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Medical Forum / Diseases and Disorders / Prostate Cancer / October 2005

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3 months out / first PSA

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Peter Headland - 05 Oct 2005 18:51 GMT
Just got back from seeing Dr Brooks at Stanford. First post-op PSA is
<0.05, so we were both in very good humour. Next test, mid-January.

Other stuff:

- Continence almost perfect (as it has been from the first few days). I
still have to be careful when passing wind (I did leak a squirt the
other day when I had some uncomfortable gas and strained to fart), and
I no longer have the total confidence that I had pre-operation - it's
not that I ever do leak, it's just that I have the sense that leaking
is a possibility where it never was before. That said, we were out
hiking the other day and I was jogging downhill with a full bladder and
had no problems at all, likewise I can move, lift, etc. freely without
leaking.

- I pee with a strong stream. Dr Brooks says that by this stage the
risk of strictures is low, especially as I have had a strong stream
throughout. One more thing to cross off the list.

- Squirting when aroused appears to be diminishing. Sadly, I don't have
enough data points to be sure about that.

- When aroused I still produce a little mucous. Nothing remotely like
the pre-op output (no more sticky spot on the bed-linen), but
interesting - ISTR that there are some extra little glands downstream
of the sphincter that produce mucous. I forgot to ask Dr Brooks about
that.

- Erectile function is still poor (some engorgement, but nowhere near
enough to be usable). If anything, I think I have slightly less than I
did 3-4 weeks ago, but it's hard to be sure (or to be sure, it's soft).
Sensation is less than pre-op (and again, possibly slightly diminished
just at the moment). Pills give me a blocked up nose and a headache,
but not a great deal of improvement, if any at all. We'll see how
things go over the next few months. I may look into a pump and/or
injections, haven't decided if/how long to wait before doing that.

- As noted elsewhere I still have some internal twinges; Dr Brooks
considers these normal and unimportant.

- Incision is still slightly tender. Not enough to be bothersome, but I
don't like anything brushing against it.

- I still have some perineal discomfort when sitting on my office
chair. I had that pre-op, so it may be unrelated (perhaps caused by
slight nerve damage from cycling). OTOH, I notice some penile shrinkage
when I sit on that chair for a couple of hours; Dr Brooks thinks that
this is probably dues to pressure plus residual internal swelling from
the op (which he expects to resolve over time).

- I have some mild oedema in my lower belly around the bottom half of
the incision. Dr Brooks says that this is quite common, may be
permanent, and he has no idea what causes it.

Signature

Peter Headland

Ron B - 05 Oct 2005 19:06 GMT
Things sound really great Peter.

Best of all...the PSA.

Everything else sounds VERY normal.

3 months is early...as you know.

Continued good things,

Ron B.

Chicago
judamd@aol.com - 05 Oct 2005 19:36 GMT
Congratulations on your progress Peter.  I have a question regarding
Dr. Brooks.  I interviewed him prior to my surgery and would have had
him do my surgery except that I wanted a  laparoscopic procedure which
he, of course, doesn't do.  He did mention one thing to me which I
found to be a big surprise and which startled my wife (a doctor) and
also every one of her colleagues who was questioned about it as well.
He told me I should have a couple of pints of blood drawn before
surgery "just in case" (normal procedure) and that because insurance
would only pay for the pro-op blood draw if the blood were used, he
puts the blood back into the patient whether patient needs it or not to
save said patient a few hundred dollars.  This practice is strongly
frowned upon by those in the know (the doctors) as a needless
additional risk.  Does he still do that?  Did he do that with you?  Did
he mention it at all?  Just curious.
Dave Perry
Peter Headland - 05 Oct 2005 19:44 GMT
> [Does Dr Brooks still put autologous blood back in even if you don't need it?]

No, he does not. I didn't need any blood and I didn't get any blood.

I paid $540 for the two autologous blood draws and got about $160
reimbursed by Blue Cross (the high charge and low reimbursement was
because Stanford Blood Bank is not a Blue Cross contracted provider)
prior to the operation. There was never any mention of reimbursement
being conditional upon actually using the blood. I could have used a
contracted provider, but that would have added to the risk of
screw-ups, because of the need to have the blood shipped to Stanford -
I was happier knowing my blood was about 200 yards from the OR.

Signature

Peter Headland

judamd@aol.com - 05 Oct 2005 20:11 GMT
Peter, I'm glad to hear that.  This business of reinjecting your own
blood was the only blemish in what was an otherwise excellent interview
with a sincerely nice guy and who is a truly topnotch prostate surgeon,
one of the "gurus".  I can't imagine why he would say what he did
during my interview.  Thanks for restoring my complete confidence in
Dr. Brooks.
Dave Perry
James A. Honeychuck - 05 Oct 2005 21:11 GMT
That mucous is from Cowper's gland, working as it should.  Don't worry
about it.

jimhoney
Steve U - 06 Oct 2005 00:05 GMT
Peter,
It sounds like you are doing very well. While you are waiting for your
nerves to wake up, don't be reluctant to try the shots. I had sex using
them starting day 13. I found that having to wait 30-40 minutes after
orgasm for my erection to go away was a huge boost when I needed one.
They don't hurt much once you get a little practice, and the results
can be fantastic.
Steve U
> Just got back from seeing Dr Brooks at Stanford. First post-op PSA is
> <0.05, so we were both in very good humour. Next test, mid-January.
[quoted text clipped - 49 lines]
> the incision. Dr Brooks says that this is quite common, may be
> permanent, and he has no idea what causes it.
John Loomis - 06 Oct 2005 15:25 GMT
Hello Peter,
   You sound like you are on a good recovery tract.
I had  similiar problems that you speak of and they do diminish.
Dr. Brooks encouraged me to use injection since I had no erectile function,
and I did use a pump.  Viagra gave me headaches also.
After about 1.5 to 2 years I started to regain normal erctile function, and
did not use the injection and or pump anymore.
Now, with about 35 mgs of Viagra I can achieve wonderful erectile
confidence.
John Loomis
> Just got back from seeing Dr Brooks at Stanford. First post-op PSA is
> <0.05, so we were both in very good humour. Next test, mid-January.
[quoted text clipped - 49 lines]
> the incision. Dr Brooks says that this is quite common, may be
> permanent, and he has no idea what causes it.
 
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