Just had to share….
That is my opinion of the organisers and attendees at this illegal rave.
We are constantly being told that it is the older generation, including me, that are at risk, that we should be abiding by the social distancing rules and self isolating.
And yet this message is somehow lost on the young in this country. Although this incident was happening in Wales, it is just one of many that are happening across the whole of the UK.
The young quite happily ignore all the rules. They ignore the fact that anything they pick up, at these events and other such gatherings, will be taken home and shared with their friends and family. Shared with their parents and, possibly, their grandparents.
Ch Supt Simon Belcher says: “This type of illegal gathering is totally unacceptable and we are aware of the concerns it is causing for the local community.
“I would like to again remind people of their obligations under the current coronavirus legislation and the overarching goal for everyone to take personal responsibility by following Welsh government regulations to keep Wales safe.”
What is required is that the government give the powers to clamp down on these incidents and for the authorities to exercise those powers.
The message isn’t getting through. It is time to make examples of the organisers and the attendees.
“See you all in six months !!!”
So said I, five years ago. A lot has happened in those five years although not a lot in the land of the prostate. Or perhaps I should say, not a lot, to my knowledge.
In 2015 we retired, and since then, we rebuilt our conservatory, holidayed in France – 2months and Italy – 8 days. We have spent 3 stints in Australia. Those 3 Ozzie visits totalled 12 months in all with the last trip stretching into 7 months, in part due to the pandemic.
And so to my prostate …
After our return from the latest Ozzie adventure, I was scheduled for a Urology Consult (telephone) 28th July. As is the norm, these are preceded by the taking of blood samples. As my GP had requested a blood sample to check my blood sugar levels, it seemed appropriate to combine them. So on Wednesday 22nd July, at eight in the morning, I presented myself at my local surgery and provided the necessary samples. I then sat back to await the consult scheduled for the following Tuesday. The next day, Thursday 23rd, I received a call from the GP surgery, could I come in and give another sample.
Apparently they wanted to rule out any potential issues with the analysis of the previous sample. As you can imagine my brain went into hyperdrive, what had the blood sample shown. I duly presented myself at the surgery and gave up some more of my blood. Although the person on the call didn’t know why I needed to give another sample, the nurse taking my blood was a little more forthcoming.
It appears the first sample showed my PSA level was up. This second sample was to determine if there had been a balls up in the lab or if something more sinister was happening.
Friday I received call from the surgery asking if I woud be prepared to have a telephone consult, with my GP Dr Mannings, on Tuesday evening. I pointed out that I also had a telephone consult with the Urologist on Tuesday morning. That’s great quipped the receptionist, you’ll be able to tell the doctor what the results are and what your urologists plans are.
With all this interest in my blood and doctors left, right and centre wanting to speak to me my curiosity was definitely peaked.
So Tuesday 28th duly arrives and I have my telephone consult with the Urologist, Mr Hodgson. Yes, he confirmed, my PSA has risen.
Apparently last June my PSA was 3.6 but these latest blood tests show my PSA at 7.9 and 8.9. A sure indicator that something is going on down in the nether regions although still lower than the 13.3 which was where I was at before having the Brachytherapy
Because of this my consultant wants me to have a series of scans. CT, MRI and full body bone scan. The call is ended with the promise that I will be contacted with appointment details.
Sure enough, later in the day I receive a call from the Scanning Dept., would I be available on the morning of Saturday 1st August, for a CT scan ? Yes of course, and so I am duly booked in for 09:00.
Later the same day I have my consult with my GP. He already knew about the consultants plans but is like a child being handed a bag of sweets, so excited, when I tell him that already have the first of my scans booked.
The NHS is actually working very swiftly and efficiently. Obviously I have Covid-19 to thank for this, the hospitals are operating in a very stripped back mode. All to my advantage.
Over the next few days I receive calls and set up the remaining appointments. Monday 3rd August @ 19:00 for the MRI and Tuesday 11th August for Full Body Bone Scan. The bone scan is in two parts. I have to turn to at 11:15 for a radioactive injection. Go away for a while, then return at 14:30 for the actual scan. Apparently, after the injection, due to its radioactive nature, I have to steer clear of any pregnant women and young children Same advice I was given after I had my Brachytherapy.
