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Archive for the ‘Catheters’ Category

PROSTABLOG NZ:  Well, here’s something good for a chuckle – my short video (right) showing improved urine stream after prostate surgery has just been taken down by You Tube.

Here’s what they say:

The following video(s) from your account have been disabled for violating the YouTube Community Guidelines:

  • Stream – (Tuckr001)

Your account has received one Community Guidelines warning sanction, which will expire in six months. Additional violations may result in the temporary disabling of your ability to post content to YouTube and/or the termination of your account.

Sincerely,

The YouTube Team

So, I’m on notice for offending good taste, I guess.

I’d love to know who complained.

Here’s my response to You Tube (be interesting to see what they say):

I have received your message with some alarm.
The video clip you refer to is a serious attempt to illustrate to men recovering from the effects of prostate cancer surgery the results such surgery have on improving urine flow.
I refer you to the blog on which this video appears. From that, hopefully, you will see the context.
To remove the video for reasons that can only be imagined shows that You Tube has little understanding of the purpose of such an item.
I request that you restore it as soon as possible.
I await your reply with interest, and will report it on the blog.
Here’s the link to my blog (which has so far received 52,000 page uploads and much favourable comment from prostate cancer sufferers and medical experts): http://prostablog.wordpress.com
Thank you

Having read the community guidelines, I’m at a loss to know where the video trangresses. Take a read (see the link above) and let me know what you think.

Here’s where the original video appeared in my series, My PC Adventure: CLICK HERE

I have to say that the video has already been through the scrutiny of the toughest censor of all, my wife Lin, who cut the length (of the video) to a short few seconds. Since she apporoved it, who could possibly take offence?

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catheter2

ME and my catheter.

PROSTABLOG NZ: More on catheters.

An English industrial design student called Sam Gough has been in touch to ask if he can use my account of having a catheter after surgery last March (see Comments).

Sam is researching medical equipment and is interested in the catheter.

If any of you have stories to tell about this indispensable – but seemingly at times devilish – piece of kit, please contact him at: samgough23@hotmail.com

I recounted a couple of negative anecdotes about catheters in last night’s blog, so perhaps I need to balance it with others that aren’t quite so downside.

One mate who went through radical prostatectomy a year before I did said it was a handy bit of gear: “You could go to the pub and just piss the beer straight through.”

He was surely joking, and it was probably just an attempt to allay my fears.

Another said: “Ah, the catheter…you’ll grow to love your catheter.” More irony, I guess.

Barry Young, president of the NZ Prostate Cancer Foundation told me that when he was recovering from surgery 10 years ago he had his catheter removed after a week or so, as you do, but then had recurring incidents of not being able to pee.

It would happen at the most inopportune times, so he had to learn to insert a catheter tube on himself.

Imagine that! After all, for some of us, the damned thing is put in place when we’re under anaesthetic, so we can only look and marvel later at how such a bloody big thick piece of tubing can be introduced to what you always imagine is a such narrow space.

Incidentally, Barry had the problem only temporarily. He has been fully recovered for 10 years, and probably – like all good boaties who suffer hell in a storm then quickly forget about it in the safe haven of harbour – now has trouble remembering the details. Maybe not.

The growing-to-love-your-catheter comment came back to haunt me straight after my surgery, when Bob Hale, the highly professional urology nurse at Wellington Hospital, came to see me in the recovery ward.

I made a gauche comment about “loving my catheter” and he looked at me sternly: “Having a catheter is one of the most uncomfortable experiences a man can have,” he said.

Bob turned out to be anything but stern. He was the one who took the tube out later and he did such a great job I felt no discomfort at all.

One more catheter anecdote: I have an old friend who, nearing 80, was admitted to Auckland Hospital with urinary problems and was discovered to have a very enlarged prostate. He had a catheter inserted for temporary relief and surgery was advised.

His response: no way. And he still has the catheter – a year later.

He truly loves his catheter.

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catheter3PROSTABLOG NZ: What is it about the catheter?

Whenever I look at the viewer statistics for Prostablog, there’s one thing that stands out: “catheter” is the most popular search word people use when they find their way to this site.

It beats everything else by a country mile.

Yesterday, for instance, there were 27 instances of the word being searched – while the next most popular occured seven times.

Today, it’s the same – so far 13 searches on “catheter”, with “Mick Jagger” scoring three (God knows why?) and “brachytherapy and impotence” getting two.

It’s been like this ever since the blog started in April.

I’m not sure I understand how search engines work, but there seems to be a message here: us blokes are very, very worried about getting that damned tube shoved up our tackle.

I can understand why. It was my biggest single fear of the whole radical prostatectomy process.

I needn’t have worried, as it turned out, because the male urology nurse at Wellington Hospital did a brilliant job of removing it. I honestly didn’t feel a thing.

However, two male acquaintances haven’t been so lucky. They both say it was excrutiating. Both had female nurses (is there something significant here? Surely not…) do the removal.

One guy had his taken out just last month and in his words “she just ripped it out.”

How common are such stories? Do they account for the general fear men seem to have about the catheter?

Perhaps someone could write in and enlighten me. All I know is, the term brings a lot of traffic to this blogsite.

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MAY 25: NEW PROSTATE CANCER INFO-LINK:  A group of German researchers has developed a method to predict the duration of urinary incontinence after radical prostatectomy based on potential risk factors. READ MORE>

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PART 20 of My PC Adventure – see full story HERE>

Having prostate cancer could be a terribly lonely experience, if you let it.

