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Medical Forum / Diseases and Disorders / Prostate Cancer / November 2006

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is walking critical to speeding the recovery from rlrp?

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gary.miller12@comcast.net - 20 Nov 2006 07:07 GMT
i was told to walk a lot and not lift anything heavier than 15 lbs for
6 weeks.
how critical is it to recovery of incontenence and ed?
i walked 30 to 45 minutes during the first 2 weeks after surgery.
i have developed some joint pain in my hip and it is now painful to
walk more than a few minutes.
i probably need to rehab the pain before i start up again.  at my age,
66, that can take a week.  it already has been 3 or 4 days and the pain
is still there, probably because i keep testing it.
gary
Steve Kramer - 20 Nov 2006 11:38 GMT
>i was told to walk a lot and not lift anything heavier than 15 lbs for
> 6 weeks.
[quoted text clipped - 5 lines]
> 66, that can take a week.  it already has been 3 or 4 days and the pain
> is still there, probably because i keep testing it.

I'd say it's very important to overall healing.  To the extent that
incontinence is due to the insult done to your kegel muscle, then it's
probably important.  However, I would think the not walking would merely
delay the recovery.  I would not view it as a lost opportunity.

When I have hip pain (or back, knee, ankle, or heart break) I walk.  Works
every time.  If walking is causing your pain, I'd recommend a trip to your
ortho.
RML - 20 Nov 2006 19:44 GMT
>I'd say it's very important to overall healing.  To the extent that
>incontinence is due to the insult done to your kegel muscle, then it's
>probably important.  

I believe incontinence is "primarily" a result of the removal 2 of the
3 shincters, the one at the bladder base, and the prostate itself,
which acts as a stooper. The one that is left, at the base of the
penis, is not generally used by males, so it needs to be activated. I
am not sure how kegels affect this shincter, but they say in general,
kegels are good for overall control of the functions of that area.
Claude - 20 Nov 2006 21:19 GMT
>>I'd say it's very important to overall healing.  To the extent that
>>incontinence is due to the insult done to your kegel muscle, then it's
[quoted text clipped - 6 lines]
> am not sure how kegels affect this shincter, but they say in general,
> kegels are good for overall control of the functions of that area.

I think, in general, physical fitness is a plus for keeping all muscles in
tone, including the sphincter muscles and the heart.  Walking is an
excellent exercize for the average older person.  You don't need to hunt up
gymns, invest in expensive exercise equipment, or get into elaborate
programs.  Put your coat on, if you live in the north like me, get your ipod
or portable CD player, if you like music, and head out the door for an hour
a day of brisk walking.  You won't build up the abs, pecs, or biceps doing
this---but you will help ward off or delay incapacity due to arthritis,
heart and artery disease, possibly Alzheimers, loss of balance problems, and
osteoporosis.
I.P. Freely - 21 Nov 2006 04:25 GMT
> I think, in general, physical fitness is a plus for keeping all muscles in
> tone, including the sphincter muscles and the heart.  Walking is an
[quoted text clipped - 6 lines]
> heart and artery disease, possibly Alzheimers, loss of balance problems, and
> osteoporosis.

The older the person is, they more they benefit from strength-building
exercise. Walking beats nothing, and is good cardio if we do it briskly
enough, but we need stronger muscles, too, especially to combat balance
and falling problems and their attendant life-threatening injuries and
to combat osteoporosis. The custom-tailored programs I see our gym
trainers putting seniors -- including my wife -- through make a huge
difference in their lives in both QOL and longevity. Our gym has a large
staff of trainers, and most of their clients are over 50 and usually
overweight. My wife has been morbidly obese for 30 years -- it ended her
sports in the mid-70s -- but her year now with a personal trainer at an
hour a week has FINALLY given her some progress and hope that she never
saw with untrained exercise.

I.P.
I.P. Freely - 21 Nov 2006 04:55 GMT
> The older the person is, they more they benefit from strength-building
> exercise. Walking beats nothing, and is good cardio if we do it briskly
[quoted text clipped - 8 lines]
> hour a week has FINALLY given her some progress and hope that she never
> saw with untrained exercise.

