If you get Prostate cancer, someone somewhere is going to tell you that prostate cancer is the best cancer to have. This news will be delivered as good news to offset the bad news that you’ve just received – you’ve got fucking cancer.
This is an account of my experience with Prostate Cancer – from diagnosis to surgery, and thereafter. I write it because being told by a medical professional of some considerable standing that you have a significant disease is a bit of a shock. So I have journaled my experience of the whole thing so that others can know what I have learned along the way.
Where to start?
My persistently high blood pressure is what started all of this. My GP, not happy with just prescribing drugs, wanted an answer. She wanted an answer to why my BP remained stubbornly high despite regularly taking the strongest doses of the best tablets known to man. There must be, she concluded, something else at play. And indeed, there was. I had prostate cancer.
Prostate cancer is the most common cancer in males, but it is not the biggest killer – that is lung cancer. If you get Prostate cancer, someone somewhere is going to tell you that prostate cancer is the best cancer to have. This news will be delivered as good news to offset the bad news that you’ve just received – you’ve got fucking cancer. And they’re right. Prostate cancer has the highest 10-year survival rate of them all – a rate which ranges from 91% for prostate cancer to 7% for pancreatic cancer.
For sure, I don’t know if I’ll wind up in the 91% or the 9% cohort. That news is yet to come. So before we get there, let’s look at what has happened so far. We start at T minus 5 months – 5 months before treatment.
(T minus 5 months)
I’ve been on meds to manage my high blood pressure for about 10 years. As is their way, every time that I go to the GP (usually for a repeat script) they take my blood pressure and it is always high – 170+ over 100+. After switching around doses and brands to no effect, my GP concludes that there must be something else at play and we should do a battery of blood tests to get to the bottom of things. We do exactly that and the results are in. My GP was right to be suspicious. I have ‘elevated PSA’. In my case it was 7-ish. In the PSA world, anything over 4 is considered ‘suspicious’. It should be near zero. My PSA reading put me in the suspicious category. My GP refers me to a specialist and the hare is off and running.
(T minus 4 months)
The first consultation was with a Prostate cancer specialist – a surgeon. The guy who will ultimately open me up. The short session involved a quick internal examination, a brief chat about what might be happening and a blood test. The results of the test showed that the PSA was moving up and moving up pretty quickly. It was now over 9 – that’s a 15% change in a matter of weeks. The PSA tests have got better over the years, I’m told, and they now have them down to 2 decimal points of accuracy. There’s little chance that this 9 is a false positive. I’m booked in for an MRI scan to see if we can’t find any more evidence of a disease.
The scan happens quickly. Half an hour in a large buzzing machine and we’re done. I feel fine. There’s something that needs looking into. I have a team of professionals on the case. I’m pretty relaxed.
The next week I’m back with the surgeon to discuss the findings of the scan. The surgeon points out a minuscule grey area that has caught the eye of the guys whose job it is to look at these things day in and day out. It could be cancer. It’s another piece of evidence to sit alongside the rising PSA score, but not necessarily conclusive. We should do some more digging and go from there. For that we need to do a biopsy. I’m not sure what a biopsy is. Things are starting to get real.
(T minus 3 months)
My first biopsy
The day of the biopsy rolls around. I’ll be in and out of hospital the same day and it’ll be quick and painless. However, I wasn’t at all prepared for the side effects of the procedure. I’ll get straight to it. My semen had turned blood red. Whilst it wasn’t in any way painful, the optics weren’t great. I’m still shuddering now at the thought. So, sex was put on hold for a while. There’s no way anyone can see this. I can barely look myself. The days pass and nothing is changing. I’m still passing a lot of blood. I’m not googling this because it’ll tell me that I have some form of rabid venereal disease. So I make a call to the nurse.
Yep, that’s completely expected. Perfectly fine. It’ll go back to normal soon. How soon? It depends. Erg.
Anyway, the nurse was right (as they invariably are) and over the weeks the redness faded into a browny colour (not better, just different) and after about six weeks it was business as usual. Looking back, I was given a handout (there are quite a few of these) that mentioned that I might ‘notice’ some blood in the semen for 2-3 months. I probably should have read it. But that said, nothing is going to prepare you for this. It’s ugly. I hated it. And it put me off the idea of surgery. Something that might have cost me dear.
Following the biopsy, the surgeon has now got a good slug of data to look at (PSA scores, MRI images, and scan and biopsy pathology reports) and it’s time for another consultation.
It’s a strange session. It’s late in the day. The surgeon is a busy man. Do we know anything about the prostate? Not really, no. We look at a plastic model of a prostate that’s on the desk. It comes apart so that we can see where it fits in the grand scheme of things – anus, penis, testicles and so forth. This is all new to me. We talk about the two choices I have – surgery and radiotherapy. My experiences post-biopsy has me immediately leaning towards a non-surgery option. I wasn’t in the mood for being cut again.
