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Sonny Day 4 Post Surgery Bladder Cycling

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Posted 9/22/2009 2:14 AM (GMT 0)
It's the end of day 4 and I have just completed my first day of the Bladder Cycling Process.

First let me say that every day gets amazingly more and more comfortable. There was no pain today, not even sneezing and the level of discomfort was almost nil.

Most of the day was spent turning the Catheter on and off and holding my water in the bladder.

I started the process by turning the catheter valve off, which directed the urine to be stored in the bladder. When I felt urgency I urinated in the measured receptacle, then I turned the valve open and let what was left in the bladder go into the collection bag. This also was measured to determine how much was left in the bladder when I thought I was done. The I closed the valve and began the process again.

I did not try to really delay the urgency by clenching the muscles since I thought this would do more harm than good. I have read too much here about how the Dr.s have told you to delay the resumption of Kegels following surgery. Likewise I did not use the muscles to try and force out the last little bit. Same muscles and same reasoning.

There were no drips, no drops and no leaks between cycles. This was very encouraging.

Today it seems as though the timing was about 1hr30min to 2hrs each time and the amount retained was fairly consistent. I had to track the voided and retained amount on a chart and I have to take the chart with me to the cath removal appointment. I guess then I will find out the importance of the amounts.

Must be a good reason for this, they have everything planned down so tight, this must be something they developed to assist in obtaining continence again.

Other than that is was just the same ole day of recovery. There was a lot of interest expressed on this forum about the Supra Pubic Catheter so I am trying to be as complete as possible in the details. If I left something out, let me know.

I know boring post, but in the interest of science and helping my fellow PCa man, here it is.

Sonny
Posted 9/22/2009 2:42 AM (GMT 0)
Sonny,This is good detailed information your giving us and it sounds like your doing great. No pain and this new method with the catheter seems to be a better way to heal.

Keep us posted and a speedy recovery to you.

My prayers are with you.

Huey
Posted 9/22/2009 3:35 AM (GMT 0)
Sonny, great reporting as usual. The details are great, both to the more experienced and to the novice here. Still amazed at your progress, that surgeon and his methods sure seem right on target for you. Sure you didn't have a gall bladder removed instead of your prostate, this has been too easy so far. lol.

David in SC
Posted 9/22/2009 4:51 AM (GMT 0)
Look, I'm happy for Sonny and all that. I really am. But, if he sends a report he made love with the wife on day 5 before heading out for a four mile walk, I think I'll go lie down under a bus. Thankfully, a neighbor has an old one in the back yard for kids to play in, so it's not dangerous.

Keep on trucking there, Sonny. You're an inspiration.

Sheldon AKA Sleepless
Posted 9/22/2009 12:23 PM (GMT 0)
Huey, thanks man, I am trying to be detailed for others that will need this info in the future. I learned so much from this forum and the detailed posts that helped me prepare for my surgery,

David, I'm sure they took the prostate and not the gall bladder. I find that when I sit down my body reminds me there is something missing and that's why the toilet is so comfortable to sit on.

Sheldon, man stay out from under the bus. I swear I'll work really hard to find something today that makes my recovery seem more normal. There must be something I am failing to report, I'll try to pay more attention. However, if it will just keep going this smoothly, I will not complain one darn bit. I will say thanks to the Lord for answering my prayers. Oh, and about the day 5 thing you propose. Don't worry, with my wife's cancer and her bone damage it's been about twice in the past 2 and 1/2 years, so I don't think she has any plans to change the schedule on my arrival home. In this case I don't think the GFMPH plan here on the forum is going to pay off for me quite yet.

Now to the question I have for all of you. Define dry for me. There is a lot of discussion here about dry from the start, dry from week two and so on. I understand the concept of dry is the absence of wet. No drips, leaks, floods and so forth is dry, I get that.

What I want to know is if dry is the time between trips to the john, WHAT IS THE TIME BETWEEN TRIPS TO THE JOHN? That's the thing that seems more important to me. I think I would trade a little drip now and then if my trips to the john were a little longer apart. Now I am new to all of this and yesterday was the first day of this cycling thing, but I was a little surprised that my time between urgent calls to go was only 1 1/2 to 2 hours apart. I figure that the bladder will continue to expand and hold more. I'll find out today as I will have a longer day to test the theory. But what's the real world experience out there with you guys.

