We're Home

Hello everyone!!!

We are back home. The surgery was a big success. As I posted before, we found an A-list surgeon, Jason Hafron, MD (Michigan), and he did not disappoint. When I spoke with him after the surgery, his report was simple: "It was a beautiful surgery." These words made me burst with happiness and relief. Dr. Hafron used da Vinci Robotic Assisted Surgery. The bilateral nerves were spared. There were no surprises.

Jeff was in the hospital for a total of 36 hours from admission to discharge. The surgery was 3.5 hours, and he was in recovery for two hours. Pain management is Tylenol and Toradol. We are hoping he can transition to buprenorphine and Tylenol by tomorrow. As you all suggested, we asked for the bowel-spasm medication. No problems with that yet, but we feel good to have the meds on hand.

All of the recommendations you guys gave me have made the transition from hospital to home much smoother. Getting a recliner was definitely the right thing to do. I don't know what we'd do without it. I made lists of all of the advice and suggestions you gave, and I follow it all. The snap-up-the-sides pants, by the way, are a lifesaver. Jeff thanks everyone for all of the great suggestions. He has tremendous appreciation.

I also researched foods to eat for wound healing. The National Institutes of Health has a great webpage on this topic. Here's the link for anyone else who might be interested:

https://www.nih.org/documents/Wound-Healing_Nutrition-2021.pdf

Here's a link to a webpage explaining why this nutrition advice is important:
https://www.woundcarecenters.org/article/living-with-wounds/how-your-diet-can-aid-in-wound-healing

So, today being the first full day home, all is going well. I know I have you all to turn to if I have any questions. Thank you in advance.

I hope you know how great you are. Jeff and I would never have made so many right choices and decisions without you. We would have been stumbling in the dark. I shudder to think about it.

I'll keep you posted as we move forward.

xo!

Most warmly,
Debralyn

Another suggestion that I never see mentioned: For my recovery, it was extremely painful going from sitting to standing. We got a cane. Worked GREAT.

I had my surgery at Ford Hospital in Mich (Dr. Mani Menon).

Mel

Excellent news! Very happy for you both.

As I'm sure you know: Follow all discharge instructions, especially about weight limit for lifting objects. Walking is your friend. Don't become constipated. Think of the surgery as an investment in your health to protect by not overdoing anything and letting the body recovery and tell you what it can do. RP is major surgery and an insult to the body. We heal from the outside in: the surgical wounds will heal quickly, but be patient about the rest, especially about regaining continence. The bladder and sphincter control have to recoop too. Men vary greatly in the time needed to regain control. You should have a tel. no. on your discharge instructions. Call your team with any questions rather than guessing.

All the best,

Djin

Debra, good to hear how well things are going so far. There will be days of lots of positive improvement, then days of things leveling off. That's common. He needs to walk as much as he can--and take naps when needed. He will see a big boost in a week or so when they take out his staples/sutures and remove the catheter.

It's all good from here on....

"A beautiful surgery is great news indeed: it suggests non extra-prostatic extension (Which I had, with a capsule-adjacent 4+3). Not the end of the world but better without. So as the final pathology etc comes in, remember, he is safe, as near as whatever, and it is just a matter of recovery (kegels, for everything, when the tube is out!) and worst case possibly RT later, which is a breeze, which is why it has so many fans on here.

Don't let them rush the tube: ANY hesitation and leave it in a few extra days. if you keep the end clean and lubricated with boiled water (not always but some of the time) you really get used to it and it is better than a complication.

This Cajun Jeff, wishing you and your Jeff great healing. Relax and heal. Walking helped me move in to my new normal life.

Do keep us posted on recovery!

No one fights this alone!

Great news! Good advice above — I would just like to emphasize a couple of points already made: lots of walking, don’t lift anything heavy for awhile (I didn’t follow that rule and got a nasty hernia), and be patient with any Incontinence — it will improve with time.

Congratulations! He will look forward to getting the catheter out. Usually not a big deal -- mine just slid out easy. Likely he'll need a ton of pads for a while after that.

