well. I started penile injections at 5.5 months post RALP and used TRIMIX which gave me around 70% of erection before surgery, but TRIMIX was extremely painful for me and could not endure in sex more then 10 minutes max. I had pain in my penis upto24 hrs after injecting. Switched to BIMIX which was not painful but did not produce anything more then chubby and went to 0.45 ml or 45 units.
Months were passing with no response to anything I tried. Year passed and I never experienced the slightest sign of life from my penis. When 18 months passed my penis was more dead then on day 1. I lost 2+ inches of length and some girth and ended with penis of 10 or 11 year old.
At 2o months I decided that waiting was futile and saw implant surgeon.
Implanted at 22 months post RALP in 9/2018.
Ironically, my RALP was nerve sparing but my penis never waked off out of coma.
At time of surgery, I was 51 , healthy, physically fit, non smoker, non drinker, never had any ED problem and never tried Cialis or Viagra before surgery.
I wish, I had my implant sooner at 12 months post RALP.
Waiting for miracle to happen, just means more time down and more depression.
MK
Posted 9/18/2019 12:11 AM (GMT 0)
I'm 13 months post op and 6 months post Adjuctive IMRT - I still get tired from time to time and will bring up with the RO on my follow up visit next week.

With the PSA tests, I've been pretty much forgetting them - I do have a reminder on the phone a week before I should go so I do continue those tests. There is no reason not to.

Depression? At 60, I'm not going to get super upset anymore. Work days fly by and I'm not ready to retire yet. If I got sick again, I might.

Sexual is going okay - the DiVinci surgeon said that I still have my right side of nerves - I'm able to get an erection with and without pills so maybe confirm that they didn't go wide on both sides for you.
Posted 9/18/2019 1:14 AM (GMT 0)
venting and complaining.

I'm in
Posted 9/18/2019 7:02 AM (GMT 0)
I jumped into surgery without knowing what I was getting into. URO said I may need Cialis after, but then removed all my nerves. I had PTSD. I was dangerous to be around. I shouldn't have been allowed to drive a car. I was constantly mad and I was 75, not 57. I feel for you.Trimix gave me pain at 15 on a scale of 1-10. Got an implant at 9 months as URO told me nothing was coming back. With no nerves at all so the implant is a hard Rod in a wet noodle. Not near as much feeling and very difficult to reach orgasm. I live with what I have now and am alive but it sure sucks. So sorry for your situation.
Posted 9/18/2019 6:23 PM (GMT 0)
I’m in the same boat as you. I take bupropion ( zyban ) and that keeps me out of trouble. If nothing works some folks have tried penile implants which will always work at your command ... and many claim it work even better.

... there are always options , but most important is that you keep a good vigil on the PSA and keep the beast at bay.
Posted 9/18/2019 6:43 PM (GMT 0)
Ddyss: Beak has an implant but is still struggling.

Beak: Are you taking any SSRI antidepressants (things like Prozac)? Your difficulty achieving orgasm is a classic side effect. The bupropion that Ddyss mentions is a different antidepressant that is sometimes taken with (or instead of) a SSRI drug to offset the sexual side effects.
Posted 9/18/2019 8:03 PM (GMT 0)
Guys, thank you so much for your replies, they really do help. I hated to whine, I am happy to be cancer free for now but I was/am down in the dumps. My RALP was nerve sparring the surgeon says. I am a very active person in pretty good shape and don't smoke. I know I just need to be patient but with no noticeable improvements it is getting to me. I have the shots and they work pretty well but are a real pain in many ways. I will not consider an implant at least for 2 years post RALP.
Posted 9/19/2019 6:05 PM (GMT 0)
Peter , I was responding to fran’s Original post as I didn’t see him having an implant.

Fran, you don’t even have to see a psychiatrist to get a zyban , your PCP should be able to get you a script if you want to give it a shot. It also helps me with “anger management” somehow.
Posted 9/20/2019 4:59 AM (GMT 0)
I am not taking antidepressants. I am much better now than in the beginning. The orgasm problem is completely from lack of sensitivity. Lots of guys that get implants just have venous leakage and still have blood filling of their glans with all the sensations. With nerves removed, you don't have much to work with. Incontinence causes dribbles when I work. I quit worrying about that also as I live out in the country and don't see to many other folks. I wear a pad when I go to town. Just living with what I have to work with now.
Posted 9/20/2019 12:19 PM (GMT 0)
Thanks so much for sharing with such candor. You’re a remarkable person.
Posted 9/20/2019 3:36 PM (GMT 0)
Beek:

When your doctor says he has "taken the nerves" he is usually talking more about the erectile nerves than the sensory nerves but you're right that the lack of glanular erection can reduce sensation even with an implant. Some guys with sensation problems find one of those vibrating "massagers" helpful. Look for the ones that are sold to deal with sore muscles -- the battery operated ones are insufficient and embarrassing to have around. Some of them have warnings that they might pinch your "fingers." Avoid those too.
Posted 9/21/2019 4:28 AM (GMT 0)
I have tried and have every model vibrator and toy on the market to no avail. Thinking of trying a really sexy and talented ****** to see if it is just old age. LOL
Posted 9/21/2019 8:20 PM (GMT 0)
****** = sexual surrogate, I'm sure ;-) and a very good investment, I think.
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