so i had my ct scan this  evening and it showed a build up of lymph fluid from where the lymph nodes were removed.  they will do a pro@edure tomorrow to drain the fluid and install a drain.  they will use a ct scan to guide the needle to drain the fluid.  i should expect to be here at least one more day, maybe longer.

i am back in good sam and will be admitted while they try to figure out the cause of my fever.  they will keep me until i am fever free for twenty four hours.  fun.

This morning I woke up with chills and a fever that hovered between 100.4° and 101.6°.  The surgeon has ordered me to return to the hospital so we can figure out why.  He even thought that there would be good chance that I’d be readmitted for observation.

I’ll try to let you know what’s going on as the day progresses.

So I’ve been itching for the last 24 hours.

First, there’s all the incision points.  They’re healing nicely but a couple of them have a nice scab over them that I just want to scratch right off.  They’re driving me nuts.  Of course, I won’t.  I’ll just leave them heal on their own.  It will be faster that way.

Second, there’s the body hair that’s regrowing where they shaved me prior to the surgery.  That stubble–in places where stubble should never be–also itches like crazy.  (By the way…  Just how do you get that job of body hair shaver?  Are you the lowest resident or nurse on the totem pole?  Did you draw a short straw or lose a bet? I don’t know.)

Finally, I’ve been itching to get out of the house, so I did.  I busted loose.  Escaped.

After paying a couple of bills yesterday, I realized that I was down to a couple of postage stamps left, so I hopped (well, not so much hopped–gently eased myself) into my truck and drove the 8 blocks or so to the post office.

With the forecast of snow, I also headed to Kroger to pick up a few things–loaf of bread, fresh fruit, freezer containers, juice.  Nothing much.

The trip lasted about 45 minutes, and that was just about the most I could handle.  I wasn’t my usual speed demon through the aisles of the store; I took it at a much slower pace.  I was very careful getting in and out of the truck and carrying the bags into the house.  All in all, it was a successful trip.  Except for one thing.

When I returned home and put the groceries on the kitchen counter, I noticed that I forgot to bring my Cialis prescription to the pharmancy.  I’ve got enough pills to get me to Friday night (take one per day).  Because of the snow, I went back to the pharmacy this afternoon to refill it. 

The surgeon’s office forewarned me that it’s not likely that my insurance would pay for it, and they were mostly right.  Interestingly, my insurance will pay for 6 of the 30 pills.  Odd.  I’ll have to do a cost-benefit analysis to see if having the ability to “sport wood” is worth $140 a month.  I know it’s important to take it regularly to reestablish that functionality, and once it’s reestablished, I may be able to cut back on the chemical assist.

There were a few snowflakes landing on my windshield as I left the pharmacy.

GRAPHIC BIOLOGY AHEAD:

As far as the incontinence goes, it’s about the same.  It really only seems to happen when I stand (although when I took a couple of steps in a parking lot, I felt a tiny squirt), but not every time that I stand.

One thing that concerns me a little.  Early on, when I would stand, I would contract my floor muscles and that seemed to be doing the trick.  Now, that seems to be less effective.

I only got up twice last night to use the bathroom (I’m cutting back my fluid intake shortly after dinner).  The second time was a close call.  I hung on almost too long.  Interestingly, as one of my fellow prostate cancer survivors told me, I was astonished at how quickly I can drain a full bladder now.  It took somewhere between 5 and 10 seconds and that was it.  Done. 

Finally, back to the itching theme…  I was told when I got the catheter out to expect an itching or burning sensation in my urethra, and I do, especially after urinating.  But there are other times it occurs, too, and that itching tells my brain it’s time to drain my bladder even when it really doesn’t need to be.  It’s frustrating trying to combat that sensation while trying to retrain my muscles.

I’m tired.  That’s the best way to describe today.

I’m physically tired from not sleeping well last night, and I’m emotionally tired from this whole experience.

I did manage to throw a couple of loads into the laundry this afternoon and also pulled my truck into the garage after last night’s warmer temperatures and rain got rid of 95% of the snow left in the bed.  I wanted it back in the garage before the next snowfall–a trace forecasted for tonight and 3+ inches for Thursday.

Based on just moving the truck 30 feet, I can tell that I’m not quite ready to go on one of my infamous road trips–or even a trip to Kroger yet.  Of course, with all the food that friends and neighbors have brought over in the last few days, I don’t think I’ll need to go to Kroger until March.  Seriously.  If I do, it will be to buy more freezer containers to store all of this good stuff.  Thanks everyone! 

