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Sometimes being average is great. And PSA results from 27 days to 16 weeks post RP

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Posted 12/6/2013 5:11 PM (GMT 0)

Hi everyone, 16 weeks post da Vinci RP and I'm in the meaty part of the recovery curve - not showing off, not falling behind (like George on Seinfeld). Very average according to the fantastic information from the forum.

For what it's worth.
JP Drain Removal: What an ingenious device! No pain on removal - quick, gentle sensation.

Catheter Removal: no pain, just glowing happiness to have it out.

Walking: started with the sport bag and when the catheter was removed walked a few miles each day. Really helped my mental health. Had the occasional "big leak" but wore black shorts and walked towards the sun. Training for April 10K and at 10 minutes per mile I guess I'm not sure that it's called "running".

Gym: I followed the six week instruction to the letter. Went to gym immediately after seeing doctor at six weeks. I didn't always follow the waiting time on hernia surgeries, but this time I did since the visual of the plumbing coming apart was worrisome. Started slow and now mostly back to pre-op strength and endurance.

Incontinence: Not much of an issue at 16 weeks. Only the rare leak. Stopped using pads early on in order to have better bio-feedback (wasn't sure about leaks when wearing a pad). Bladder control and urgency seemed a little poor at first but now all is pretty much back to normal. A new normal perhaps. Seem to leak when I get excited or have unexpected physical exertion. "Is that a wet spot on your pants or are you just happy to see me?" Both.

ED: did not really expect complete ED -- shocking! about 50% at this point which is still like shooting pool with a rope -- a line attributed to George Burns. Very happy to get to 50%. Using trimix to reach 90% and pleased with results. Hope to return to all natural, but again, I seem to be on pace for average recovery.

PSA tracking: da Vinci RP August, 2013, path: Gleason 3+4, PN1
27 days .11
6 weeks .05
8 weeks .04
12 weeks .04
16 weeks .03

The University of Colorado Health system delivers test results within about two hours to my Smart Phone and my doctor approved this with the caveat that I'll know the results before he does -- it's been great. I expect to have a six and nine month PSA test.

Best,

Luther

PS: A few of my favorites that are often referred on this forum.

Half life calculator which matches my Excel calcs:
http://www.calculator.net/half-life-calculator.html
Nomogram from MSKCC:
http://nomograms.mskcc.org/Prostate/PostRadicalProstatectomy.aspx
Han Tables from Johns Hopkins:
http://urology.jhu.edu/prostate/hanTables.php
PSA Doubling Times from Johns Hopkins
http://urology.jhu.edu/newsletter/prostate_cancer829.php

Posted 12/6/2013 11:49 PM (GMT 0)
Luther, you are doing great on all accounts being less than 4 months out. All good things take time, of course. Sounds like you are making progress even with the ED, that will take the most patience of all for you.

Good luck, as you continue to recover.

David
Posted 12/7/2013 12:38 AM (GMT 0)
Good report Luther and sounds like you are "Healing Well." And yes, I would consider a ten minute mile running or else it would mean that I am not. Good luck with the 10k and have fun.
Michael
Posted 12/7/2013 2:25 AM (GMT 0)
David and Michael,

Gentleman, thanks for taking a look at my post. I appreciate your input and hope that someday I can be more useful to the forum other than posting raw data.

Best,

Luther


Ps - Michael, my last 10k was just a shade under 10 minute miles and I even had the advantage of training in Colorado altitude and running in Richmond Va. We took a team of people from my company and challenged our clients. We just happened to select a pro triathlete from one of our divisions and as I was explaining the wave start and the crowd in my wave QQ he replied that he didn't see any crowd in wave A, just behind the elites. Good news, he couldn't have lapped me with that flashy 32 minute run. Or did he hold back? Ah well, it's nice to run again.