I duly attended the three scans. One thing I noted is that I am able to lay completely still during these scanning sessions. They each have taken anything between twenty minutes and forty five minute. At home I find it just about impossible to keep my legs still, whether I am sitting watching TV or laid in bed. Maybe I need to get a huge doughnut installed at home.
For each of the scans I also had an injection. The one administered during the CT, I was warned, would trigger a warm sensation in my nether regions. Something akin to wetting oneself. Not something you want to consider when typically any sensation in the bladder region typically turns into a pee panic. As it happens, the sensation I felt was around the neck and up around my ear. Something like I used to feel when my Mum had caught me out in a lie. For the MRI I was given an injection of Buscopan. When I mentioned that my wife takes Buscopan for her IBS te doctor said it’s the same stuff but won’t hang around as long but that it might affect my eye sight i.e. blur my vision. He assured me it would have cleared my system before I got back to my car for the drive home. As for the bone scan and the radioactive injection I was informed that, other than having to stay away from pregnant ladies and young children, there were no side effects, that I wouldn’t be aware of it in my bod.
All that remained was for me to await the results. I assumed that I would receive a phone call from my consultant, Mr Hodgson.
I did receive a phone call, but not from Mr Hodgson. It was from a yong lady, I assume from the Urology Department reception.
She informed me that she was calling to book me in for a Pre-op Assessment !!!
My heart dropped, my stomach did a flip. “Pre-op ?” I said, “pre-op for what ?” “Well, you came into Urology yesterday” says the young lady. “Nope” says I, “I didn’t, I haven’t had any contact with Urology since the 28th July”. “Oh !” she says “And you haven’t seen the letter ?” Again “Nope” says I, “In fact I would have expected a phone call from Mr Hodgson, not a bloody letter”. She is really apologetic and puts me on hold briefly. When she comes back on line she asks me if I want to wait for the letter, or she could read it out to me. I take the latter option. So, she reads the letter to me. My heart and stomach resume a more calm state.
None of the three scans suggest any spread of the disease.
Needless to say, this news was not what I was expecting. Nevertheless, it was encouraging. The letter, from Mr Hodgson, set out the next steps to be taken to determine if in fact my cancer has recurred.
Those steps are
- A PET CT
- Template Biopsy (to be carried ot under GA and the reason for the Pre-Op)
The PET CT has been scheduled for Tuesday 25th August @ 15:00 and I have had the Pre-Op. This was in two parts. Part 1 was on Tuesday 18th, a telephone assessment which was then followed up with a hospital visit on Thursday 20th, where they carried out an ECG, swabs for MRSA and took a urine sample.
So there we are, all up to speed. I’ll post my next episode after the PET CT and when I know the date for the biopsy.
I am currently languishing in the Perth suburbs, Western Australia.
Last October, my son-in-law Steve was diagnosed with a brain tumour (glioblastoma). Very quickly, following the diagnosis, he was whisked into hospital for brain surgery. At the time we didn’t know how much after care he would need but we offered to help out and so my wife and I travelled out to Oz to provide support.
After care wasn’t the issue. Steve really recovered well after the surgery with no real pain and none of the residual weakness that would have been present following an abdominal or chest operation.
No, the follow up treatment and schedule was the real issue.
The radiotherapy was daily, Monday to Friday, for six weeks. Whilst the chemotherapy was tablet form, taken daily Monday to Sunday during the same six weeks. Following the surgery Steve was forbidden to drive for the next six to twelve months. So, to enable my daughter to carry on working, my role was to act as chauffer. Daily trips to Fiona Stanley Hospital, Perth interspersed with trips to Sir Charles Gairdner Hospital, also in Perth. As well as various trips for blood tests and scans.
As the chemo built up in his system, the expected nausea and fatigue and exhaustion also built up. Alongside all this came the loss of appetite and corruption of taste buds.
And here is the conundrum.
What do you feed someone, who has all this going on ?
Even after the initial course of chemo and radio therapies has been completed, the dietary disruption continues.
After all, it is hard enough, under normal circumstances, to cater for the normal familial likes and dislikes of
- a granddaughter who doesn’t eat meat that isn’t chicken or ham (unless its a burger or a rissole, then almost anything goes) and has a limited set of veggie likes (eats broccoli and cauliflower but not green beans or pumpkin). By the way she loves fish but won’t eat salmon.
