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Prostate Cancer: Home Again

Tuesday

After getting out of my wet clothes, I had a "little" doze and woke up around 13:00.

Pat was very surprised to find me at home when she got back from work. She said I should have phoned and she would have taken leave and come home early.

After the clear liquid diet in hospital, I felt like something different for supper so I made mince and mash. Pat had to mash the potatoes as using the masher hurt me in the abdominal region, around the diaphragm. As usual pissiness was an irritation...

Of the home treatments I had to do, was change the dressings on the op wounds and another was to inject myself in the gut region with Clexane to minimise the risk of thrombosis. That evening, with some trepidation, I gave myself a Clexane injection, after watching a couple of YouTube clips on the subject. Fortunately, that took place with no hassles.

Wednesday

Pat worked half a day, took leave for the other half and was given compassionate leave (called "family responsibility leave") for three working days. This was quite useful as I found it quite painful to bend with the wounds in my gut region. Bending also gave rise to a pissiness episode. She did lots of other things in the days she was off, but having help immediately available was a boon. She also changed the dressings on my wounds, something not easy to do myself.

Laying down remained the best way to overcome the pissiness. As soon as I changed from a sitting to a standing position, the pissiness would hit me. This was a major irritation as I still did the cooking.

That evening's Clexane injection burnt quite a bit.

When I did a late night emptying of the catheter bag, I was rather worried to see that my right ankle was rather badly swollen. However, when I thought about, this was to be expected as the straps to the bag were acting as a tourniquet. They had been tied rather tightly for more than 36 hours. The swelling disappeared about an hour after I released the straps. It was also a whole lot more comfortable to sleep with the bag not attached to my leg, as I could lay on my side.

Thursday

Fred popped in for a visit and also for a bit of help getting his Volkano Bluetooth speaker working with his Lenovo tablet. I had recommended that he use Stellio as a music player as it was relatively easy to use, but he could not get it to work. After much swearing, I found that he had ripped his CDs to WMA files and very few Android apps can read this.

While Fred was still there, Trevor arrived. I had promised Trevor the use of my tent for his upcoming trip to Kruger Park. To get to the tent, I had to move the bakkie out of the garage and unfortunately, getting into the bakkie started a whole new pissiness incident. Fortunately, I had brought a towel to put on the seat so as not to soil it. I supervised Pat, Trevor and Fred in pitching the tent, but could not keep out of the action which just increased the pissiness problem...

That evening's Clexane insection also burnt like hell.

Friday and Saturday

Two rather quiet days with Zeke popping in for a flying visit on Friday morning.

Pissiness remained an issue, and as usual a major irritation when I tried to braai for Saturday lunch.

The Clexane injection really hurt on Friday evening. It also bled quite a bit, and showed pretty nasty bruising the next day. I tried to contact the urologist on Saturday afternoon to ask about stopping the Clexane injections, but could not get through to him. I decided to inject on Saturday evening as I had no idea what the implications of stopping would be. Although it did not bleed, it did burn quite badly for about half an hour.

Sunday

I sent Pat off to look for incontinence pads as the pissiness was really starting to get to me. The local pharmacy had none and LCM pharmacy only had nappies (strange as it is a hospital pharmacy). She finally got lucky in Dischem. They had many different styles so she eventually settled on MoliMed for Men and Softi Protective Stress Pads. (Her former colleague's husband had used the MoliMed after his robotic prostatectomy). I am quite glad she bought two types, as the MoliMed is totally unsuitable for using with a catheter - it will be the one that I use when the catheter comes out. The Softi is more suited for use with a catheter.

Ferdie popped in for a quick visit to bring me up-to-date with the results of the bowls competitions and he also brought me some boerewors from Tzaneen.

I finally managed to contact the urologist on his cellphone and he said it was ok to stop the Clexane, but I must drink plenty of water.

Monday

I tried an experiment of cutting a Softi Pad in half for use while I wasn't too active. It worked well until I got dressed to go to the urologist, then the pissiness got just a bit too much for the half pad. The pissiness is definitely dependent on the amount of physical activity at any given instant. Zeke took me to the hospital, dropped me off and went off to Fanies while I was busy with the urologist. I had no accidents on the trip there, nor during my visit to the urologist even though I used the stairs to get to his consulting rooms. I could feel urine bypassing the catheter on occasions, but the full Softi Pad did its job.