L
Posted 12/7/2013 4:33 AM (GMT 0)
As I aged I went from 6 minute miles to a present 10 minute miles. The funny thing is from age 26 to now all the runs , seemed the same pace, as I ran. Obviously the clock didn't match that but my mind did. Yes you are running. Any time you are moving forward , using your legs and feet for propulsion and in air with both feet off the ground at the same time, as you exercise,its running. Jogging is what folks do as they wait at a light street corner for traffic, etc. A silly thing to do, imo, but I suppose it excludes "cheating"
Posted 12/7/2013 5:08 AM (GMT 0)
Dear Logo, thanks for the visual of both feet off the ground at the same time! Congrats on maintaining the 10. I have to train hard to reach 10 and even then I needed the old altitude training benefit.
Apology for straying off PCa topic.

L
Posted 12/8/2013 12:42 AM (GMT 0)
Luther its your thread. I hijack my threads all the time and have fun doing it. I also hi jack other threads and or maybe just ask the capt for some stick time. Most hi jacked threads are connected in some way with info for the thread originator specially if a newbie. Most are harmless, and I rarely see a complaint from a thread originator on the issue. Its one of the terms I disdain in forums like this. Like lurker. Hey all roads lead to Rome in my view. Keep up the good work on fitness, I've been into it since I was 25 and trust me as you age, you will see and enjoy those years better than the time you are in now. Altitude really is a great training method as is attitude. Regards
Posted 12/8/2013 1:00 AM (GMT 0)
Logo, thanks for the encouragement. I tell the kids at the gym that weight training is mandatory for my age group. Not sure they understand but a few do and that's cool.

And thanks for the note on getting off topic. Might have to add "but I digress" to signature.
Posted 12/8/2013 1:14 AM (GMT 0)
Luther,

Good going, but you've got to tell me. Do you keep a "port" going in a vein for all those PSA tests?
Wow, I may be new to this, but I have no idea why a protocol would include so many tests so close together. Can you elaborate?
Posted 12/8/2013 2:48 AM (GMT 0)
clanda, excellent question. Thanks, here are my answers. Let me know if this makes any sense. I'm open to taking a better, well reasoned path.

1) my doctor was less than enthusiastic about my 4 week post RP test results of .11. I've been reading this forum and have seen many posts about the timimg of the first PSA test post RP. And I thought, maybe 6 weeks would be a better indicator, again based on the forum posts and viewpoints and yet contrary to PSA half-life calcs which do in fact indicate that 4 weeks should be the first test. So, to offset the mental strain of updating my estate plan after the .11, I decided to get a 6 week test. And I'm still confused why most uro's use 12 weeks other than that's when they book the first return visit, when half-life, even at a 3 day half-life period, says 4 weeks. (Even a PSA of 50 should have dissipated to less than .1 after 4 weeks according to my arithmetic)

2) I enjoy data and consider PSA "series" data to be useful That is, can I map my PSA trend line to other cases? The more data points I have, the better for mapping. So, while some use 6 weeks and some 8 and some 12 weeks, I can overlay any of those data points since I have a fairly complete series. I'd prefer a standardized world where everyone had the same data points, but that's not what we have.

3) And of course, it's my way of handling PSA Anxiety. The lab I use takes about 15 minutes to painlessly draw the sample (no port) and two hours later the PSA number is on my Smart Phone.

4) And the final note. I don't spend time researching a treatment path until I'm headed onto that path. If, and when my PSA numbers start to rise I'll start to read (with curative intent as they say) about the next steps -- in detail.

and just for fun, maybe someday we'll all ask "what's your Luther Series indicate?" Ok, maybe not.

I appreciate your view and comments.

Best,

Luther
Posted 12/8/2013 4:03 AM (GMT 0)
Actually, I really have no particular view as I am the last person to say anything against how anybody handles the stress of having this disease. I have always said that you should wrap your mind around any treatment plan that makes sense to you and when it comes to post surgical PSA, you've got your plan. I've been on three threads in the several weeks since my surgery that dealt with the pros and cons of ultra-sensistive PSA tests and standard range tests. So far I'm very strongly leaning towards the standard as I'd be quite satisfied with a <0.1 and wouldn't need to go to the ultra range. I'm not up for the potential for increased anxiety based on too much information that may very well mean nothing useful. But that's just me and the way I tick. You've got an interesting protocol to deal with.
I hope it continues to work for you. Best of luck.
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