Just for grins and giggles, I hopped onto my health insurance company’s website to see all the claims processed for this little journey through cancer.  So far, the total is right around $70,000, and I didn’t see a claim from the surgeon yet.  (The hospital bill alone was at $53K.)

Speaking of the surgeon, I return on Thursday, 10 February to have my first post-surgery PSA blood test.  Those results can be turned around pretty quickly, so I expect that I might have them as early as the next day (Friday) or the following Monday.

A better day today. Still not perfect, but better.

Friday and Saturday nights, the first two nights without the catheter, I slept in the full Depends diapers not knowing what may happen. Last night, I took a chance and just used the guard in my underwear, and things were just fine.

I can tell that I can stand a little more quickly and a little more confidently each time I try. Most of the time, I can do it without any leakage which is a good thing. In fact, I felt confident enough this afternoon to go for a little walk up and down my cul-de-sac (two laps). Nothing happened.

I do want to become more and more active as time goes on. I actually think that it will help train my bladder to expect certain kinds of movements (steps, walking, standing, sitting, getting into/out of a vehicle, etc.) and it will learn to compensate for each over time and with repetition.

If it weren’t for these small signs of progress, I would be quite depressed right now.

While getting the catheter removed was a great step forward physically, I don’t think I was expecting the psychological kick in the pants that came with the new adventure of incontinence.

Even with the catheter for ten days, I felt as though I was making forward progress with my recovery each day. Now, it feels as though I’ve been pushed back on my recovery at least a week, and that I’m almost starting from scratch. I know that’s not the case, but emotionally, it’s been an unexpected setback.

I know that things will continue to improve with each day, and as long as they do, I should get back on emotional track.

A friend from work stopped by for lunch today, and another friend will be bringing dinner by for me this evening.

I’ve yet to try to drive, and I don’t think that I’ll give it a try until the middle or end of this week. We’ll see how confident I feel about being away from home for any extended period of time (and an hour or so would be an extended period of time for me right now).

What a strange day.

It started with several runs to the bathroom (let’s just say that the Percocet that I stopped taking isn’t constipating me any longer and leave it at that), and then a feeling of being chilled.  No fever to cause the chills.  In fact, my temperature was my typical below normal–97.1° F.

By midday, I was up and about around the house feeling better sitting up for a while, and then laying down for a while.  The pain from the incision points is truly minimal at this point.  Again, if I sit funny or twist in a funny direction, they’ll remind me that they’re there, but on the whole, it’s pretty much behind me.

As far as the incontinence goes, it seems to be getting better.  When I stand (which is when I had experienced the majority of my problems yesterday), things were better today.  Not perfect, but better.  Fewer and smaller squirts.  I really try to control my bladder sphincter through my Kegel exercises when standing.

I probably look funny, because I’ll stand in a somewhat bent position, tightening my pelvic floor muscles, and most likely have a goofy look on my face as I stand there, waiting to be sure that nothing will happen.  The first three or four steps are also taken quite gingerly.

I really had planned on getting outside and taking a walk down to the end of the cul-de-sac today, but that wasn’t in the cards.  Maybe tomorrow, weather permitting.

Be patient. Be patient. Be patient. That’s what I keep telling myself.

Last night–the first without the catheter–was a dry night. That’s good. Although I have to admit that I got up to pee about 4 times last night to help make sure that I didn’t have an accident in bed.

It was great to be able to roll around in bed as I slept, and not have a certain key part of my anatomy tied off to the nightstand!

Today has been an exploration into what happens without the catheter in place. I find myself moving much more slowly and gingerly than when I was catheterized, not knowing what’s going to happen with each step, each seat taken, or each time I stand up. Sometimes things are just fine; sometimes there’s a little squirt into my guard. I certainly don’t wish for the catheter back, but this definitely seems to be slowing my forward progress.

Be patient.

On a positive note, it’s not as though I have no control over my bladder whatsoever. I do. I can sense when it’s getting full and when I have to empty it (although, I will have to admit that that sensation isn’t quite as pronounced as it was before the surgery). The most frequent time that I have a little squirt is when I stand up from a seated position.

