With a lot of helpful input from this group + Walsh and 2 other good books,
I opted for Robotic RP with Dr. Ash Tewari at Weil Cornell Columbia
Presbyterian in New York City. He and his team are impressive: sharp, caring
and apparently superbly competent. After a day of recovery in the hospital,
I walked a mile and a half the first day home, yesterday four miles, today I
walked 3 miles this morning and will do another three tonight. The hour-long
ride home by car from the hospital was quite painful because of potholes and
the like, and for the two days since my return home, abdominal gas from the
surgery has pushed painfully on my stitches. I also find coughing quite
painful and seem to lose quite a bit of scarlet fluid (over 100 ml every
couple of hours) through a drainage tube in my abdomen, but despite these
concerns, my recovery is much better and faster than I expected. In
addition to the competence of the Tewari Team, my wonderfully supportive and
helpful family have contributed substantially to this outcome.
The catheter is a nuisance, but not really painful (yet?). I swab my meatus
every few hours with lidocaine(sp?) which seems to minimize chaffing.
Of course, we have yet to see what will happen in the continence, potency
and strictures department, but rapid progress to date makes me hopeful about
those areas as well.
Dr. Tewari said my cancer was quite close to the rectum. He believes my
margins were clear, but because it was so close, he is awaiting the final
pathology report in about a week for confirmation of that assessment. He did
say that he was able to spare both nerve bundles. Alleluia!
So, I thank God, the Tewari Team and my great family that I have plenty of
reason for hope at this stage.
Steve Kramer - 13 Aug 2005 22:36 GMT
Ordinarily, I'd warn you not to take it too far too fast, but with 8 miles
under your belt in 3 days, I suspect it would fall on deaf ears.
So, I'll just tell you I'm elated to hear you are so far so fast.

Signature
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA .1 .1 .1 .27 .37 .75
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05
PSA .07 .05 .06 .05
non Illegitimi carborundum
> With a lot of helpful input from this group + Walsh and 2 other good books,
> I opted for Robotic RP with Dr. Ash Tewari at Weil Cornell Columbia
[quoted text clipped - 25 lines]
> So, I thank God, the Tewari Team and my great family that I have plenty of
> reason for hope at this stage.
Peter Headland - 14 Aug 2005 01:49 GMT
At risk of getting my head shot off, I will relay to you what I got
from my surgeon: Don't overdo it!
Just because you can't see all the cutting and stitching doesn't mean
it isn't there. The risk to your anastomosis of too much stress is
increased leaking, herniation, and increased scarring leading to
strictures. The nerves that should tell you something is wrong may not
be working just yet.
6 miles+ per day seems excessive to me - the goal is not to get fit, it
is to heal. Exercise will not heal anything; quite the reverse. The
main benefits of walking at this stage are helping your bowel to
function and reducing your risk of thrombosis, but frequent short walks
of a few hundred yards are much better for those goals than 2 long ones
per day.
In some ways I think RRP has an advantage over Lap., because the
incision in your belly reminds you to take it easy...

Signature
Peter Headland
Gogarty - 17 Aug 2005 17:32 GMT
>At risk of getting my head shot off, I will relay to you what I got
>from my surgeon: Don't overdo it!
I agree. I was forbidden to drive for six weeks, not because driving
itself would cause problems but such things as emergency braking might.
Takes awhile for those wounds to heal, and you only see what's on the
outside.
Not being able to drive when one owns a car in New York City can get
expensive. You can't park the car on the street and forget it.
Steve U - 14 Aug 2005 02:02 GMT
Michael Keily,
Welcome back. I too did a lot of walking right away. I think it helped
my recovery go faster. I wish you the same good results. Enjoy telling
your friends the good news.
Steve U
Ron B - 14 Aug 2005 13:44 GMT
Sounds great Michael.
I'll just add...along with using lidocaine on the meatus (which just
'numbs' any irritation)...I'd use something like bacitracin or other
antibiotic ointment often to lubricate the cath so it doesn't rub any
more than it needs to.
When I got home...I walked a lot the first day and the meatus was sore
for a while after that.
Don't want THAT. :-)
Continued healing,
Ron B.
Chicago
Ross - 17 Aug 2005 16:16 GMT
> Sounds great Michael.
>
[quoted text clipped - 7 lines]
>
> Don't want THAT. :-)
Definitely need something - my urethral meatus definitely doesn't like
being banged around. I don't have access to any objective evidence, so I
hope I'm not promulgating a hospital-urban myth, but a jelly or cream
might be safer even if shorter acting.
A wise and experienced nurse who was part of the team looking after me
advised specifically against regular use of ointments on the catheter -
she said they'd stopped routinely using them because of risk of
degradation of the material (mine's silastic I think) from the ointment
base - resulting in some catheters parting company from their owners
before schedule. She said creams and jelly (like KY) are fine. I've been
slathering jelly on mine with excellent relief. Only problem is it's
temporary because the jelly soon dries out - oil based ointments
definitely hang around longer.
The difference as I understand it is that an ointment has a hydrophobic
base such as vaseline (water in fat) whereas a cream has hydrophobic
material suspended in a hydrophilic base like real dairy cream (fat in
water).
Ron B - 17 Aug 2005 17:20 GMT
Ross noted:
"Definitely need something - my urethral meatus definitely doesn't like
being banged around. I don't have access to any objective evidence, so I
hope I'm not promulgating a hospital-urban myth, but a jelly or cream
might be safer even if shorter acting."
Since they're currently using bacitracin and other Ab oints to lube the
meatus...I gotta think that most cath materials are OK with it.
Certainly, if they were NOT...water based products (though short acting)
would be the way to go.
Ron B.
Chicago
jenniferb - 17 Aug 2005 21:26 GMT
Michael,
I'm so glad to hear that your surgery went well and that you were happy
with Dr. Tewari and his team. I hope that your recovery continues to be a
fast and easy one. Please post when you get the final path results.
Best of luck and warm regards,
Jennifer (and Jennifer's father)