Robotic Surgery tomorrow morning, emergency question!

Travelingman

Well, today I felt good enough to fire up the laptop with my wife's help. My prior 2 posts were from my Blackberry. Between the small fonts & trying to recover I really made some bad spelling errors. I'd like to post my thoughts about the last couple of days to help anyone going through surgery. In my opinion, the most critical factor in recovery is having someone to help you once you get home. My wife of 27 years is an angel! Neither of us got any sleep the night before the surgery yet she stayed with me in the hospital until they kicked her out at 9pm & was back early the next day. Even though I received excellent care in the hospital, the nurses are limited by their case load. I won't go into every detail but I was pretty helpless for the first 48 hours. Right now I am 69 hours post surgery. The best news I can give you is that 24 hours post surgery I felt 100% better but still felt very, very miserable. 48 hours post surgery I felt 100% better again & today I took my first shower. Boy did that feel good! Here are my suggestions. First, slow is good & don't let anyone move quick around you. My wife is a can do, active 66 year old & quite frankly, she made me nervous so I insisted she move slow. The RN who took care of me first 4 hours post surgery was excellent. Next came the 7pm to 7am nurse, an RN from the Philipines. She had a very heavy workload but checked on me frequently. She suggested I take all the pain meds prescribed. Said they wouldn't have been prescribed if I could not have them. I took morphine every time it was offered & did not move in bed. My strategy was to avoid pain till I got some strength back & get out of there ASAP. In addition, my roommate was an 83 year old man who had refused his doctor's reccomendations about his prostate for 7 years. He had only gone to the ER 4 days before when he could no longer walk due to hip pain. The doctor (who is also my urologist) told him he had cancer in his hip & gave him Casodex. He was in constant tremedous pain & could not get comfortable. His situation reminded me why I chose to get the surgery rather than go through WW. The next best thing after my wife & of course the surgeon, is having a medical person who is familiar with these surgeries & recoveries to take care of you. The nurses in the hospital had my catheter too tight, which the surgeon took care of the next morning. Then before I left the hospital, another nurse redid the connection of the tube to my leg way too short.I left the hospital about 24 hours after the surgery ended. My surgeon has 1 RN with 28 years experience in urology care come to the house to follow up on his patients. She showed up Wednesday & she has been through over 100 of these procedures so she told me that I would feel better & gave me a little glimmer of feeling better. She showed me how to keep the catheter comfortable, how to get up & down to minimize pain, how to cough, etc. She also encouraged me to get off the percocet & on to only tylenol to avoid constipation. Well, forgive the rambling & I hope I haven't discouraged anyone. I can tell you that having never been in a hospital before or really sick, that I was very depressed the first day because of the feeling of helplessness but now I feel sore but optimistic. I will post more if anyone wants to hear & thank you to all who helped me on this forum.
_________________
PSA 18, Gleason 3+3+6, Age 58, Rising PSA since 1999, Biopsy 5% of one core
Robotic surgery 10/26/09 T2B Tumor 30% of prostate involving left & right lobes NOMX Gleason 3+4=7 Urethral Resection margins & resection surface clean Seminal vessicles clean

JustJB · Posted: Thu Oct 29, 2009 3:03 pm Post subject: Welcome home!

Glad to see/hear that you're doing better. Now that the catheter is adjusted how is it to live with? Does your doctor plan to pull it out at 7 days or 10? I think the catheter is my biggest concern about the surgery. How is your pain in general at this point? Have you walked around at all or are you staying in one place mostly?
With your surgery on Monday and Cantexplain's yesterday, and mine in one week, I feel like we're all in the same graduating class! Best wishes for a continued rapid improvement!
_________________
Age 52
RRP 11-5-09
Post Surgical Gleason 3+4 = 7
Stage T1C
Pre-surgical PSA: 5.3
Post-surgical PSA: Undetectable at 13 weeks

Travelingman

The catheter is not painful but I am very careful not to pull on it. It's always there & a pain to deal with. My nurse said not to bother with the leg bag. She had me use the 2 leg straps to hold the catheter line in place. When I showered I took off one strap & used it after shower to hold catheter line till shower strap dried. She had me place bag in a small trash can. Works well. Pain is much less today except for muscles that are sore in my back. Incisions don't hurt much now. No stitches they used super glue. Catheter stays in 7 days. I started walking Tues morning, just in the house. Good luck with your surgery. The best news is that each day I feel 100% better & so will you.
_________________
PSA 18, Gleason 3+3+6, Age 58, Rising PSA since 1999, Biopsy 5% of one core
Robotic surgery 10/26/09 T2B Tumor 30% of prostate involving left & right lobes NOMX Gleason 3+4=7 Urethral Resection margins & resection surface clean Seminal vessicles clean