Does all of this change after surgery? If we are dry can we hold our water as long as we used to. Seems to me that this piece of the equation isn't talked about very much here. Guys like me seem to assume that if I practice the kegels, find a good surgeon with good procedures that address this, pray real hard and get lucky as hell, being dry will be like it was before PCa. Now I am not sure. Time to fess up a little guys, not just for me but for those that will follow in our footsteps.

I think I could live with 3-4 hours between trips, that would give me time to umpire a college baseball game without calling a diaper timeout. I wouldn't even mind getting up 1-2 times during the night to pee, I am a light sleeper anyway and go back to sleep easy. But if it turns out to be 1-2 hours, then would bring about an really big change in my lifestyle. I would have to give up umpiring. Only be around really good friends that won't mind if I just whip it out and pee anywhere we are. And find the world's best traveling urnial for extended trips on the road. And dang I hate to stop when I'm driving.

Chime in guys. I need to know what I may be facing. I realize everything is different for each of us. But out of all of this we still look at the odds and statistics about every facet of this as we make our decisions about alternatives.

Thanks guys. I know I keep repeating myself, but, I could not have made this trip alone. The support you have given me will stay with me the rest of my life. If I ever win the Lottery or Powerball in Florida, I will find a way to let all of you know just how strong I feel about this.

Sonny
Posted 9/22/2009 12:59 PM (GMT 0)

 hey Sonny good to hear you're doing so well......the anticipation of all that can happen is always, or normally worse than the actual event. I remember I was like you, I read and took all I could from the site, all very good info as we've said over and over. Man' was I anxious, but the surgery came and went......you're other post about "waiting" for the worst to happen, I know exactly how you felt. I did the same thing, I mean I sit and wondered, oh man I better not go for that walk, something HAS to happen. The worst thing was when my girlfriend pulled my JP drain out on about day seven(she too is a ER nurse)I don't mind telling ya, that hurt! I too put my leg bag in a bucket sometimes and off I went, flip-flops and gym shorts....walking, lots. Listen to your body it'll tell you when you're over doing it...you're doing great, keep it up

 As far as dry vs wet, for no longer  post op you are, you sir are doing great. Myself, I wouldn't worry too much about the time in between...if you're holdin' for as long as you say, that's great progress and it will just get better as time goes on. I leaked during the day and only used one pad a day, and that was a mini-pad.  I'm happy to report to you yes, I can hold as long as pre-surg....althougth sometimes, sometimes if I'm doing heavy lifting, or whatever I may still slip a pad in, just to save the "spot issue"....it's no big deal. As I said, you know your body and as time goes on you'll understand what may or may not trigger the need. 

 At this point, don't even think or worry about maybe having to give up calling games....I see you achieving total dryness in a pretty short time frame, and if by chance you "spot" or leak a little when assuming the ump's position......one pad during a game should serve you well. Don't let PCa rob you of anymore than it already has, you're pitching a good game here, keep throwing those strikes and you'll be fine. Good luck brother....Blue

Posted 9/22/2009 1:44 PM (GMT 0)
Blue, thanks for the response and encouragement. That's the kind of feedback I was hoping for. I am the eternal optimist and would never look down on any gift I am given. If I have been gifted with a tremendously great recovery, the peace of having the cancer gone and the future of a giving and wonderful life, I will embrace it whole-heartedly and with great thanks.

As I have said in an earlier post; my life has been one of giving and finding this site has raised my level of giving and supportive nature to a much higher level than I knew I possessed.

Thanks again,

Sonny
Posted 9/22/2009 2:21 PM (GMT 0)
Sonny,

That is great and you continue to amaze. But I am with Sleepless, does that bus have two wheels? LOL. Actually it is always good to root for people although our own recevery might not be as speedy. The night after my surgery they had all of the Prostate patients up and walking arounfd the nursing station and I remember thinking those other guys looked like they were feeling better than I did. It reminded me of a freind who was running a marathon in Georgia and at mile 22 a drunk walked out into the middle of the road and looked at Jim for a second and then said to him, "You look like hell." Jim replied, "thank you, your the first honest person I have met today." But Sonny keep up the great work as you deserve that as do many others on here, it just adds encouragement for all of us.

