Eight months ago today I had RRP surgery, I consider myself pretty darn
lucky because I found the cancer early.  I had been having my PSA tested
yearly starting at 50 and even had it checked at 45.  I'd like to record my
story so that others who want to have surgery or are contemplating it can
find this and get a picture of how I have progressed over the past eight
months.

As I mentioned I had my PSA check at 45 and it was 1.2, at 50 it was 1.7, at
51 it was 2.1, at 52 it was 2.3 and at 53 I had a discussion with my GP
about the fact it was rising but still low but the speculation ended because
it came back at 5.8.  I went to an Urologist who suggested I have a biopsy,
I asked about a round of antibiotics and a retest, which he didn't have a
problem with.  I left the office without any treatment plan to discuss the
options with my wife, we both agreed why wait for the inevitable and I got
the biopsy which was positive in February 2006.  I was 53, the Urologist had
me read Dr. Walsh's Surviving Prostate Cancer a book I highly recommend.
Two weeks later the urologist recommended surgery but covered all options.

I chose surgery after much research and debate between my wife and I, and we
had pretty much settled on surgery before I had my official visit with my
Urologist.  Additionally, even though I believed my urologist to be caring
and level headed I knew he would not do the surgery, and I later confirmed
he only 250 total surgeries under his belt.  But to the point of choosing
surgery, we felt that the following factors compelled me to have surgery
over other treatment options:

 1.. Age, at 53 I expect to live at least 15 to 25 more years.
 2.. Stage, I was a T1C with a Gleason of 3+3=6.
 3.. Pathology, I wanted confirmation of the state of the disease, while
not absolute I felt it was as good as I could possibly get.

Worries:

 1.. Incontinence and Impotence were a definite concern with surgery, I was
most afraid on Incontinence.
 2.. Dying during surgery, I had never had any surgery and was very afraid
of not waking up.

I found my surgeon by attending the local Man-to-Man Prostate Cancer Support
Group and obtaining a copy of America's Top Doctors for Cancer.  I settled
on two cancer centers to visit, M. D. Andersen in Houston, Texas and
University of Colorado Cancer Center in Denver, Colorado.  I was highly
impressed with both facilities and their personal.  Each of these facilities
offered an environment where all available Prostate Cancer treatments were
practiced and ongoing research is performed.  Each facility offered a
complete array of specialist in Incontinence, Impotence and nationally
recognized surgeons.  I picked the University of Colorado because I live
close to the city of Denver and I wanted to be as close as possible to the
facility in case of complications and for follow-up.

The morning of the surgery I woke up to give myself an enema.  At the
hospital I begin the prep phase and I let the anesthesiologist know of my
fear of not waking up.  She reassured me that I had a much greater change of
dying in a car accident on the way to the hospital than during surgery and
she was right.  The doctors poured over me including my surgeon and then my
anesthesiologist gave me a shot and the next thing I knew I was leaving
recovery for my room.

I had a private room, which I recommend so that my wife could spend the
night with me.  Having some one stay with you at least the first night is
pretty important because they can advocate for you while you stabilize.
Things I learned:

 1.. My brother insisted on being there which turned out to be a good thing
when I came out of recovery.  While they moved me to my bed my wife was
overcome and almost passed out and my brother had to care for her while they
got me set up in my bed.  As with me she had not experienced a surgery and
became over whelmed at seeing my all trussed up and raving from the
anesthesia.
 2.. Nausea became a problem, I wished I had a fan and had known there was
a shot.  Later when I got out of bed I had an attack in front of the nurse
and she gave me a shot.  I never felt sick again, if you feel sick get the
nurse for a shot, in the mean while have a small battery powered fan to keep
you flushed with cool air.
 3.. Pain medication, during my pre-surgery exam I was told I'd have a
button for pain medication but this was not the case.  When I first came in
from recovery I was pretty doped up so they didn't want to give me much
morphine because it slows your respiration.  I did get a shot after two
hours and pretty much forgot about pain medication after that.  I woke up in
the middle of the night shaking; the nurse told me it was pain, not in the
traditional sense that I was use too.  I did not feel much pain from the
surgery so I was not clamoring for medication.  After a brief discussion
with the nurse I started a maintenance pain medication regiment, which
worked very well.  So the lesson is as soon as your head clears get a
regular pain medication regiment started because you body needs it whether
you head does or not.