Sounds ridiculous to say that, doesn’t it.

After all, prostate cancer is scarcely a rare disease. In fact, it seems like an epidemic when you start asking around. A lot of famous people seem to die from it.

On any given day there are millions of words written about it on the ‘net.

There is a fully-developed medical structure for dealing with it, and each year there is a well-publicised fund-raising campaign which persuades young men to grow awful moustaches for the cause.

So what’s with the “L” word?

Well, think on this.

If I’d just had a triple by-pass heart operation and did what I did today – climbed to the top of Wellington’s Mt Victoria - people would be saying “Hey, you’re looking fit and healthy. It obviously went well…” etc.

If it was a brain tumour I’d had removed, they would be complimenting me on my restored mental acuity (if I had, in fact, regained it, or had it in the first place).

But the prostate…you can’t invite people into the loo and show them how well you’re peeing.

And there are  those little question marks in people’s minds about manhood, continence and nappies. Does he have a wet patch down there? They can’t take a look, overtly. That would be like staring at a woman’s chest after she’s told you about her breast cancer operation.

Men have been the butt of cruel jokes about prostate problems for a long time, and traditionally they’ve kept discussions about it to spouses/partners, who must get thoroughly sick of the whole thing.

Friends and colleagues are wonderfully concerned and supportive, for a while, but who can blame them for moving on. Even close relatives show a reluctance to go into too much detail (why would they – they might be next?).

The prostate doesn’t exactly have the stigma of Aids or syphilis, but it isn’t something you can readily bring up at a party and hope to sustain dialogue.

It’s just too complicated. A heart transplant sounds easier…and consequently, easier to talk about.

The other problem is where to go to check on all the little hurdles and side issues that arise during recovery.

This is no indictment of the medical system, but once you’re seen to be healing (within a few days of surgery), you’re essentially on your own, unless something goes obviously wrong.

It’s one long wait, in silence. You can’t ring up the surgeon or your doctor every five minutes because you can’t remember what he/she said about such-and-such a development.

How long should there be blood in my urine? Should my boys be this swollen and this colour? And what’s incontinent as opposed to a little bit incontinent in certain circumstances? And how…you get the drift.

This is a long and probably tedious buildup to what I want to discuss next: the discussion group.

Whoa, I hear you say: why would I want to trust the advice of a bunch of fellow patients, who are probably just as unqualified as me?

Fair question. But take a look at these samples from a prostate cancer discussion group on the web and ask the question again (names changed to respect privacy).

First discussion is about PSA levels after surgery:

PHIL: Had RP in January, 2007, Gleason 7, negative margins, cancer (5% volume) contained to prostate. Had seven blood tests since the surgery, with PSA at undetectable levels. At my two year marker (March, 2009), I had a .28 PSA. It was recommended to see a radiation doctor for further treatment. I am presently in the process of gathering information to make a decision in what direction to take. I am 69 years old. I am open for any input.

ANDREW: (same day): What happened to you is the “usual”. PC more often than not, especially G-7 and up, develops microscopic mets very early, outside the Prostate. You might still have area confined disease, though. When my PSA started to “get up there”, I had a detailed biopsy before I made any moves. The results were negative…bad news…the “Horsie was out of the barn”. However, at least my urinary system was not under threat!

You had a different treatment than I did. Nevertheless, I’m not happy with the sudden rise of PSA from undetectable to .28 either. I would discuss this with my doctor. He might advise you to get one or two more PSA tests for comparison in establishing doubling time before making a move, but he probably will suggest an area biopsy somewhere down the road. If it is positive, that, in an important sense, is good news…you might qualify for salvage radiation. If the biopsy of the area is negative, you might want to use some ADT treatment for a couple of years and then come off for a while to see if you have a durable remission.

You are lucky you are 69. It is highly unlikely you will die of prostate cancer! It just looks like you will be obliged to manage your situation as you would manage any chronic condition.

ALAN: (17 days later):  Check out articles by Dr Snuffy Myers and the work they are doing at the Dattoli Center in Florida on radiation therapy for high risk cancers, even after surgery.

PERCY: (same day):  First thing, make sure you got an accurate PSA, same hospital or office, same lab, etc. Also, sometimes it is recommended that you have another in 3 months. Second, regardless of opinions, make sure you get a second or third, to get a good look at what several experts are saying. Some teaching hospitals have a medical staffing on second opinion case where all the oncology Docs make a recommendation. I would for sure use somebody like Dr. Snuffy Myers as recommended by Alan above. He is the best. Keep us posted and up to date on what you do so we are abreast of what’s going on. Keep you in our thoughts.

TERENCE: (a month later): I am 63 and had a RP in 2002. PSA was 7.5 with Gleason of 7. After 2 years, PSA started rising. Had radiation to prostate bed and PSA returned to undetectable. In 2009, PSA was again detectable and rose to a high of 0.85 and has now leveled off at 0.70 for the last few months. Continuing to watch PSA was having it checked about every 6 weeks, but now every three months since it is staying at 0.70.

PHIL: (same day): I decided to get another opinion from a different hospital and Doctor here in the Portland, Oregon: Oregon Health, Sciences University. They recommended I get another blood test and follow up from there. I just received the results: my PSA dropped to .10. They asked me to wait another 3 months and do another blood test. Thanks for all your concerns and prayers.