Travelingman

Well, this is the 93 hour update. I still slept in a recliner last night but might try the bed tonight. I would be very happy if I could sleep more than a couple hours at a time. I don't think this is pain related, I even skipped a dose of Tylenol last night. It is more of my routine being upset, being confined due to the catheter, & the bowels still getting back to normal. I really didn't truely get the catheter comments by Replicant, Srtimons, & others till I started feeling well enough appreciate its annoying qualities. I thought that I would be most bothered by the feeling of it being inside my penis but that is not a real problem. The fear is that somehow I might snag it on something or do something to get an infection. I am paranoid about this because I want the sutures between bladder & uretha to heal to get the catheter out of me & to speed the recovery of urinary control. I feel much better today. Muscle pain from trying to avoid strain on those little holes in my belly is much better today. I also don't get the blood/urine coming from around the catheter in my penis when I try to pass my bowels. Urine has been pretty yellow last couple of days with no pink tinges.
Has anyone heard how Can'texplain's surgery went? Also, one more comment about how important your wife or other "helper's" role will be as you recover. My wife is incredible. If I were her, I wouldn't have been able to put up with me.

Last, if these posts aren't helpful, please let me know. I just feel good about writing & want you guys facing the surgery to know how much better you will feel each day. At least I do as I approach 4 days postop. Replicant, should I change the topic of my thread to more accurately reflect the thoughts of a "big baby" as he recovers?
_________________
PSA 18, Gleason 3+3+6, Age 58, Rising PSA since 1999, Biopsy 5% of one core
Robotic surgery 10/26/09 T2B Tumor 30% of prostate involving left & right lobes NOMX Gleason 3+4=7 Urethral Resection margins & resection surface clean Seminal vessicles clean

robyn · Regular Joined: 11 Oct 2009 Posts: 30

I really don't think you are being a baby, not at all. You just underwent a MAJOR surgery, your body has to recover and readjust, and is in turmoil from being cut open and messed around with. One of the problems with laparoscopic or arthroscopic surgery is that a LOT of stuff got done thru those tiny incisions, and they look very misleading--it seems like a tiny surgery b/c you have tiny incisions. But dont' misjudge the time you'll need to recover and heal. Don't push yourself--your body has been thru a lot!

I'd suspect that you are leaking a bit w/ a bit of blood when you move your bowels b/c even if you are trying not to strain, it's natural for your body to do this a bit anyway. This bit of straining could easily cause enough pressure to force some urine and blood around the catheter. If youre' having problems having a BM you might ask the doc re: stool softeners for a short time. And of course drinking lots of fluids and getting fiber is good too.

Robyn

JustJB · Posted: Fri Oct 30, 2009 12:22 pm Post subject: Helpful!

Your posts are very helpful! Personally and selfishly, its very helpful to hear from you and your experiences with my time coming so soon. Please continue your posts.
I spoke with Can'texplain on Tuesday evening and he seemed to be in good spirits and ready to get it over with. He said it would be at least a couple days before he posted so I'm sure we'll hear from him soon.
_________________
Age 52
RRP 11-5-09
Post Surgical Gleason 3+4 = 7
Stage T1C
Pre-surgical PSA: 5.3
Post-surgical PSA: Undetectable at 13 weeks

Putt · Regular Joined: 04 Aug 2009 Posts: 36 Location: Kansas

To those that are home with catheters, one small piece of advise from one who discovered this the hard way.

After sitting on the bathroom stool, and in process of getting up, be sure you are NOT standing on the bag hose. Shocked

I guarantee that it will only happen once in your lifetime............
_________________
PSA at Dx 105 at age 68, 4/04. ADT, RRP, 5/04. Gleason 4+5=9, Staged pT3c N0 MX, 3D rad, 40 treatments, 8/04. PSA 1/05 <0.01. ADT till 7/07. PSA 0.03 12/08, 0.07 4/09, 0.13 8/09, 0.19 12/09. Will start ADT3 after PSA reaches 1.2.

JustJB

[quote="Putt"]To those that are home with catheters, one small piece of advise from one who discovered this the hard way.

After sitting on the bathroom stool, and in process of getting up, be sure you are NOT standing on the bag hose. Shocked

I guarantee that it will only happen once in your lifetime............[/quote]
Thanks for that timely warning. Sounds like a big OWEE!
_________________
Age 52
RRP 11-5-09
Post Surgical Gleason 3+4 = 7
Stage T1C
Pre-surgical PSA: 5.3
Post-surgical PSA: Undetectable at 13 weeks

JustJB · Posted: Fri Oct 30, 2009 8:58 pm Post subject: Cantexplain

I just heard from Cantexplain; he's doing fine after his surgery on Wednesday.
_________________
Age 52
RRP 11-5-09
Post Surgical Gleason 3+4 = 7
Stage T1C
Pre-surgical PSA: 5.3
Post-surgical PSA: Undetectable at 13 weeks

Jean222 · Senior User Joined: 14 Dec 2008 Posts: 262

Travelingman,

I think your posts are very important for those who will come along later.

