Life After Radical Prostatectomy: 72 Months Later

So it’s been 72 months since my radical prostatectomy. How am I doing?

c76ae-cautionsymbolsmall

Graphic Biology Ahead

Status

Since my 66-month update in July, we learned that my PSA continued to play yo-yo by dropping from 0.08 ng/ml in April to 0.05 in August and 0.06 in November. So I’m still hovering well below the 0.2 ng/ml widely accepted recurrence threshold. That’s good.

Emotions

The emotional roller coaster that I was on at the beginning of my elevated PSA trip has really subsided into the kiddie version of the ride. Sure, there are things to be concerned about, but the initial panic and fear over the possibility of recurrence are gone.

Incontinence

My weight loss of 100 lbs. / 45 kg at its best point certainly helped reducing my incontinence. (I’ve sadly put about 8 lbs. / 3.6 kg back on thanks to the stress of our stupid election and the holiday feasts at Thanksgiving and Christmas).

What I find is that when I’m physically active or when my body is tired is when I’m more inclined to have small episodes of incontinence. At the beginning of December, we had an event at work where I was on my feet for 12 hours and doing a lot of lifting at the end of the day cleaning up after the event. By the end of the night, my underwear were damp from seepage that I never really felt as it was happening. (I generally don’t wear pads because 99% of the time, I’m dry.)

Knowing that I already have some incontinence when active is a concern if we ever get to the point of salvage radiation therapy, as SRT tends to worsen incontinence.

Sexual Function

Really not much has changed in the sexual function department in the last year or so. With only one nerve bundle, I’m pretty pleased with the fact that I can achieve a decent erection 80-90% of the time, but it does require some effort. (And I’m not taking any ED drugs like Cialis or Viagra.)

Earlier I talked about penile shrinkage after the surgery, and I’m happy to say that things are back to where they were before the surgery. I’m not sure if that’s the norm, but I’ll take it (even though it took years to get back here).

Summary

As I was wheeled into the operating room six years ago today, I had to have a little fun with the surgical team. I stopped them and said, “I just need to know one thing before you start.” “What’s that?” my surgeon replied. “Are all of you over your New Year’s hangovers?” When they laughed and said, “Yes,” I said, “Good. Let’s do this.”

Here I am, six years out from the surgery, still kicking and getting along fine for the most part. Sure, this elevated PSA is a concern, but I’m not going to live my life from PSA test to PSA test. It’s just too draining to do that. As I said at the beginning of this journey, I’ll just do my best to take things one test result at a time and go from there.

I’ll continue to stay plugged into the prostate cancer community to keep abreast of the latest research so that, if and when my elevated PSA ever becomes more than a nuisance, I’m educated and ready to make decisions that are right for me and my desire for quality of life.

 

Life After Radical Prostatectomy: 66 Months Later

So it’s been 66 months since my radical prostatectomy. How am I doing?

Honestly? Scared. Afraid of the cancer coming back.

Status

Since my 60-month update in January, we learned that my PSA doubled from what it was in December 2015: 0.04 ng/ml to now 0.08 ng/ml in April 2016. That’s still below the recurrence threshold of 0.2 ng/ml, but obviously moving in the wrong direction. In four weeks, I’ll go for another PSA test and we’ll just have to wait and see what happens with it.

Emotions

Yep. There’s been plenty of emotions in the last six months.

When I saw the PSA at 0.08 in early April, it was as though I was knocked off a horse, fell to the ground, and had the wind completely knocked out of me. Dazed, confused, and not even sure that I wanted to try and get up. It took until early June before my emotional response subsided and I got back into a more normal mindset.

Incontinence

I continued with my weight loss program (90 lbs. / 40.8 kg), and that has certainly helped with my incontinence. Very rarely do I have any leakage at this point.

Sexual Function

I continue to do so-so in the ED department. Remember, I have only one nerve bundle remaining, but I can get an 80%–90% erection most of the time. Some days are better; others are worse.