Coming home was pretty easy, I had an RRP, which means the operation was
performed open and I left the hospital the next afternoon after surgery.
The point here is you don't have to stay longer with an open procedure than
a LAP procedure; it's all about picking the surgeon and facility.  I got out
of bed the first time just hours after surgery and the next day I got out of
bed two more times and walked out of my room and down the hall.  I did this
in part to convince myself I could get around at home.  I was pretty sore
and moving around was difficult until the doctor removed my drain, then
getting around was less painful.  The ride home was pretty uncomfortable, my
wife had made a trip home in the morning and scoped out the least bumpy
route and I traveled in my brother's rental car rather than my pickup for a
smoother ride.  Have a pillow to hold over the effected area to ease jarring
and for sneezing or coughing.  Overall, I recommend getting home as soon as
possible because home is so much more comfortable.

At home I had borrowed a recliner, this may be the most important thing I
did because it is very hard to sit up straight or completely lay down for
the first few days.  Additionally, my butt hurt quit a bit and the chair was
easier to get out of than regular furniture.  I had purchased one pair of
loose fitting scrub type pants and my wife went back and purchased the same
thing as shorts, (I had planned to have long ones cut off).  I had my
surgery in June so long pants were too warm at night.  I wore the scrubs
without any underwear because I wear briefs and they were too tight with the
incision and catheter.  At night I mostly slept on my back with an extra
pillow under my legs and back to keep me in a semi-folded position.  I
placed my night bag on a plastic hanger that was inserted between the
bedsprings and mattress.  My doctor recommended that I take Vicoden and
Advil regularly for pain; I dropped the Vicoden after about two days and
only took Advil for another week or so.  Looking back I think I would take
the Advil much longer just for inflammation purposes.  The second day after
being home I took my first walk down to the end of the block and back, three
houses.  The next day I walked around my block, less than a quarter of a
mile twice.  If you live in a cold and snowy climate I would recommend
having the surgery in the warm months so that you can have at least three
months of warm and obstruction free walking.  My catheter was removed after
14 days, while the catheter was not horrible I was really ready to get it
out.  Removing the catheter was not bad just a little sensation and during
and after removal, bring some Depends briefs for the ride home.

The next three months I continued to heal and transition from Incontinence
and Impotence to continence and partial erections.  The first day after my
catheter was removed I had some continence and a lot of junk coming out when
I did urinate.  I also had a small amount of spotting in my Depends.  My
wife had purchased the adjustable briefs but I really recommend getting the
ones with elastic and no tabs because they don't hold very well.  By the
second day I tried the pads and never went back to the briefs.  I also drove
to work that day for the first time.  Some things I learned:

 1.. I left my incision open, I would not recommend doing this because my
underwear rubbed my incision and caused it to get infected at the waistband
twice, a very painful experience.  I found that a two-layer dressing worked
well, first layer of Talfa dressing using low adhesive paper tape with a
thick gauze layer riding on top.  This keeps the chaffing down and allows
the underwear to move over the incision.  I kept this bandage on for three
months, not fun the tape will eat you up.
 2.. I used baby powder to keep from getting diaper rash; I did get some
jock rot.  I was pretty lucky because I was able to hold a lot of urine and
only leaked when I got up or coughed and sneezed, etc., stress Incontinence.
Mostly I was uncomfortable because my butt and the area between my legs
ached and the more it hurt the more I leaked.  Because my whole urinary
tract was sensitive I constantly felt uncomfortable which translated into a
desire to urinate often.  This sensitivity diminished weekly and monthly.
 3.. Blood in my urine occurred at five weeks, I got up to urinate one
morning and it was red, I had not had blood in my urine until this point.  I
had been having some burning but I was about to visit my surgeon the next
week for my first check-up.  I visited the emergency room and was discharged
without finding anything such as an infection.  My surgeon ordered a
cystoscopy, but when I arrived I complained of more burning and a cloudy
urine, I did have an infection.  After taking a round of antibiotics I never
had another problem with bleeding or burning again and I never had the
cystoscopy performed.
 4.. Kegels, I started doing them the day after I had my catheter removed
as recommended, 2 sets of 10, counting to ten while holding and in-between
each one, then 1 set of ten 1 second kegel.  I did this 4 times a day until
about 3 weeks before I became dry.  I noticed that the area between my legs
would ache after doing the kegel set and my continence would get worse
especially in the afternoon.  I modified my routine to perform 1 set of 3x10
in the morning and once at night.  I found that I was continent in the
morning and at night after the stress of the day had passed.  I stopped
kegels completely soon after I became dry; I believe that the healing and
reduced inflammation did the most good in this area.
 5.. The road to continence was not an easy one.  For the first six to
eight weeks after surgery my butt hurt when I sat and I had a desk job.  To
combat this I would walk around my office every hour or so and sit on a
stadium pad to soften up my chair seat.  Additionally I walked 1.5 miles
before going to work and after coming home.  At first I used about 2 pads a
day, I'd get a new pad in the morning and one after my evening walk, then I
started changing after the evening walk and finally skipping a pad in the
evening and while sleeping and only wearing one during the day.  I took a
vacation during the last weeks of incontinence and would walk all day site
seeing.  I believe this really helped because I notice that I would only
have problems with wetness late in the afternoon.  Additionally, by this
time my sensitivity was much improved, more and more often I would forget I
had a problem and not feel the need to go until I really had to go.  I may
have been able to take medication for the urgency I had but I did not want
to become dependant, good or bad idea I don't know that is just how I
handled it.  Finally, one weekend in September I decided to go without pads
at home and see what happened, I never wore a pad again.  I did still have
sensitivity and an occasional leak of a drop but each month I looked back to
the previous month and I was better.  Today I still occasionally will have a
period of sensitivity but it is very short lived and I still have some
trouble with dribble at the end of urinating, I just have to stand there a
little longer and this condition seems to still be improving.  I started
yoga right after I became dry; yoga uses your abdominal muscles and helped
me with control and stretching out my innards.
 6.. Dealing with Impotence was not my major concern going into this but to
my surprise I was able to have sex with my wife at four months with the aid
of Viagra.  I was getting partial erections soon after surgery but I
attribute most of that to the inflammation and healing causing phantom
arousal.  My wife and I worked on erections right away and I even
accidentally got an orgasm.  The orgasm was nice and dry, I could tell what
it was but it felt different because of the lack of ejaculation.  I did have
some pain in my butt and between my legs; this event occurred about 4 weeks
post surgery.  My first erections produced a pretty good result but at a
right angle then they went away as I healed so that at the point I went to
the ED doctor I had soft but straight penis enlargement sort of erections,
nothing capable of intercourse.  Right at four months post surgery I visited
the ED doctor and was prescribed a vacuum pump and Viagra.  I used the
Viagra that weekend to have sexual intercourse though it took a lot of
manipulation and as soon as I entered I had an orgasm and could not continue
because I was still experiencing discomfort after orgasms, not the most
satisfying experience in one since but amazing in another.  This first
experience I took a 100mg pill and it really made me feel strange for most
of the day, I got a big head ache and felt light headed until the evening.
I have never taken that much since; I now cut the 100mg pill in half and
take that which lasts until the next morning, I still get the headache.  Now
using Viagra I can pretty much get hard with foreplay and a then a little
hand manipulation and I'm ready for intercourse, I have been very happy with
this progress at eight months.  I have been using the pump without the rings
just pumping up and holding the vacuum for a few minutes as therapy.  I have
never used the pump for sex, I also have gotten a prescription of Calis to
try, I have tried it once and it works but the side effects last longer so I
might stick with Viarga.  My doctor thinks I will be able to eventually
achieve an erection without medication.  I'm hoping for natural erections.

This narration got long even though I tried to keep it short.  The main
points I took away and recommend to those who ask are:

 1.. Plan on three months of recovery before attending any event or trip,
which you have been looking forward to.  You may not be able to enjoy it as
much as you would like to.
 2.. Make sure the first three months after surgery are in good weather in
which you can get outside and walk.
 3.. It was about 8 weeks before I could comfortably ride long distances in
a car, due to butt pain and urinary tract discomfort.
 4.. Everything was well worth the recovery discomfort, I know my
pathology, which was excellent and I have passed through the hardest
recovery period.
 5.. This is my personal story everyone's experience is different and take
nothing for granted.