@Mumbo Hahahaha. @Debralyn, it feels just like having a foot of rubber tube with a balloon that has deflated but like any balloon that has been inflated for a week, is crinkly, pulled through your urethra. Not painful as such, but more than uncomfortable! Certainly @Mumbo captured my reaction although I think my precise wording was along the lines of "Mwaaaaah" than "Freedom"...

@DjinTonic is raising a good point: I know you will get that report up here but make sure you do. I said "beautiful" suggests no extension and again, NO PANIC if that is wrong but these surgeons do all fancy themselves. You have to, to do that... So by "suggest" I did not mean "means". As Djin points out, the path report is the final word. With any luck it confirms the initial diagnosis. THEN you can cartwheel because: radiation? "meh: maybe, but we're basically home." Or a bit of EPE of a 3+4: same deal. I EPEd a 4+3 and _I_ am going to be the one possibly asking for radiation, not the Drs. Well see. We'd all be swimming in a 98-99% 15y cancer-survival MSK Nomogram pool.

But any high-risk indications are a bit different. Not massively, but needs a bit of care. You mentioned a not-so-good genetic result early on, so a "beautiful surgery" does not rule out eg GP5, although you would not expect it. Sorry to point that out. With that PSA that is unlikely to be the end of the world, but the margins matter more etc. and so it might change the plan. Again, should not expect that but hope for the best prepare for the worst and if it happens you need lots of advice, stat. So good luck.

As an obsessive, and with the pathology I mentioned, so teetering on the cusp of high risk (well done whoever it was who called me out on that on my first thread), I want to know if my GP4 has any cribriform pattern. That was NOT in my report and they are looking again. Any of that and I am going to glow in the dark whatever they say. So to keep the Drs on their toes you could ask. It seems it is not generally volunteered. Here's why I asked. I reckon it will be GP5 before we are much older. https://pubmed.ncbi.nlm.nih.gov/25189638/

Sorry: I feel like this was a rather hypochondriac post. As I said, I am obsessive and Jeff will be fine, I am sure. So take with a pinch of salt...

I'm so glad to read that the surgery went well. One additional bit of advice from my PT: he said the body heals from the outside inwards, so after the surface incisions appear healed, there is still a lot of healing to be done below the surface. Be careful so as not to herniate anything and let the body do what it needs to do. Don't lift anything heavy, but be sure to move around as much as possible to keep the juices pumping.

A stool softener is OK, but consult you surgeon's office about any laxatives. Docs have different opinions about what to try first, the strength, and the order of what to try next if there is no success.

Djin

Debra/Jeff - Takes a few days, the anesthesia drugs seem to paralyze everything. I am a big fan of Miralax but it takes a day or two to take effect if you take 2X per day but seems to be gentle without issues of laxatives. Same stuff they give in large quantities for colonoscopy prep nowadays. Otherwise, keep him eating fiber rich foods, figs, raisins, bean burrito, FiberOne cereal, and drinking lots of fluids. Should take care of itself and 3 days sounds about right. The first bowel movement can be difficult, you don’t want to strain but yet you want to get it going and over with so how to do that without hurting yourself? I sat on the throne trying figure that out for some time.

My catheter was removed by a urology nurse following some procedure and was done in 5-10 minutes. My scheduled doctor appointment was 10 days later when the surgery results and pathology was reviewed in detail with my wife and I. Be prepared for anything.

RE: Pathology report...

As I recall, my surgeon called me a few days after the surgery to tell me the basic results of my pathology report (upgrade from G6 to G7, clear margins), and then he emailed me the full report later that day. I didn't actually see him until 6 weeks post-op. I was also a little different from most: I had my surgery 90 miles from home, and my local uro handled my post-op care (catheter removal, meds, etc).

So, the report will be passed on in multiple ways, so be prepared for any format, at any schedule.

It's also OK, after the catheter is out, to ask for a scrip for viagra or cialis. No, not only for the obvious reason. It helps with blood flow in the pelvis, which is good for healing overall. And, if and when he does start to get stirrings in that area, it's important to not overdo it, but it is also a time for you, Debra, to help him along in any way you can.