Finally, having the catheter posed its own set of personal hygiene challenges; having minor incontinence poses a different set of challenges. I do feel pretty confident, however, that I can get by with using just the guards in my regular underwear instead of having to wear the full-blown diapers based on what’s happened in the last 24 hours. That will make things simpler.

As predicted, now that there’s no tumor pressing against my urethra, my urine flow is much stronger–as if I were 16 again.

Now that the catheter is out, I can resume my Kegel exercises, and I’ve been doing them several times during the day.

I really am doing my best not to get discouraged by the incontinence, recognizing that I’m only a little more than 24 hours into this next chapter. I know it will get better. I just have to keep doing my exercises and be patient. Again, some guys regain control in weeks; others in months or even a year.

I’ve removed the Steri-strips from all of my incisions and it feels great to be free of any adhesive tape stuck to my belly. I’ve also not had a Percocet since last night. There’s some occasional pain depending on how I sit, but it’s tolerable.

A couple of neighbors popped in for a visit this morning, bringing some homemade goodies for me to munch on as I continue my recovery. Thanks!

The catheter is gone!!  Hallelujah!!

So the majority of this post will be pretty descriptive…  Sorry.

Unfortunately, last night was not a good night for sleep for me.  I don’t know if it was the anticipation of getting rid of the catheter or something else that kept me up, but I don’t think I fell asleep until 2 AM.

I was out of the shower by about 8:30 AM and getting ready for the 40 minute drive to the office by changing from my overnight urine collection bad to my leg bag.  That never was a fun process–always the risk for a big mess if I let go of the wrong hose at the wrong time.

A friend drove me to the doctor’s office and we arrived around 11:30 for my 12:00 pm appointment.  I was in the examination room within ten minutes of arrival.  The nurse had me lie down on the table and disconnected the drainage bag from my leg before draining the saline solution from the Foley catheter that inflated the little balloon in my bladder that held the catheter in place.

She then told me to take a deep breath and exhale.  When I exhaled, she would pull the catheter out.  Fun.  I inhaled; exhaled; and she pulled.  “Hello!!”  Yowza and it was out.  And what a good feeling!

The doctor came in and talked with me on how my recovery was doing, examined my incision points, and said that everything was looking good.  He told me to immediately call if I wasn’t urinating, as that would indicate a serious blockage that would have to be taken care of.  He said that I should come back in four weeks for the first post-surgery PSA.

Before leaving, I was given an antibiotic to take today and tomorrow to prevent any urinary tract infection after the catheter came out, and a pack of Cialis.  Taking the Cialis now will help with the redevelopment of sexual function later.

Once the doctor was through I put on my first pair of Depends (funky!) and got dressed.  We were out of the office by noon and headed home.

I had no idea what to expect.  Would I fill my Depends during the trip back?  Would there be any leakage at all?  Not a clue.  (I did bring a towel to put on the passenger’s seat in my friend’s car just in case I sprung a leak.)

The good news: Nothing happened on the way home.  Nadda.

However, when I went to get out of the car, I could feel a small squirt of urine hit the Depends–stress incontinence. 

It’s nearly four hours later and I’ve peed a couple of times and had one other episode of stress incontinence (very small amount of urine).  I suspect that I’ll be able to use the protective pads rather than the full diapers.  The exception might be at night.  I’ll probably try a full Depends for tonight and see what happens.

Before pulling out the catheter, I told the nurse that I was having a slight burning/tingling feeling at the end of my penis, and that when I strain to have a bowel movement, a little urine leaks out outside the catheter.  She said those were both very good signs that my bladder is ready to go back to doing its thing on its own.

So it’s great to be rid of the catheter; I just need to adapt to the latest leg of this journey now.  They reminded me to continue with my Kegel exercises and to be patient as I regained control over my plumbing.  I’ll do my best.

It was a pretty quiet morning here.  The systems continue to function as intended and the pain continues to diminish, so I’m beginning to spend more time sitting upright.  Still, there are limits before my belly says “enough.”

A coworker stopped in for a nice lunchtime visit.  Afterwards, I found myself a bit tired, so I crawled into bed and the next thing I know, it was 3:30.  I guess I needed the sleep.

I’m soooo looking forward to the catheter removal tomorrow, if for no other reason than because I’ll be able to sleep on my sides again without fear of tugging on it in the middle of the night.  Of course, the whole freedom thing ranks right up there as another reason to anticipate its removal.

After the nap, I called a couple of friends to update them on my status and progress.

Aside from that, there’s really not much else to report.