RALP recovery

My surgery is scheduled for 03/17/21. What items would you suggest I have at home to help with recovery/comfort/etc.? My doctor's office doesn't have a list of this information.

I do have one, and will use it. Here is a list I've already compiled, from suggestions I have received from a prostate cancer Facebook group I'm a member of:

Neosporin - in case your penis gets irritated from the catheter
Bucket - to carry your large catheter bag in; it's easier to carry that way and helps to protect your floor, etc. from any leakage.
Breakaway pants - can pass the catheter tube through one of the spaces between the snaps.
Depends - for after the catheter is removed
Mirolax - to keep stools soft; don't want to strain while healing.

Dear Music:

I can't really contribute to the answers to your question but I'm sure you will continue to get the info you seek.

Hope you don't mind but I would like to offer up a couple of other suggestions related to your diagnosis:

1. If you have not done so, I suggest you get another reading on your biopsy slides. Dr. Epstein at Johns Hopkins is the best expert we know. Reading prostate pathology is difficult and you want to make sure you really know what you have.

2. Assuming the diagnosis holds, you should be able to be cured by any of the mainstream treatments including surgery and various radiation options. Also, I suggest that you at least get the opinion of radiation oncologists who specialize in SBRT and HDR Brachy so that you are completely educated on your options before you make a potentially life changing decision.

Best of luck,

Jim

Music, I'm not talking about seeds radiation....that is LDR Brachy. I'm talking about SBRT and HDR Brachy which I understand can be done after TURP. But, I'm not a doctor so that's why I suggest you talk with doctors who specialize in those procedures (NOT a urologist) before taking the plunge under the knife.

Jim

Probably doesn’t bear repeating. But, in these threads, I always say the number one thing you’ll need is some help.

musicmanone,

Some tips. Couple are not strictly what you asked, but I wanted to get them out to you since may not have another chance to do so...

(1) Look around your house at the area you will be utilizing after you get home from surgery. You *do not* want to snag your catheter on any items like doorknobs, cabinet knobs, brackets, etc. Could mean a trip back to doc or E.R.
Just be aware of where you are walking/lying and make sure your catheter & bag come along with you safely, without getting hung on something.

(2) yes, second the motion to use Epstein for a second pathology! When I got my 2nd, I got Epstein's order form off the web, filled it out, then met with my surgeon on a follow-up (there will be a few for sure) to ask him to send the form + my check to Epstein + the 1st path slides to Epstein's group. On the form I remember there was a section something like "things the patient would like to know". I would write something like "please report the gleason grade at any margins found". If it's like my case, knowing the gleason at the margins may help you later decide whether to do SRT if your ultrasensitive PSA becomes detectable and keeps rising. Some first patholgists do report margins, some do not (mine did not). Regardless, ask Epstein to report on any margins-he's world renowned.

btw, you may encounter a little resistance from surgeon and 1st pathologist on this -- it's kinda like they don't want anyone else looking over their shoulder, I guess; but it's your tissue and your right.

(3) In a similar vein to (2), it may be helpful to get a genetic analysis of the prostate tissue someday. You will have year or so after surgery to get it done (if you wish to at all), but after a couple years, the tissue may degrade such that the analysis can no longer be done. So just tuck this comment away and remember to revisit this down the road.

Good luck!
Robert

Excellent advice you're received so far. I might also suggest getting some adhesives for attaching the Foley Catheter tube to your thigh. I think they gave me just one extra when I was sent home the day after surgery, and a few more would have been helpful as the initial butterfly adhesives (or whatever they are) lost their grip surprisingly quickly once I started showering post-surgery. (And I was pretty lame about showering frequency while I had the catheter in--my family learned to keep their distance...) I ended up purchasing some on Amazon which could have been avoided if I'd just asked for more extras before discharge.

Also might want to consider timing any free trials for new video streaming services you might be interested in to cover the weeks post-surgery...and/or getting/charging/stocking a kindle reading device.

And I'd reiterate that you need to make sure you've been informed about all your options from appropriate specialists, and not just from a urologist/surgeon. Make sure you meet with a radiologist to learn about radio options and hopefully a medical oncologist also! I did and it made me that much more comfortable with my decision to go with surgery.

Good luck!!

I take it that one becomes constipated? I'm already chronically constipated due to opiates. I control it well with senna,stool softener and biscodyl
I suppose I can double up on the dosage. My wife swears by Miralax and we have plenty on hand. Milk of magnesia works but hate the taste

Glen Heinsohn

Thank you Halbert. I think I'll have to try the miralax.
Funny that you posted as I just re-read your whole surgery story.
Lost another 2 pounds and hope to be down into the 240's by surgery. I saw my cardiologist two day's ago and he said I'd be okay under anesthesia. He said they understand my issues with sleep apnea obesity and Afib. My BP was down to 120/72

Glen Heinsohn

I am a supporter of Miralax also for surgeries. It is relatively slow acting for me so I take a capful with a liquid twice a day and it takes a couple of days to take effect so I start the day before surgery or as soon after as possible. For me, it just softens and loosens up the stool so that system works with minimal effort. The other stuff never works well for me or is too harsh.

Surgery anesthesia paralyzes the GI tract and opioids keep the constipation going. I try to never use opioids after surgery other than maybe the first night since I hate constipation, especially after abdominal surgery. I just grin and bare it with Tylenol and Ibuprofen or any other non narcotic that I can get from Doctor.

Everyone has covered the post surgery issues well. You will snag the catheter tube on something in the first day home. That is how you learn not to do that again. I hooked my bag to a handle and walked away, big mistake and never done again.

My wife took some of my underwear and installed Velcro on one side so I could get them one and off regardless of the tube.

I used the leg bag & strap the hospital gave me and just slept on the couch with that leg down and foot on the floor for the week after I got out the hospital. Also became that old naked guy you may have seen online sitting at his computer surfing the net for that week.

The wife stuck that nasty little pill up my butt for me, much to the relief of the nursing staff. That relaxed my cinched up muscles so I could poop.....with an audience of 5 nurses and the wife. I lost all illusions of dignity that day.

Oh this may be important to some because it happened to me.
If uncircumcised, try and pull the foreskin back as far as you can over the glans penis (head) or you can strangle the glans penis and develop a paraphimosis.
That was a horror show. The skin split and was almost necrotic. I am still not completely healed

Glen Heinsohn

I did not have prostate surgery, but I did have a major, major (multi-procedure open-heart surgery consisting of valve replacement, bypass and pacemaker implant), so I can discuss post-op constipation with some experience "under my belt." I also have been an online counselor for heart valve patients for over 15 years.

Our advice to all heart surgery patients is to use Miralax (powder, mixed with water or juice), starting immediately post-op. Do not let things get "bound up" as it becomes more difficult to get things "going" again. With Miralax, things typically do not get too loose, and if they do, you can reduce the dosage to reach the desired effect. Miralax is gentle, and does not cause muscle cramping like some other laxatives can. Also, once you are a couple of weeks along and things are getting back to normal, you can move to half dosage, then quarter, then stop it.

Trust me, with all of the other stuff that will be going on inside you, you do not want to become constipated. The one time I did, I ended up with an umbilical hernia from straining. That's a whole 'nother story. . .