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Need to prepare for biopsy on Thursday, 7/9

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Posted 7/6/2015 3:59 AM (GMT 0)
My husband's biopsy is scheduled for this coming Thursday. We got the MRI results last Thursday, and with the long holiday weekend the office has been closed since then. Should my husband be doing things now to prep for the biopsy? Diet? Antibiotics? Stop any meds or supplements? Only thing he takes is Vit D, a multi & his BP med. Will he be able to return to work on Friday? Thx!
Posted 7/6/2015 4:09 AM (GMT 0)
Usually the doctor's office provides instructions. If I recall correctly there will be instructions to stop eating some time before the procedure and use a laxative of some kind in the morning to make sure the lower colon is free of feces. There will be an antibiotic to take before the procedure and a few days after. There may be a prescription pain med like vicodin before the procedure as well. The the patient is taking aspirin or any other blood thinner or anticoagulant they usually want that stopped a few days before the procedure. But it doesn't sound like that applies in your husband's case. if your husband is particularly anxious about procedures he might ask for an Ativan or some other anxiety-reducing medication before the procedure.

These instructions may vary from one doc to another so don't be alarmed if what you hear from the doc is slightly different from this. If the procedure goes normally he should be able to go back to a typical desk job on Friday but if his work is physically active he may be asked to take more time off before returning.
Posted 7/6/2015 5:43 AM (GMT 0)
Thank you proscapt. That's a good summary of what we should expect in general. Hopefully we will hear from the office tomorrow with instructions. If not, then we will call, but it sounds like there will be enough time before Thurs. to make any adjustments to diet and medications, if needed.
Posted 7/6/2015 11:04 AM (GMT 0)
They'll give him a scrip for some Cipro to start the day before for a couple days. They had me do a fleet the morning of. Drink lots of water, and be prepared to pass blood for up to a week or so (be prepared for dark red to dark brown ejaculate). I have generally bad reactions to opiate pain killers, so I made do with Naproxen. I went back to work the next day.

The worst, most painful part was this:

Nurse: I see you can't have penicillin
Me: nope
Nurse: OK (leaves room, returns with a syringe and needle)
Me: What's that?
Nurse: your antibiotic (I proceed to start to roll up my sleeve) Nope. Come over here and drop trou.
Me (sighs) OK

That darned injection site hurt for a month.
Posted 7/6/2015 11:39 AM (GMT 0)
My doc numbed me up quite a bit so it wasn't too bad. But I was counting every snap of the trigger. I do recall having a little concern about not being able to pee for a few hours afterwards. I called the doc and they said it was normal. I guess the prostate inflamed a bit after the biopsy and constricted the flow. It was all fine after about 2-3 hours. Of course there is the blood in the urine for about a week or more, and the yucky discharge for about a month for me. Not something I would want to do again, but I'm glad I did, and wish I had done so sooner.
Posted 7/6/2015 12:26 PM (GMT 0)
I listened to advice from HW and was sedated. Woke up fine with some blood in pee and slight discomfort for a day and right back to normal except for about 7 ejaculayions that cleaned out the blood from the procedure. I believe this mental stability issue which HW brothers provided to be the best prep.

Hope everything goes well and keep us in the loop.
Posted 7/6/2015 1:05 PM (GMT 0)
Suzhtz

Assuming he is not allergic to antibiotics, the doctor would normally give him a script for some antibiotic (Cipro) and a program when to start taking it in preparation.

I had a massive bloody bowel movement in a bedpan once I came out of the recovery room -- that was some serious bloody s-hit. Luckily I did not have to go to work and enjoyed my rest until I got THE NEWS two days later.

Yeah, "THE NEWS ...", I wont forget that day!
.
Posted 7/6/2015 1:09 PM (GMT 0)

JFL1957 said...
My doc numbed me up quite a bit so it wasn't too bad. But I was counting every snap of the trigger.


Yeah, no kidding! As I recall I was sore for several days - it's a soreness that's difficult to describe, I felt it deep in my pelvic area and somewhat exacerbated by sitting. If spite of it being an unpleasant experience, it was absolutely necessary so zero regrets about having it done.

Then you get to wait for the results confused . Bear in mind the biopsy report might not report the final/ultimate status assuming they find some cancer cells - there's no way they can punch every suspected area. My Gleason score was initially reported as a 6(3+3), then on another reading of the slides at MD Anderson they upgraded it to a 3+4 then upgraded again on the path report as a 4+3.