I do find that my libido is still there, and there are times through the day where I can feel things stirring down below. Not enough to obtain a natural erection—those days are gone—but enough that with a little stimulation, it would be much easier to achieve an erection.

Summary

Yes, I’m one of the 98% of men diagnosed with prostate cancer to hit the five year survival mark. But with elevated and apparently increasing PSA readings over the last 10 months, what’s in my future is uncertain. (With the exception of two certainties: 1) An unending series of PSA tests ahead and 2) the thought of cancer ever-present in my mind.)

Life After Radical Prostatectomy: 54 Months Later

So it’s been four and a half years since my radical prostatectomy.  How am I doing?  (Remember, what follows is a graphic description, so proceed only if you want to read…)
Continue reading “Life After Radical Prostatectomy: 54 Months Later”

Life After Radical Prostatectomy: 48 Months Later

So it’s been four years since my radical prostatectomy.  How am I doing?

Continue reading “Life After Radical Prostatectomy: 48 Months Later”

Life After Radical Prostatectomy: 42 Months Later

So it’s been three and a half years since my radical prostatectomy.  How am I doing?

Continue reading “Life After Radical Prostatectomy: 42 Months Later”

Life After Radical Prostatectomy: 36 Months Later

So it’s been three years since my radical prostatectomy.  How am I doing? 

Continue reading “Life After Radical Prostatectomy: 36 Months Later”

Life After Radical Prostatectomy: 30 Months Later

So July 4th marks 30 months since my radical prostatectomy (and 30 months of independence from cancer!).

Where am I at in this journey?  Well…

Continue reading “Life After Radical Prostatectomy: 30 Months Later”

Life After Radical Prostatectomy: 24 Months Later

So it’s been two years since my radical prostatectomy, and I think that things have plateaued for me.

There really hasn’t been any significant change in my status since writing my 18-month update.

Continue reading “Life After Radical Prostatectomy: 24 Months Later”

Life After Radical Prostatectomy: 18 Months Later

So it’s been almost 18 months since having that pernicious prostate plucked from my pelvis.  For those who have read the entire blog (thanks!), you’ve been following my status all along.  For those new to the blog, here’s kind of where I’m at in key areas.

Continue reading “Life After Radical Prostatectomy: 18 Months Later”

Life After Radical Prostatectomy: 6 Months Later

Okay, today marks six months since having my radical prostatectomy on 4 January 2011, and I thought that I would provide a general overview of what life has been like in those six months.

Elements of this page will be very graphic in nature (talking about incontinence and sexual function), so if you’re not a fellow prostate cancer patient, you may just want to hit Google’s “I feel lucky” button.

The Early Days

I was off work from 3 January to 14 February, and might have been able to return sooner had it not been for the little episode with the infected lymph fluid that sent me back into the hospital for five days in late January.

Because the lymph fluid built up around my bladder and squeezed the piss out of it (literally), my bladder control wasn’t exactly where I wanted it when I returned to work.  Fortunately, it was good enough not to have to wear the full Depends diapers, and only the protective pads.

In late February and March, any residual pain from the surgery or drain tubes was gone and I resumed most of my normal activities–walking, stairs, driving–without much of an issue.  I was typically going through two or three pads a day depending on how active I was or just whether or not it was a good day or bad day for me.

That’s one thing my surgeon told me to expect–a roller coaster ride of good and bad days.  I didn’t let myself get too discouraged on the bad days because I knew that the trend line was going up–my good days kept outnumbering my bad days more and more.  

The other thing that he reminded me was that recovery times vary person-by-person.  One person can be dry in a matter of weeks, and another can take a full year.  I’ve been in the middle on that.

Incontinence

Stress incontinence was an issue early on.  Chances of me spring a leak were pretty good when squatting, lifting groceries from an odd angle, sneezing, or coughing.  In the very early days, I found that even standing too quickly could cause a leak.