It's always good to get different points of view from those who've been there.

If you're not on a stool softener, call your doc and get one asap.

Constipation will only make you feel more sluggish and may add to your discomfort.

If you can tolerate fresh fruit and maybe some bran cereal, it'll help do the trick as well.

Once your catheter comes out, you'll feel much better....it truly is like a ball and chain.

We worried about Hubby getting an infection, I was paranoid about it but it didn't happen.

In hindsight, I think regular showers and cleansing of the penis were sufficient. Didn't use any ointments on the area, some will rot the rubber, not a good thing.

It's probably a good idea to sleep in your own bed, if possible as the quality of your sleep may improve.

Keep up the good work, you sound like you're doing very well.

Best wishes, as always,

Jean

Travelingman

Well, it's Saturday morning at 10 am. At 2 pm I'll be 5 days post surgery. I slept in bed last night for the first time. Felt great! Yesterday, surgeon's nurse came by for her second visit since surgery. She was very happy with my healing. Said skin was nice & pink. I asked her to see if she could improve on the attachment of my catheter to my leg. She attached a leg lock which is an adhesive pad with a clip swivel on it. The catheter goes into 2 grooves, one to hold the catheter line & 1 to hold the balloon portion. Works great. she also suggested a belt worn looseley over the hip to hold the catheter bag when I'm walking around. Freedom, yeah! My highest temp since surgery was 100 degrees, which is good. Since sometime yesterday I can cough gently without a pillow. Today I feel great & am going outside for a walk with my new setup. I could use the leg bag but I just don't care if someone sees me with the big bag. If they don't like it they can look the other way. I asked my nurse yesterday if she knows why some docs leave catheter in longer. She said that all of her surgeons robotic patients have it in a week. She said the robot can stitch the uretha to the bladder better than human hands because the fingers of a surgeon can't fit 360 degrees around the uretha, not a lot of room in there. Evidentally, with ttraditional surgery it can be as long as 3 weeks. I also learned that some guys have to have the catheter reinserted if there are problems emptying the bladder. Have any of you guys had this happen? My wife gets to buy pads for me tomorrow. Thanks to the guys who gave me info on what to buy. I hope Can't Explain is doing well, just hang in there, it gets much better!
_________________
PSA 18, Gleason 3+3+6, Age 58, Rising PSA since 1999, Biopsy 5% of one core
Robotic surgery 10/26/09 T2B Tumor 30% of prostate involving left & right lobes NOMX Gleason 3+4=7 Urethral Resection margins & resection surface clean Seminal vessicles clean

cantexplain · Posted: Sat Oct 31, 2009 11:09 am Post subject: Cantexplain checking In

I thought I'd hop onto TravelingMans thread, if you all don't mind. I had surgery Wednesday at noon, and came home yesterday afternoon. So many thoughts to try and organize, but like TM, I'm feeling better and better. I've been married 21 years, and there's nothing like this to remind one how important a wonderful woman (or partner) is in this life's journey. She was the one who kept me calm. Now on to the good and bad.

The surgery took nearly 4 hours and the first night back in the room was a challenge: so many people coming and going, hour after hour laying on my back trying to sleep but just not getting any real rest. And, my new friends: the IV and Catheter which seem to swarm you like an octopus! In the morning I felt good to see the light coming on, then ran into my only real problem For whatever reason, my body did not react well with the remaining nitrous oxide that is used to "inflate" your abdomen to allow the Da Vinci instrumens access to everything. It was very severe pain and not intestinal gas (as the nurses' insisted) but much more. I kept up the morphine all Thursday and by Thursday afternoon the pressure from the gas had been absorbed enough that I could rest more comfortably. It took a nurse experienced in laproscopic surgery to correctly identify the issue being nitrous oxide, not intestinal gas. Anyhow, home last night and I slept on a couch (so I could have support on my back) and let my new bladder buddy do the work. Just JB: it's actually really neat not to have to get up and go to the bathroom at night to pee!
Taking Vicodin for another day, wounds healing well. I need to take it easy, just like TM said. No rush, no rush.
Chris (Cant' Explain)

PositiveGuy

To both you guys,

Be patient with your recovery. You have both had major surgery and it does take 4-6 weeks to get back to your normal self. All in good time. It has been almost 5 weeks since my Da Vinci surgery and I still have to take it easy with lifting and other tasks. Everything has to heal before you can move forward.