And, oh yeah . . . Researchers at Michigan State recently showed that
high-intensity exercise may prevent these diseases more effectively than
low intensity exercise (Thrombosis Research, August 2006).

Most heart attacks and strokes occur when plaques lining the arteries
break off and pass down the artery to form a clot that completely blocks
the flow of blood to the heart or brain. Intense exercise helped prevent
clotting by increasing tissue plasminogen activator and plasminogen
activator inhibitor-1 far more than low-intensity exercise did.

I.P.
Claude - 22 Nov 2006 01:33 GMT
>> I think, in general, physical fitness is a plus for keeping all muscles
>> in tone, including the sphincter muscles and the heart.  Walking is an
[quoted text clipped - 21 lines]
>
> I.P.

This is a quality of life issue in anothe way.  Obviously, IP, you don't
mind---and perhaps like----spending a lot of time in  the gym, going through
rigorous exercize programs.  Me?  I don't want to be bothered with all that.
In fact, I hate that sort of activity.  I like walking.  And I walk briskly.
I'm 68 years old, 5:10, 160-165 pounds, blood pressure on the low side and
other blood tests good.  Walking has served me well.  I skip the walking on
the days I mow the lawn, shovel snow, or dig in the garden.I don't want to
spend large chunks of time in whatever limited years I have left doing
things I hate doing to give me a greater chance of living a bit longer or
having marginally better physical fitness.  Everyone is different, and
everyone needs to do what gives *him or her* the greatest happiness and
wholesome pleasure.  What you like and/or can tolerate is different from
what I like and/or can tolerate.  Walking briskly an hour a day, watching my
saturated fat intake (though allowing myself once a week pizza, my absolute
favorite food), keeping my weight down, making sure I get 3 to 5 servings of
fruit and vegetables a day, and enjoying two glasses of wine a day with
dinner works fine for me.  And I don't feel deprived or pressured.  I have
no need or desire to put gym time, formal work-out programs, or
weight-lifting into my days.
I.P. Freely - 22 Nov 2006 02:43 GMT
>> Claude wrote:
> Obviously, IP, you don't
> mind---and perhaps like----spending a lot of time in  the gym, going through
> rigorous exercize programs.  

My wife chuckled at that one. In fact I hate the time, effort, tedium,
and cost of gym time. I began using a gym for the first time in my life
last winter, for one overriding objective: to reduce the impact of age
on my capacity for play, especially now that cancer, and not senility,
may end it all too soon. It's strictly to prevent lost time and enhance
my performance when the new play season starts.

> I don't want to
> spend large chunks of time in whatever limited years I have left doing
> things I hate doing to give me a greater chance of living a bit longer or
> having marginally better physical fitness.

A "bit" longer or "marginally" better fitness aren't the issue. Good,
sound, proper exercise adds decades of QOL and years of heartbeat to
unfit people's lives, and leanness is no measure of fitness.

> What you like and/or can tolerate is different from
> what I like and/or can tolerate.

I wasn't trying to change your mind or heart; you're welcome to do as
you wish. I was just providing Gary some facts contrary to "You don't
need to hunt up gyms, invest in expensive exercise equipment, or get
into elaborate programs."

I.P.
Claude - 22 Nov 2006 03:46 GMT
>>> Claude wrote:
>> Obviously, IP, you don't mind---and perhaps like----spending a lot of
[quoted text clipped - 6 lines]
> it all too soon. It's strictly to prevent lost time and enhance my
> performance when the new play season starts.

You see....there's a difference.  I don't have the same "play" activities
you have, so I don't need that level of fitness.  I feel fine for the things
that do give me pleasure.  Since they are not terribly demanding physically,
I can't see aging being too much a deterent (until, of course, we reach the
age when everything starts getting deterred.)

