Monday, February 13, 2006

Prostate Surgery – Post-Surgery Status

Day 0 – Tuesday – Pre-surgery. I arrived at the hospital at 5:15am with my wife. I was efficiently checked-in and changed to my hospital garb. In addition to the rear-opening robe, they also provide you with a second, front-opening robe so you’re not walking around with your rear-end hanging out. They led us into the pre-op room and put me on a gurney. Over the next hour or so, several nurses, nurse technicians, and anesthesia people dropped by to do their thing; put on “compression” socks, hook me up to an IV, take a blood draw, ask me several questions, etc. Surgery was scheduled for 7:30am. About 7:20am, my surgeon came by to see how I was doing and to let me know we were about ready to go. They had me drink some foul-tasting liquid and that was the last thing I remember until after surgery.

Post-surgery. The first thing I remember after waking up was this overpowering feeling I had to urinate. I flickered in and out of consciousness for some time, I don’t know how long, and then was wheeled into my hospital room. I had a liquid “dinner”. My wife and youngest children came by to see me. I was “out-of-it” most of the time, but do remember they were there. I also remember feeling like crap.

Day 1 – Wednesday. If you’ve ever stayed in a hospital overnight, you know that you are woken up several times during the night. Hospital personnel have to empty out your urine bag, or draw blood, or give you a new IV, or whatever. So, not much sleep to say the least. It was a liquid diet all this day, too. I felt awful, simply awful. I was feeling extremely weak and had no feeling at all in my right arm. One of my Urologist’s partners came by to see me. He said the numbness was not normal, as they (supposedly) took great care in how they positioned my body pre-surgery, but that it occasionally happened and feeling would gradually return over the next several days. He also said that because of my slow recovery, they would not be discharging me that day (normally they do the next day after an operation of this sort). I also heard my first hint of trouble. When I asked him why I felt so weak, he said that it was due to blood loss – my surgery was, and I quote; “bloodier than normal.” Joy. Again, a visit from my immediate family and liquid meals. I was never able to sleep more than a couple of hours at a time as I would be woken up by nurses to “do their thing”. I also had a roommate who just wasn’t all there. He would press his call button to the nursing station at all hours of the day asking to “get dressed” or to visit someone or whatever. Before I went to sleep that night, I remember beginning to feel a bit betrayed. I was supposed to have been out of the hospital that day (i.e. Wednesday) and blood loss during this type of surgery was supposed to have been “minimal”. In an earlier posting, I discussed how I was told there was no need to bank my blood for this type of surgery.

Day 2 – Thursday. Again, only short periods of sleep during the night, interrupted by hospital people performing their errands. Around 10:00am or so, another one of my Urologist’s partners came by to check on me. He brought with him the results of my latest blood test. It seems that my red blood cell count was just a bit over 7, about half of normal, and was almost surely the reason for my feelings of extreme weakness. He said that my blood loss was much more than usual during laparoscopic surgery and approached that normally seen during open surgery. I was an “oozy type of guy”, he told me, and related how that absolutely everything my surgeon touched during surgery tended to bleed – not normal. He recommended that I receive some blood. As I had, most fortunately, insisted on banking a pint of my blood prior to the surgery (I wanted to bank two, but that’s another story) that was fine with me. I just wanted this crap feeling to go away and had no qualms about receiving my own blood. If it had been blood from a blood bank, I don’t know what I would have done – fortunately I didn’t have to make that choice. They were unable to put my blood IV into my right arm as it was still numb (though feeling was beginning to return), so I now had multiple IV’s into my left arm. Within an hour or two after my blood had been re-tranfused, I began to feel much better. Later that evening, my surgeon called – this was the first time I had spoken to him since the operation. He said that they had just received the pathology report from the lab. My prostate was “greatly enlarged”, he said, and fully 20% of it was cancerous. The good news was that the “margins were clear”, i.e. all of the cancer seems to have been contained within the prostate. He told me the stitching of the urethra from my bladder to my penis went without any hitch (i.e., I should be continent) and the “nerve-sparing” part of the operation also went “very well” (i.e. I should be able to get an erection again). He also asked if I wanted to go home that day. I was unsure; yes, of course, I wanted to get out of there. On the other hand, I had only begun feeling better a few hours ago and didn’t know what would happen later that day. So I opted to stay in the hospital one more night. This was probably a mistake as, that night, I was woken up and moved to another room; they wanted my bed (which was located right outside the nursing station) for another, sicker patient. The room they moved me to was freezing cold. Twice during the night I had to ask the nurses for additional blankets and ultimately had to ask them to turn up the heat. By morning, I had developed a full-throated cough.

Day 3 – Friday. I woke up coughing and feeling crappy. Coughing, after surgery like this, is NO fun – it is EXTREMELY painful. I was also mentally kicking myself for not leaving the hospital the day before when I had the chance. Late in the morning, yet another partner from my Urologist’s office came by to see me. After examining me, he recommended that I stay in the hospital one more day. I still had a drain in me from surgery and he was concerned with how much blood and other fluid was collecting inside it. I told him “No”, I wanted to go home, and asked him to call my surgeon. A few minutes later he came back with the welcome news that my surgeon had OK’d my discharge. He removed the drain, bandaged up the incision, and told me that tomorrow (Saturday) I would be able to take a shower. Heaven! The next few hours were spent receiving post-operative training and signing the discharge paperwork. About 2:30pm, my wife came by to pick me up and I was finally able to leave. I don’t think another night there would have been pleasant at all.

Day 3 – Friday – Home, at last. It’s so nice to sit in a comfortable chair, have my family around to take care of me, get some real food and feel a bit more normal.

Days 4 & 5 – Saturday and Sunday. I took a shower Saturday morning – what a joy! I’m wearing a catheter now and it complicates matters somewhat, but the shower was still a delight. My dog can’t figure out what’s going on with me. Normally I’m the one who takes her for walks, horses around with her in the back yard, etc. Now I walk around like an invalid and it’s obvious that she misses the “old me”. I miss the “old me”, too, and can’t wait for him to return. I’m feeling better, but still am nowhere near 100% yet. All of the numbness has left my right arm, my right palm and my 3 smaller fingers. But my thumb and pointer finger are still a bit “tingly”. In the case of my thumb, part of the issue is the thumb surgery I underwent just a couple of weeks ago (a story for another time). I’m pretty confident now that within a week or two, the feeling should be back to normal. Another side-effect of my surgery which is starting to recede is the incessant pounding noises I hear in my right ear; noises caused by my blood pulsing. If you’ve ever had this happen to you, you know what I mean. You actually hear the blood being pulsed through the vessels in your ear. Though it’s not painful, it’s been a constant with me since the surgery and, among other things, has not helped my ability to sleep soundly. My surgeon believes it’s due to some fluid build-up in my right ear and he’s probably right. It’s starting to go away and I’m most grateful for that. Bowel movements have returned, and though painful, odiferous and tough to perform with a catheter in you, are also most welcome. I’ve been eating solid food for a few days now and don’t want to start having to take laxatives, too. The only medication I’m on now is Vicodin. This is good stuff – it really does make a difference. When I wake up in the morning, I feel crappy and lethargic. Within 30-45 minutes of popping a Vicodin, however, I start feeling much more normal. The prescribed dosage is “one or two tablets every six hours”. I don’t want to get too dependent on them, but do take one “as needed”. Very handy stuff.

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