ANDREW again (same day): It looks like you dodged a bullet to me! Really, those tests can be off and your approach was absolutely correct. Remember, a small amount of healthy prostate tissue sometimes remains after surgery…that tissue obviously produces PSA. If your post-surgical PSA…as accurately measured, shows an actual decline, you have a very good chance of being in the clear! Thanks for keeping us updated!

SITE ADMINISTRATOR: (same day): Hey Phil…That’s good news. Keep the microscope focused on the numbers for a while, just in case, but there’s a great lesson here for everyone – don’t over-react to small changes in the PSA level. It happens.

Second discussion is about the immediate after-effects of surgery:

BILL: Well, the surgery went off w/o a hitch Monday afternoon. Returned home last night. Couldn’t believe my eyes when I stepped on the scale, + 10 lbs! Some minor swelling and bloating, but feeling fine. Even the cath (catheter) isn’t as bad as I thought it would be :) Dr says all went well and was able to save both nerves. However….my palpable “camel hump” concerned him. Will meet 10 days hopefully for cath removal and keep our fingers crossed for a promising path report. Till then…

JED: Great job Bill. Now that is behind you and the healing begins.

BRIAN:  I’m sure the swelling will disappear, as mine did over a couple of weeks. One advantage was I couldn’t look down and see my scar. I’ve found I’ve actually lost about 4 kilograms in the long run (op was a month ago).

BILL:  HELP!! I just noticed that my penis and scrotum are now turning black and blue. Is this normal post op? Feeling fine otherwise. Don’t recall reading or hearing about this. Thanks…

JOHN:  Obviously time to make a telephone call to your urologist rather than rely on “what I did” from other men.

BOB:  Go to the Dr ASAP.

BRIAN:  Good advice. Mine swelled up, but there was no black and blue bruising.

JEFF:  Bill…ask your Dr. After I had mine it shocked me to see my scrotum the size of a small grapefruit!! HAHA…it sounds funny now. I did notice some black and blue there also. Good idea to check it out though.

TERRY:  I can relate to the grapefruit analogy. I also recall discoloration, but don’t know that I would call it black & blue. But I would suspect that it’s in the realm of normal, considering the trauma inflicted.

JEFF:  You’re right, Terry…it wasn’t exactly black and blue, but it was discolored. The size shocked me, they didn’t warn me, so I called my Dr. It was from all the trauma.

Four days later:

ALBERT:  So, Bill, how are you doing now? Please tell us. My surgery is scheduled [next month].

BILL:  Thanks for asking, Albert. Everything seems ok…for now. Meeting w/dr [soon] for path report and (hopefully) cath removal :) My wife is nervous and struggles sometimes. She’s just scared and it seems to get the best of her sometimes. I just try to comfort her and tell her it is what it is. One step (report) at a time. Sure, I’ll be pleasantly surprised if the path report is promising. But the reality of this program is it’s something we will have to manage for the rest of my years. That’s just the way it is and I’ve accepted it. Will update later this week. Sounds like you have a bit of a wait until your surgery. I didn’t catch much of your info other than it appears you’re on top of things. Sounds like we may have similar situations…50-something, 2nd marriage? Any way…good luck & enjoy yourself. It really hasn’t been too bad.

The benefits of this kind of exchange are obvious: lonely patients getting into contact with those who have experienced something similar.

The dangers are obvious, as well: unqualified people passing on their inexpert advice to others. But in the first discussion, note the affirming interpretation from the site administrator, who in this case has considerable expertise available to him.

In the second discussion, see how quickly contributors urged Bill to go and see his doctor. Sometimes, that’s all that’s needed for someone to realise they’re not being neurotic.

The other plus in this kind of forum is the warmth that comes through from fellow patients. Medical practitioners can exude the same compassion, of course, but are necessarily constrained by their professional status.

Nothing quite like reading someone else’s account of something that also happened to you. The sense of affirmation (and relief) is palpable.

NEXT:  End of the golden weather.

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PART 18 of My (Our) PC Adventure:  see the full story HERE>

lin01By LIN TUCKER

A few of weeks before Christmas, 2008, a very worried Jim told me that our GP had found some roughness when performing a digital examination of his prostate.

He’s the family worrier, so I went into reassurance mode with comforting words such as “found something early”, “stats in your favour”.

I must internalise worry, because no alarm bells rang: maybe it’s the two years of nursing training I did, so I understand the odds are usually in the patient’s favour.

Besides, Jim has had regular checks and his PSA reading was never high. Well, that’s what we thought then.

Fast forward to Christmas Eve: my niece from Canada has arrived to spend Christmas with us. Jim says he still hasn’t heard about his biopsy test results. I say “no news is probably good news. However, if you’re concerned, why don’t you call the surgery.”

He calls, and the nurse says yes, the results are back, but you will need the doctor to interpret them. A small tingle replaces the former insouciance I have been feeling.

Some time later, the doctor hasn’t called back, so Jim phones him and is told that the tests show cancer cells present, but the situation is not considered so urgent that it couldn’t have waited until after Xmas. An appointment will be made for him to see a urologist.

The cancer word is a bit scary, although Christmas and a vacation with an old nursing friend are enough to keep my mind from dwelling too long on any worst-case scenarios.

Jim doesn’t follow the accepted male ideology that you ignore symptoms; he is not shy about getting medical advice and for this I’m grateful. It means that as a partner I’m fully informed about the options, as – being a journalist – he will have done exhaustive research.

Knowledge is powerful as a tool for my peace of mind. If I can rationalise, I can cope.

