What the stomach looks lies after the operation

You will see there are five bandages where the robotic keyhole surgery take places and the bandage on the left is the drain for the blood to leave. These were checked and replaced upon leaving the hospital one day later and 4 days later at the surgery. The clips held underneath are then being removed 4 days later still, so in my case 9 days after surgery.

A surgical drain is a small plastic tube that is sometimes used after an operation. It is put inside you during the surgery by the doctor and will stick out of your body until it is removed, usually a few days later. It connects to a small plastic bag that collects any fluid or air that has drained away from where you had the operation. Not all operations require a drain to be in: your surgeon will advise you if one is necessary.
https://patient.info/treatment-medication/surgical-drains

Fragmin injections

You will have the joy of 28 Fragmin injections to enjoy once you leave hospital.

My wife kindly does mine directly into the lower stomach here are some picture of what the injections look like.

The following photos show you from pre opening to disposal.

Day 1 after surgery and going home !

The picture is pretty much how the ward round felt from my perspective and was so short!

I was very keen to get out of bed but it was not happening. Around 9.30am the ward round took place and my bed became surrounded by a surgeon, doctors and nurse.

I was expecting to be examined but no they was a 2 minute conversation mainly wanting to know how much my drain has let out - 295ml and on that basis I was told I was free to go home that afternoon! I had not even been out of bed yet!

I asked if the 295ml was normal and told it was slightly higher than they would like but happy that I could go home.

I checked if getting out of bed had any issues I could stay and that was confirmed and at the end of the Ward round the consultant did come back to check I was happy with his decision.

Around 10am the nurse was able to get me out of the bed much to my relief.

We ordered lunch and then went walking around the wards we were in. We were meant to do 160m and walking with my neighbour we easily achieved that before lunch.

We had lunch then went for a longer walk. When we got back I was tired and went to sleep for an hour in the chair.

Even as I write this I find it astounding that once I woke it was not to long before my wife turned up from work.

At this time I still had the drain inside me and yet I was being released within 90 minutes as it transpired.

Once the nurse has the paperwork from the doctor he took me to the bed and redressed all of the wound bandages and removed the drain.

At the end of this I was able to get dressed just over a day after waking up from the surgery.

We waited to be discharged and were provided with extra dressings, clip removers, a discharge letter, 28 Cialis which becomes a repeat prescription, 28 days of Fragmin injections and a disposal case for the injections,  Extra catheter day and night bags and extra relevant  attachments, extra TED stockings which again you need to keep on for 28 days. Also some notes on how the catheter works.

We were told we would be contacted regarding catheter removal and for me it will be 2 weeks and 1 day after surgery first thing in the morning.

We had to book up the wound dressing check with our local district nurse who conveniently is at our surgery. That took place 5 days after surgery.

The first night

I should make clear the patient is not me, but this is the angle I was asked to sleep. I had a drain coming out of my right side and a catheter both linked to collection bags, so I was going nowhere! 

Unfortunately although I was resting the level of activity and nurses coming to check various patient’s including myself meant it took ages to get to sleep.

My blood pressure was all over the place on the low side for me and that slightly concerned me and lying down my pulse was to low at 92 and needed to be 95 so I was asked to rest in a raised position.

The bed was very comfortable and could be moved to all angles.

I also had a pain relief button that put a small amount of morphine into you. I did use this on a number of occasions through the night as the anaesthetic wore off.

I probably got 3-4 hours sleep that night and woke up for breakfast.

In the ward after the operation

The ward was a group of 4 gentlemen suffering kidney stone or Prostate removal.

I was still feeling remarkably well and was provided with two set of sandwiches and some fruit which filled me up.

I got chatting with the gentleman opposite who was having his third day in hospital and desperately wanting to get back home.

We had ended up as the only two in the ward but around 6.30 both other spaces were filled. One by a now friend who had had the same surgeon as myself in the afternoon. He had to wait from 7am to be operated on after I had been done. Worst of all he was not told how long the day was going to be. We both believe this to be unfair, as I am sure you would if you were in his position.

At this point it is fair to say my day where I have been writing this blog turned into a disaster with extremely painful constipation which will have its own page. What ever you do make sure you allow for the potential of this and ensure you are given a stool softener prior to leaving hospital. I certainly don't want anyone going through what we went through.

I was still well and was helped to get to a seat which was quite amazing in my view seeing I had only woken three hours before.

My family came to see me which was special and once they had left I watched the Apprentice.

