Can't Take You Anywhere

Entry 33
Saturday, December 25


Harry went for his first outing since having had the catheter removed.

No More T----

Entry 32
Thursday, December 23


Gayle, the urology nurse at the Manitoba Prostate Centre pulled the last t--- out of me on Thursday morning. It went well,  almost anti-climatic. There was the slightest burning sensation as my indwelling Foley catheter came out. The entire process took less than fifteen minutes. I'm now back to being my old self without things dangling from me and that's a big deal to me.


After two weeks of relying on it, I'm happy to see the last of the catheter but have mixed emotions about my new best friend called Men's Depends, a kind of protective underwear. It feels bulky and "frilly" even though it's designed to resemble men's briefs.  The other option I brought along to the appointment was a man's Depends pad similar to those used by women during menstruation.  


I think I felt the urinary sphincter muscle trying to contract itself several times during the day. We've been advised that with time and my Kegel exercises, any incontinence should steadily decline. I'm going to be as patient and persistent as I can be.


I came home with another informational DVD (Telling It Like It Is : Sex and Prostate Cancer) from Dr. Anne Katz who continues to offer her support. 

This didn't happen!

More About Catheters and Prostate Cancer Patients

Email contact: hdstimson at shaw.ca

|  Before Surgery |  After Surgery  |  Before ADT  |  ADT/Hormone Therapy  |

When We Were Young

Entry 31
Thursday, December 23


See the 40 year old photo below? That's not Buddy Holly, that's Graham Fuchs with me before we imagined that I'd have prostate cancer and he'd be my doctor who would first twig to the fact. We've been friends since we were kids together in Churchill, Manitoba. Thanks, Graham.

This is Going to Feel Weird

Entry 30
December 22


Yesterday my pelvic drain was removed at the Manitoba Prostate Centre. When the urology nurse began to extract the tubing of the pelvic drain she remarked, "This is going to feel weird." Picture someone pulling a long, chubby worm through your skin. There was no pain.


The contraption consists of a transparent plastic bulb often compared to a grenade that is attached to a rubbery tube. The idea is that the fluid that builds up around the site of the surgery seeps into the tube, through your abdominal skin and collects in the bulb. The bulb was loosely attached to my shirt with a clip. Once or twice a day we poured out the lymph that collected, measured it and logged it in the journal.


Each time we emptied the fluid from the bulb, we had to squeeze the air out of it too. The vacuum created that way caused the suction around the surgery site. The day before the pelvic drain was removed, Gayle, the urology nurse told me to release the vacuum and see what amount of fluid still accumulated during that day. When output is minimal, as in my case, the drain can be taken out.


The pelvic drain never hurt but it did feel odd. It also impeded my movement at night slightly.


Tomorrow, the catheter comes out.

 Removal of a JP pelvic drain from a female patient

Good to Be Home

Entry 29
December 20


We are not surprised the medical folks encouraged Harry's rapid exit from the hospital. In his case, almost everything is better at home.. food, peace&quiet, view, company, and amenities. He's been home a week today. Here's an excerpt from one of his recent e-mails:


Below are some notes I jotted down for friends who are connected with or have some familiarity with the medical profession. I salute you all.

As I think I may have mentioned this was my first experience with the business end of a hospital in 45 or so years. Boy, did I get my eyes opened! The Health Sciences Center in Winnipeg is a large inner city hospital and in retrospect I can assure you, is not the place for rest and recovery. I now understand why the urology nurse told me, "leave as soon as you are able." The Urology/GI wing was right over top of Emergency and our ward wasn't full, consequently we got the spill over from down below. I got a taste, just a taste mind you, of the equal parts of regimen and chaos that plays out on the weekend in a big city hospital. There were times when I was lying in bed (we were 4 to a room) listening to what was going on beside me (separated by a mere curtain) and I'm sure my eyes looked like poached eggs! I have nothing but thanks and the most sincere admiration for the people who staff those wards and the way they treat the transients like me that blink in and out of their lives on a daily basis.   I couldn't do it.