>> I don't want to spend large chunks of time in whatever limited years I
>> have left doing things I hate doing to give me a greater chance of living
[quoted text clipped - 3 lines]
> sound, proper exercise adds decades of QOL and years of heartbeat to unfit
> people's lives, and leanness is no measure of fitness.

I think decades of QOL is a bit of an exaggeration.  And QOL is determined
by the individual person and his/her needs and likes.  Leanness is not a
measure of fitness, but it is better for you, generally, than being
overweight.

>> What you like and/or can tolerate is different from
>> what I like and/or can tolerate.
[quoted text clipped - 3 lines]
> hunt up gyms, invest in expensive exercise equipment, or get into
> elaborate programs."

And I stand by what I said contrary to what you say.  It depends on what he
wants to do.
I.P. Freely - 22 Nov 2006 19:24 GMT
>> proper exercise adds decades of QOL and years of heartbeat to unfit
>> people's lives, and leanness is no measure of fitness.

> I think decades of QOL is a bit of an exaggeration.

I and the literature disagree. Look at how many 50-somethings are in
sorry shape -- roughly 2/3 of them are obese, for example -- and
consider how many of us now live into our 70s or 80s. And look at all
these people in their 70s and 80s shuffling around in baby steps or
using walkers simply because so many of them don't get any exercise.

> QOL is determined by the individual and his/her needs and likes.

Certainly. But most people of middle or old age don't realize how many
of their aches, pains, disabilities, limps, fatigue, imbalance, falls,
broken hips (often fatal), and inabilities are self-inflicted by lack of
exercise and reversible with exercise. You have learned it from your
walking, but millions our age don't realize how much better we can feel
and function if we exercise and how much MORE that matters the older we
get.

> I was just providing Gary some facts contrary to "You don't need to
> hunt up gyms, invest in expensive exercise equipment, or get into
> elaborate programs."

I agree with that to the extent that we can get plenty of routine
exercise with some simple exercise gear, gravity, shovel and hoe, and/or
some good sneakers and the open road. For post-op incontinence those
should all be great training if accompanied by Kegels. What I'm trying
to emphasize is the importance of some proper and specific exercises to
mitigate or reverse the effects of aging, and we need professional
advice in selecting and learning some of those exercises. As much as
I've studied exercise physiology and thought I had designed an effective
but way-too-lengthy regimen for myself, the gym trainer helped me
achieve far greater results in well under half the time of my plan. Even
during my peak midwinter gym season I spend less than half the time you
do at deliberate exercise. And while I didn't know what to do for my
wife's repeated, unfettered full-face-plants on city sidewalks, the
trainers knew exactly what to teach her; she's now far more confident
and stable. I saw her do something last week she hadn't done in many
years: actually walk down the stairs facing forward like you or I would.

> This is a quality of life issue in another way. I don't want to be
> bothered with [organized exercise]. I like walking. Walking has
> served me well. Everyone needs to do what gives *him or her* the
> greatest happiness and wholesome pleasure.

I understand that fully, and have preached it for years. We who find a
form of play or at least exercise that challenges our bodies and puts a
big grin on our face are worlds ahead of the rest of the population in
many measurable ways. An exercise we love is far more valuable than a
gym-full of stuff we hate; it's one place where a moderate obsession is
a good thing. But a modest amount of professional advice can greatly
enhance the experience and benefit with little additional -- or even
less -- effort. Senior runners, and that may include excessive walkers,
may tend to waste away their upper bodies because they get no upper body
exercise and burn more calories than they eat.

