Latest PSA and Incontinence Question

Hello to All: Reading post and continuing to pray for all of you as you cope and fight with PC.

At 21 months from surgery yesterday's PSA came back with <0.1

So at the moment PC has been managed, ED - almost back to fully normal, but I still have a small amount of incontinence. I measure my pad output and the total is around 10- 14 cc (2 teaspoons) per 24 hours. Do my Kegels but still leak when walking or doing activities and sometimes for no apparent reason at all. My daily work/commute schedule is long so dinner is consumed around 8:00 to 8:30 pm. That moves my water consumption later than I would like it to be, but I have to drink something. That late fluid consumption causes me to get up at 2:00 am and void anywhere from 400 to 500 cc and another 200 - 250 cc when I wake up for work at 5:00 am. (So, that amount of urine is about the amount in a standard wine bottle -750 ml) So, my nocturia causes a leak to occur because I am in a deep sleep state and even 500 cc in my bladder takes a while for my brain to register with the urge to get up and go. I noted recently that if I drink 20 oz of water during my evening meal as opposed to 12 ounces, my leak can be confined from 6 cc (with drinking 20 oz) down to 1.5 to 2.5 cc (if I can get away with only drinking 12 oz) However, with the summer approaching, one has to drink something so I am a bit stuck with my long work and commute schedule.

My questions: Has anyone who leaks a small amount like me found success with physical therapy in a physical rehab facility? Has anyone with nocturia found a way, other than severely curtailing evening fluid drinking, found relief from this issue.

Any helpful suggestions and encouragement will be deeply appreciated. Again, I continue to think positive thoughts for all of you who post and keep you in my daily prayers. You provide inspiration to fight on with whatever active battle or SE that exists as an impediment in our lives.

Best to All,
Mike S.

mike, that's a great PSA number you have (jealous, lol). Congratulations to you, hope you continue to do so well


david

Mike,
You post makes me smile. Another data taker! (Wait till I tell you about sub-observable leak. )
I weighed my pad every day so I knew exactly how much I leaked. I plotted the curve daily with a 2 and 3 day running average and a forecast curve. When the curve started to flattened out and my forecast predicted I would not improve (~16 months) I decided to get a sling. No amount of kegels, no e-stimulation, no holding it worked. I went to an incontinence specialist who scoped me an saw that post surgery I had a short bladder sphincter. That is why I was leaking the surgery.
If you don't want to go through it try limiting your fluids a bit. Your kidneys make about 1 ml per kg of body weight per hour. If you weigh 80 kg you will produce about 80 ml per hour. If your bladder can hold 480 ml, that means you have 6 hour capacity when fully hydrated.
Eat dinner early and don't drink much after dinner. You want to empty out before bed and only have your kidneys produce enough so you have less than your capacity.
When you get up you can drink as much as you want.
Jeff

Mike,

Congrats on the main thing, keeping that PSA in check.

It took me 8 months to achieve continence. I felt like a little kid who couldn't wait to wear big boy pants. I was pretty good, probably about where you are. But I work a pretty active job. Climbing ladders, climbing around equipment, heavy lifting, etc. I have never tried to measure how much, any amount that makes a wet spot on your pants is too much. Recently the doctor put me on beta-blocker for heart regulation. Seems to make the dripping a little worse. I finally decided that I was going back to a pad. My whole demeanor has changed. Not worried about wet spots on my pants, or running down my leg.

I have found that it is not always how much I drink, but what I drink as well. Iced tea, which I love, nutrasweet, and some fruit juces will make me leak more. Not a drinker, but many say that alcohol also causes more drips.

I am more concerned with living the Good Life. Loving my family, helping others, doing the things I like to do, are worth more to me than a few drips.

Good luck to you. Hope things tighten up a little more.

OMG!!!!

Ms. Wamp

To All: Thanks for the encouragement.

Goodlife: I have viewed the things you posted over the past and your message is one that really gets to the heart of the matter. I really need to learn to block out the annoyance of having the pad and feeling the occasional drip or dampness. This may be the hardest thing that I will ever have to do. Incontinence, or more appropriately the sensory signals that are a part of it accompany you like a shadow. I find them really hard to ignore despite the fact that I have never had urine running down my leg or a wet blotch on my pants. Stupidly, I still feel like people around me have x-ray vision and know I am wearing a pad. I feel like a really active life is for all those other people who don't leak. I need to be really careful because the price I will pay for walking fast or jumping up will be a greater degree of dampness that I will feel. I need a pathway to get over this feeling and stop fixating on the incontinence. "Just don't think about it," is not working for me right now, especially when I see that this is about as good as it is going to get.

Jeff: Brief me on what a TENS unit is. Knowing you it likely involves wires and electricity, resulting in a mild form of electrocution. Why do I keep envisioning you akin to the character of Doctor Emmet Brown from Back to the Future, especially the scene when Marty McFly visits Doc at his home when he had that crazy mind reading apparatus on his head. I have this though that you weigh and measure nearly everything. Perhaps for fun, you have a home-made cannon in your backyard and and shoot canon balls and measure their distance? Neighbors give you suspicious stares. Anybody visiting your home never accepts a drink from you especially if it is served in a red Solo cup. Regardless, you provide a great attitude and you share so much high quality humor with the HW community. I enjoy it immensely. What gets me tired is having to pre-measure my unused pads. With dry weights anywhere from plus or minus 1.5 grams, at the level I leak, a half gram either way skews the data. Oh, and BTW, I am happy to have paid cash up front for the skills of my Hopkins surgeon. Now at 21 months, I have a high degree of tumescence thanks to his surgical skill. Not like at 18 years of age but enough to do the job. For the curious: When I booked my surgical date I learned that my surgeon charged $5,000 for the surgery. He is not a BC/BS preferred provider so it was cash up front. That was for open RP. His colleagues, covered by insurance, charged $11,500 for robotic surgery and when Patrick Walsh was still doing open RP he charged $20,000 for his services. So did I get a deal or what????

Bronson: Do let us know about the super kegel machine. I hope to avoid the reality show TV drama with Jeff. Oh, Jeff, don't read the following: I got into this measuring gig because my urologist told me it would help me to know when I reached total dryness. So I took his advice. I am a humanities major. I am in the fine arts field. My science background is rather thin. The most scientific thing I have to do is use a spectrophotometer and record Delta E color measurements. I paint landscape pictures on the weekend. I like science, I just don't do science.

Again, thanks for the good wishes. I did achieve the primary goal I wanted to attain. Get the PC out and onto a pathology slide. Any suggestion for how to mentally cope with incontinence will be greatly appreciated.

Peace, good thoughts and my prayers to all of you.
Mike