Life After Radical Prostatectomy: 8.5 Years Later

So it’s been 8.5 years since my radical prostatectomy on 4 January 2011. How am I doing?

Status

My PSA dropped from 0.13 ng/ml to 0.10 ng/ml at the last test back in March, which was quite the pleasant surprise. That’s more in line with three tests prior to the 0.13 test, so perhaps the 0.13 was the anomaly. In any case, we agreed to test in six months instead of the four month cycle that I had been on, and I’m okay with that. Two extra months of not worrying about PSA is a good thing.

Emotions

There isn’t a day that goes by where cancer doesn’t pop into my mind at least tangentially. The good news is that with such a slow upward trend in my PSA (PSA Doubling Time of 155 months or so), I’ve been able to shift my thinking to managing this more as a chronic illness than something to panic over. That’s been emotionally liberating. Of course, I may be playing with fire and my test in October will snap me out of that mindset.

Incontinence/Urinary Control

There really hasn’t been much change in this area. Still the occasional stress incontinence squirt and the post-pee dribble if I don’t go through my routine to drain my urethra. I’ll stick a pad in my underwear if I know I’m going to be more physically active, as that tends to cause a few leaks as well. On the whole, it’s more a nuisance than a real quality of life problem.

One of the good things is that I rarely have to get up in the middle of the night to empty my bladder, which means that I can sleep through the night. Mind you, though, that I need to get better at getting more than 6-7 hours of sleep per night, and that may change the equation a little.

There are times during the day, though, where I can have a sudden need to urinate right now, even though my bladder is far from its capacity. It’s an occasional thing, fortunately, and I’ve always been able to make it to a toilet in time.

Sexual Function

This is one area where I seem to be regressing a little. Erections aren’t as strong as they used to be; now they’re in the 60%-75% range. Again, that’s without chemical assistance. I may talk with the doctor about this the next visit.

Summary

My shift in thinking of this as more of a chronic illness has really been helpful. The stress and worry aren’t nearly at the levels that they once were, so that’s good. But that lasts only until the next PSA test, and then we take the latest factoid and go from there.

Month 99 – Stubbornness, Independence, and Relationships

My mother was fiercely independent right up to the final weeks of her life. Or at least she wanted to remain as independent as she could for as long as she could, and she generally succeeded in that.

Let’s say that this apple didn’t fall far from that tree.

IMG_20190204_195859215 (1)Last week I had a cyst removed from my right thumb (I’m right-handed). It started out quite small over a year ago and had grown to the size of a small pea just below my thumbnail. It wasn’t painful, but it was beginning to change how my thumbnail grew and, because it was sticking out from the surface of my thumb, it would get abraded if I rubbed it against things. It was time to go.

I drove myself to the hospital with the understanding that this would likely be done with a local anesthesia, but I needed to be prepared in case they needed to give me stronger happy juice during the procedure. Let’s just say that the hospital over-achieved and knocked me out for the surgery.

Thanks to the nerve blockers used in my arm, my hand was flopping around like a dead fish, completely uncontrollable and completely useless. (Much like in this classic Tim Conway / Harvey Korman sketch.) When it came time to go home, I had to have the nurse button my shirt and tie my shoes so I could leave the hospital. So much for independence.

Of course, that meant that I couldn’t drive myself home. Thankfully, I had given two friends a head’s up that I may need a ride and had each of them on standby waiting for a call from me. Tom was gracious enough to chauffeur me home during a rainy rush hour in San Diego. (San Diegans lose their minds when it comes to driving in the rain because it happens so infrequently, so I really appreciate his navigating through that mess.)

The next morning with full control of my hand and minimal pain from the incision, I had to retrieve my car from the hospital’s parking garage 31 miles / 50 km from my house. Being stubborn and wanting to regain some independence, I took three buses and two trolleys (light rail) and two hours and forty minutes to get to the hospital. But I got my car on my own. Woo-hoo! (Although it’s been almost a week and I still haven’t untied the nurse’s knots on my shoes—I’ve been slipping my feet in and out of them all week long.)