- a wife who loves fish especially salmon, has a short list of veggies (eats cauliflower but not broccoli and no sprouts or carrots) and doesn’t eat “spicy” food or creamy food i.e. white sauces are something of a minefield. Still waiting for the clear definition of what constitutes spicy.
- a daughter who also doesn’t like “spicy” food, likes fish that isn’t salmon or trout. Not sure about tuna ??? Eats most veggies (definitely no sprouts) and all non chicken meats have to be cooked to near charcoal point i.e. no pink
Before the tumour and chemo, Steve used to pretty much eat everything. Now he finds the flavour of most foods to be too strong, overpowering.
So, bland is the order of the day. Steamed fish or chicken predominates. Or the same but simply pan fried or baked. No sauces and definitely no herbs or spices. Some meals comprise just two tenderloin chicken pieces, total weight around 60g, steamed and maybe accompanied by a couple of carrot batons and/or a small broccoli floret.
So, how do I feed Steve without overpowering his hypersensitive taste-buds ? How do I coax him to eat a bit more as his energy levels are already depleted due to the chemo ? The lack of food does nothing to boost those already depleted levels. How do I introduce a bit of variety to his diet ?
Although he completed the initial concurrent chemo / radio therapies, my son-in-law has now started a new regime. He takes a five day course of tablet form chemotherapy, one week in four.
So, the disruption to taste, appetite, stamina and energy levels will be continuing for the next six months at least, maybe even for twelve.
Any suggestions ?
A cautionary tale.
For a couple of days I was suffering from a “crick” in my neck / shoulder. I have no idea how these things occur but I do get them from time to time. Possibly caused by laying in an odd position when I sleep or, perhaps, caused by laying in a draught. Air-con ??
Anyway, having taken some pain killers and trying a hot shower focused on the painful area I was offered the use of a “wheat-bag”
The bag was heated for just two minutes in the microwave and on removal was quite warm to the touch. Not hot.
I placed the back on my shoulder such that the bag was also partly heating the side of my neck. After 10 minutes or so I could feel that the “crick” was easing so the bag appeared to be doing the trick. Possibly the heat combined with the pain killer taken earlier.
After treatment I went out for the day and, with time, the movement in my neck became much easier and the pain had virtually disappeared.
Later that evening I was changing my shirt and noticed a red mark on my shoulder. A more detailed inspection via mirror showed what looked like bite mark, almost like I had been bitten by a human. No indentations, just two large red horseshoe shaped marks . At the center of these two marks were three large blisters, each one approximately half a centimeter across. Subsequently these have joined to become one large blister.
I should point out that the wheat bag was not placed directly on my skin as I was wearing a heavy cotton polo shirt at the time. Also, at no time did the heat being emitted by the bag feel extreme or cause any discomfort. And I have not felt any pain since. Some may suggest that perhaps my pain threshold has some bearing but I don’t think so. I have, over many years, experienced burns caused by hot metal during metalwork at school and in later years and hot water splashes. They all hurt like hell at the time and stung for some period of time afterwards. I can only think that the time elapsed had some bearing on the creation of my blisters.
Both my wife and I have used wheat bags before with no negative effects and I can think of no other contributing factors. After several days I still have the blisters but there has been no soreness. Strange.
All I can say is …..
Be Careful Out There !!
So at the end of my last post I had just escaped from the QA following my Brachytherapy procedure. This was to be a temporary escape as I had to present myself back at the hospital for a CAT scan.
So the following Monday I dutifully presented myself for scrutiny. Unfortunately it was organised chaos due to a lack of availability of notes. This is not the first time that my notes have not been available although it is more usual for them to not be available for an appointment that has been set up for weeks.
I did press the radiographer as to why it was necessary for my notes to be available when they knew that the scan was to confirm placement of the radioactive seeds in my prostate. I said that I assumed they knew where the prostate was and therefore where to target the scan.
She, very patiently, explained to me that having a scan 3 days after brachytherapy was not normal procedure. The norm is to have an MRI after about a month, so they needed to know if there were any other issues that they needed to be aware of. They did their best to find my notes, even going up to the ward to search on the assumption that they, my notes, were “in transit” due to the weekend.
