Chris Mathews PCa

Chris Mathews returned to "Hardball" tonight after a two week absence. He revealed he had surgery for PCa, and that they "got it out." I couldn't help but chuckle because we hear that phrase so often here. It would interesting to know the biopsy report that guided his treatment.

I didn't have surgery, but only being out of work two weeks seems fast to me. Although he does have a desk job.

That said, I have a brother that had PCa surgery. He's a sportswriter and he was doing locker room interviews while he still had his catheter.

Two weeks after my surgery I could go teach my classes, and had enough energy to do a good job. That's not so different from that Chris Matthews does for a job. But after I finished work, I went home and collapsed. I was unbelievably tired. Maybe Chris falls apart after the show is over, but we don't see that.

VinceInMT said...
I'd never heard of the guy and had to look him up. (I got rid of my TV 30 years ago.)

I suppose everyone is different in terms of what they are comfortable doing. One week after RALP I had the catheter out and then walked from my hotel to the Dittrick Museum of Medical History on the Case Western Campus, about a mile, visited the museum (well worth it), and then walked back. The next day I flew from Cleveland back to Montana. After a week with the catheter I was more than ready to get moving.

I think it's important to note Matthews is 74.

Surgery at 74. What a doc. Patrick Walsh, the best PCa surgeon ever, had a strict age 70 limitation.

I agree with most everybody here. Once the catheter is out I was ready to do most anything but I did need a nap everyday for several weeks.

The more times you've been under a general anaesthetic, the more it hits you I suspect. I've been under about 4 times in the past 3-4yrs. First time, I recovered very fast. Though, as trailguy mentions, I was probably affected for a time but I just didn't notice it. The last time I went under, I really felt it for ages. Makes me very skittish if there's a next time ....

I is head mny sur juries nd i nevah no tissed any kogs miss ing

Mel

BIG difference between sedation used for prostate biopsy or colonoscopy (often Versed, Demerol, Fentanyl) as opposed to General Anesthetics used for surgery.

Not only are sedation drugs much lighter duty than General Anesthetic drugs, the duration of a prostate biopsy is around 15 minutes ( I’ve had two comfortable biopsy’s with local anesthetic), for open or robotic prostate removal its hours.

justwondering said...
BIG difference between sedation used for prostate biopsy or colonoscopy (often Versed, Demerol, Fentanyl) as opposed to General Anesthetics used for surgery.

Not only are sedation drugs much lighter duty than General Anesthetic drugs, the duration of a prostate biopsy is around 15 minutes ( I’ve had two comfortable biopsy’s with local anesthetic), for open or robotic prostate removal its hours.

This is true. And even more so, these days if the surgeons can get an anesthesia pro to administer the sedation, and sometimes even if they can't, every one loves to use propofol. If that is used and nothing else, they can not only keep you down ( i.e. still, not responding to painful stimuli, but still breathing adequately on your own) far better than with versed/fentanyl etc, and less likely to stop breathing and need manual ventilation, but once you stop pushing the propofol into the vein, commonly within 10 to 20 minutes, patients are so wide awake that you can not tell they have had any drugs. They could absolutely get up, get dressed and go back to work if protocol allowed. If all they had was propofol, and nothing else, then unlike with any other drug combo, it would be extremely unusual to see someone held longer than the minimum required in the recovery room. Or going home obviously hung over. Here is the secret: though used in the same way as so called sedation, propfol all by itself- if an adeqate dose is given, is a full on general anesthetic. However, it wears off far faster than not only any gas anesthetic, but far faster thn any of the usual sedation drugs like versed or fentanyl.

Actually, fentanyl(unless given in massive doses) has about zero sedation or alteration of consciousness, but has profound analgesia(pain relief), as well as profound dose dependent respiratory depression(like all narcotics). It was not uncommon, when sedating with fentanyl, to have to constantly remind a seemingly wide awake patient to breath.

And if you didn't knock them out with something else like versed or propofol, they would always breath when you reminded them, for 1 breath at least. They could be laying there totally oblivious to pain, even though about wide awake, only problem was that pesky breathing. That's why street fentanyl is killing so many folks. They just stop breathing. I lost at least one co-worker- addicted to fentanyl unknown to all of us, a very nice young man with a wife and young children. He was on call, at the little hospital where my wife worked way back then, and no one could find him, and he wouldn't answer his pager. Finally they looked in the anesthesia work room closet, and there he was, on the floor, needle still in his arm and tourniquet on. Just stopped breathing.

