Post Radical w/Question o' Plenty!

Hey Murphmatic...welcome to the club...sorta!

I don't know...It's ok...Yes.

I can't speak to the Luporon question as I have no experience with that. As far as pads go, you are probably in the same boat as 50+% of us at post RP. From my experience and what I've learned here, the general progression is; First, dry at night, second, slow to a dribble, third, no pads at all. The problem is the time line. There is no way of knowing how fast or slow different men progress. I'm 4 months post op and still use about 2-3 pads a day. I'm dry at night (no pads) and good until about 1pm then I fill up a couple of pads till about dinner time. Then dry again. The thought is the small sphincter muscle is getting tired in the afternoon. I still walk and I do kegels when I remember to do them but I drink coffee and carbonated drinks during the day...probably 25-35 oz of water too. I'm optimistic is will start to improve rapidly.

I too have a script for Viagra. I haven't tried it yet... however, the "urge" is there. I think there is some mental relationship between having major surgery and wanting to have sex. It seems it's the body's way of saying...slow down while you recover. I haven't had an erection (maybe a 5 out of 10) yet but have had an orgasm so part of the mechanism is working (erection and orgasm have different control mechanisms)... again, every guy is different.

So every guy is different and will recover at a different rate and ability. As crass as it sounds, you're probably just average (in recovery). The part where you excel is that your stats are great, the Gleason was down, the margins are clear and you made it another year! Happy New Year 2018!

murphmatic said...
Had a per-surgery shot of Luporon

I understand that you got the shot on the day of your surgery. Then it will not influence the report of the pathologist.

Starting with ADT right after surgery has shown very good results for high-risk patients in several studies. Since you are no longer a high-risk patient now the shot may just reduce the risk of recurrence.

George

Congrats on the undetectable PSA and the GS downgrade. about the dribbles. While some guys are dry right away, most aren't, and it just takes a while. Maybe you should buy a large supply of pads now in the hopes that will end your leaking, in the same way that carrying an umbrella prevents rain (that has been scientifically proven, hasn't it?).

Tall Allen said...
murphmatic-

It is unconventional to give a patient, even a high risk patient, a shot of Lupron before surgery. There 's no evidence that improves survival and it does increase toxicity. The only thing it does accomplish is lower the positive surgical margin rate by shrinking tumors at the margin. Unfortunately, that has never translated into improved overall survival in clinical studies. I hope this was discussed with you. Congratulations on the downgrading - but I hope the pathologist was well-versed in reading hormone-pretreated Gleason scores. You might consider sending the whole mount to Epstein for a second opinion, letting him know you were on hormone therapy.

(1) Lupron comes in different strengths - 1 month, 3 month, 4 month and 6 month. You apparently had the 3 month shot.

(2) As Jerry said, it varies. Most guys (80%) get back most of their continence within a year.

(3) Yes your libido will come back as your testicles start producing testosterone again. that can take a while after you stopped lupron. You should have your T level checked whenever you have a uPSA. I'd say if it doesn't kick back in in 6 months, discuss clomid and hCG to kickstart natural production. if that doesn't work and your PSA remains undetectable on an ultrasensitive pSA test, your doctor may be willing to prescribe T replacement.

Meanwhile, penile rehab is important to help regain erectile function and prevent size loss. You should be using a pump everyday, nightly low dose and on-demand ED meds. You can use trimix injections if the pills don't work. The pills only work if you have some libido, the trimix works even without libido.

I should have clarified: the Luporon shot was given to me 3 weeks before surgery. Don’t know if that matters.
So a penis pump daily? Wow! Thanks. Will look into it.

Skypilot56 said...
Allen - if he got a 3 month shot of Lupron before surgery how do they really know what his psa is?

Murphmatic - Like I tell everyone this is the only advice I give but if your able to walk start walking and then walk some more and then walk more!!! This helped more with in continence for me than kegals which I still do occasionally still but not only that but spending a couple hrs out walking gets your mind off from what's going on with this darn cancer and you think about other things. Just my take on this

Larry

Shot was given three weeks before surgery. I should have clarified that in the original post.

Thanks for the advice on walking. I was up and walking around the house when I got home. Three weeks after I was out walking the dog. Since the weather has gotten cold I’ve walked less but we have a tread mill. So I’ll get going on that now.

John_TX said...

murphmatic said...
....3) Right now I'm just like "whatever" with even having sexual urges. I have a 'script for Viagra (to start getting the blood flow going down yonder) but the doc told me that lack of sexual urge is because of lower testosterone due to the Luporon. Will my libido come back? ....

You are going to have to wait for a few months to find out about your libido. My testosterone is in the 350 range but I have very suppressed libido and total ED after Lupron and salvage radiation. A couple of months after surgery, there was hope I was going to get Mr. Happy working again but not now. Like somebody recommended, use a vacuum erection device ("pump") daily. Amazon has some really good ones in the ~$50 range.

Thanks👍🏾

Thanks Allen

Larry