The urologist removed the staples from the gut area. He was very happy with the condition of the wounds and said that he would remove the catheter on Friday, but I need a cystogram before then, just to make sure that the urethra and the bladder have joined without any leaks. This aricle gives a nice overview of the use of cystography for post-robotic prostatectomy catheter removal, from a more scientific point of view.) I showed him the two pads and he said the Softi should be more than adequate for the type of incontinence I should experience, but agreed that the MoliMed may be better for when the catheter comes out. He went so far as to say a smaller Softi should also be adequate. (I was happy with this as the Softi is half the price of the MoliMed.)

I did mention both the pissiness and the pain in the prostate region to him, but he said both were fairly normal. In our talk he said cancer had been found in the prostate and in one place it extended through the prostate shell. When I asked if he had gotten all of it, his response was a worrying "time will tell".

After I got back from the urologist and finished early supper, I noticed that there was very little urine flow into the catheter bag. This was rather worrying, especially as I had had two glasses of diluted iced tea while cooking supper. It looked almost like an airlock was hindering the flow. Fortunately, that problem disappeared as soon as I lay down!

I had bought a new Foley Catheter Securement Device at the hospital pharmacy as the one I had been given when I checked out was starting to look a bit tatty and coming apart in places. Pat helped me put this on before I went to bed.

The urologist had told me to take off the dressings on Tuesday morning, but I noticed that the wound which had held the drain had opened and was weeping a bit, so I had Pat put a new dressing on it.

Tuesday

One week out of hospital! Pat's short holiday to "look after" me was over, so she had to go back to work.

After breakfast, I removed all the dressings, as instructed, except for the one where the wound had been leaking. All were a bit tender, but only the centre one was sore.

I put on a new full Softi Pad as I wanted to do some CD ripping on my computer, which is upstairs. Having to walk up and down the stairs might have resulted in some strain on my system and I wanted to avoid any pissiness accidents.

During the night the catheter securement device had gotten stuck had gotten stuck on my sleeping shorts and managed to come apart. Pat tried to get another one at LCM pharmacy, but they didn't have any (I'm beginning to think that the LCM pharmacy is not too good for a hospital pharmacy), so I tried to patch the current one with elastoplast. That didn't work too well at all, so I just tied the upper strap on the catheter bag really tight. After I had showered, and the securement device was dry enough, Pat put on some really long elastoplast strips to secure it. That seemed to do the job!

As expected from the day's exertions, the pissiness had been quite bad. I decided that I would do as little as possible on Wednesday.

Wednesday and Thursday

I took it easy on Wednesday, but in spite of that, the pissiness was quite severe. Every time I moved into an upright position, the pissiness would occur.

I took Pat to work on Thursday morning, and had no real problems with the pissiness while driving. However, the rest of the morning was much the same as Wednesday had been.

I also had no problems with the drive to the hospital, and no problems during the cystogram. Fluid went into the bladder and came out via the catheter and not by a pissiness leak. The radiologist could see no leaks from the cystogram and sent me off with his report.

On the way back to pick up Pat, I decided to stop at the Club as I knew Trevor would be there, and possibly Zeke and Daryl. It was pleasant chatting to everyone who ended up at the table with Trevor and I (Sue, Daryl, Hawks, Kevin, Willem and Glenda) as well as those who passed through (Bill, Thomas, Robin, Allie and Frederick). I was naughty and did have a beer (my first in more than two weeks), with no ill effects. For once, the pissiness gave me no grief.

Friday

As I had the cystogram and the radiologist's report, I headed for the urologist as soon as I had dropped Pat. I was the third patient in the queue and the catheter came out before 07:30. I was finally free of all appendages!

The urologist said that I would suffer from incontinence for a while, but must start practising kegel exercises to strengthen the muscles between the anus and the penis to learn to control the urine flow.

I had put a new Softi pad on for the trip to the urlogist and had taken a Molimed pad with for the trip home. However, I left the Softi on and got home without an incident. Getting out of the car to open the gate did cause some leakage, but the Softi contained it.

Post-catheter

I am not going to go into as much detail about this as earlier, but it has taken me far longer than I was told to gain complete bladder control. Currently, it is almost twenty weeks since the op, and I find that I am still having to wear pads during the day.

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