Insofar as the operation was concerned the surgeon on repeated visits told me it went very well. I lost a lot of blood but appeared to bounce back pretty well once in recovery. As expected the nerve bundles took a hit, but I'm not sure of the extent of that yet. He removed the pelvic lymph nodes and said they looked and felt healthy so he is hopeful that the earlier CT Scan is correct and the cancer has not migrated. The lymph nodes are at the pathologists as we speak and he of course has the final say. I await the results.

I got home December 13th and have been recovering daily. I stiil have the catheter and JP bulb hanging off me but go in Thursday, December 23rd for assessment by the urologist's nurse. I assume it will come out if she likes what she sees. I receive home care nurse visitations 3x a week to change the dressing on the JP drain as well as watch for any other potential complications. Thus far I get an A grade!

I'm walking a good 1 1/2 hours a day, drinking lots of liquid as suggested, and have not taken any pain medication since the weekend. My appetite has returned along with my strength, indeed I have to stop myself from wanting to do more than I should at this stage. So to the best of my knowledge I'm bouncing back. I don't want to come across as too positive because it's early and there are more shoes to drop as you well know, but that said I'm pretty positive.

Once again my thanks for your friendship and good wishes. Last summer Buck told me how important that was - now I get it.

Some Things Change

Entry 28
December 18


Harry is doing well (dare I say, really well). Some things have changed since his return home from the hospital:

• The pup seems to sense that she has to be calm around him.
• Harry is bored. Walk-read-walk-read-eat-walk-read
• His weight has dropped a few pounds. 
• His ablutions take considerably longer.  He still hasn't been in the shower because of the bandage covering the pelvic drain. When the home care nurse comes, she will be replacing that with a water resistant bandage.
• He has increased strength. Now he can wring the washcloth dry. Even though he was asked not to feed the fire when I went out, he added wood because he was enjoying the fire so much. Lifting is a no-no.
• Sleep has become satisfying for him. Getting up from a prone position has become a lot easier.  He doesn't sleep during the day.
• Harry's walks around the house jostle the catheter which then rubs the bladder causing minor irritation, so threads of blood have appeared in the bag. Initially we were worried about it, mainly because it was something new. We contacted our doctor and read a couple of forums on the topic all of which alleviated our concern. Harry says there's a technique to working with the catheter otherwise it can be uncomfortable and inhibits the freedom of movement.  As Wayne J put it to Harry, "You're like a deer with one antler and it has velvet on it - sensitive."  [ Blood in urine forum thread ]
• Other than drinking less coffee and eating more prunes, Harry's diet is becoming quite normal. He craves fruit and vegetables. I didn't tell him there are mixed nuts in the cupboard. He wouldn't be able to resist those. [ What coffee does to your brain ]
• Harry is confused about the pain that came along with this operation and recovery. He had a hard time defining it right from the day of the prostatectomy. There was an adjustment at the hospital when they removed the epidural and IV and then again when he got home with his Tylenol 3s. He experiences only the slightest pain if he presses on his abdomen or leans forward. He hasn't taken any pain killers today.
• The dining room has turned into a dispensary for the home care nurse. A box of 100 pairs of gloves and some abdominal dressing pads arrived via courier yesterday. They've been added to the pile of twenty or more different products. The pile is not shrinking one bit. We've only had the one home care visit in the five days since Harry's been at home.  [Update: The home care nurse visited for the second time in the late afternoon on Saturday. She said Harry is a "stellar patient." ]

Relieved in More Ways Than One

Entry 27

Wednesday, December 15

Caution to blog readers  =:0

We decided to be forthright and write about today's success...

We had been worrying about Harry's bowel function. You would too. After all, it had been a week since his last BM.  Success came today.  All it took was a bearable two day regimen of Senokot (laxative) and Docusate (surfactant used as a laxative and stool softener) with a single dose of Milk Of Magnesia not to mention prunes, prune juice, lots of water, and some bran cereal in addition to regular small meals. The Foley catheter presented only minor logistical problems.  According to Harry, this event was not big on the Richter scale, but was big on the relief scale. 