My consultant must have foreseen this as he had provided me with an extension number on which he could be contacted, even though he was in surgery. I passed this number over to the radiographer and after a short chat with my consultant we were good to go.
So after nearly two hours pfaffing around I had my ten minutes of scanning and we were out of the hospital. Of course there is then a period of trepidation, waiting to hear if I was going to have to go back in for more seeds. As time passed I relaxed, no news is good news after all.
A month after the procedure I had the MRI. This was a much quicker visit than my previous MRI. I guess because this time they were only interested in checking the prostate itself and the immediate surrounding area.
Once again, there is that trepidatious period of time where you wait for the bad news phone call. And, once again, as time passed I relaxed.
The next check point in all this was to be a visit to the consultant preceded by a visit to the vampire clinic.
Which brings us up to date.
Last week I gave the blood sample required to check my PSA levels and yesterday I visited my consultant. After all the pleasantries, how is your bladder, how are your bowels, etc. etc. we eventually got round to the important business i.e. talking about my PSA.
Brilliant news !!
Prior to the brachytherapy my PSA was up at just over 13. Now my PSA reads just over 1. Which, in the words of my consultant means that the seeds are doing their job. My next check point will be in six months when I will have another blood test and another consult.
My thanks to Clotho, Lachesis and Atropos, the three fates (Moirai) for watching over me. I think they were watching over me last December when my operation was cancelled due to a lack of hospital beds. When I think about all the possibilities I am so, so glad that I have taken this path.
See you all in six months !!!
For those of you who are following this saga you will remember that my last post was shortly after attending hospital for surgery. That the surgery was cancelled due to a lack of availability of beds.
I think the fates intervened and the cancellation of the operation was a blessing in disguise. There were just too many risks with the operation and the potential impact to my lifestyle for the following year (at least) were just too much to consider.
So, surgery, which was always my first choice, has now been kicked into touch, and became the option of last resort.
Since December 2014 I have had follow-up appointments with Mr Wilkinson, my consultant. We have discussed fully, my reasons for not going ahead with the surgical option. As a result I was referred to an oncologist, Mr Nagar who talked me through the alternative radiotherapy options.
- External Radiotherapy
Given in the hospital radiotherapy department, as daily sessions from Monday–Friday, with a rest at the weekend. The course of treatment would last for just over 7 weeks.
- Low-Dose Rate (LDR) Brachytherapy
This type of radiotherapy is sometimes called internal radiotherapy, implant therapy or seed implantation. This uses small, radioactive metal ‘seeds’ that are inserted into the tumour so that radiation is released slowly. The seeds are not removed but the radiation gradually fades away over about six months. There is no risk of it affecting other people.
So after a full and frank discussion with Mr Nagar I was left with a lot of thinking to do, along with more discussions with my wife. The net of this was that I decided that LDR Brachytherapy was the right treatment for me. The following images show the basics of the procedure.
And so it was back to Mr. Wilkinson who scheduled me for a Flow Rate Test. I mentioned that this was somewhat less than successful last time so he suggested that the fall back plan would be a visit to Urodynamics.
As preparation for the Flow Test I had to keep a diary, over three days, of how much liquid I took on board, the type of liquid (tea, beer, wine etc.) and how much pee I produced. On the day of the flow test I thought I would help things along by arriving at the hospital early and drinking lots of water. I spent nearly an hour walking the grounds sipping at my bottle of water. Twenty minutes before my appointment my bladder started to indicate that it would need emptying soon so I headed up to Urology. I let the receptionist know that I might have an urgent need to perform. I was directed to take a seat and to let her know when things became truly urgent. So I sat there and my bladder went to sleep.
At my allotted appointment time I was called through to another waiting area asked to sit, offered tea and told to shout when I was ready to do the test. My bladder snoozed on. It was perhaps another thirty minutes before my bladder woke up. So I looked for the nurse. No sign. Well she said to shout so I did. After all I didn’t want to waste this opportunity. Thankfully the nurse appeared and we dashed to the flow test equipment. Basically it looks something like this….
After successfully performing I was given a quick ultrasound check to see what was left in my bladder and there it was, job done. Although I had a second appointment set for a visit to Urodynamics it was deemed not to be necessary and was cancelled. Instead a new appointment with the consultant, Mr Hodgson, was set.