Michael

Posted 9/22/2009 3:36 PM (GMT 0)
Sonny,

Sounds like you're doing fine so far. As for me, I too was lucky that I didn't "leak" after my RRP; no drips, no leaks and no errors. Eight days post surgery I had the Foley catheter removed and I was immediately able to go several hours between emptying my bladder. Now four months out I can go 6 to 8 hours during the night and easily about 3 hours during the day with no liquid restrictions. The only issue I have is that when I do have to go, I really have to go right now.

Posted 9/22/2009 3:50 PM (GMT 0)
Sonny I have also noted that the only time I leak is when I have Red Wine. (I drink it anyway) I agree with Jack when I have to go "I have to go"!!
Posted 9/22/2009 4:02 PM (GMT 0)
Great reports. It always good to hear about new treatment possibilities. I will be interested to hear how the catheter removal goes.

My understanding of the issue of urine retention in the bladder is that less is better, at least as the healing process goes along. I think retained urine increases the risk of bladder infection.
Posted 9/22/2009 4:41 PM (GMT 0)
As geezer says, now isn't the time to be practicing urine retention. That can come later, after you been healed up. I found that I came off the catheter dry after about 2 days. I went 1 1/2 to 2 hours ar first and it slowly got longer. I now adopt the position of never waste a chance to pee, as the full sudden urge is hard to control. I can go about 4 hours day time and sometimes up to 5 hours night, on a really good day or night.
Posted 9/22/2009 5:18 PM (GMT 0)
Guys, thank you so much for chiming in on this. I may have misunderstood to a degree that whole purpose of the bladder cycling. What you guys have to say makes sense. Right now it's not about trying to see how much I can hold it's probably more about gaining the elasticity back in the bladder though the constant filling and emptying.

Thanks. I won't feel discouraged anymore if an hour and a half is all I can do. I need to relax and let nature take it's course. I should just relax and rejoice in the fact that I don't drip or leak in between.

I knew you guys would help me keep my head on straight. Now the little head is a different story. I hope they didn't twist anything when they reconnected. With all the bruising and the fact that it is trying to hide like a turtle, I can't tell if is right side up or not.

Sonny
Posted 9/22/2009 6:50 PM (GMT 0)
Sonny: I am looking at a guy that had major surgery just 5 days ago, you are already on an amazing recovery path which I sincerely hope you get to stay on. But your body still needs some natural healing on its own time schedule. There are sound medical reasons why catheters stay in x amount of time, and lifting limits for x amount of time, etc. etc. You are doing wonderful in every way, but please listen to the still voice of your own body as it's fighting to heal itself.

David in SC
Posted 9/22/2009 8:26 PM (GMT 0)
Thanks David,

I am going to post this in two places to make sure you see it, regarding the Supra Pubic (SP) catheter.

I talked with a Dr. today the is on the staff here at Henry Ford. He describes himself as an academic Urologist. He has been researching and teaching for the past 35 years. He and Dr. Menon were having a conversation where Dr. M was discussing a new approach he wanted to take in the surgery to remove the prostate. They discussed the advantages of being able to do it this new way and were excited about the reduction of trauma to the body, the more completely and easily the prostate could be removed and how the nerve sparing and incontinence issues could be better addressed. Dr. M said that the real drawback was that during and after this method he could not have any urine escaping into the area. They continued to talk and arrived at the possibilities of using the SP. It was about this time that a patient came to see Dr. M about PCa and surgery. When the discussion turned to having a catheter for 1-2 weeks, the patient told Dr. M. that if had to have a cath he would not do the surgery. He had already had a bad experience with caths.

Dr. M discussed with him at length his ideas about the new surgical procedures and the use of the SP and the patient agreed to be the first.
So for the last 2 years it is the only way they have done the surgery. They found it superior to the old methods and it addressed their other patient continued complaints about the foley.

When I asked the academic about the apparent unwillingness of other Dr.s to using the SP he said most likely it would take them out of their comfort zone. Dr.s are so busy just seeing their patients and attending their needs they don't have or don't take the time to stay abreast of advances in technology, techniques and developments. Hence their reluctance.

I described your situation as best I could. Told him about the 7 caths in 10 months and now with IMRT and blockage the prospect of having another for 2 months. I told him that you sensed reluctance on the part of your Dr. to use the SP. He said that of course he did not have your medical info in front of him, but he could see where the SP would be the perfect solution for your situation. He said that this was one of the main reasons why it was developed in the first place. He also said that you should really question you Dr. about his reluctance and added that he would have to have a very valid reason not to be using.

