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Medical Forum / Diseases and Disorders / Prostate Cancer / March 2008Update and First Post-RP PSA
Today is a good day! Got my first post-op PSA result and it was <0.01. I was a little apprehensive since I had positive margins on biopsy after surgery. I guess I can relax for another three months! The urinary incontinence situation continues to improve two months after robot assisted RP. I'm down to two pads/day and stay dry most nights. I've also resumed my gym visits three times/week. Feels good to get back in that routine. Henry Ford Hospital has a sexual function rehab program which I'm following. That consists of 50mg Viagra/day, use of a VED to achieve four erections/day and twice weekly penile injections. They kick off the program with a two hour class. There were about 15 guys who had recent RP's and their wives/girlfriends in the session I attended. I think everyone was OK with the oral meds and the vacuum pumps but then they offerred us the first injection in the clinic. We lost about five guys at that point but the rest of us are trying the full program. I'm keeping my fingers crossed and trying to avoid an urge to cross my legs on injection days. :-) Good luck brothers! Jim Oct 2007 - PSA 7.0 Nov 2007 - Biopsy Positive - Gleason 7 (3+4) Jan 2008 - RLRP T3a/N0/M0 Positive margins Mar 2008 - PSA <0.01 > They kick off the program with a two hour class. And here I thought we were using the term "homework" in jest. ;-) I.P. Congratulations on the good news Jim. Keep it up. Alan > Today is a good day! Got my first post-op PSA result and it was <0.01. I > was a little apprehensive since I had positive margins on biopsy after [quoted text clipped - 22 lines] > Jan 2008 - RLRP T3a/N0/M0 Positive margins > Mar 2008 - PSA <0.01 Great results! I had a regular RP in 2000 at age 67. One man's experience need not be relevant for another, but let me tell you anyway. I was impotent for some 18 months following surgery. After about six weeks to recover, I tried Viagra, but it didn't work. I then started using a pump, and after a week's "training" period, my wife and I resumed sexual activity, which continued at about the same frequency as before surgery. We could have continued indefinitely that way, but I thought I might try injections to see if that worked better. Before I could, my erections started to return. Today, I have spontaneous erections while sleeping which suggests the physiological machinery is working, but in practice I find I need to use Viagra. The fear of failing and other practical difficulties which result from arthritis in both of us means the old days of spontaneous sex are gone anyway. Still we manage, and at our age, not every couple can, PC aside. I am completely continent except that when I need to go, I can't hold it in very long, which can sometimes lead to accidents. If I know I will be in a situation where a bathroom won't be handy if I need it, I use a pad, but I only rarely need to use it. I had similar problems before my PC, but not quite as bad. I hope that you find this tale encouraging. Your training program seems to be using everything at once, which is much more than anything I tried, so perhaps it will help erections return much earlier. I'm told by people who used injections that the injection itself doesn't hurt much but that there may be pain afterwards from the effects of the drug. That pain supposedly moderates as you continue using the injections. If this holds true for you, the injections should become progressively easier until you can do them without any significant repercussions. Great PSA test...... Oh, The Bark is worse than the bite with the injection. I used it, and it helped me.........regain.......all function now normally with no injection and maybe 30% of a 100 mgs viagra for a kick start..... Do not be afraid of the meds.......and such....... It does help.! jloomis > Today is a good day! Got my first post-op PSA result and it was <0.01. I > was a little apprehensive since I had positive margins on biopsy after [quoted text clipped - 23 lines] > Jan 2008 - RLRP T3a/N0/M0 Positive margins > Mar 2008 - PSA <0.01 >>Henry Ford Hospital has a sexual function rehab program which I'm >>following. That consists of 50mg Viagra/day, use of a VED to achieve four >>erections/day and twice weekly penile injections. Is this also to prevent atrophy? Or just find the best method per individual? Hi Doofy, The presenter in the class said they have recent statistics that the combined therapy is more effective than one or two of the three parts. However, they haven't published these results as yet so I would consider the claim anecdotal for now. I also haven't researched the relevant literature to see if there are other studies already publushed on a similar three part protocol. They did say that one of the advantages of any program that encourages blood flow in and out of the penis is reducing atrophy and recommended that we do the Viagra (or Cialis) and VED if we don't want to use all three parts of the program. The only individualization at the start is in the strength and dose of the injectable. They prescribe one of three strengths based on pre-op sexual performance and start you off with a low dose of that. You are supposed to increase the dose until you get a satisfactory result. If you reach the maximum dose without getting there, they increase the strength. Finally, there is an individual followup in four months to assess progress and modify the protocol for each patient. >>>Henry Ford Hospital has a sexual function rehab program which I'm >>>following. That consists of 50mg Viagra/day, use of a VED to achieve four >>>erections/day and twice weekly penile injections. > > Is this also to prevent atrophy? Or just find the best method per > individual? ================== >... That consists of 50mg Viagra/day, use of a VED to achieve four >erections/day and twice weekly penile injections. My insurance only covers 10 pills per month... How doe's yours work? It would be way too expensive for me to participate in such a program. Thanks, Steve Nice timing Steve! My insurance just rejected a script I submitted as exceeding the amount of Viagra they will cover. My doc first wrote a prescription for 10 pills as one month's supply with 11 renewals. He wrote the script for 100mg pills and told me to cut them in half so that would cover 20 days. With the eight days I'm doing injections that just about fills the month. I submitted the original script to my mail order pharmacy and they filled it and have filled a refill, charging me $30/month as my co-pay. However, they normally provide three months of medication for $30 if the doc writes the script for 90 days. I asked my doc to write me another script for three months at a time, I mailed it in and it was rejected yesterday. I don't know if that's because the first script is still in effect and they will only cover 10 pills a month like your coverage or if there's some other problem but I'm going to try to track it down later today. Also, I don't know how to submit a claim for the injectable med since it had to be made up by a compounding pharmacy and the mail order folks don't do compounding. The pharmacy that the Henry Ford program uses with doesn't accept any insurance. However, the full cost of the injectable and syringes is a lot cheaper (under $200 for six months supply) than the full cost of Viagra. Regards, Jim > ================== >>... That consists of 50mg Viagra/day, use of a VED to achieve four [quoted text clipped - 5 lines] > Thanks, > Steve > Today is a good day! Got my first post-op PSA result and it was <0.01. I > was a little apprehensive since I had positive margins on biopsy after > surgery. I guess I can relax for another three months! With a T3a and positive margins.... well, it don't no better than that. It is fantastic news.
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