Time flew by and once again I presented myself for the scheduled appointment with Mr Hodgson. Sadly, not for the first time, there was a distinct lack of notes. At least the computer was working this time and he was able to access my notes that way. However, what was missing was the flow rate test results. Two sets of print outs were found from that date and I had to choose the chart from my test. Thankfully the graphs were very different and I could easily identify mine.
The results were deemed good and I was informed that I would need another rectal (digital) exam as well as having my prostate vital statistics taken.
So there I was again, trousers round my ankles, up on the couch, laid on my side with my knees under my chin. Different room but the scenery hadn’t changed just a blank wall painted in that neutral paint that all hospitals seem to choose.
First up was the rectal (digital) exam and for the first time since this whole process began I actually felt some discomfort, though not for very long. This was followed by an Ultrasound Scan during which measurements were taken of my prostate. These help to determine the shape and mass of the prostate and would be used during the Brachytherapy procedure.
Soon the scan was finished and I was back in the vertical plane. I almost had my trousers secured when I was informed that some of the data from the scan had not been saved. So it was trolleys round the ankles again, back on the couch and staring once again at the blandly painted wall. This time the scan image was saved and once fully dressed we were back to discussing the procedure and timing.
Apparently hospitals don’t keep a cupboard full of these things around and the seeds have to be procured. I wondered if they went to Suttons, Fothergills or perhaps our local garden center to obtain the seeds. I did not vocalise these thoughts. They implant 80 – 100 Iodine 125 seeds @ £30.00 each. That’s dearer than a packet of Impatiens seeds.
When my consultation was over I had to visit with the nurse for nasal & groin swabs. She was less than amused when I suggested that I had saved the NHS money by using one swab for both areas. Either she’d had a humour bypass or had heard it all before.
On 13th May I presented myself for my Pre-Op Assessment and was duly measured, weighed and gave up a blood sample.
Before I knew it a date had been set for the procedure, May 15th. This was sooner than anticipated and I will admit to going through a moment of panic.
On the day I presented myself at reception and was shown through to a consulting room. I was measured and weighed again, blood pressure taken and given some premeds, antibiotics etc.. I was visited by the anaesthetic and the consultant and signed the consent forms after having everything explained to me. Thankfully, this time, the wait was not very long between these consultations and being taken through to theatre.
Preparation for the procedure was a surreal experience, what with me being dressed in the wonderful hospital smock and stockings, also the jokey disposition of the theatre staff. We were actually having a good time and that was before I had any anaesthetic.
It was about this time that I started to misbehave. As usual they inserted a canula, except that they had two goes at that. Then they informed me that I was due to have an epidural, which had not been discussed previously. At the same time they administered something through the canula that they said would make me feel like I had consumed a couple of G & Ts. I remember feeling a little woozy and then nothing more until came to in the recovery area.
I was subsequently informed that the anaesthetists assistant tried on two occasions to set up the epidural. They are supposed to see spinal fluid come out of the needle and on each occasion I wouldn’t give any up. The anaesthetist then took over and tried herself, three more times, and still I wouldn’t give any fluid. At this point they decided that they would give up on the epidural and put me under with a general anaesthetic (GA). Once they had me under, and the procedure was underway, that’s when I really began to misbehave. I decided to vomit.
From what I have heard vomiting whilst under a GA is not good. This required the use of dyna-rod and a vacuum cleaner to clear out my tubes and the upper reaches of my lungs.
As a result of this the procedure took much longer than the estimated two hours which would be normal. A further consequence was that I had to stay in hospital overnight, when I had expected to go home, and I was wheeled up to a ward where I was connected to an oxygen supply with attached humidifier. This was so that they could monitor me and make sure that I hadn’t inhaled any of my stomach contents and didn’t suffer an infection.
So there I was stuck in hospital. Hungry, I hadn’t eaten for over twelve hours. Thirsty, no fluids other than a few sips of water prior to the procedure. Catheterised, for the procedure and for the duration of my observation. Sore throat due to the GA and subsequent rodding out and suction due to my vomiting session.
The nurses brought me a sandwich to alleviate the hunger. A cheese on wholemeal sandwich was the only choice and was so dry that it was very hard to swallow, especially kind to my sore throat …. NOT !!