Of course, Michael Jackson was taken out in a similar fashion, and that was propofol. But, that probably was not that he just stopped breathing until hypoxia set in, and certainly not while awake or semi awake. He was under a general anesthetic at home, a DIY general, with no anesthesia provider to keep him alive, and while his personal doctor briefly left the room, he ether obstructed(still trying to breath but his tongue was blocking his airway) or vomited and aspirated, or both. Almost guaranteed. So as long as you have some one to manage your airway, and maybe blood pressure, propofol all by itself can take you down deep enough for surgery, and then you can be wide awake 20 minutes later. And by wide awake, I mean no one can tell you have had a drug. So much so that sometimes, patients would get angry with us because they are convinced we never put them to sleep or gave them any drug, even though a few minutes before they had not just been sedated, but were under deep anesthesia.

Post Edited (BillyBob@388) : 10/24/2019 8:12:55 PM (GMT-6)

trailguy said...
It is not commonly known, but if you have major surgery under a general anesthetic you will experience "mild cognitive impairment" for about a year after.

Most lay people are unaware of the difference between sedation and general anesthesia. It all means the same thing to most of us. The MCI, I've come to know much more recently.

justwondering said...
BIG difference between sedation used for prostate biopsy or colonoscopy (often Versed, Demerol, Fentanyl) as opposed to General Anesthetics used for surgery. Not only are sedation drugs much lighter duty than General Anesthetic drugs...

Thanks "justwondering" ... It's also good to have the input of a professional, BillyBob. As I remember you've mentioned in the past that you are or were an anesthesiologist or anesthetist. Having had sixteen major surgeries in my life, I've learned a bit about anesthesia. Throw in a couple dozen "procedures" done under sedation (biopsies, extractions, placements, etc) I now know the difference. Doctors seem to assume that we all somehow know this.

Soon after my first adult surgery forty years ago (actually two abdominal surgeries back to back) I noticed the profound depression which lingered for weeks afterwards. Having never had any MH issues in my lifetime, I wasn't sure what to call it. That was a time in my life which I prefer not to dwell upon.

Some years later, I discovered that Methocarbamol, a medication I'd used since childhood for a neuromuscular condition, also started causing a kind of depression. Just within recent years I learned that the commonly used Flexeril would also send me into depression. And now having been on Effexor for a couple years, and having had six surgeries in just the past three years, I feel like I'm finally getting a handle on the maelstrom going on in my body.

So here's what most people don't know. General anesthesia has three components... sedation, analgesia and paralysis. Please clarify or correct me BillyBob if I have any of this wrong. The gas makes you unconscious or unaware of what's going on around you. An anesthetic (narcotic) reduces your sensation of pain, a muscle relaxant prevents you from reacting to the pain, and the short acting tranquilizer (Versed) causes you to forget what you've experienced.

I think I've discovered that it is the muscle relaxant that makes me feel so depressed after every surgery. Fortunately this doesn't occur after "procedures" like biopsies, but it can be induced by Rx oral meds. Recently my GP advised me to "lay off the surgeries for a while" to allow my body to rest (if only it were that simple). I'm still working out what works best for the myoclonic spasms while avoiding muscle relaxants.

Regarding MCI, I don't know just what to blame. It's been nearly two years since my final Lupron injection, yet my testosterone is still at castrate level. Certainly there is some "brain fog" caused by the hypogonadism, and which is not a direct effect of the leuprolide itself. There may be some MCI that goes along with long term use of venlafaxine... I don't know. But life with the V is better than life without it. As mentioned before, I'm all new to the MH aspect of all this. Lately I've been hanging around the chemo brain groups on FB as my brain fog seem close to what the members there experience.

Now I have to count the scars on my body to remember everything that's happened, and it helps if I categorize them as H&N, ortho, GI and GU and count from there. I don't post much here anymore (though it may not seem so) as I'm trying to move beyond my past. Sounds easy, but not so easy to do. Knowing that I am not alone helps. More than anything, I wish that my first Uro and my most recent Uro had treated me the way most of you guys here seem to have been treated. I'm trying to take more personal responsibility for not making better decisions early on... but nobody told me anything. As stated in another thread... No info URO.

trailguy said...
Yeah, and that person was my first uro.

Trailguy, I identify closely with you here... your age, diagnosis, your wisdom on leuprolide chemo and your monorchidism... except maybe your outdoorsyness. I'm pretty lame in that department.