The home care nurse came for her first visit to change the dressing on the pelvic drain and to answer our questions. We're keeping a log of everything that we observe or measure including temperature, blood pressure, fluid amounts and colors. The home care nurse was complimentary about our notes. There will be home care visits three times a week for a couple of weeks until the foley catheter and pelvic drain are removed.


Harry continues his mini treks around the house, probably pretending he's on the Mantario Trail.

Getting Home After Prostate Cancer Surgery [pdf]

Three Good Signs

Entry 26
Tuesday, December 14

Harry felt "sh**ty" yesterday. When Graham, our friend and family doctor called in the evening, we told him about the elevated blood pressure that was measured by the nurse prior to Harry's leaving the hospital (189/110). He expressed anxious concern and stressed that we should keep track of the blood pressure. We remembered we had a blood pressure device that was given to us this past year so we took it out of storage and put it to use right then (187/97), at bedtime (176/95) and again several times today (143/83). It's encouraging that the BP is trending down and getting very close to acceptable levels. 


Harry's blood pressure probably rose slightly when I dropped the collection cup that held the contents of his pelvic drain. I'm a klutz. No cure for that. Luckily, we were in the bathroom so cleanup was easy.


Good sign number two...He felt like eating this morning, for a change. He had part of a grapefruit, a little yogurt, a few almonds and prunes.  He is not excited about drinking prune juice but until the bowels are functioning normally he has to consume stool softeners and natural laxatives and keep well hydrated. We have Milk of Magnesia on hand if necessary. Abdominal rumbling and passing gas is what we like to hear. Can't believe I said that.


The third good sign is not a physical improvement. It's that he's reading the newspaper, an activity he really enjoys.  Right now he has two new newspapers and a copy of the latest Skeptic magazine in front of him. This is proof of healing because for the previous few days he was unable to concentrate enough to read much. 


Maybe there is a fourth good sign. His sense of humor has returned. He says he's skeptical about the Skeptic magazine  :) 


Second night back in his own bed, Harry had his best sleep since the surgery. 


Here is one of the handouts given to us at the hospital on what to do when we get the patient home. Instructions For Care Following Conventional Prostatectomy

Today or Not Today ? That's the Question

Entry 25
Monday, December 13


7:20 AM CST - We're expecting a call from the hospital telling us if and when we can pick Harry up from the hospital. Two of the three of us will have to wear masks around him due to our new sore throats/colds.  Does anyone else believe that hospitals are the scene of germ festivals?


10:20 AM CST - Getting good at waiting.


12:20 PM CST - Finally. Heading to the hospital to retrieve Harry. 


2:00 PM CST - Harry is sitting comfortably in his favorite chair at home.    He walked through the hospital to the car and had an uneventful ride home. We took the long route through the park because he said he was enjoying being outside. The shopping list he's making out now is getting longer so maybe he is getting an appetite after all.


2:10 PM - 6:10 PM CST - He slept away most of the afternoon. Even the smell of food hasn't wakened him


10:30 PM CST - After having been awake a large part of the time from 6:30 to now, Harry has gone to sleep sitting in the chair.  He walked around several times this evening, had his Jackson Pratt bulb drained and his blood pressure taken (too high). He was listless and had no appetite most of the day . Seems harsh to wake him so that he can go to bed.


If you'd like to email him directly, Harry can be reached through his Shaw account [ hdstimson at shaw.ca ]

Sleep is Good

Entry 24
Saturday, December 11


Harry continued to show improvement on his second full day of recovery from prostate surgery. The number of his outings down the hallways of the Urology/GI ward increased as did the distances covered and he went on his own without a nurse clutching the back of his gown. He mentioned to the nursing staff that he was feeling itchy and slightly bloated. A sponge bath, baby powder, cool cloths, medication, and walks seemed to relieve those symptoms.


The doctor predicted that Harry would probably be leaving the hospital on Sunday. It seems to depend on a variety of factors like the amount of excess abdominal fluid that is being collected with the Jackson Pratt drain,  the return of Harry's normal bodily functions, and the reduction of pain once the epidural is out.  As you can see in the pictures, he is still wired and plugged in to various bags. The epidural will be removed on Sunday. The nurse thinks his exit from the hospital will be Monday. We'll see who is right tomorrow.