I took him to the hospital for the biopsy prior to Xmas. Although the procedure is not entirely pleasant, Jim didn’t find it too much of an ordeal. But after the effects of the biopsy, which was quite invasive, he needed a bit of looking after.

Jim made another visit to the urologist just after New Year and returned with material to read and view, and a request to discuss it with me and make a decision about treatment.

At the end of January, I go with him for the treatment consultation. The urologist is young enough to be up-to-date, but old enough to have some gravitas, which is very comforting.
 
We’re informed that three of the 12 samples have shown cancer. On the positive side the cancer is not of an aggressive nature. 

The urologist mentions “margins”, where the cancer cells might have migrated to the surface of the prostate and affected other tissue. Not quite so straight-forward after all.

On balance, though, things are more favourable than not; I tend to concentrate on the positive.

Right from the beginning, Jim is keen on having a radical prostatectomy rather than brachytherapy. I’m a little worried that he’s making the decision on a cost basis, but the literature seems to lean that way. The urologist says he is a good candidate for surgery.

Jim can have the operation done at the public hospital by the same urologist, so we wait for a date. Hospital surgery waiting lists vary and Jim is hoping it will work out during his between journalism courses, a break when he can have plenty of recovery time.

His wish is granted – March 25, the day before his students graduate – oh well. 

By now we’re in early March and I’m given the “realignment” news at work. I’m numb: another team has also been disestablished. Work is a flurry of shock, questions, and a couple of weeks’ consultation period.

The following weekend, we’re off to New Plymouth to enjoy the wedding of Jim’s niece, Jaclyn. It should be a wonderful weekend catching up with his nephew’s newish son, family and friends and getting our minds off the pending surgery and redundancy.

The operation itself doesn’t worry me unduly. However, the risks of anaesthetic are very real and I’m feeling some disquiet, while trying not to show it.

The wedding day is wonderful, perfect even. The weather shines, the venue is fabulous, the bride’s mother and father behave well (their rift is still somewhat raw). Tensions are non-existent. Jacs is marrying an Australian and he has plenty of family and friends for support. The speeches are hilarious and heartfelt. The bride’s sister, Philly, makes a very warm and loving speech to her big sister. We leave at 11pm and they’re all dancing up a storm.

Next morning, we’re sleeping in when we’re woken with a message that Rob is trying to get hold of us: some accident…Philly’s seriously ill in hospital. We get to the hospital and find she is in an induced coma and they have called a helicopter to take her to Wellington, but they need to carry out emergency intervention!

We try to console each other, joined now in a wave of horror equal to the joy of the day before. It is all surreal. We take Rob’s wife home and keep busy with household chores, when we’re called to say the outcome is not good. We rush back to the hospital.

I stay outside minding the young ones, who are moving quickly into shock, recalling the morning’s events of hearing screams, Philly on the floor of the unit, having apparently fallen from the balcony above.

About 2pm, she is pronounced dead and we go back to Rob’s to prepare for the coming funeral in four days. The Aussies and guests silently file back to what was going to be a post-wedding friendly international cricket match. Instead, the wake starts.

The family tensions buried for the wedding quickly resurface under the stress. The estranged fiancé and his family are also in the mix; it’s not pretty. Eventually, we farewell the yellow coffin.

Due to the funeral, Jim has to change his pre-op check date, hoping he will not lose his place in the operation queue. I am hoping for this, too, as I don’t think I can stand any more waiting to get his situation resolved.

Away from the funeral-wedding, we start to prepare mentally and physically for the operation. When we go to town he walks home to Hataitai over Mt Victoria to get fit. I’m unable to concentrate much at work. 

Jim and I head for Wellington Hospital at 6.45am on Wednesday, March 25. He has a bag packed with PJs, clothes and toilet gear. We spend an hour or so in a small room with no windows where he changes into the sexy nightgown, socks and hat. No need for the contents of the bag – I take it home. Nobody gives clear instructions that you will spend the small time in hospital in their gear and won’t need clothes until you are discharged. 

A number of staff come in with their various checklists and tick off all the boxes, some for a second or third time. Part of me is glad they are being so careful and another part is just screaming “get on with it”.

We are then escorted up to pre-op, where he is put in a bed. More checks and a visit from the surgeon. I’m relieved when he promises to call me after the op, which should take three to four hours.

I wave Jim through the doors and set off home. We live only about five minutes away, and there’s no point hanging around the corridors.

I had intended to go into work, but there’s no point: my mind is mush. I go home and wait. About noon, one of Jim’s work colleagues calls. I tell her no news yet.

At 12:25pm, the urologist calls…relief, all went well and looks good. I figure that is code for no obvious signs of marginal cancer cells…hope I’m right. I let out my breath.

I have Jim’s cellphone, so I text all and sundry, call close family, and head back to the hospital about 3pm. It’s going to cost a fortune in parking fees.

He’s sitting up in bed looking morphine-sleepy. I don’t stay long, leave money for a morning paper, his cellphone with all the incoming well-wishing messages. It was good to touch him and know he’s okay

Next day, I come back at about 10am when visiting starts. He’s had a reasonable night, aside from bringing up the jelly he tried for dinner. We visit until lunch, then I leave. I go back to tuck him in late afternoon.

That night wasn’t quite so good, bit of pain. Next day it’s up and showering, the drain having been removed. He may come home tomorrow.