By this time I was getting tired and sore and felt it was time to try and get some sleep.

Recovery from the operation

Having woken in the recovery theatre I was very surprised how little pain I was feeling and was able to make jokes with the nurse looking after me.

This was a case of waiting for the bed space to come free as I found out later.

I had a drink and bourbon biscuits as I had not eaten since 7pm the night before and it was now around 4pm.

Around 4.30pm the bed had come free and three nurses wheeled the bed from the recovery area up one floor in the lift to the ward.

The day of the operation

Having woken at 5.30am I did 10 mins on the cross trainer for my “brisk walk” you are advised to take.

My wife took me to the hospital and we arrived at the ward around 6.45 and were almost immediately taken to a small room to wait. As we found out later my neighbour on the ward was also there but he was left in the waiting room! He was not operated on until the afternoon after my appointment.

Once in the room we had a series of nurses come in and do various checks and take bloods. This all took a good hour plus and then we saw one of the doctors yo sign the consent form and to ask an final questions.

After this the anaesthetist came in and explained what was going to happen and at this point my wife went off to work and I was taken to the anaesthetist theatre.

I passed my consultant on the way who did come and have a very brief chat while I was on the bed going through the anaesthetic process.

This was actually all very straight forward with a couple of jabs and then breathing oxygen at which point you remember nothing else until awakening to a nurse in recovery.

Pilates, emotions realisation and fear

I have not felt like updating the blog until now so will attempt to do 3 updates today

The day after being diagnosed with the cancer I spoke to a Prostate Cancer UK nurse who was explaining the need for building up your Pelvic floor muscles. That after I ended up by chance at a Pilates lesson which included lots of Pelvic floor work. I continued for the weeks following right up to the Monday before the op on the Wednesday morning and so glad I did.

During this time I did experience a lot of different emotions and the last two days before the op I was very tetchy experiencing worry and fear.

The realisation of what was happening and seriousness of it almost made me not want to function but I did and got through.

Obviously you have the fears of the unknown some, the majority of which have been unfounded as you will see in the later posts.

Finally the day of the operation came about and we had an early night as our appointment was at 7am

A busy week last week piles of information and now the wait

Gleason Score from Prostate Cancer UK guide

Just back from letting my doctors know what is happening and finding out how to contact the district nurse if needed after the operation.

So last week we had one appointment with the designated personal nurse - 2 hours and the pre op appointment where further tests were done last Friday which lasted an hour.

The first meeting had lots of information including my current Gleason score of 7 as shown above, which given the circumstances was about as good as I could have hoped for.

We were informed 9/22 of the samples taken at the biopsy had cancer in them and that the level is currently T2 where the cancer is seen on scans but is believed to be contained within the Prostate. I am also fortunate enough not to require having the lymph glands removed.

The other good news was it is only in the left side of the Prostate so at worst it should be a unilateral nerve saving operation. The nerves impact the sexual feelings you have after.

So overall the stage is described as Localised (early) which is why I was provided with the three options of treatment.

In terms of the operation we were informed I have the joys of an epidural to look forward to before the general anesthetic is administered, antibiotics,  the joys of wearing flight socks.

Afterwards I will need to be injecting heparin for 2-4 weeks, have the joys of a catheter for at least two weeks and then incontinence recovery and no caffeine and preferable no alcohol. Guess a lock in at the pub is out of the question for a while!

Pain control is simply the classic Ibuprofen and Paracetamol mix. You also may be provided with some Codeine if necessary.

I have to say the treatment we have been provided with to date has been excellent and provides you with every opportunity to discover what is going to happen to you with total transparency as long as you are not too embarrassed to ask the personal questions in this situation nobody minds.

We were also informed how important it is to keep mobile and move around as much as your body will allow as soon as possible without overdoing it.

In terms of driving a minimum of 2 weeks but if able you can be a passenger if you are fit enough to get to places.

On the Friday I answered a lot of standard questions that you would expect, had an ECG, blood test weight height measured and received more information and 3 drinks you have to take for energy prior to the op . 2 the night before and one in the morning, in our case early as we need to be at the hospital for 7am.  Also found out to turn up with own PJ's and dressing gown. Everything else to be brought in the evening for a one night stay. Likely to be home again late the following day when the fun begins !

So now the wait for the operation,

We are already preparing and buying items we are going to need. I am to keep this updated as events occur.

Right now everything is focused on the build up to the operation and quite obviously a major topic of conversation ! Feeling ok about it so far.