This is the day that solid food is on the menu. Harry turned down what would have been his first solid meal, the chicken cordon bleu special. He requested toast for dinner.


Harry still experienced waves of tiredness, especially after the walks.  That was exacerbated by the fact that his roommate, a very elderly gentleman, ranted off and on for hours from 4 PM, through our evening visit, until nearly midnight on Friday. Harry had a good set of headphones and his iPod but we purchased wax ear plugs for him just in case there was a repeat performance tonight. We hope he is able to get the good rest that he needs.

Get Up Or Die

Entry 23
Friday, December 10


The day after his prostate surgery, Harry is making a good recovery. He walked back and forth along his ward hallway three times in the day, each time farther than the last. He was slightly dizzy at first and weary at the end of his walks. His nurse who we'll call V said we could take his picture but we can't capture V's friendliness, encouragement and good humor that went a long way to getting Harry on his feet quickly.  He pointed out to Harry in blunt terms the reasons why he has to move out of the bed. Clots. In spite of a soup, juice and jello diet, Harry is a very cooperative patient and we have pics to prove it.

Harry holding his giardia toy, walking the halls with Tom and V, being poked and prodded by V while B watches. Click image to enlarge it.

The quote of the day goes to Tom.  When Brekyn gave Harry his giardia toy (See Blog Entry 1) and I remarked on how it was the cutest microbe toy, Tom quipped, "But not as cute as clap."

|  Before Surgery |  After Surgery  |  Before ADT  |  ADT/Hormone Therapy  |

What a Day

Entry 22
December 9


Harry was up at 4 AM, out of the house at 5 AM, admitted to hospital at 5:45 AM, prepped by 7:30 AM and on the operating room table for the start of the operation at 8 AM.  


Twice during admitting, someone called out "Henry" (Harry's given name) and we had to nudge him because he didn't recognize that as being his name. Later when they placed his belongings in a large plastic bag, he noticed that on the bag they had changed his name to "Yenry" .  "I can't even get used to Henry", he joked.  


The retropubic prostatectomy started at 8 AM and ended at 12 PM just as Dr. Saranchuk had scheduled it.  The doctor came out to speak to Tom, Brekyn and me in the PACU waiting room right after the surgery.  You may be comforted to know as we were that Harry's surgery was routine. He lost quite a lot of blood but not enough to warrant a transfusion.  Pelvic lymph nodes were removed and examined, revealing no obvious lymph node metastases.  The doctor seemed to be pleased with the results of his morning's work. As soon as he left us, we jumped up and down, hugged and cried.


Harry's anticipated 2 hours in Recovery stretched to 4 hours. The pain management plan had to be altered because he was still experiencing considerable, "fluctuating" pain. It turned out that the epidural placement needed to be adjusted.  He was tired and very thirsty throughout the stay in Recovery. We were allowed to pop in twice briefly during the four hours to hold his hand and listen to his weak attempts at humor.  


At 5 PM, 12 hours after leaving home, Harry made it to Room 348 in GH3 of the Health Sciences Centre. He was feeling and looking better but was still extremely tired when we left him in the early evening.  We're happy this day is over.

Harry's left arm is being warmed for the IVs. Click on the image to enlarge it.

BBC video of actual retropubic prostate surgery [ graphic images ]

The Day Before Surgery

Entry 21
December 8


Thanks to everyone for the good wishes.


This day has been one of preparation for the radical prostate surgery.  Never thought I'd have jello for breakfast. Only tea, apple juice, weak coffee, bouillon, Gatorade, carbonated drinks like ginger ale, and jello are allowed during the 24 hours prior to the surgery which takes place tomorrow morning.  I just had supper. It was a popsicle. By the time this is over, I'll be gnawing on the table legs.


After tea and jello this morning, we headed to the hospital for my 9 AM appointment with the anesthetist for another blood pressure measurement, more blood sample extraction, and more questions about my health history. Sounds like I will be having a combo anesthetic consisting of an epidural and a general anesthetic administered by IV.