Some of you may recall that several posts ago, I talked about relationships and how disillusioned I was with some of them. Some reflection since that post and this incident have recalibrated me to a degree.

Facing any illness in general or cancer in particular as a single person poses its own set of unique challenges. Obviously, I have to impose on the lives of those around me to meet some of my needs if I can’t do things for myself. I hate having to do that (stubborn independent streak) but obviously know that it’s okay to swallow my pride and do so when the time comes.

This incident highlighted for me the handful of people that I would feel comfortable approaching for assistance, and that’s a good thing.  (Keep in mind that my family is half a continent away in Chicago, so something major would have to happen for them to be of assistance. Either I go there or one of them comes to San Diego.)

I would like that list of potential helpers to be a bit longer just to spread the burden among the lot of them, and that’s where some of my questions about current relationships still come into play. Relationships that were fostered over decades before I joined social media (i.e., Facebook), seem to have been reduced to mere “likes” and 🙂 now from people who used to call, email, or visit. Will I be able to call on them and rely on them if and when the need arises? In most cases, I should be able to count on them, but time will tell.

With luck, any need for physical assistance will be years away and I’ll have time to sort things out. In the meantime, I won’t burn any bridges and will work to ensure that I’m holding up my end of the relationship.

 

Life After Radical Prostatectomy: 96 Months Later

So it’s been 96 months since my radical prostatectomy on 4 January 2011. How am I doing?

Status

My PSA resumed its upward climb last month after a brief hiatus between April and August. It certainly wasn’t unexpected, yet I was holding out hope that I could have had three consecutive PSA readings at the same level. It just wasn’t meant to be. That means that I’m one step closer to having to make a decision about what’s next.

Emotions

At this point, I’m at peace with where I’m at regarding the cancer returning. What’s actually been gnawing at me since my last post like this six months ago is something completely different—relationships.

Relationships require effort and commitment by both parties and lately, I’ve been asking myself the question, “At what point does one stop investing in a relationship when you get little or no return?” I don’t know that I have the answer to that question. I don’t want to burn bridges, but time is the most precious thing we as cancer patients have, and we want to invest our time as wisely as possible.

The sad thing is that I’m beginning to ask that question of the people who are the ones that I’ll  need to turn when the cancer advances to the point where I’ll need assistance. (Remember, I’m single and the thought of facing this alone scares the piss out of me.)

Incontinence

Speaking of piss out of me, let’s talk incontinence. (Sorry, I couldn’t resist.) I have noticed a slight increase in stress incontinence episodes and, if I’m perfectly honest with myself, I would attribute that to the fact that I have gained weight again. I really think there’s a correlation there, so I’m going to work on losing some weight and see what happens.

I’m still 90+% dry, but when I sneeze, cough, or lift something of even moderate weight, the likelihood of a few drops leaking out has gone up slightly.

The other time that I have issues is immediately after emptying my bladder. (I don’t know why I haven’t talked about this before, but it’s been an issue for quite a while.) If I don’t go through a little routine at the urinal to “milk” any residual urine from my urethra after emptying my bladder, the chances are good that I may have a squirt of urine as I’m putting everything away.

Sexual Function

My ability to achieve decent erections has remained pretty constant through the last six months. I’m in the 70%-85% range now. Good enough to achieve an orgasm, but questionable for much more than that. Some days I can get lucky and get in the 90% erection stage, but those days aren’t common. Of course, all of that is without any chemical assistance.

Summary

I’ve got a lot on my plate in the months ahead. I’ll continue to research imaging trials and salvage radiation in anticipation of my next PSA test in April. I’ll also evaluate my relationships, looking inward first to see how much of this may be my problem, to see where I should invest my precious time. I have no doubt that 2019 will prove to be an interesting year.