> watching my saturated fat intake (though allowing myself once a week
> pizza, my absolute favorite food)

Then you'll love most of these concepts the literature is tending towards:
1. At our age sat fat and cholesterol may not be the threat they are
(were?) to younger people. We're thought to be to old for moderately
high cholesterol to be a worry, and the primary LONG TERM threat
remaining from sat fat is thus its calories, which we can burn off.
2. With each new study, moderately high cholesterol is emerging as less
of a direct threat than it was thought to be. Other markers correlate
better with CVD, somewhat like PSAV threatening to upstage PSA as a PC
marker. [I can hear the Glassman gloating in the dark, with some
justification.  ;-) ]
3. But in people with known CVD, single fat-laden meals often trigger a
heart attack or stroke.
4. That risk, and the arterial plaque deposits laid down by each of
those pizzas or other sat fatty meals, can be significantly and
measurably mitigated by downing some walnuts or other high Omega-3
source with the meal. Hey . . . THERE'S a reason for anchovies on our
pizza!

Naaah . . . it's not worth the shudder and stink. ;-)

> keeping my weight down

Valid only if achieved through exercise and proper eating, as opposed to
calorie restriction alone. Your walking 30 miles a week burns off
roughly 3,000 calories -- a whole pizza. Enjoy.

However . . .
> I get 3 to 5 servings of fruit and vegetables a day

Our target should be 5-9 servings (half a can or a whole fruit) -- more
if we get much exercise and thus eat more calories than the average slug
-- including as many bright colors as we can manage.

I.P.
Claude - 22 Nov 2006 21:05 GMT
>>> proper exercise adds decades of QOL and years of heartbeat to unfit
>>> people's lives, and leanness is no measure of fitness.
[quoted text clipped - 6 lines]
> their 70s and 80s shuffling around in baby steps or using walkers simply
> because so many of them don't get any exercise.

The disagreement is not about the value of exercise, but whether or not
regular, brisk walking is a  suitable  exercise for older people whose work
and play don't require high level physical fitness.

>> QOL is determined by the individual and his/her needs and likes.
>
[quoted text clipped - 4 lines]
> millions our age don't realize how much better we can feel and function if
> we exercise and how much MORE that matters the older we get.

Did I question the value of exercise?   Quite the contrary.

>> I was just providing Gary some facts contrary to "You don't need to hunt
>> up gyms, invest in expensive exercise equipment, or get into elaborate
[quoted text clipped - 11 lines]
> in well under half the time of my plan. Even during my peak midwinter gym
> season I spend less than half the time you do at deliberate exercise.

But I enjoy mine---or am accomplishing something around the house.

And while I didn't know what to do for my
> wife's repeated, unfettered full-face-plants on city sidewalks, the
> trainers knew exactly what to teach her; she's now far more confident and
> stable. I saw her do something last week she hadn't done in many years:
> actually walk down the stairs facing forward like you or I would.

This is very annecdotal, and you abhor annecdotes as guidance for cancer
treatment.  Here you are being very annecdotal concerning the value of
guided physical training.  Earlier you mentioned that your wife was morbidly
obese.   That puts her in an even more special category, and I would
probably agree with you that professional guidance on the exercise program
was needed.  And I'm not at all surprised by the improvement.

> > This is a quality of life issue in another way. I don't want to be
> > bothered with [organized exercise]. I like walking. Walking has
[quoted text clipped - 11 lines]
> to waste away their upper bodies because they get no upper body exercise
> and burn more calories than they eat.

I'm not talking about excessive walkers or senior runners.  Certainly not
people engaged in your type of physical "play".  I'm saying the average
person my age does not require what you feel you require for a long,
healthy, and satisfying life.

> > watching my saturated fat intake (though allowing myself once a week
> > pizza, my absolute favorite food)
[quoted text clipped - 15 lines]
> mitigated by downing some walnuts or other high Omega-3 source with the
> meal. Hey . . . THERE'S a reason for anchovies on our pizza!

I've certainly got no problem with the above.  Except for the
anchovies---they taste like rotten fish.

> Naaah . . . it's not worth the shudder and stink. ;-)

100% agreement!

> > keeping my weight down
>
[quoted text clipped - 8 lines]
> we get much exercise and thus eat more calories than the average slug --  
> including as many bright colors as we can manage.