I'm sure you realize this, but you or somebody will need to drive your hubby to/from the procedure (to the procedure if he takes a Valium or whatever.) Best of luck to you both!!
Posted 7/6/2015 1:29 PM (GMT 0)
Thanks, everyone, for all the helpful info, and for sharing your war stories. Both my husband and I are planning on a long weekend, so no work on either Thursday (bx day) or Friday. I sit at a desk all day, but hubby is a building contractor and he tends to be hands on when there is work to be done. We are hoping that he will feel well enough to get back to work on Monday. He's self-employed, and when you're in that situation, it's a 24/7 work schedule. :)

Still no word from the dr's office regarding prep, so I've got a call in to them.
Posted 7/6/2015 1:42 PM (GMT 0)
He should be absolutely fine by Monday.
Posted 7/6/2015 6:57 PM (GMT 0)
I was a little worried about it, but it was not as bad as I thought it was going to be, I had no blood in pee, no pain afterwards...could of gone back to work, but nah figured I deserved the day off :-)

Not sure what I was worried about really, I hope yours goes just as easy! I'm sure it will :-)

Posted 7/6/2015 7:05 PM (GMT 0)
In talking to the office today, they said they will admin the antibiotics prior to the biopsy -- probably that shot that halbert and John TX mentioned. They told me the whole process was a little like getting a tooth filled. No big deal. Really!?! Are they kidding??? They did instruct to stop all aspirin/Advil type drugs.
Posted 7/6/2015 7:21 PM (GMT 0)
I was given a cipro pill just before the procedure and a small number to take home (I think, two or three days worth).

and they aren't kidding. The procedure is not that big of a deal. It's annoying, uncomfortable and undignified, but not painful - no more painful than the dentist's Novocain shot. Most men tolerate it just fine. Except for peeing blood for a day or two the after effects are short lived, however the list of possible side effects can generate more than a little anxiety if you actually pay attention to it.

The really big deal is when they call with the results. Now that phone call really changed my life.

Andrew
Posted 7/7/2015 2:02 AM (GMT 0)
Easy for them to say it is like dentistry! The worst out come is you have cancer and your life is going to change forever.

It doesn't really hurt, it is just uncomfortable. Also a little humiliating to be laying on your side with your naked backside facing a doctor and nurse. I had a large puddle of blood under me when I sat up after the procedure. I was also a little dizzy, the doctor prepared me for that.

No one has mentioned that your husband should not have sex or ride a bicycle 24-48 hours prior to the test. That can affect the results, believe it or not.

I drove myself there and back, it was my third biopsy in 10 years. I was pretty normal the next day.

My doctor and I set an appointment to discuss the results one week later. That worked out well, even though the results were not good. If you have the doctor call you with the results, you will be nervous and jump every time the phone rings. Whatever the results are, ask for a copy immediately, they will give it to you.

As Halbert said, your husbands semen will turn a brownish red color for the next couple of weeks. Prepare for that and protect your sheets or use a condom.

Good luck, hope you are just visiting us this week and won't have to join our pity pot!

Bill from Florida cool
Posted 7/7/2015 2:12 AM (GMT 0)
You got lots of good information from the above posters. I'll just add that when the local anesthetic wears off (probably on the way home) he'll be really sore. My doc said I could take Extra Strength Tylenol, but I didn't have any at home and had to stop at the drug store.

I suggest you get a bottle of Extra Strength Tylenol and take it to the appointment. If the doc says he can take that for the soreness, ask if he can take it right away. It'll make the ride home a lot better. I remember mine being pretty uncomfortable.

Depending on what he does for a living, your husband may be able to return to work on Friday. However, I'd take the day off if possible. He may still be pretty sore.

Good luck with the test. I hope you get the result you want.
Posted 7/7/2015 2:32 AM (GMT 0)
Thx jazzman. No one in the docs office mentioned about sex & the bike riding, so I appreciate that info. They did tell him to stop all aspirin/Advil but that he could take Tylenol for any back issues or headaches. We will have plenty of ES Tylenol with us - great advice.
Posted 7/7/2015 11:41 PM (GMT 0)
Ask for a "peri-prostatic nerve block." Ask for it by name. An experienced Uro can deliver this. They inject the lidocaine into the nerves that feed into the prostate, blocking all sensation. It's painless, and it doesn't leave one groggy like general anesthesia does. I had 3 biopsies - 1 raw (very painful), 1 with general anesthesia (very groggy), and the third with the nerve block (just right!).