He lives here in the apartment bldg and I see him many times a day. I approached him the first place because I remembered him from my first meeting with Dr. M back in July. He sat in on the meeting, didn't say a whole lot then but observed and heard everything. Seems he works very closely with Dr. M in continued development of new and better ways to deal with PCa surgery. He said that one of the reasons that Dr. M is so successful is that he has the resources and the time to continually review processes and does not live the life of the overworked private practice physician/surgeon.

The whole conversation seemed to make a lot of sense.

Thought this might help.
Posted 9/22/2009 8:38 PM (GMT 0)
Sonny, I answered you on the other thread, thanks.
Posted 9/23/2009 2:29 AM (GMT 0)

 "....no drips, no leaks, and no errors..".........I love it! tongue

Posted 9/23/2009 3:41 AM (GMT 0)
Sonny, I too had the SP cath and went through the cycling process. After the cath removal I expected to leak, so I continued to wear pads for two weeks and finally stopped after not wetting them. I could only go 1 1/2 to 2 hours between trips to the restroom but as time went on it expanded.  Daytime I can now do 4 to 6 hours and at night I get up once unless I had a lot to drink before bedtime. Most of the time I dont have trouble postponing but other times when I feel the urge, I have to get moving. Cath removal was an experience, it leaves a hole in your stomach for a few hours, which will allow water to flow through that hole. They will tell you that it will heal in about 24 to 48 hours, the key is to try and keep your bladder as empty as possible during that time. When the SP tube is removed they will put on a pad and bandage, but be prepared to change that pad, I had to change mine within a half half hour, I could feel water spraying out the hole left from the SP tube, but that only happened once. Henry Ford Hospital took good care of me and sounds like you are doing very well also, just remember to stay with your stool softner for at least two weeks until you body takes over. At three weeks you may start to experience a little pain when sitting but it will go away. Surgery on 3/18/09 and I was swinging a golf club at 4 weeks. Six months and still looking for that magic potion to restore erections without meds or VED. In my opinion, I believe, the most important aspect of recovery, is to have a very supportive spouse. Good luck on your recovery.

Bonedoctor

Posted 9/23/2009 10:14 AM (GMT 0)
Bonedoctor,

Thanks man, that was a very informative post for me. As you have seen there aren't a lot of us that have been this route before. I don't know how the rest of the recovery will go for me but I have to say that these first 6 days have been relatively easy compared to a lot of the stories related by others.

I see that you haven't posted a lot but I do appreciate you chiming in for me.

Thanks,

Sonny
Posted 9/23/2009 11:21 AM (GMT 0)
Sonny,
I've been leaking since the surgery. Even my Foley leaked because is was underinflated.
My definition of "dry" is keeping urine out of my pads. If I have to run to the pea/pee gravel pit out back 20 times a day, I still call that "dry". Once I stop leaking, I'll work on the frequency.
I am dry when I sit but must empty within 30 seconds of standing if I want to save 28 cents.
That SP sounds like a better idea all the time. I'll admit, at first I thought it was overkill and another route to infection but now I can see some advantages. Thanks for sharing.
Hey Sheldon, Save one of those tires for me.
Jeff
Posted 9/23/2009 12:17 PM (GMT 0)
Hey Sonny,

My fondest wish is that I am feeling as good as you are after my syrgery. You are doing amazingly well and also have a great disposition and attitude. It can only help. With a frame of mind like that I suspect that your bladder control will not be an issue and you eventually will be able to continue the things that you enjoy like umpiring.

Keep well,
Regards,
Bill
Posted 9/23/2009 12:27 PM (GMT 0)
Sonny,

I had looked for a site like this for a long time and couldnt find it. One day I was looking for information on the effects of Viagra vs. Cialis, so I googled it and presto I was at this forum, couldnt believe it. Since then I've told other guys about it who had also been looking for support from fellow PC survivors. I dont post a lot but I do read the post, not only to learn but to also share when I feel neccessary. When I went back for my Friday morning class, it was interesting to sit in with guys from Penn., Fl., India and my home state of MI., it made me feel good that I was at a place where people come from all over the world for treatment. For those of you that dont know, the Friday morning class was for erectile rehabilitation, at the time that I went, it was being held each week and you had a standing invitation, but attended only if you wanted to, very informative. Imagine walking in my shoes and its just a thought, walk in my shoes and you,ve had an experience.

Bonedoctor

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