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Final meet with surgeon-12 days to go

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Posted 11/14/2013 9:15 PM (GMT 0)
Had a very open and frank discussion with my surgeon yesterday. Thanks to all of you on the forum, I had a list of a dozen or so questions that I wanted to hear his answers. I am much more nervous about the post op pathology report than the surgery itself. I understand the risks of surgery but the path report will dictate the most important aspects. He did tell me not to expect the report when I have my first post op visit since I am having the robotic prostatectomy two days before Thanksgiving. (November 26)

He wants me taking Sildenafil on a nightly basis. He initially gave me a sample of Viagra which I divided by 4. I found that some doses had no effect while others made me flush. My pharmacist told me that the active ingredient in the pill might not be equally distributed to all areas of the pill. He recommended that the surgeon write a script for generic sildenafil, 20mg. This is actually used for a different medical issue but is the same medication. I picked up the Rx today and 90 pills were less than $150.00.

Waiting for the surgery is a little difficult but I am mentally in a better place than I was a week or two ago. I believe that I needed time to reconcile the intellectual and emotional "halves" in order to fully process what was happening to me. I am embarking on a new journey and have no idea where I am really going. That is a little scary but my new mantra is "embrace the change" since I really have no other choice.

Again, thank you all for your personal and intimate observations. Even though I am a health care provider, I ultimately found these blogs more informative than the professional literature which was downright contradictory at times.

I will be posting here from time to time, and lurking the rest.

smdub

10/1/13 PSA 3.9, irregularity noted on ultrasound.
Biopsy 10/16/13 5/12 cores +
2 cores 3+3 Gleason, 2 cores 3+4 Gleason, 1 core 3+3 Gleason with PNI
CT Scan 10/28/13 neg.
Posted 11/14/2013 9:18 PM (GMT 0)
Scooterdu hope the countdown phase goes as anxiety free as possible. You have an excellent attitude.
Posted 11/14/2013 9:43 PM (GMT 0)
The waiting is the difficult part. You'll be fine. Surgery isn't fun but you'll get through it.

Keep us updated on your progress.

Andrew
Posted 11/14/2013 10:17 PM (GMT 0)
Scotterdu,
As we tell all new members, sorry that you are here but now that you made your decision never look back! I am glad that you were able to review this forum and make your "personal" decision. With your stats there is no reason that you won't be fine. We are a diverse group with the benefit of "experts" and others with actual experience. Please stay with us and provide us with updates and information that may be beneficial to other members making this journey. As Yoop would say, "Pay it forward"..All the best to you, Sir.
Bill idea
Posted 11/14/2013 10:23 PM (GMT 0)
Good luck, keep us posted. I'm also taking that 20mg sildenafil daily and have no luck yet.


Don
Posted 11/14/2013 10:33 PM (GMT 0)
Thanks for the replies.

Pre operatively I have no ED problems but my surgeon felt I should be on the medication before surgery since it will maximize pre surgical blood flow and may be protective of endothelial cells (the cells that line the blood vessels.)

It's something how through all of this, you are at least admitted into a "brotherhood" that none of wanted to be in but are grateful for nonetheless.

I will keep you updated.

63 y.o.
10/1/13 PSA 3.9, irregularity noted on ultrasound.
Biopsy 10/16/13 5/12 cores +
2 cores 3+3 Gleason, 2 cores 3+4 Gleason, 1 core 3+3 Gleason with PNI
CT Scan 10/28/13 neg.
Posted 11/14/2013 11:02 PM (GMT 0)
Scooterdu,

I just had my da Vinci surgery this past Monday. I too am more fearful of the post surgery pathology report. Surgery recovery the fist two or three days are a little rough. I was very concerned about the catheter but it too isn't a problem, usually I don't even notice it and when I do it isn't painful, just a little uncomfortable, like a sock curled up in you shoe (very tolerable).

I get my catheter and path report out next Thursday (10 after surgery) and hoping for the best outcome.