My eating regime seems to work for me.  You go a bit beyond mine.  But
that's OK.
I.P. Freely - 22 Nov 2006 22:47 GMT
>  And while I didn't know what to do for my
>> wife's repeated, unfettered full-face-plants on city sidewalks, the
[quoted text clipped - 8 lines]
> probably agree with you that professional guidance on the exercise program
> was needed.  And I'm not at all surprised by the improvement.

As implications of LIKELIHOOD, anecdotes are invalid. I used my wife as
an EXAMPLE of the benefits, and used the trainers' immediate knowledge
of the solution as an example of the problem's commonness. Her problem
of falling forward in response to the slightest trip is endemic in
aging, inactive people regardless of their weight; it's largely a
product of atrophy from disuse in the hip flexor muscles and nerves.

Morbid obesity, at 9 million and very rapidly increasing in commonality,
is twice as common as Alzheimer's. A U.S state populated only by
morbidly obese people would be our 12th largest state.  I'm constantly
surprised at the simple things people younger and lighter and far less
wracked by sports injuries than I cannot do in the gym, the back yard,
or everyday life. These ordinary middle-aged people of ordinary
appearance and ordinary activity levels can benefit very significantly
short and long term from increased exercise levels, and I'm rapidly
becoming convinced that even modest levels of professional training can
greatly enhance that benefit even in reducing exercise TIME. An hour a
week for a few months of pro training to EDUCATE a person in some
optimal exercise regimen, backed up by DIY exercise "homework", will be
a great start. Additional hands-on training can greatly boost the
benefit if extra motivation is needed.

You're welcome to ignore that advice personally, but I believe it's a
disservice to advise others against it. I personally see dozens of DIY
weekend warriors and DIY exercisers wasting countless hours doing
improper, often even harmful, exercises they obviously dislike and which
at best are expending a few calories, and I've got to assume mine is not
a unique sample. You're fortunate or sage in your exercise of choice;
can you imagine how many millions of people retire to see the world --
or just our national parks -- only to realize they can't even
accomplish, let alone enjoy, a two-mile stroll through the woods, a
cobblestone street, or Yellowstone?

I.P.
Claude - 23 Nov 2006 01:08 GMT
>>  And while I didn't know what to do for my
>>> wife's repeated, unfettered full-face-plants on city sidewalks, the
[quoted text clipped - 32 lines]
> You're welcome to ignore that advice personally, but I believe it's a
> disservice to advise others against it.

Once, again, there is not much in the above I disagree with.  But you are
distorting my original comment.  I did not *advise Gary against* such a
regime.  I said that it was *not necessary*  in order to keep important
muscles in tone.  Reread my original statement.  And I still hold to it.
Steve Jordan - 23 Nov 2006 01:20 GMT
On November 22, Claude tried to respond to Mike Freely, in pertinent part:
> ....you are distorting my original comment.  I did not *advise Gary against* such a
> regime.  I said that it was *not necessary*  in order to keep important muscles in tone.  Reread my original statement.  And I still hold to it.
>  
Forget about instructing Mike Freely on facts.

He makes up his own as he goes, truth be damned.

Regards,

Steve J

Epitaph for a wasted life:

"He lived beneath the moon
   And slept beneath the sun.
   He lived a life of going to do
   And died with nothing done."
-- Anonymous
I.P. Freely - 23 Nov 2006 02:02 GMT
> you are distorting my original comment.  I did not *advise Gary against* such a
> regime.  I said that it was *not necessary*  in order to keep important
> muscles in tone.  Reread my original statement.  And I still hold to it.

I have reread it, but since I apparently misinterpret it, maybe I'm not
the only one. I think you and I are on the same page now, and others our
age including Gary have now seen both sides of the question and can
make better-informed choices, so I'd guess our job here is done. IMO,
that's what makes impersonal discussions, even those that get a bit
heated if they stay on topic, so valuable when there's no cut and dried
answer available.

I.P.
Mary Fisher - 23 Nov 2006 17:10 GMT
...

You talk a lot of sense, Claude. Apart from your weight - Spouse is 5'5" and
9 stones - you sound just like him.