We also talked about the percentage chances of surgery rendering me a) unable to control my bladder and b) experiencing varying degrees of erectile dysfunction. Stats such as 5 in 100 patients are unable to blah are flying about and not registering. The numbers are going in one ear and out the next as the life-changing potential of what is around the corner starts to sink in. We talk about a two-year hiatus on solid erections. We talk about sex aids and penis pumps. Incontinence pads. And we talk about the certainty that I would have a sperm count of zero post-op. You don’t want any more kids do you? No thanks.
The session finished up with me asking what would happen if we did nothing for a few years. I really wasn’t in the mood for any more surgery post-biopsy, but the doctor explained that such a delay might not end well, and instead, I should have another scan and get a second opinion from a radiotherapy specialist. So that’s what we did.
(T minus 2 months)
I head back to hospital for a PSMA scan. Like the MRI scan, this involves half an hour of sliding in and out of a massive beeping machine. During this procedure, something will be injected into me so that they can get a better view of what’s going on inside. I had a nice salad beforehand and it was all over without any dramas.
The same week, we went along to see the radiotherapy specialist. I explained my nervousness about surgery and that the surgeon had recommended that we get to hear about the pros and cons of radiotherapy from the horse’s mouth. The session was short and to the point, as they often are with busy and exacting folk. The doctor explained that the treatment was going to take 9 weeks and that I’d need to be in hospital 5 days a week over that period. There would be some chaffing downstairs. There could be complications. He also mentioned that surgery was the ‘gold standard’ for someone of my age and general state of health. It was also mentioned that radiotherapy might make future surgery more complicated if required. In a short space of time, we concluded that surgery was the right option. Trying to pick between the two with a finger-in-the-air assessment of least-worst side-effects was simply not the right way to do it. I just needed to be guided by the pros. Anyway, the consultation was super-helpful as I meandered towards a decision.
The next day I received a call from the doctor with news of the PSMA scan. The headline was that the disease seemed to be ‘quite active’ and that my score of 7 might have escalated to potentially an 8. I’m told that one of the traits of prostate cancer is that it can move quite quickly once it gets going. I’m certainly now much less inclined to sit on my fingers for a few years to see what happens. I report to the doctor that I’ve seen the radiotherapy guy and that we are now clear that surgery is the way forward. And that we should just get on and do the fucking thing. Prevarication over. The call ends with me speaking to a kindly assistant and booking in for the op. A ‘Robotic Radical Prostatectomy’. There are two words here that I don’t like, main offender being ‘Radical’. Surf-dudes use the word as a proxy for ‘awesome’. I’m guessing that that’s not the intention here. I didn’t ask. And I didn’t google.
(T minus 1 month)
The hospital gave me an info pack that included lots of stuff I daren’t read. And the contact details of a recommended physio. I’ve been to physios before. My shoulders are wrecked from swimming and my legs shattered from running. And the physio would normally give advice and guidance on what to do to address these issues. But this physio session was like no other. This one was about managing incontinence.
The physio was great. Still is. Very down to earth and happy to field any questions or concerns that I may have. As you go through this journey, lots of questions crop up. But the doctors are busy people, so you don’t want to burden them. And don’t even think about googling it. So, the physio quickly becomes your go-to-guy for questions like:
- Will I ever be able to go to the pub again?
- When can I get back in the pool?
- Really, no coffee?
- Who is going to give me Valium if and when this doesn’t work out?
Having worked with thousands of patients, he’s seen it all. So, the session is part counselling, part physio. We start with the physio part and focus on the exercises that I need to be doing in the run up to the op. These are commonly referred to as pelvic floor exercises. The operation is going to leave me without a prostate which, amongst other things, works to stop me uncontrollably wetting myself. Once the prostate is retired, what’s left has more work to do. So, beefing up those muscles is going to be helpful in the dignity department post-op. The physio pops a slippery probe between my legs and we watch on the screen as I try to engage different muscles independently – cock, balls and arse. The physio isn’t so crude but avoids sex-ed medical terms like ‘penis’ in favour of more user-friendly terms like ‘willy’. The goal here is to leave knowing which muscles need to be exercised and which do not. And we’re done with the first session.
The next day, we’re back in hospital to see the nurse. I’m with the significant other. I rang through beforehand to ask if it was OK to bring a partner. Yes, it was. Most everyone does.