This was only the beginning of the fun night. Did I mention that I was catheterised ? Through the night I was subjected to hourly obs. Just as I was drifting off to sleep along would come the nurse to take my temperature and my blood pressure. Then, just as I was drifting away again, she would come back and I would feel a pulling at my penis. This was specifically related to the brachytherapy and the catheter. She had to use a Geiger counter type device and scan the contents of bag attached to my catheter then along the length of the tube up to the old fella. Required to ensure that none of my seeds had escaped. Any found would need special handling for disposal. Seeds can escape from their implantation point and move around the body. Supposedly this is not harmful.
Saturday morning arrived and I felt a bit fresher after a strip wash and some breakfast. I was scheduled to go down for an X-ray but someone cancelled it which meant a new booking for later in the day. Hospitals are the most boring places to be when you are waiting to be released.
I was visited by the consultant who informed me that I would need to go for a scan on Monday. This was to ensure that the seeds were implanted in the right place and the right quantity. He also said I could have the catheter removed. Yippee !! His female assistant performed the removal saying “this might feel a little strange”. Decidedly unpleasant would have been my description. Mind you, after my first few pee’s following catheter removal I would have gladly had it back. The sensation is as close to burning as I can imagine and it seems like you can feel it all the way back to your bladder. Thankfully that sensation slowly faded away over the next couple of days.
The consultant also gave me a little blue card, which I have to carry for the next three years. This card informs people that I have “received a permanent radioactive iodine seed (Iodine – 125) implant to the prostate”. This is not because I glow in the dark, but the seeds will show up on various scanners and may even set off alarms at airports.
Back in the hospital, the consultant said he was happy for me to go home but that the final decision was down to the anaesthetist. And he wouldn’t give the go ahead until I had an X-ray.
Well it was nearly 16:00 when I was taken down for the X-ray and it was gone 17:00 before I was finally released. At this time I was given a box of Tamsulosin capsules.
Tamsulosin is used to relax the muscle around the Prostate which, not unexpected, can be a bit irritated following the implants. How would you feel after 80-100 foreign bodies were inserted about your person. Add to the facts that they are radioactive too. The irritation / inflammation can cause the Prostate to swell and constrict the urether making it difficult to pee.
So home I went. What a relief it was to get out of the hospital.
The tobacco giant Philip Morris is suing Uruguay for having some of the best anti-smoking laws in the world, and there’s a good chance it could win, unless we strengthen the fight in court.
It’s a scary reality that one company, whose product kills, could overturn laws that protect our public health. But if our community’s voices are brought into court by a world class legal team, we could fight back with a force no judge could ignore, showing how this sets an unacceptable precedent for the world.
Let’s tell the court that this doesn’t just affect Uruguay — if Big Tobacco gets their way it opens the door for challenges everywhere — companies already have at least 4 other countries in their crosshairs, and many more have anti-smoking laws at risk.
We have to move fast — the court is already hearing arguments. Sign to protect our public health and our democracies from corporate greed — each of our names will be submitted to the court.
My Prostate Operation Was Cancelled – After 3 + hours of waiting.
Well, it’s taken me a while to get my thoughts together after what turned out to be a really stressful morning. Truth be told, I had probably been stressing for quite a few days but had not realised……
As I said in my previous post, we had been requested to arrive thirty minutes earlier than the 07:00 originally planned. This was, supposedly, so that I could have my pre-operation meet with the surgeon and anaesthetist. So my wife and I dutifully presented ourselves at 06:30 in Theatre Admissions and were, almost immediately, shown through to a consultation room.
A nurse arrived, wrote out a luggage tag for my small holdall, and attached a fancier version to my wrist. So far all was moving along quite nicely. Next she started taking / checking my details and very soon I began to wonder what the point of the pre-operation assessment was since all the questions were repeats of Wednesday afternoons interrogation. My doubts further increased when she informed me that she didn’t have my blood details nor my ECG results both of which were part of the Wednesday session.
Already somewhat stressed, in anticipation of the forthcoming procedure, I was beginning to get a little terse. Not just that, but I was also beginning to wonder if they knew what I was in for. A thought that was reinforced a few minutes later when I was invited to get changed. Some of you will remember from my previous visit, for the template biopsy, that I had been given a gown which was way too small and couldn’t be secured. In an attempt to prevent the same indignity I asked for a larger gown. Yet again I was offered a small size. It was obvious that it wouldn’t even fit across my shoulders, let alone do up at the back. Almost grudgingly I was offered a “bariatric” gown. I muttered “whatever that is ” under my breath. Obviously not under enough, as I was informed “oh they are huge !!! “.