On the continence front, it will come faster to some and slower to others. Seems to be a combination of a bit of luck and the skill of the surgeon. As everyone's surgery was different, the recovery from Incontinence and ED will vary with each individual.

Keep well,
Regards,
Bill
_________________
Age 64. Diag. 01/09 PSA 5.6, Gleason 3+3=6, T1c TRUS biopsies of prostate left adenocarcinoma of prostate involving part of 1/4 biopsy fragments, less than 10% of the surface area involved, CT scan clear. RALP - 09/29/09, back home 10/02/09. Pathology - 10/14/09 Gleason Score 3+3 = 6 No positive margins. No Seminal Vesicle, Perineural, Lymphovascular or Lymph node involvement, and bladder neck cancer free.
10/16/09 - 3-4 pads a day, 10/31 2/day, 11/09 one pad/day
ED 10/16/09 - Zip, nada

Travelingman · Posted: Sat Oct 31, 2009 4:41 pm Post subject: Re: Cantexplain checking In

[quote="cantexplain"]I thought I'd hop onto TravelingMans thread, if you all don't mind. I had surgery Wednesday at noon, and came home yesterday afternoon. So many thoughts to try and organize, but like TM, I'm feeling better and better. I've been married 21 years, and there's nothing like this to remind one how important a wonderful woman (or partner) is in this life's journey. She was the one who kept me calm. Now on to the good and bad.

The surgery took nearly 4 hours and the first night back in the room was a challenge: so many people coming and going, hour after hour laying on my back trying to sleep but just not getting any real rest. And, my new friends: the IV and Catheter which seem to swarm you like an octopus! In the morning I felt good to see the light coming on, then ran into my only real problem For whatever reason, my body did not react well with the remaining nitrous oxide that is used to "inflate" your abdomen to allow the Da Vinci instrumens access to everything. It was very severe pain and not intestinal gas (as the nurses' insisted) but much more. I kept up the morphine all Thursday and by Thursday afternoon the pressure from the gas had been absorbed enough that I could rest more comfortably. It took a nurse experienced in laproscopic surgery to correctly identify the issue being nitrous oxide, not intestinal gas. Anyhow, home last night and I slept on a couch (so I could have support on my back) and let my new bladder buddy do the work. Just JB: it's actually really neat not to have to get up and go to the bathroom at night to pee!
Taking Vicodin for another day, wounds healing well. I need to take it easy, just like TM said. No rush, no rush.
Chris (Cant' Explain)[/quote]

Chris, AKA Can't Explain, I think this is no longer my thread but, more importantly, a thread for those of us going through the Robotic Surgery & recovery, the ones who will go through it, & balanced by comments from those who have graduated to the next phase in their journey. I hope that Replicant, the moderator can come up with a means to perhaps relabel the thread so that it identifies what it is becoming. I'm glad you're home. I had a bout with the surgical gas which was identified to me as CO2 gas. I think nitrous oxide is laughing gas & it's interesting they used it in your surgery. The pain from the gas is awful but in my case went away after a day but seemed to creep back in for a short time later. Don't forget the stool softoner to offset the constipation from narcotic pain relievers. I also took a little Milk of Magnesia 36 hours after surgery to help. The nurse who came to the house thought it was too early but I started the first passage of liquidy bowel movement 48 hours post op & felt much better. When you are first recovering, the catheter is a blessing because you don't have to get up. By today it is a pain in the---. Even though you might not want to, walk as much as possible in the house. It gets the intestines working again... any chance you can post your PSA, Gleason, involvement, etc in your signature? You are going to keep feeling better each 12 hours or so.
_________________
PSA 18, Gleason 3+3+6, Age 58, Rising PSA since 1999, Biopsy 5% of one core
Robotic surgery 10/26/09 T2B Tumor 30% of prostate involving left & right lobes NOMX Gleason 3+4=7 Urethral Resection margins & resection surface clean Seminal vessicles clean

cantexplain · Posted: Sun Nov 01, 2009 11:39 am Post subject: Surgical Gas

You're correct, the pain wasn't from nitrous oxide (laughing gas) but from whatever the gas was that was used to inflate my abdomen. In my addled state, I probably heard nitrous oxide from the nurse. All going well this fifth day. I threatened last night to answer trick or treaters at the door with my cath bag in one hand, a plate of candy in the other. My wife didn't think that was too funny Smile

I'm still amazed how much liquid my body sends through to the cath bag overnight. And, I'm still reminded to take it easy after walking around this morning for an hour or so, helping put decorations away. While the main pain is gone, I still feel like I was run over by a truck on my abdomen.

Cantexplain

Age: 56
PSA: 4.1, 4.9, 5.1 over 4 months (March '09 to July '09). Never had it checkd before then that I know of.
stage: T2a
gleason 3+3 = 6
Biopsy: 10% in 1 of 10 cores

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