My provincial health card has my birth month wrong, May instead of June. We had to continue to use the wrong birthdate on the request for blood from the Red Cross. According to the nurse, if there is any mismatch of patient data between that request and the info held in the Manitoba Health data bank, the Red Cross will not process the request. The blood may not be required, but on the other hand, it may if there is excessive blood loss during the surgery. When the dust settles, we'll get that date fixed on my Manitoba Health records.


We walked to find the admissions center which is where I have to check in at 5:45 AM tomorrow. That was a good exercise because it gave us a clear sense of where to park tomorrow.


Earlier today, we watched a good made-in-Manitoba DVD called "You've Had Your Surgery...Now What?". The video was professionally prepared by Dr. Anne Katz & Cancer Care Manitoba specifically for prostate cancer patients. It contained valuable information about what to expect in the hospital and when I get home.  Most likely I won't have many surprises.

At hospital for appointment with anesthetist

Tonight, one hour before bed,  the Fleet enema.

T-3 Days and Counting

Entry 20

December 6

Countdown . . . . 

• Confirm operation time. Thursday, Dec 9th, 7:30AM
• Review hospital stay checklist and pack items such as flip-flops, sweat pants, etc. Thanks to Wayne Johnson for the suggestions. (Update: You can't wear flip-flops with compression stockings)
• Buy or check out audiobooks and ebooks to hear or read while in hospital. Kobo is replacing my eReader as it quit last week
• Repeat Kegel exercises
• Eat well and drink lots of water
• Decorate Christmas tree and split wood for future fires in the fireplace
• Enjoy life as usual including cross-country skiing at Beaudry Park today and watching a good televised football game tonight

On another note, here is an interactive explanation of tumor angiogenesis in 3D or HD.

Blood .. not funny

Entry 19

November 26th

Having no obvious symptoms of prostate cancer, I've been going about my days as I normally do. Yesterday morning I had a snow walk with Gracie, our border terrier.  In the afternoon, I worked out at the Reh-Fit lifting weights and using the stepper.  Today I'm installing a new overhead fan with my friend, Jim. That has the potential to be funny.

I started this day by giving blood samples to the Unicity Lab near our home. The surgeon had requested a CBC (complete blood count), a PT/INR/Pfib, and an APTT (Activated Partial Thromboplastin Time).  Seems these are typical presurgery tests to get a picture of your health via the contents of your blood and to see how your blood will coagulate.  

Of the many possible different blood tests,  I only needed these three.

Blood, Not Funny [video] :)

Kegel Time

Entry 18

November 23

Do you know what kegel exercises are? Google it, you'll have fun.

Today was another adventure.  I went to a physiotherapy center for a pre-operation assessment of my pelvic floor muscles. The twenty-something physiotherapist was all business, making me more comfortable with the impending procedure. I assured her that I had been goosed so many times recently that I was fine with this, which was true. The pelvic diaphragm exam involved the physiotherapist inserting her fingers into my rectum for ten to fifteen minutes as I flexed my pelvic floor muscles for her to determine the muscle strength. I left there with a stack of brochures and other written instructions to remind me of what to do before and after the prostatectomy.

She also provided me with a list of food/drinks to avoid including some of my favorites.... spicy foods, chocolate, citrus fruits, coffee, alcohol .... as they irritate the bladder.        

Eight glasses of water a day is okay, tho'.

Right now, back at home,  I'm about to stretch out on the floor to do the "kegels", twenty in a set with the first 10 contractions each held for 5 seconds followed by 10 rapid contractions. I have to do 2 sets like this in succession.  Twice more in the day, I have to repeat these forty contractions for a total of 120 a day.

Inspirational Speech

While the 15 minutes of his speech is worth a listen, his account of having cancer starts at 9:04 on the video.

From 13 Most Inspiring YouTube Videos of All-Time http://bit.ly/dvhtVn

Remove my sphincter? What?!? Are you kidding?

Entry 16

November 20

When the supervising nurse called to go over surgical preparation and post-prostatectomy follow-up, she informed me that she had set up an appointment for me with Nova Physiotherapy who specialize in dealing with the pelvic pain & incontinency in people who had their sphincters removed.