And then there are just the, “What the hell was that?” episodes.  I can recall just standing in the grocery store talking to a coworker when I felt a little squirt just hit the pad for no apparent reason.   Go figure.

None of the leaks were large in volume.  In other words, I wasn’t peeing in my pants.  Most, I would estimate, were less than a teaspoonful (or perhaps a tablespoonful on some occasions)–enough to warrant having a bad to avoid a wet spot in my trousers.

Throughout all of that, I found myself running to the bathroom more frequently than I did before the surgery.  It wasn’t that I really needed to “go,” rather I think it was more psychological at first.  I just wanted to make sure that I wouldn’t have an accident.

Part of it was physical, too.  Up until rather recently, there was a near-constant urge to urinate.  That made for frequent trips to the bathroom even though my bladder was relatively empty.

Interestingly, in mid-May, the leaks pretty much stopped (save the stress incontinence) and I decided to stop wearing the pads. And I’ve done so with only one small incident–a sneeze surprised me before I could tighten my pelvic floor muscles and cross my legs.

By the first week of June, the near-constant urge to urinate went away, although it came back for a couple of days last week.

Traveling

By April, I was able to resume traveling for fun and work.  I took several lengthy road trips and my first flight.

Interestingly, there are some logistical and security concerns when traveling with pads.  First, you have to remember to bring them.  Second, getting through airport screenings with something shoved down your underwear is probably something you don’t want to do unless you want to have an intimate experience with a TSA agent.

For my first flight, I actually wore a pad as I drove to the airport.  I went to the men’s room after checking in, removed it, and then proceeded through security.  As I went through security, I explained my situation to the TSA agent and asked what would happen if I had to wear the pad through security.  He said they’d pull me into a private room and conduct a search there.  

After clearing security, I went to the men’s room, pulled a spare pad out of my carry-on bag, and put it in place for the flight.

Sexual Function

As far as sexual function is concerned, we may as well call it sexual dysfunction at this point.  Nothing’s happening in that department yet.

Remember that, because my tumor was so large, the surgeon had to take one set of nerve bundles, so that greatly reduced my possibility of regaining normal sexual function without some sort of assistance.

The doctor started me on the daily 5 mg Cialis pills when he pulled the catheter out.  We stopped them when I was readmitted to the hospital for my infection, and then resumed them on my return home.

Shortly after returning to work, my vision started getting pretty blurry.  Knowing that one of the side effects of Cialis is blurred vision or–worse–out-and-out blindness, I stopped taking the pills.  Saving my vision was more important than getting a boner.

I think that I may have overreacted some, because a visit to my optometrist revealed that I had perfectly healthy eyes.  Perhaps it was just getting back in front of a computer under miserable fluorescent lights that caused the blurriness.  Still, I have yet to resume the Cialis.

While I haven’t been able to have an erection, I have been able to generate enough excitement to have orgasms.  Orgasms after the prostatectomy are much different than those before.

First, there’s the obvious fact that there’s no ejaculate.  All of that plumbing was disconnected or removed during the surgery.  Interestingly, I find the orgasms to be more intense after the surgery.  I find myself much more hypersensitive to touch during or immediately after.  That’s something that I wasn’t expecting.

Summary

So it took me from January to the end of May to become “dry” again as far as the incontinence was concerned.  Wearing the pads was a minor inconvenience and they certainly beat the alternative of having cancer and dying.  As my doctor reminded me, not everyone recovers the same, so be patient.

As far as the sexual function is concerned, I’ll be patient on that.  A fellow survivor told me it took him 18 months to regain function, and he had both sets of nerves left behind.  Besides, I’m not in a relationship right now so it’s not as though that’s an immediate need to satisfy a partner.  If I do find someone, then this will take on increased importance.

Are there days that I wish I had my prostate back?  Of course.  But I’m thankful that I’m around to have those thoughts.