Nick
Posted 11/14/2013 11:25 PM (GMT 0)
Scooter, you have a great attitude.

You are headed into battle, but you'll come out of it stronger.

Did your surgeon tell you if you're going to stop the Sildenafil right after the operation and how soon to start up again? If not, you'll want to verify that as the range seems to be 3-4 weeks post surgery with some literature claiming 2 weeks.
Posted 11/14/2013 11:44 PM (GMT 0)
Hi..scooterdu
You 'll be fine...
All the best to your surgery.
Posted 11/15/2013 12:35 AM (GMT 0)
Thanks for the report, and all the best to you.
Posted 11/15/2013 2:23 AM (GMT 0)
Thanks again for the kind thoughts.
LApilot. I'll look to you for a little advance notice.

DavidG. The surgeon did not talk about post op sildenafil. He just said to take it until the day before surgery. He's pretty thorough so I guess he will talk about it after surgery.
Posted 11/15/2013 4:49 AM (GMT 0)
Best of luck. The waiting can suck.
My doctor had me take 25 mg of Viagra for two weeks pre surgery to increase blood flow to promote health of the tissue. No viagra with the catheter, then start the 25 MG again after the catheter came out. Was told not to try sex for three weeks. When I did try on day 21 ( with awesome wife of 33 years), no ED. I had to go off Viagra when I went on antibiotics for a sinus infection, still no ED, so I haven't restarted. I have some extra Viagra. I've been very lucky. Everyone's experience is different, but no reason not to be positive and hopeful! Your cancer has been found and with numbers like yours, you're gonna die......in a long time.....of something other than PCa!
We're all pulling for you!
Mikey
Posted 11/15/2013 7:05 PM (GMT 0)
Mikey

Thanks for your encouraging words. You are ahead of me on this journey so your reports are so important to me. Started taking the 20mg of Sildenafil and doing ok. Just counting down.
Posted 11/16/2013 1:27 AM (GMT 0)
Hi Scooter,
If you have picked a great surgeon with hundreds if not thousands of Da Vinci surgeries, he/she will do the best they can to get it all. Then the path report will be what it is. I came out with positive margins but I know my doctor did the best he could with what he had to work with. He has done over 6,000 Da Vinci's. So far my PSA is still undetectable.

My surgeon had me on Viagra 72 hours after the cath was removed to get blood flowing down there ASAP. I have been taking Sildenafil for over a year now. I use 100 mg cut in half 2 days a week and a 100 mg "boost" pill one day. Also use a pump, hopefully your doc will have you on ED therapy pretty quick.

Good luck and keep us updated.

Bill from Florida cool
Posted 11/16/2013 3:41 PM (GMT 0)
Scooter,

Having just had my RALP this past Tuesday after waiting 2 months since dx and scheduling, I have a pretty good sense of how you're feeling. Once I wrapped my head around what I wanted to do and who I wanted to do it, I could then accept any outcome. Once you make your choice, fuggetaboutit. It is what it is. I get my catheter out and my path report next Thursday (9 days after) and will accept whatever results I get because the surgery is now over and there's nothing more I can do. It's great that you've made your decision. I wish you only the best!!!
Posted 11/16/2013 10:57 PM (GMT 0)
Scooter,

Hang in there buddy! I know that you won't bee celebrating Thanksgiving with a large meal, but that is secondary to getting the darn thing out of you, and a speedy recovery. I know you will, but don't worry about the post op pathology report. Looks like you caught it fairly early according to your statistics. You have time to do that latter if it isn't good news.

Nick
Posted 11/17/2013 2:09 PM (GMT 0)
No doubt that waiting for path is no fun but your stats so far look promising. I was GL 9 so I had no illusions about my path, which was poor (gl9, SVI, 4mm pos marginal at base , EPE, GL 7 at margin, clear lymph nodes) . But my first post op PSA after two months was .1 which I'm elated about. Hang in there!
Bob
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