Day 1: Monday 4th June 2018
Retzius-sparing Robot Assisted Laparoscopic Radical Prostatectomy on the NHS at the Royal Surrey County Hospital.
Seven hour wait - 9 hours “nil by mouth”. Three hour procedure. Minimal blood loss. Woke up in the recovery room around 5 pm, all wired up to life support monitors and umpteen pipes in and out of me via seven “keyholes” and multiple cannulas. Didn’t feel a thing as I had been injected with a spinal anaesthetic together with a general anaesthetic. Mouth very dry. Moved to General Surgery ward. Find out I have been treated to some “Manscaping” - a half Brazilian above my bollocks!
Day 2: On the ward. International nursing and support staff everywhere - nurses from Uzbekistan, Spain, the Philippines and India. Where would the NHS be without them? Surgeon says op went very well, and he was able to perform nerve-sparing as well as Retzius-sparing procedures during my surgery, which my local urologist said would not be possible using the techniques he practices. In bed all day connected to drips and drains. First three drains removed, I thought I was being disembowelled for a few minutes! I could have been discharged that night, but as I had a long car journey home, the consultant and I agreed I should stay another night. First fart, followed by loads more. They inflate your abdomen with gas so as to form “a cathedral” so they have a workspace. The gas has to find its own way out, sometimes over a period of weeks!
Day 3: Discharged with enough drugs to open a pharmacy. 115 miles journey home. Felt every speed hump, pot-hole and drain cover! Stopped at two pubs on the way to recover from the battering. There were various vitamin pills, laxatives, ibuprofen, tablets to prevent stomach damage from ibuprofen, fibre gel drinks - didn’t need any of them, save the occasional paracetamol. Also a plumbers’ merchant’s full of pipework, valves and taps and bags for the catheter. There was also 28 day’s worth of a self-administered anti-coagulant injection. The needle is so fine you can hardly see the exit point on your thigh, and no bleeding. I am a big baby, but I hardly feel a thing
Day 4: First bowel movement. Less discomfort. Suspect I had stomach ache due to disruption of my peristaltic bowel action as a result of the anaesthetics and surgery, rather than the surgery itself. Urine now looks normal, no longer pink - a good sign? The hospital blurb on discharge states you can be peeing blood for up to two weeks. Suspect my surgeon and his sidekick da Vinci are very good at internal needlework. Weigh myself, have put on two pounds despite eating barely anything in hospital as my mouth was so dry. Perhaps all the intravenous drips I was connected to were packed with calories!
Day 5: Up at 2am, as the night catheter bag wasn’t filling properly. Turns out the tube was kinked in bed by my tight underpants. I go commando now. No need for any pads....yet. Taken to going commando in the day too, and wearing braces as my belt irritates the still-sutured keyholes. Had a slight temperature of 99.8°F and felt sleepy. A couple of paracetamol sorted that, but I didn’t leave the house till 3.30 in the afternoon.
Day 6: Virtually back to normal. Cannot believe I had major abdominal surgery less than six days ago. Still get a twinge when I cough. Penis is now badly bruised and has taken umbrage at his sexual assault by an automaton, and withdrawn into my swollen scrotum like a frightened tortoise’s head. When I say “back to normal”, I wonder if my surgeon does penis extensions? Shrinkage is supposed to improve with time. If not, you may see me on a future episode of “Embarrassing Bodies”! Out supermarket shopping and then off to the pub. Felt a bit tired in the late afternoon.
Day 7: Slept right through from 10pm to 4am (normal for me) and have now got used to the catheter pipework and can sleep on any side. Mr Tortoise is poking his head out to see what’s what. More supermarket shopping, cooking full English, then off to the pub. Starting to get the occasional dribble of wee from my urethra - at least that shows it’s all reconnected up properly!
Day 8: Tired again this morning, but every day the slight discomfort and itching around the stitched-up keyholes improves.
Day 9: Today is a big day. At 9 am I am to turn off the drain tap to the catheter bag and allow my bladder to fill and begin to micturate normally. I have to record the times and amounts of urine passed. Her Loveliness says: “I hope you won’t be using my measuring jugs”. I did point out that urine is sterile and promised to put them through a dishwasher hot wash before putting them back in the kitchen cupboard. 08.30: Catheter bag stop-tap closed. 09.36 first normal urination through a swollen (and shrunken) penis. 100ml, since you ask. Amazed that I can stop and start as before my op, with no “razor blade” sensation. A bit disappointed a little later when a sly fart resulted in a bit of a dribble. Still, this is day 1 without the bag. Bag is binned, and various micturitions (unquantified) have taken place around Coventry. I am wearing the very slimmest Tena pad, which is just as well, as contractions of my anal sphincter seem to encourage a dribble from my urethral sphincter. No problems with coughs or sneezes though.
Day 10: Supra-pubic catheter removal. My local hospital has agreed to do it so I don’t have a 230 miles round-trip for a quick out-patient procedure. The nurse rips it out, brief sensation like a needle. Dressing applied and my treatment is complete. My first wee is pinkish with tiny spots of clots. Continence is good, incompetence is the same as before the operation!
I am amazed at the speed of my recuperation and at the skill of my surgeon who facilitated it, and so thankful to our often maligned, over-subscribed and under-funded NHS. I honestly feel almost as well as I did the day before my surgery, only 10 days ago. I had no symptoms then.
Follow-up meeting with surgeon is due in July, to discuss the histology of the removed gland and the way forward. As I had 42 cores sampled during my template biopsy, I doubt whether my overall score or grading will change much.
Hopefully I am “cured”, but I am starting to wonder if PCa ever really goes away “forever”. Recurrence rates are quoted for 5 and 10 years, given specific parameters, but not for 30 years. Not that I expect to live to 92.....
But on from that? I remember what was said when Ronald Reagan had pre-cancerous lesions (polyps) removed from his bowel years ago. “If everyone lived to 150 everyone would have bowel cancer”.
Fortunately, I have just had the all-clear from the NHS “s***-on-a-stick” bowel cancer screening programme!
Keep breathing.
Cheers, John.
Edited by member 16 Jun 2018 at 03:12
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