Yes, after the night from hell (including him wrenching the catheter tube out and wetting the bed thoroughly), having been moved from the “must-be-watched-closely cubicle” across from the nurses station to one around the corner, he is happy to be coming home.

Eventually we’re allowed to take him, and his spares home. I drive carefully, but Newtown roads are not in good shape. You would think streets and roads around a major hospital would be smooth.

At home, Jim is doing well and the first night we attach the extra catheter bag for the night and all goes smoothly.

We are lulled into a sense of false security. The next night, the valve joining the bags doesn’t work, so I’m changing a wet bed at about 3am. The following night I get to change it twice. Finally we get it right.

He gets the catheter out after six days. This process is very interesting, as this is a teaching hospital and I learn a lot. I take JT home with his “pad”. I’ve purchased a “dry sheet” for any accidents: I’m too old to be changing beds in the early hours of the morning. I sleep patchily as it is.

At work on Friday I get a call from JT at 3pm. He sounds in severe pain: “Come home, please. I need to go to A & E.” I make the fastest trip home. On the way to the hospital, he tells me how he came to be in that state. Feeling chipper he found that he was getting some penile action, so he tested it to the point of orgasm, which caused muscle spasm of the acute variety.

Oh no, I thought. I hope this doesn’t put his recovery back at all.

ED do their thing with so much pain relief an elephant would be downed. Then he’s finally able to pee and the pain stops. He can go home.

But this is not to be the last of his tribulation. That night he has trouble peeing and at 3am I get the car out of the garage (why do all these things happen at this hour) for another trip to hospital. Sorry darling, but I’m just so tired.

But then he passes a massive clot. Much relief, more mess, but the pain is over, and recovery resumes. 

Eventually, the blood in the urine passes, and normality (whatever that is) returns. 

Each day I come home, JT looks and seems to feel better. I am so enjoying his recovery. So far, so good.

NEXT: Spreading the news.

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PART 14 of My PC Adventure (see full story HERE> )

FORGET Marx, Kinsey, Salinger,  Solzhenitsyn, et al: in my view, Philip Roth wrote the 20th century’s most revolutionary book.

Portnoy’s Complaint, his 1969 account of sexual frustration and the creative solo ways it might be relieved, changed everything for young men around the world.

Brought up on our fathers’ homilies about “self abuse”, blindness, insanity and the growing of hairy palms, we were liberated by Roth’s frank revelations about masturbation, although not necessarily uplifted.

portnoy

His tale of the fate of a parcel of liver ‘twixt the neighbourhood butcher shop and his family dinner table was compellingly shocking.

Why am I telling you this?

warningRegard it as my version of the television AO warning: readers may be repulsed and offended by the content of the following story.

Got your full attention now? Good, let’s proceed (but you have been alerted).

During the various processes already narrated in My PC Adventure, there was opt-repeated medical advice that I should visit the rehab clinic after my radical prostatectomy for help in regaining erectile function. Polite term for being able to get it up again (sorry, but let’s be frank about this).viagra-v

I learned that restoration of spontaneous nocturnal erections is important for the good health of the old fella. The sooner the better. There was talk about injections (ahhh!), Viagra and other stuff.

Fair enough. I booked an appointment for about a month after the op.

But then, home alone 10 days into my recovery and a couple of days after the catheter was so deftly removed (and I was continent, and peeing bloodlessly and with commendable force) I decided perhaps I should just experiment a little, freelance, to see what happened. To see, I suppose, whether I really needed to go to the clinic at all.

Spending $12 on a viewing of SkyTV’s Spice porn channel seemed like a justifiable investment.

It was slow, at first, but, hey, bingo: 75% function. Woohoo!

But wouldn’t you know it. That other warning from our fathers about the standing thingamajig having no conscience (or, in this case, no sense of caution) turned out to be so, so accurate. I was like a teenage driver – no frontal lobe development, no sense of fear, invulnerable and reckless.

An orgasm at this early stage of recuperation seemed like a miracle (although I’ve since read on the web of some overly keen soul who had intercourse the night after his op…and suffered two days of agony in return).

My agony started about five minutes after the feeling of euphoria began to fade.

What agony!

mick_jagger032608_color_lrgIt resembled something called “lover’s balls” that an adolescent male can suffer if, as Mick Jagger puts it, he can’t get no satisfaction after a period of prolonged tumescence (an hour or two of holding hands in the movies with the object of one’s desire will do it).

I upped the painkillers, trying the codeine for the first time. No relief.

After an hour, I rang Lin at work and gasped that I needed to go to A and E. Could she come home and take me, please?

My explanation in the car on the way to Wellington Hospital was met with amusement and sympathy.

At A and E, I staggered around in the empty waiting room while the bureaucracy filled out my name, date of birth and other obviously vital statistics, then – after 10 excrutiating minutes – I was led through to a bed.

I blurted out a coded explanation, well rounded with verbal self abuse, while they pumped in increasing amounts of morphine, to little effect.

Then  I raised my knees and the pain suddenly subsided. I saw why when I looked into my underpants and saw a spectacular amount of blood emerging from the end of my penis.

A specialist ran a scan over my belly and said the news was good – no blood in my bladder. He rang surgeon Rod for advice.

A couple of hours later, I was able to pee into a bottle, so they allowed me to go home.

Little did I know, my troubles were just beginning.

Doped up with morphine, I dozed through Coronation Street and something else, then – about three hours after getting home – went to the loo.

Oh hell – nothing. Even though my bladder felt full.