Mary
Heather - 23 Nov 2006 18:43 GMT
> ...
>
> You talk a lot of sense, Claude. Apart from your weight - Spouse is
> 5'5" >and 9 stones - you sound just like him.

Ye Gods, he is a slim one!!  For the non-British on here, a stone is 14
lbs.  So her husband is 126 lbs, give or take an ounce.

I think the last time I weighed that was on my honeymoon!!  (VBG)

Cheers, Heather

> Mary
Mary Fisher - 24 Nov 2006 11:08 GMT
>> ...
>>
[quoted text clipped - 3 lines]
> Ye Gods, he is a slim one!!  For the non-British on here, a stone is 14
> lbs.  So her husband is 126 lbs, give or take an ounce.

He's always been thin - but is muscular and strong too - although not as
strong as in his prime of course. He hasn't an ounce of fat anywhere, no
flabby spare tyre or stout paunch (beer belly). I love looking at his body,
it's far better than most Brits of half his age.

> I think the last time I weighed that was on my honeymoon!!  (VBG)

I must have been about eight years old! I was always tall for my age and
well developed, it all stopped when I was eleven, at 5'3" and ten and a half
stones. If I could get off a stone and a halve (21lbs) I'd be back to that.
but my gynaecologist says I'm not fat, a bit overweight perhaps ... trouble
is, that lovely man is Irish :-)

We're like Jack Sprat and his wife :-)

My aim is to get back to what I was when I was married so that in a couple
of years when we have our 50th anniversary (DV) I can spray my wedding dress
gold and wear it at the Big Party. .

Dream on ... <sigh>

Never had a honeymoon! the day after we married I was competing in a Time
Trial - against my bridesmaids among others. I'd forgotten that! Nobody
broke any records that morning.

Mary
callalily - 24 Nov 2006 16:08 GMT
Dear Mary,

> "> >
> >>
[quoted text clipped - 3 lines]
> strong as in his prime of course. He hasn't an ounce of fat anywhere, no
> flabby spare tyre or stout paunch (beer belly).

Well, the crown of middle age for a man is a paunch and I have to say
that as much as I tell JJ to get rid of his little belly, I love
stroking it.  Biggest problem is that he wears his pants hip-hop style
almost on his hips  and he says they won't stay up even w/a belt.  And
he's only got a little microbelly.

I like looking at him too.  As a matter of fact he just got a digital
camera and to try it out I took some sexy pics of him.  Then he told
some friends he was going to show them his first pictures and I just
freaked out...however, he told me later that the artistic photos were
on the trial "card" that came with the cam and this was a new one....

Best to you,

Leah
Mary Fisher - 24 Nov 2006 17:52 GMT
> Dear Mary,
>
[quoted text clipped - 3 lines]
>
> Well, the crown of middle age for a man is a paunch

It certainly seems to be :-(

> and I have to say
> that as much as I tell JJ to get rid of his little belly, I love
> stroking it.  Biggest problem is that he wears his pants hip-hop style
> almost on his hips  and he says they won't stay up even w/a belt.  And
> he's only got a little microbelly.

Spouse has to have a belt to keep his trousers round his waist because his
hips aren't big enough for the job:-) When his scar was fresh he borrowed a
son's braces to hold  up the trousers.

Incidentally, he told the surgeon last week that the lowest part of his scar
was sensitive. Mr P said that it wasn't an uncommon feeling for scar tissue
on that area and suggested a very mild hydro-cortisone cream. I'm not keen
on using such a preparation but it's working and it won't be permanent.

> I like looking at him too.

I'd hope that all wives like looking at their husbands but when I see some
grossly fat people I'm not sure that I could.

> As a matter of fact he just got a digital
> camera and to try it out I took some sexy pics of him.  Then he told
> some friends he was going to show them his first pictures and I just
> freaked out...however, he told me later that the artistic photos were
> on the trial "card" that came with the cam and this was a new one....