My sphincter will be removed ?  ? ? "What, nobody told me that! I didn't agree to that!"

Apparently, I did.  

Turns out we have more than one sphincter.

She was referring to the urethral sphincter muscle that acts to prevent urine leakage from the bladder. Damage to the urethral sphincter is an expected result of the procedure of separating the prostate from beneath the bladder.    Here's a bit more about that at http://www.webmd.com/urinary-incontinence-oab/mens-guide/urinary-incontinence

 

We made the graphic with Wordle

Surgery Date Changed Again

Entry 15

November 17

Shingles aren't a good thing for someone facing an operation.

Thanks to my friend and family doctor, Graham for connecting with the specialists, this time to clarify the options for someone who faces a radical prostatectomy soon and who has developed shingles.

The anesthetists thought that although my chances of being clear of the shingles by the date of the operation (November 25th) were good, they just couldn't be sure and weren't prepared to take the risk. For that I don't blame them one tiny bit. I would have a hard time living with myself if I were in any way connected to compromising the safety of that operating room.
 

As it turns out there is a fellow with a Gleason score of 9 (I'm a 7), so they slotted him into my spot. My operation has shifted to the 9th of December. 

I'm now on valacyclovir, an antiviral treatment for shingles. 

What happens now?

Entry 14

November 15

Something was not right. Unusual skin tenderness and a rash appeared on the 9th. I had shingles once before about six or eight years ago. Is this shingles again? Is this another complication of being immunosuppressed?

I've been reading shingles information . Varicella-zoster ( the virus that causes shingles) sounds like the name of a pasta dish. 

I'm wondering if this will this affect my surgery date, a mere 10 days from now.  Apparently the shingles has made its appearance close to the epidural entry point.

Today, Monday, I called the Prostate Clinic and after answering her questions related to the geographic location of the shingles on my torso, the nurse told me they would likely go ahead with the surgery on the 25th as scheduled. I gather that came from the urologist/surgeon .

She did however want to clear that with the anesthetist and indicated that I might expect a call from that individual. She also said they might want me back for some more blood work this week. When that happens they will be able to better assess this new problem.

Thanks for Your Concern

Entry 13

Written November 9

Notwithstanding this blog that has garnered little attention, we haven't talked to many about the prostate cancer. Below is my e-mail written to those few with whom I shared early on:

Hello,

This is just a quick note to update you on the latest information regarding how I'm planning to move forward in dealing with my prostate cancer. 

It was the considered opinion of the urologists, radiation oncologists and my doctor, that given the state of the cancer in my prostate (the biopsy revealed 12 out of 12 cores containing cancer cells), that I was a candidate for 2 of the variety of treatments available in combating the disease. Those two options are surgery and radiation therapy. After considerable research and consultation with nurses, doctors, friends and individuals who have been through the alternative treatments presented to me, I have opted for the surgery.

The date set for that procedure is Nov 25th at the Health Sciences Center in Winnipeg. The operation itself takes on average, between 3-4 hours and the standard hospital stay is 3-5 days. 

As I think I have mentioned to you, the bone scan and the CT scan which I have undergone both came up negative. For the uninitiated that's a good thing because it would appear the cancer has not migrated outside of the prostate gland into either the bones or the organs. The trick is to get to it before it does.

The odd thing to me about this whole process is that I am exhibiting absolutely no symptoms typically associated with prostate cancer and feel no different than I have for the past year. I almost feel like going back and saying "are you sure you have this diagnosis right". Of course I know they have and I'm quite aware that an illnesses can be present without manifesting itself, but it sure seems odd.

In any event my physical and mental health are just fine and I'm really pleased with the way I have been treated at the Prostate Center in the Cancer Care Manitoba facility. From all that I can learn I have an exceptionally good Urologist/Surgeon and at the finish of my preoperative meeting last week he said the exact right thing. " Well Harry, with any luck we should have you back paddling your canoe this spring."

I would like to take this opportunity to thank you all for respecting my request that you keep my diagnosis to yourselves until I was ready to go public. It wasn't that I was scared or trying to be secretive but rather I just wanted to have all the data in and the decisions made before going to a wider audience. I'm there now so the publication ban is lifted!! 

