Sunday, December 26, 2010

Can't Take You Anywhere

Entry 33
Saturday, December 25


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

Thursday, December 23, 2010

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!


Email contact: hdstimson at shaw.ca

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.





Wednesday, December 22, 2010

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



Monday, December 20, 2010

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.



Saturday, December 18, 2010

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." ]



Wednesday, December 15, 2010

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]

Tuesday, December 14, 2010

Three Good Signs

Entry 26
Tuesday, December 14

Harry felt "sh**ty" yesterdayWhen 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

Monday, December 13, 2010

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 ]

Saturday, December 11, 2010

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."


Thursday, December 9, 2010

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 ]

Wednesday, December 8, 2010

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 KatzCancer 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.

Monday, December 6, 2010

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.