:-)

I took pictures before the surgery, I realised this morning that I haven't
done and 'after' series. Must remember later.

Mary
I.P. Freely - 24 Nov 2006 20:08 GMT
> the crown of middle age for a man is a paunch

Except that fat carried there is the most dangerous fat we have. Don't
let it get out of hand.

I.P.
Mary Fisher - 21 Nov 2006 12:17 GMT
>>>I'd say it's very important to overall healing.  To the extent that
>>>incontinence is due to the insult done to your kegel muscle,

?

Kegel exercises are named after the doctor who 'invented' them, not the
muscles themselves.

>> I believe incontinence is "primarily" a result of the removal 2 of the
>> 3 shincters, the one at the bladder base, and the prostate itself,
>> which acts as a stooper.

That would mean that every man who has rrp is incontinent and that's not the
case, there's a wide variation from 100% continence to 100% incontinence.

> I think, in general, physical fitness is a plus for keeping all muscles in
> tone, including the sphincter muscles and the heart.

I agree.

> Walking is an excellent exercize for the average older person.

If you can walk. I can't at the moment because of toe surgery, I can't flex
the toe because of the inserted K pin which I hope it will be removed
tomorrow. But even then I shan't be able to walk far because of spinal
deterioration which causes a lot of pain when I walk. Spouse won't walk
without me but he's very fit anyway (as well as 100% continent) so we'll
swim and cycle as soon as this wire comes out.

Overall fitness, in whatever way it is achieved, is the greatest benefit -
to everyone, young or old.

Mary
RML - 21 Nov 2006 19:08 GMT
>>> I believe incontinence is "primarily" a result of the removal 2 of the
>>> 3 shincters, the one at the bladder base, and the prostate itself,
>>> which acts as a stooper.
>
>That would mean that every man who has rrp is incontinent and that's not the
>case, there's a wide variation from 100% continence to 100% incontinence.

How you jump to that conclusion from my statement is beyond me.

Is it possible that men vary as to the strength and function of the
sphincter that remains?
Mary Fisher - 23 Nov 2006 17:04 GMT
>>>> I believe incontinence is "primarily" a result of the removal 2 of the
>>>> 3 shincters, the one at the bladder base, and the prostate itself,
[quoted text clipped - 8 lines]
> Is it possible that men vary as to the strength and function of the
> sphincter that remains?

Of course they do :-)

They vary in every other aspect of treatment and results too. I'm sorry if I
didn't express myself well.

Mary
Leonard Evens - 20 Nov 2006 17:15 GMT
> i was told to walk a lot and not lift anything heavier than 15 lbs for
> 6 weeks.

The lifting restriction, I believe, is to avoid the possibility of the
sutures coming loose.

>  how critical is it to recovery of incontenence and ed?

I don't know how important it is for ED, but my guess is that it is
pretty helpful for developing bladder control.

> i walked 30 to 45 minutes during the first 2 weeks after surgery.
> i have developed some joint pain in my hip and it is now painful to
> walk more than a few minutes.

If you developed pain in your hip, it is most likely what is called
overuse injury.  If you were pretty sedentary before surgery, the
increase in exercise level could have stressed underused muscles.
Generaly, it is important to work up gradually, increasing your exercise
level no more than 10 percent per week.

> i probably need to rehab the pain before i start up again.  at my age,
> 66, that can take a week.  it already has been 3 or 4 days and the pain
> is still there, probably because i keep testing it.

There are several things you can do about the pain.  Taking
anti-inflammatories such as ibuprofin or naproxen can help quite a lot.
 but you have to take them on a regular schedule.   Since taking such
medication can induce various problems, you should discuss such therapy
with your doctor and do it under medical supervision.  The application
of ice for 20 minutes at a time, several times a day can help.  If the
problem persists, getting some physical therapy may help quite a lot.

If the problem does persist, you may need evaluation by a medical expert
since it is remotely possible you have something like a disc problem in
your back or some other arthritic problem.  But that seems unlikely to
me as a layman with considerable experience with joint and muscle pain.