Don't be afraid to email or call; be assured that I am no different than I was the last time we spoke, and am fine with what's ahead.

My thanks for your concern and your encouragement. Margaret or I will continue to provide you with updates as events warrant.

[Update] Surgery is now set for Dec. 9, 2010

Date is Set

Entry 12

Written November 3

The date for surgery is set... November 18th.

[Update] Now the date is November 25th.
[Update to the Update] Due to my having shingles, the new date for the radical prostatectomy is Dec 9, 2010.

The following is from my e-mail to Graham, our good friend and my family doctor.

"I was beginning to get a bit antsy because it had been a week since my meeting with the urologist and I still hadn't heard. Turns out they were trying to reach me earlier this week but had my very old, defunct phone number and it just rang. Don't know how they got that. The 18th is earlier than I had been led to believe but he did tell me that he penciled a date in for me when he first saw me in September.

I have to go in this Friday for an Xray, EKG etc. I guess they will let me know what time I have to show up on the 18th. I would imagine bright and early."

------------------------------------

Snap of a Glove [video] - Nova Scotian Dan Hennessey's account of living with Prostate Cancer

Mark the Calendar

Entry 11

Written October 25
Pre-surgery Appointment

So far, so good. My prostatectomy is scheduled for about a month from now. We'll discover the exact time this week.

It does help to have someone with you when you visit the specialist because more questions and answers tend to be generated. I went solo to today's pre-surgery information appointment with Dr. Saranchuk, the urologist/surgeon and his resident.  My note-taker, Margaret has accompanied me to many of my previous appointments but she's in Vancouver with her elderly mother for a couple of weeks. 

By comparison to past appointments, this one was brief, less than half an hour. It hadn't been necessary to feed the parking machine for three hours.

During our meeting, the urologist explained the surgical process and the potential side effects once more. One new thing I learned is that there will be some blood loss during the surgery. In anticipation of that, my own blood will be drawn and stored just before the surgery. Other fluids are added to compensate for the drawn blood. He also told me that the average hospital stay is three days.

He reassured me that he would be doing the operation. We were wondering about that as this doctor is also an assistant professor working for a faculty of medicine in a teaching hospital.

Now, the wait......

Ancient Eygptian Surgical Tools

Decision Time

Entry 10

Written October 22th

Our good friend Graham who is a doctor in Selkirk has helped us to consolidate and process much of the information that has come to us. He also took our  last lingering questions to the specialists and then interpreted their responses so that for us the choice became more obvious.

I've elected to have a prostatectomy.  Now to tell our family and friends.

The following is from my e-mail to Hugh, my friend and June paddling partner:

"This is not a 'gimme' operation. I'll be on the table  for 4 hours and in the hospital for 3-5 days. The catheter stays in for 2 weeks.

My body is in a no holds barred battle with the cancer in my prostate; indeed it may have been the reason why I got Giardia and you didn't considering we drank mostly the same lake and creek water this spring. In retrospect it was probably fortuitous I contracted Giardia because it was while they were trying to figure that out that they twigged to the spiking PSA rate.


The docs all strongly recommended I get the flu shot including the Pneumococcal vaccine shot because of that immune deficiency. We have both had our flu shots as of today. Margaret & I have always got the flu shots to good effect over the years so there was no need to convince me.


In any event after long discussions with the Urologist, the Radiation-oncologist, and particularly my doctor all of whom have been amazingly patient, helpful, and objective about options other than their own field of expertise, Margaret and I decided to go the surgical route. I won't bore you with the details as to why mainly because it's complicated as hell.


What it boils down to is this - my bone scan was clean as was my CT scan, so to the best of their knowledge the cancer hasn't migrated outside of the prostate into the bones or organs. The key then is to get it before it does.  If it does get out the highway is via the lymph nodes in the pelvic area. Surgery is the only way to find out if it has metastasized because when they open you up they biopsy the lymph nodes while you are on the table and remove them just in case they don't get all the cancerous tissue during the surgery (microscopic cells invisible to the naked eye hiding in the walls and lining to the other organs). Radiology accepts the CT Scan as the truth and does not address the lymph nodes. I have trouble accepting that.