As she handed me my bell tent I was asked “what is it you are having done? ” I replied “my Prostate!! “. “Then you should take everything off!!” she informed me.
With that I was left to change. The gown had enough room in it to hold a small disco but at least I could fasten it up. And, best of all, my new dressing gown was of sufficient length to reach the lovely sage green pressure stockings I was sporting. This new vision of sartorial loveliness was finished off by my new suede moccasin style slippers. Now, properly attired, I returned to sit with my wife in the consultation room.
There then ensued a, seemingly, long wait. In truth it was probably only minutes but eventually the anaesthetist arrived and after he had confirmed my details, and repeated many of the questions from Wednesday afternoon, and from earlier this very morning, he ran through what the order of play would be.
For the first time the duration of the operation was mentioned. I had been under the impression that this was to be a two hour procedure. Nope, this was to be four to five hours in duration. Suddenly the first penny, of a whole bag full, dropped and the true magnitude of this operation began to sink in. Five hours!!! He also mentioned that it was possible that the robotic basis of the operation could switch to full open surgery should any problems arise. This had always lurked at the back of my mind and, to be honest, that is where I kept it filed. That is, until the session with the surgeon.
Fast forward a few minutes….
Mr. Wilkinson talked us through the operation and thoroughly explained risks. How little I knew. Over the last couple of years I have reviewed the implications of having this operation and thought that I was pretty well versed. Trouble is, I had been focusing on the post operative time frame. I had not paid too much attention to the detail of the surgery itself.
He, Mr Wilkinson, listed the various risks involved with a radical prostatectomy, starting with how difficult it was going to be to find the little sucker. Especially given the route taken during keyhole surgery, in through the abdomen then turn due south and head for the pelvic zone.
Add to that the fact that the robot has fixed length (but short) arms. I know some folks who are like that when it comes to buying their round in the pub. Next up was the proximity of the prostate to my bladder which introduces a risk of damage over and above the urinary incontinence which is to be expected. Moving swiftly on, next on the list is the proximity to the bowel.
New news here was that the prostate could be stuck to the bowel and that this could have been caused by, if not caused by then exacerbated by, the biopsies I had as part of the original diagnosis and active surveillance regime. At no time was it ever explained to me that the biopsies, TRUS or Template, could have negative impact on future surgery. Apparently during the prostate operation they mighty have to peel the bowel away from the prostate. The biopsies could contribute to any adhesion between the bowel wall and my prostate and the act of separation could cause damage that would have to be repaired. If such damage occurred it would require a colostomy to allow the repair to heal. Obviously, once the repair was healed there would have to be another operation to undo the colostomy. My four to six weeks recovery period suddenly looked to be extending with the possibility of the further surgery and recovery period.
Continuing on with the inherent risks of this surgery, let’s not forget that during the procedure I would be tilted head down by approximately 30 degrees. This would cause my innards to slop towards my head, thereby putting pressure on my heart and lungs. Apparently this is a negative thing.
The coup de grace was the underlying small print of robotic surgery, if they ran into any difficulties, i.e. the Da Vinci machines short arms couldn’t reach, they would revert to the good old fashioned procedure and open me up from stem to stern.
Bottom line for me was that, due to my 18.5 stone (259lb) weight, the risk factors were double the norm.
This operation, and the potential ramifications, was taking on mammoth proportions. And now, the anxiety I was already feeling, was ratcheting up to whole new levels. I really was beginning to feel that I was making a big mistake. But, despite my misgivings I still signed the consent forms.
You may well ask “Why?” Why proceed when I was obviously having doubts.
I can offer no sensible answer. Guilt, Fear, Not wanting to let anyone / everyone / myself down.
After Mr Wilkinson left, my wife said “I fully expected you to refuse to sign that “.
Her statement just added to my anxiety and it was at this point that the anaesthetist returned to ask if I would agree to an epidural. As there was the possibility of my robotic surgery converting to full open surgery he thought it might be a good idea to give me an epidural to help with the pain management.