I returned to bed and dozed, awakened every hour or so by the urge to pee. But nothing would come. And the agonising pain was back.

About 4am, I decided I needed to go back to hospital, probably to have a catheter inserted again to clear whatever was blocking the tubes. As I dressed, doubled up with pain, I had a sudden urge to go at the other end.

When I did, the pain eased off greatly, so we postponed the run to hospital, even though I still couldn’t pee.

At 6am, I got up to try again – with spectacular result.

huka-falls-bulletA blood clot the size of a .303 bullet shot out and smashed into the back of the toilet seat.

It was followed by a gusher with the momentum of Huka Falls.

Oh my God, the relief! It was over. 

In fear of the clotting happening again, I drank copiously and peed hourly for the next couple of days and nights, after which the blood cleared from my urine and everything felt fine.

Rod rang on the Saturday morning to see if I was okay. He explained that while the performance was encouraging, it had caused a spasm in my pelvic floor muscle, and since things were “still pretty raw down there” that had caused the bleeding.

Had I done any permanent damage? He doubted it very much. Just relax and take it easy.

NEXT: Being a patient patient.

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PART 13 of My PC Adventure (read the full story HERE)

The 18-year-old occupies a mystical place in the minds of baby boomer males, because of a piece of supposed medical science that emerged when, for us, it was already too late.

According to this story, men at 18 were at the peak of their sexual powers: from then on it was gradual decline. The same story said women reached this stage at 35. The fodder for fantasy was extensive.

But 18-year-old males have another attribute, much under-appreciated by them - they can pee highest up the wall (even over it).

In the post-RSA generation of testosterone-driven management power games (the days of the Brierly boys) the epithet about young male managers competing to piss highest up the urinal wall ruled supreme. Metaphorically speaking, everybody in the board-room was eternally 18.

Now I’ve discovered a way to get it back: have a radical prostatectomy.

Surgeon Rod said this would be the case (although we didn’t use the 18-year-old simile), but I may have overlooked his advice on one of the better side effects of the treatment, because I was preoccupied with scoping my fears about incontinence and functional dysfunction.

My first pee after getting the catheter removed was spectacular. If you can stand the sight, click on the arrow:

[youtube=http://www.youtube.com/watch?v=yOr8W7hsQQs]

UPDATE: You Tube has removed this video, citing it an offence against their community guidelines. Here’s a still from it:

Getting to this milestone, naturally, was not uncomplicated.

After six days of Mr Catheter, Bob Hale rang from the Wellington Hospital urology clinic to say they’d successfully completed the move to the new building and my tentative appointment for 1pm was confirmed. I got there to discover I was his first ever patient in the new quarters.

I hid my terror beneath talkativeness. How was he going to get this thing out of my thing without it hurting like hell?

First things first. I laid on the bed and he prepared to remove the clear plastic dressing from my wound: “Open your eyes,” I was instructed. “There’s a bit of hair regrowth…” Off it came. No problem. No pain. Every gain.

He had a young Indian med student with him, so Lin and I got a good running commentary on procedure.

Next job: to very gently pump 150 mills of water up the tube and into my bladder. Lying back on the bed, I was unaware of the process.

Then: “Open your eyes.” He was going to withdraw the tube. Oh shit!

But…nothing. I FELT NOTHING! And then it was out. Big phew! What a master.

Okay, says Bob, gently sit up. He held a pad beneath my willy. Nothing leaked.

Okay, now sit on the edge of the bed. Same. No leakage. “Excellent.”

Now stand. Just a drip or two.

Okay, here’s the bottle. He turns on a tap to run water, and he and the student retire behind the curtain. I think to myself: ‘It’s okay, Bob. I’m not piss proud any more.’

I pee. “Listen to that,” says Bob. “That’s a very good stream.”

Exactly 150 mills in the bottle. Splendid.

pads2Next, he fits an absorbent pad to the inside of my Dan Carters.

It’s there to take any “accidents”.

It has a sticky side which adheres firmly to the material of the underpants. Ingenious.pads3

The pad he uses is bulky and I immediately think of Elizabethan gents and their cods-wallops.

Later I discover that pads come in various sizes.

I’m able to switch to slim versions that are barely noticeable.

pads1I also discover by accident just how clever the mechanics are.

I drop one into the toilet pan and when I fish it out, there isn’t a drop spilt as I transfer it to the rubbish bin.

Now that’s absorbent!

Women readers (if there are any) will be smiling, I guess, since I now realise their knowledge of absorbent pads is a lot greater than that of me and my male peers.

Next, Bob runs through the exercises.

Exercises? Yep, I will need to learn to flex my pelvic floor muscle.

Let’s give it a try. Yep, I’ve got it straight away: feels like tightening the rectum, while the willy gives a little twitch.

Practice at this will be needed over following weeks so the sole remaining sphincter (valve) at the foot of my bladder isn’t required to do all the work when it comes to damming things back.

A well-trained pelvic muscle will complement the process, and stop me peeing myself at the wrong times, such as when I cough, sneeze or get up suddenly from a chair.

It will take about three months, apparently: clench and hold for up to 10s, do it 12 times, with rests between, and keep breathing. Then 12 short ones.

Takes about five minutes a day, and later I find myself doing it on walks, sitting in the car, lying watching telly.

Back home, I get the urge to have my first try at freelance peeing.

The result is a shock.

I’m used to hunching above the pan with my left forearm leaning on the wall, but now it’s an entirely inappropriate stance – my urine emerges in such a rush of fire hydrant power it hits the back of the seat.