- Allen
Posted 7/8/2015 12:03 AM (GMT 0)
Thx for the advice, Allen. We will ask but they have been adamant that this is not a painful procedure. I'm coming to the conclusion that every male urologist should be REQUIRED to personally experience the procedure "raw" before they are allowed to say it is not painful. Lol
Posted 7/8/2015 12:14 AM (GMT 0)
If only they would! I nearly fainted from the pain, others say they feel little. In fact, the first time they only took a few cores before they had to stop because my BP was tanking. That's why they gave me general anesthesia the next time. It probably has something to do with how densely it's supplied with nerves and how sensitive one is.
Posted 7/8/2015 12:22 AM (GMT 0)
suz, sorry I'm late to this thread.
I had two biopsies, two different docs. With the first one the anticipation of the unknown was the most horrible part. But the procedure itself was not at all painful.
The second one was less difficult mentally, as I knew what to expect. And the procedure itself was not bad as well. In both cases I got a shot of lidocaine, and also prior to the procedure I loaded up on Xanax.m


Blood in urine lasts just a few days, although in some it can last a week. Blood in semen of one colorful variety or another can last weeks.
I was sore for a day or so after the second biopsy, not so much after the first.

Good luck, the procedure will go well in all likelihood, then the dreaded waiting. I hope your result is a negative biopsy and you can disappear from here for a while. But do keep us posted.
Posted 7/8/2015 1:24 AM (GMT 0)
Listen to the Tall one, would you have a tooth drilled without anesthetic? Of course not, how about a root canal?

You should also be on a an antibiotic. A pain killer and/or xanax should be an option if you want it, I had them, put on head phones and it was over very quickly, very little discomfort.

I also had an enlarged prostate with a growth impinging the urethra, the swelling almost landed me in the ER. Uro never mentioned that possibility.
Posted 7/8/2015 1:47 AM (GMT 0)
Thx everyone! All this info is helpful and we will ask for the peri-prostatic nerve block. Not sure that we'll get it , but we will try.
Posted 7/8/2015 11:13 PM (GMT 0)
Got a bit of good news today. Cleveland Clinic deemed our MRI (done at another facility) to be of "good quality" and they loaded it into their system. Radiologist was going to mark the targets today so they can do the guided fusion biopsy tomorrow.

Tomorrow... the big day is finally here. Hubby is very anxious. Says he's not sure "how they're going to get all that stuff up my butt at once" (excuse his French). He had nightmares last night. Dr's office ok'd taking an OTC sleeping pill tonight (basically Benadryl). Hope it helps.

He's already got some meetings scheduled for Friday, against my advice that he take the day off. At least the Thursday biopsy is relatively early - 10 am - and he will have most of the day to rest and recover.

Thanks again to all for your support & guidance. You've helped to get us to this point with our sanity intact -- well, if I'm being totally honest, it might not have been intact to start with. Lol
Posted 7/9/2015 12:16 AM (GMT 0)
That reminds me - I just read about a new kind (new to me, at least) of nerve block called a "pelvic plexus block," that seems to be even less painful than the "periprostatic nerve block," according to the following new study. Print it for his urologist - even if it's too late for your husband, it may help the next guy.

Transrectal ultrasonography (TRUS)-guided pelvic plexus block to reduce pain during prostate biopsy: a randomised controlled trial

The mean pain scores were 2.9 out of 10 for the pelvic plexus block, 4 out of 10 for the periprostatic nerve block, and 5.4 out of 10 for no nerve block, only local anesthesia (where 10 is the worst).

Tell your husband that it's the same instrument that does the ultrasonic imaging that they use to do the anesthetic and take the biopsy cores, so it's not a matter of shoving multiple instruments up there. It's well lubed and not that big.

- Allen
Posted 7/9/2015 12:24 AM (GMT 0)
He'll do fine. It'll be over before he knows it. The next few days until the results come back will be tough, be ready for him to be totally on edge. And, like we said before, be prepared for him to be passing blood for the next few weeks.
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