In any event I go in next Tuesday for another conference with the Urologist (Surgeon) and he will give me a date as to when the offending gland and the related bits and pieces are to be removed. I would expect it to be within a month."

Article on Surgery

Surgery is Cutting Things with Knives

Entry 9

October 13

Before Dr. Ong, the radiation oncologist met with me to discuss radiation as a treatment option for prostate cancer, his resident, Dr Peterson came in to interview me and explain the process.

It's very clear after speaking with Dr. Ong that each treatment method has advantages and disadvantages. And each treatment method has other treatments that follow should the first method fail to eradicate the disease. The choice of how to proceed now has been left to me.

Some treatment options have been quickly eliminated because of the state of my disease (Intermediate, Gleason 7, PSA 17, T2c [which means cancer is in both lobes]). Active surveillance, laproscopic surgery, and brachytherapy are out; prostatectomy and radiation are in.

It has been evident from the beginning that surgeons prefer surgery and radiation guys prefer their method of treatment. To quote Dr. Peterson, " Surgery is cutting things with knives."

We found a good chart  that shows the range of options for men with prostate cancer & typical side effects.

Link: Urologists are biased about the treatment of prostate cancer…but not like you’d think..

Annual Seminar : A Room Full

Entry 8

September 28

We attended an evening seminar on many aspects of prostate cancer. The panel featured four medical specialists including Dr. Jeff Saranchuk, Urologist and Dr. Aldrich Ong, Radiation Oncologist with whom I'm meeting in early October.


It was a very informative evening hosted by the Manitoba Prostate Cancer Support Group. The auditorium at the Health Science Centre was packed. After all speakers completed their 10 minute presentations, audience members could ask questions. Even those were interesting.  

Support Group Newsletter [Oct 2010]

A Better Experience

Entry 7
September  21

The Manitoba Cancer Care Centre is impressive. We headed up to the Prostate Care Centre on the 3rd floor.

Beforehand, we knew a bit about Dr. Saranchuk from Graham who said the guy is about fourteen. (He's closer to forty)

Dr. Saranchuk was amazingly professional from the first moment to the last of the appointment. He outlined the options for us based on the evidence at hand. He then conducted my third DRE of the summer.  I learned I was a good candidate for radical surgery or external beam radiation. A less aggressive or less advanced cancer might be "treated" with watchful waiting, laproscopic surgery, or bracytherapy.

Treatment Options:

Active Surveillance  |  Experimental and Alternative Therapies  |  Surgery  |  Laproscopic Surgery  | 


External Beam Radiation  |  Brachytherapy  |  Hormone Therapy  |  Chemotherapy  | 


Complementary Therapies  |  Palliative Therapies

Dr. Saranchuk then introduced us to Dr. Anne Katz, his colleague and fireball who buzzed about how "it's your body" and "do what's right for you".  She made obvious her preference for the skills of Dr. Saranchuk over those of Dr #1 Urologist without being overtly critical.  Before we left the office, thanks to Anne Katz, we had a future appointment with the Radiation Oncologist for the beginning of October.

Thank you Dr #1 Urologist

Entry 6

September 17th

During our follow-up appointment with Dr #1 Urologist, he informed us that as the result of the bone & CAT scans there was no sign of further spread of the prostate cancer.

 

He gave us answers to every question we could think of.  We were pleased with his patience and feeling a little guilty that we had scheduled an appointment with Dr. #2 Urologist aka Dr. Jeff Saranchuk.

We were informed that the cancer rated 7 on the Gleason Scale which ranks it as intermediate, the most common grade of prostate cancer.


The only odd thing about the tests was that the bone scan showed some right ankle damage. That was all. Are you sure that's my bone scan analysis??? I broke my knee in a heli-skiing accident but I've never injured an ankle.

We have a slight remaining, niggling concern that these scans were taken with what our friend Graham calls, "blunt instruments." 


We found the Nomogram prediction tool online. Maybe that will help with my decision making, maybe not.