I reel back and find I can get it in the pan from a metre away.

I let out a whoop that has Lin running into the bathroom in panic. Wow, the sheer joy of it, after years of struggling to get a stream.

A friend told me before the operation he had seen men in tears at the urinal of his club, desperately trying to have a leak. If any of them are reading this, think about it.

If this is “quality of life” change, then I’ll take it, thanks.

NEXT: Bloody disaster!

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PART 12 of My PC Adventure (read full story HERE)

Love him or not, Mr Catheter becomes a dominant part of your life after a radical prostatectomy.

I didn’t ever love mine, of course. And I see now that the guys who told me I would were just jiving, trying – prior to me having the operation – to make light of something that, as urology nurse Bob Hale wisely warned, is a very uncomfortable experience.

But, my God, having Mr C certainly gives you insight into the workings of your inner plumbing.

I will forever respect my bladder (although not to the extent of giving up Heineken). What an amazing organ. It’s working full time, day and night, judging by the flow I watched going into my temporary “outer bladder”.

As they say, you watch pinot noir gradually become rose and then chardonnay and finally lime juice.

When you’re lying abed, which I did for most of my first few days at home, the paraphernalia of a catheter is easy to manage during the day.

catheter2The bag is strapped to my upper right calf by a couple of adjustable elastic straps. It has a clear plastic tube running up through another strap around the thigh to a three-way junction, one of whose tubes – made of opaque grey plastic – enters the penis, and presumably heads up to the bladder.

Your first thought is – what the hell’s stopping it falling out. Aha. A little bit of Googling tells me there’s an inflatable balloon on the bladder end.

Ulp! How do they get it back out again? No, no, no – put that thought aside. That’s next week’s worry. None of my catheter-hardened friends have talked about that bit, although a female neighbour accidentally (I hope) recounts how much it stung to pee after she had hers removed.

Why do I have this thing, anyway? So far as I recall, nobody actually explained that prior to the op. “Of course, you have a catheter,” was all that was said.

The why is explained in some literature I read: the operation to remove the prostate requires the surgeon to cut the urethra (pee tube) off the bottom of the bladder and then reattach it afterwards. The catheter is needed for a week or more to drain the bladder while the wound heals.

All right. So lying still in bed is easy enough. You can check the bag every now and again and see when it’s getting full, which requires a shuffle down to the loo, where you hold the bag over the pan and open the valve. Just like peeing, but second hand, sort of.

The whole thing is a closed system to prevent infection, so the mechanics of it are intriguing.

What about other functions, like walking and showering, and what happens at night when you’re not awake to monitor the flow?

Walking is okay, so long as you get the bag straps right to ensure the full bag doesn’t pull downwards. and the thigh strap has the tube held at the right angle: AT ALL COSTS, YOU DO NOT WANT ANY PULL ON THE WILLY.

At first it feels a bit sensitive (rather than painful), and after a while you don’t notice the ingoing tube much.

Showering is easy enough – you just leave the whole thing in place. Only trouble is trying to get it dry afterwards. I invariably get a wet patch in the bed because the bag and straps are still damp.

catheter3Night-time presents the biggest problems at first. A second, larger bag is hung from the sheets by safety pin (carefully) so it dangles just above the floor. It is connected by tube to the tap-valve on the bottom of the leg bag, the idea being it will take the overflow and ensure the leg bag never gets completely full.

Unfortunately, we have a problem with the connection between the two bags. It doesn’t seem to work, and the lower bed is soaked. That means a bed change about midnight. Then it happens again, which means another change of bedding.

We haven’t thought to buy a rubber under-sheet, but luckily the pee doesn’t soak as far as the mattress. The washing machine runs red hot next day while sets of bedding (sheets, underlays, duvet covers) have to be washed.

We have another disaster the next night when I thrash around in my sleep and rip the connecting tube out of the lower bag, spraying urine across the bottom of the bed.

Poor Lin. I assure her we’ll look back and laugh one day, but I’m not sure she’s convinced. I’m not, either.

We change to the spare bags and tubes provided by Bob, install a rubberised sheet, test everything out, and hope for the best on night three. It’s all fine. No more spillages.

Aside from the catheter, there are other adjustments to make because of the fragile state of my lower abdomen. I compile an inverted bucket list of things not to do:

  • Sneeze.
  • Laugh.
  • Cough. Even throat-clearing has to be gradual.
  • Get out of bed at anything other than glacial speed.
  • Get back into bed at anything other than glacial speed.
  • Sit in a chair.
  • Walk at anything other than glacial speed.
  • Strain on the loo.
  • Reach for anything.
  • Try to put on socks.
  • Sleep on my side.
  • Fold my arms on my chest (too much weight).
  • Look at the scar (difficult, fortunately, because of a swollen belly).
  • Allow anything to confine, bump, handle or in any way interfere with the boys.
  • Wear anything other than XXXXOS underpants.

But enough whingeing. The recovery goes well, mostly thanks to Lin’s tender care.

I’m preoccupied for days sending text messages to well-wishers and calling people to let them know I’m okay.

I watch the third cricket test between India and NZ and try not to get depressed.

I eat ravenously, and since I’ve lost a few kilos, ignore my usual cholesterol-inducing food no-goes. I drink endless quantities of lime juice to keep the system flushed, and a lot of liquorice to loosen the other function.