Just an enlarged Prostate - new therapy

Given so many of my male friends are in the bracket to have their Prostate checked and may be suffering daily symptoms of a large Prostate (as shown in the image), the link below from the BBC from last year provides a positive way forward to improve your daily lives.



https://www.bbc.co.uk/news/health-43877002

It can happen to us all

https://www.bbc.co.uk/news/entertainment-arts-49713937

The link is a story regarding Sir Rod Stewart from today's BBC 16/9/2019

The key passage to note is

"If every single man between 50 and 70 went to see their doctor, we would see the number of deaths reduced dramatically."

What are the symptoms?

There can be few symptoms of prostate cancer in the early stages, and because of its location most symptoms are linked to urination:

• needing to urinate more often, especially at night
• needing to run to the toilet
• difficulty in starting to urinate
• weak urine flow or taking a long time while urinating
• feeling your bladder has not emptied fully

Men with male relatives who have had prostate cancer, black men and men over 50 are at higher risk of getting the disease.

Weekend update

As you can see the pack arrived from Prostate Cancer has arrived with lots of information and samples of what you are going to need after the operation.

The last week was all about getting your head around the situation and finding out as much as possible. Without doubt the first thing I would recommend you do is contact Prostate Cancer UK and speak to one of their nurses to learn and ask if they can send you a pack out to you. Also do the 1 to 1 if offered as it provides you with an opportunity to talk to someone who has gone through your experience.

Emotions are far more stable as you accept the situation and move on. Do not underestimate the impact on your loved ones, it impacts them as much as you. Make sure they know exactly what is happening.

We have been doing research and learned what to expect in using a catheter. The doctors just say you will have one inserted for two weeks after the operation as if you know what they mean off course you do not unless you have experienced one.

The best You tube video we found to explain it  can be seen at

https://www.youtube.com/watch?v=L7lIIYArTX4.

The most appropriate words are at at 9.12 the doctors states "You will feel very relieved to have your catheter removed. I am not certain the use of the word relieved is most appropriate given the subject but I am certain he is going to be correct!

Make sure you are positive about the whole thing, keep your humour and keep yourself busy,

A Prostate Cancer Blog

Hi and welcome to my new blog, this week on the 9/9/19 I have been prescribed with prostate cancer and have decided to create a blog for anyone in a similar position to learn from.

The journey to the operation

Whilst on holiday I noticed the frequency with which I was urinating and the urgency was increased significantly and resolved to see the doctor on my return. This I duly did, and the doctor actually said I had done exactly the right thing and he would undertake tests to make sure everything was ok.

So initially I had blood tests and urine samples taken. The latter did not highlight anything but I received a call from the doctor saying he wanted to talk to me about my blood test.

I arrived at the surgery and the doctor explained I had a PSA level of 3.7 when I should be less than 3 for my age and on that basis he would like me to have an MRI which I agreed to. To be honest I did not consider it to be an issue but in hindsight should of!

So the MRI was completed and then I was invited back to discuss the results, which had shown two areas of concern and they wanted to undertake a biopsy.

I won’t mind admitting I was expecting to suffer through this process but to be honest it was more uncomfortable than really painful. Yes, each injection made you jump and the taking of the samples felt and sounded like a staple gun inside you but you got used to it after a while and the 18 -30 samples were taken, I lost count. The worst bit was the probe entering which was totally alien to me.

I was expecting to suffer the next day but to my great relief I did not experience any issues at all and had minimal side effects.

I was the offered an appointment to discuss the results and unfortunately was told this week that my samples had indication of cancer at level 3 and 4. I was given three options of monitoring, removal or radiotherapy and chose the removal option. That was 3 days ago form when I wrote this.

Since then I have read up lots of information on Prostate cancer and contacted the marvellous charity Prostate cancer UK whose nurse was able to talk to me for 50 minutes and deal with all the issues I wished to cover. She also is sending out a full information pack.

As part of the Prostate cancer UK charity work, they provide one to one conversation with someone who has had the operation at a similar age. I spoke to someone who had it at the same age as myself and we were able to openly discuss all issues including sexual ones. This was incredibly beneficial, and I would recommend anyone in this position to do this.

The emotions have been all over the place as you read the consequences of the operation which range in severity and these provide you with the fear of the unknown. I am though determined not to let this get in the way of what I want to do and despite the fact I know this is going to be stressful and limiting I intend to work on getting better as quickly as possible.

The operation is in just over three weeks’ time and I will be updating the blog as  events occur with the pre op assessment in 8 days’ time.