It was then that I experienced what I can only describe as a “crisis “. It wasn’t that I was crying, there was no wailing and gnashing of teeth, just that my mind was in total turmoil. I was in a flat spin. I really don’t know if I was coherent but I do think I was borderline having a panic attack. I couldn’t answer him. I tried to explain that I was seriously thinking that I shouldn’t go ahead with the surgery. He sat there patiently until I regained my self control and eventually I informed him that he should go ahead with the epidural.
So I was still going ahead. I think that I probably convinced myself that it was normal to have doubts and that I was probably magnifying the issues out of all proportion.
At around 09:00, my wife, took herself off to work and I went to sit with the other surgical victims where I waited for nearly an hour. During this time I was brought a cup of tablets, my antibiotics, anti vomiting, anti anti everything etc etc. And a small cup of water to wash them all down. This was the only drink I had since 05:30. The nurse that delivered them said something that I didn’t quite catch but when I asked she apologised for the long wait and informed me that there was meeting underway to discuss if my operation was to proceed as there was an issue regarding availability of a bed for me after my operation.
Around 10:00 Mr Wilkinson arrived and took me off to a consultation room. He explained that my operation had been delayed due to the beds issue. That he and the other consultant, Mr Solomon, had decided at around 09:30 that the operation was a no go. At around 10:00 the management had given permission for the operation to proceed but by then this was considered to be way too late. The operating list for Friday was morning only, such a late start would mean changing members of the surgical team mid operation and a probable finish time around 17:00. Adding to the risks previously outlined and putting the surgical team under the clock, more so than they would normally be. All in all, not good for the patient, Me! And not good for them.
To say that I was relieved would be an understatement. I had a long chat with Mr Wilkinson about my earlier “crisis” and whether surgery was the right option for me. The net of this was that the reschedule of my operation would be deferred until after Christmas.
To be quite honest,my wife and I are taking this time to rethink if this is the right way to go. Right now it doesn’t seem that surgery is for me.
I think, fate was on my side, that this operation was never meant to be.
Monday I had a meet with my consultant. We reviewed my notes, discussed my latest blood test and the current PSA levels which are still high. This was not unexpected and I wanted to use this session to fill in answers to a number of questions buzzing around in my head .
How long would I be in hospital?
When could I get back to work?
When could I start driving again?
Some of the responses were a surprise.
My stay in hospital is likely to only be over night but I had previously been told 2 to 3 days. This is, of course, a good thing. The sooner I am back home the better.
Getting back to work is a much more difficult question to answer as there are many factors involved.
The first is the issue of continence or, to be more specific, incontinence. After the op I will be catheterised for a period of time, to allow the newly joined urethra to heal properly. Apparently, it can be quite uncomfortable when sitting, especially in a car. After the catheter is removed I will have to relearn bladder control and this can take quite some time. This is the main issue that made me so reluctant to have the op. Potentially pissing myself in a public place or in the workplace is a huge concept to deal with. Actually, in my mind, sitting in a restaurant with friends or family when my bladder decides to unleash a tidal wave of urine across the floor is probably my worst nightmare. Of course I am magnifying worst case scenarios, so anything less is actually a positive step.
Apparently fatigue is a common issue following the procedure. Not just tiredness but the inability to focus mentally.
The net of all this was that I would probably be away from the office for a few weeks.
My actual return to participating in work by working from home could be very much sooner.
It all depends on my body’s ability to recover. We are all different and our powers of recuperation so variable that it’s nigh on impossible to predict any outcome accurately.
At some point in the proceedings my consultant threw into the conversation that, not only would they be removing my Prostate, but they would likely harvest a few lymph nodes too. Apparently this is becoming a more common practice as analysis of the removed nodes can indicate if cancerous cells have started to migrate.
All good things come to an end and as my appointment was drawing to a close, the consultant suddenly left the room, returning with his hands full. Saying “These are for you ” he dropped a black bag into my hands. This was followed by a large tome similar to a filofax.
These, it transpired, were my initial starter pack of “tenna man” pads and helpful information regarding the after op time. In the filofax, more of the same, plus pages to record my diagnosis and treatment details.
Net result of this visit was confirmation of much that I already knew but also shows that there is no clear cut outcome for my forthcoming procedure.
Next step is the pre-op assessment….. Stay tuned 😉