I read books kindly sent by friends, and plough through a series of legal who-dunnits by John Grisham, my favourite writer.

scar1I suffer no pain. There’s Panadol and a standby prescription of codeine (not needed) to keep me comfortable.

After the first weekend home, we get a visit from the district health nurse, a cheerful and competent woman, who has a student in tow. They look at the wound and she thinks it’s fine. After a chat, she’s away.

I settle in for some serious bed rest and the first real break from work in years. Heaven!

NEXT: Goodbye Mr C and hello Mr Pee, big-time

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PART 11 of My PC Adventure (read full story HERE)

THERE’S nothing like your own bed.

We’ve all said that. I kept saying it and saying it as I settled very slowly onto the king-size and took in the surrounds. Ahhh…

There was only one thing missing – a control panel to set the bed at any angle you like, a device that became a favourite toy during my brief time in the surgical ward at Wellington hospital. But you can’t have everything.

mccavitypainting1What I had instead was loving care from Lin, real food, McCavity the cat (pictured), a night shirt, HD TV to watch the cricket, radio to listen to RadioNZ National, a bottle of lime juice, remote controls, a toilet just down the hall, sun coming in through the window, a view of blue sky and rooftops, concerned neighbours, books, phones, a stash of fruit and an array of lollies (jet planes, 72% chocolate, liquorice, pine-apple lumps), enough painkillers to start a drug lab, well-wisher cards and flowers, the electric toothbrush, the bedside magnifying light…and, of course, some additional plumbing strapped to the side of my leg.

How did I get to this paradise?

Let’s step back a few hours on that notable Friday, the day I came home, just a couple of days after the radical prostatectomy operation that would change my life (and hopefully prolong it).

The morning began strangely in the ward. About 6.30am, after hours of little abatement in the circus – beepers beeping, buzzers buzzing, nurses poring over charts and administering, codgers trudging to the loo – everything suddenly changes.

The staff seem to vanish. This is probably entirely inappropriate as a simile, but it was like a concentration camp as the Russians approached – the guards melted away, and the inmates suddenly felt very alone.

The only person left to cope with the cacophony of beeping and buzzing is an elderly aid, who is preoccupied with cleaning up the mess from Mr PI’s “sit”.

Mr Seaman is half dressed and confused. His operation has been cancelled (all that finger-pricking for nothing). Mr PI is back to “hallo, hallo…” after his unfortunate experience with the buzzer. Mr Newcomer lies and listens to his radio and remains aloof.

Nobody answers the buzzers.

This goes on for about half an hour, then just as suddenly we’re “staffed” again, with a new shift of nurses frantically boning up on who’s in, what meds they need, what tests, and so on.

Mr PI is whisked away to the shower by a young Polynesian male nurse, who deals with him politely but firmly.

Mr Aloof has a visit from God, who tells him his operation is postponed.

As for me, well the phalanx is back, swooping in without warning, and we’re discussing my home-going. “Has he had a bowel motion?” asks Phalanx Leader, this apparently being one of the rules for freedom.

billy_connolly_brentwood3For some reason, I feel jocularity is required, so blurt out Billy Connolly’s line: “Never trust a fart.” Everyone looks blank (unsurprisingly). I’m trying to indicate that a movement is imminent, trust me, but the point is lost. We all let it pass (the remark).

I’m prescribed laxatives, which will replace the delicious kiwifruit concentrate that has been administered up till then to “keep things loose. We don’t want you straining…”

I’m introduced to one of the team, Bob Hale, the senior urology nurse, who will be providing catheter and post-operative care. Another mistake on my part: I relate my friend’s remark about everyone growing to love their catheter.

Bob is stern: having a catheter is one of the most uncomfortable (or a word to that effect)  experiences a man can have, he says unsmilingly.

They move on, and I’m left to assume I can escape. I announce this to a nurse, who says fine, but I need to fill out some forms. That will take forever, so why don’t I get dressed and head down to the lounge. He’ll get the discharge papers mailed out to me.

Surgeon Rod appears, togged up in white gummies and dark blue overalls (he must be operating again today) and asks how I’m going. I’m good. No pain, and the catheter bag is starting to run Chardonnay.

Did he get it all? “I think so.” The lab analysis will tell, and he’ll have that in a week or so. He asks me to cough gently while he feels for the hernia, and it seems fine. “I’ll give you a call when I’ve got the results,” and he’s gone.

He thinks so…hmmm.

The nurse comes back to remove the drip valve from the back of my hand.

Lin arrives and we get me dressed. We’re off out of here, me waddling at pensioner pace and feeling strangely disoriented, woozy, frightened, hopeful.

Sitting in the lounge, we wait for a while, visited a couple of times by the nurse, who explains why the ward emptied out earlier: there was a major emergency in another section and everyone went to have a look. Oh well, it’s a teaching hospital, and people have gotta learn.

The handsome young Asian doc comes past and wishes me well. Surely, Shortland Street will snap him up before long.

catheter-drawingBob arrives with meticulous advice and my catheter take-home pack. He says the catheter will be in until the following Wednesday, when I need to come and see him at the urology clinic. They’re in the middle of moving into the new hospital, so he’ll need to let me know if they’re ready that day. He’ll be removing the catheter and advising me on after-op care.

I totter down to the main entrance, feeling vulnerable and weak, and lean against a railing in the door airlock while Lin gets the car. The short drive home is dominated by pothole avoidance.

At home, I change into a nightshirt and collapse, slowly, into bed. And doze…

NEXT: Learning to love my catheter – not.

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