From my personal experience, I would guess that your hip pain results
from tight muscles, stressed by the sudden increase in exercise level,
pulling on the points of attachment around your hip.  Stretching before
and after exercise may help avoid such problems in the future.  But you
obviously don't want to do too much stretching while you are sore.  A
physical therapist can also help you with stretching exercises.

In the mean time, you may be able to find other ways to get exercise
without pain.  There are various things you can do in a swimming pool.
You may be able to walk in the water because the water supports your
weight.  You can also swim without excacerbating your hip pain by using
a pull-buoy.  That is a pair of cylinders tied together which you put
between your thighs.  It holds the lower part of your body up without
the necessity of kicking, so you swin entirely with your arms.   But if
you try to swim, remember to start small and increase the amount of
exercise gradually, or you will soon also have sore arms and shoulders.

Let me tell you a story about some surgery I had on my heel many years
ago.  I was still feeling pretty lousy several weeks aver the surgery
and I asked my doctor if that was normal for such surgery.  He told me
that the problem was that I was out of shape and read me a sermon about
the importance of physical exercise.  I took him seriously and have
tried to keep phsyically fit.  Each time I've had surgery, it has been
clear that I recover faster than most other men my age.  It is never too
late to begin.  But you have to do it carefully and gradually increase
the amount of exercise you get.  If you do, you will find you generally
feel better and you will be much better able to deal with whatever
medical problems may arise in the future.

> gary
I.P. Freely - 20 Nov 2006 19:36 GMT
> i was told to walk a lot and not lift anything heavier than 15 lbs for
> 6 weeks.
[quoted text clipped - 6 lines]
> is still there, probably because i keep testing it.
> gary

Go to the gym and find some other exercise that places less emphasis or
weight on the hips. "Walking isn't magic; it's exercise in general
that's important. Swimming, exercise ball, Nautilus, seated cardio
machines, weights, pilates . . . plenty of options.

I.P.
gary.miller12@comcast.net - 20 Nov 2006 20:50 GMT
thank you all  for the advice.
i was advised by my chiropractor this morning to ice the joint 3 times
a day.
looks like i just strained the muscles around it.
it hurts when i stand and walk for a few minutes so i'll just go easy
on it.
swimming would be an option if i wasn't incontenent and i'm hesitent to
do stretching and other exercises since i'm not sure if it could
present a problem related to the surgery i had 3 weeks  ago.  my only
concern is that it would delay or rob me of the oppertunity to heal the
inconentence or ed.
gary

> > i was told to walk a lot and not lift anything heavier than 15 lbs for
> > 6 weeks.
[quoted text clipped - 13 lines]
>
> I.P.
gary.miller12@comcast.net - 20 Nov 2006 20:55 GMT
i am wondering if post general anesthesia is a source of depression?
i tend to get muscle tension when i get depressed or anxious, which may
have been the cause of my strained hip.  i am generally a very active
person and do a lot of exercise.
gary

gary.mille...@comcast.net wrote:
> thank you all  for the advice.
> i was advised by my chiropractor this morning to ice the joint 3 times
[quoted text clipped - 26 lines]
> >
> > I.P.
I.P. Freely - 20 Nov 2006 21:28 GMT
> swimming would be an option if i wasn't incontenent

Let's see . . . swimming . . . water running down one's leg to and from
the pool, and water IN the pool. Sounds like perfect camouflage to me!
I'm no longer an open faucet after two years, but I'm sure I leave a
trail any dog could follow from shower to pool to shower.

> i'm hesitent to
> do stretching and other exercises since i'm not sure if it could
> present a problem related to the surgery i had 3 weeks  ago.

That's one nice thing about controlled exercise such as most gym
activities: control. As long as one pays attention to what muscles
s/he's using in a stretch or exercise, the abs can be avoided. I would
certainly err on the side of avoiding any significant or uncontrolled
abs involvement. I liked Leonard's suggestion for water exercises.

I.P.

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