This session is about expectation setting. What’s going to happen on the day. What’s going to happen immediately after and so on down the line. The nurse is brilliant. Of course, she knows that we are somewhat nervous about what’s coming. But she puts us at ease by making it all seem normal and nothing to be concerned about. We hear about the catheter that I’m going to wake up with after surgery. I don’t know what a catheter is. We hear about a leg bag and a night bag. The nurse jumps up to mime the leg bag, lightening the mood. It going to be attached to my leg. We hear about Tena pads. I don’t know what a Tena pad is. We hear about Viagra. At least I’ve heard of that stuff. We hear about the goody bag that she’ll be giving me when I come back and have the catheter removed six days after the op. We hear lots of stuff and some of it we remember. We leave hospital quite buoyed. For the first time this is seeming like it might be OK. Or at least… not-so-shit. We walk to the pub down the road for a debrief. We conclude that that was the best session. It’s pissing it down with rain.
(T minus 1 week)
I’m back at the physio and we’re talking about how the exercises have gone. In truth, not great. The problem is that it is really hard to remember to do them. So, progress has been a bit patchy, but I know what to do and the session is a good reminder to do more of it. I’ve got a week to go before the op. The next time I’ll see this guy, I won’t have a prostate. The next time I see this guy I might be spraying piss uncontrollably all over his office. What do I know? I book in for another session 2 weeks post-op.
The run-up to the op is a mixed bag. I know I should be as fit as possible going in but working on my core seems somewhat pointless if they are going to slice through my stomach. Which they are. Six times over. I ease off the workouts.
During the nurse’s orientation meeting, she mentioned that the supermarkets are now stocking Tena pads for Men. These are designed to capture any leaks before they manifest in an embarrassing wet patch in the crotch area. I don’t remember ever seeing them for sale, but I’m in the shop now so I’m on the lookout for them. The men’s section is the usual array of razors and deodorant. No pads though. How about the lube section? Nope, nothing there. I continue on to the Women’s section. The pads for Men are on the bottom shelf underneath the pads for Women. That’s why I’ve never seen them. I pretend not to look at them like I used to do in the olden days when in the ‘family planning’ sections looking at condoms. I decide I’ll save this wild ride for another day and wander off to put other stuff in my trolley.
I get a text confirming the date and time of the op. We go to the seaside and see the beautiful people enjoying their time off work in lycra leggings. I have three pints of diet coke to kill the day. It’s more expensive than beer. That really pisses me off.
(T minus 1 day)
The day before the op is a public holiday. Yay. No work. I busy myself with packing an overnight bag consisting of, on the advice of the nurse, loose fitting underwear and pyjamas. These things I do not own, so we have to go shopping. Shopping when you’re buying stuff you don’t want or like is miserable. So, I pick out a crap pair of pyjamas, a handful of crap boxer shorts and a pair of doubly-crap slippers. In the checkout line I silently vow to burn the lot once this is over.
(T minus zero)
They want me in the hospital at 6am. So, it’s an early start and a drive on empty roads. I check in. We’ve already done the pre-admission paperwork, and I’m herded upstairs to where the action happens. I’m invited to get out of my civilian clothes and into a gown and a stylish pair of compression socks. I put my clothes and my dignity into a bag and strap in for the ride. A porter comes after a while and we start wheeling through the corridors. It’s just like in House. Every episode of House. First stop – the anaesthetist. She explains that there will be two things happening. A general aesthetic and a ‘block’. The latter is going to make me completely numb from the waist down and, I’m warned, will still be working when the general has worn off. So I’m not to panic when I can’t feel my legs.
Right. Got it. No legs. Fine. What they didn’t say was that I wouldn't be needing them anyway. I don’t remember anything else.
Two minutes later I wake up in a ward with nurses buzzing around. I can’t feel my legs. I’ve got a drip hanging out of a wrist. I’ve got a tube draining ooze from my stomach and a tube hanging out of my penis. The nurses keep tabs on me for a while before I’m wheeled to a room. The surgeon pops in and tells me that it went well. Everything was ‘spared’. That bit, I do remember.
The prostate is now on its way to the lab for its second biopsy. This is going to tell them if further treatment is going to be required. Hmm. Further treatment? I thought that this op was going to be the end of it. Perhaps not. That’s still to be determined. If the cancer has spread outside of the prostate, then there may be more work to do. Fuck.
Nurses continue to buzz in and out. Blood pressure and heart rate are being checked constantly. The anaesthetist pops in to say hello. Everyone is so nice and utterly professional.
Pain killers need to be swallowed. I’m hugely dehydrated. I’m so dry that the tablets are sticking to the inside of my mouth. I’m downing bottle after bottle of water. And the bag hanging out of my bladder is filling up double-time. Having the bag is really helpful because I’m trapped in the bed with the drip and the drain and two dead legs. A quick trip to the toilet is not an option. Nor is a slow one. The nurses diligently drain the bag as my dignity waits quietly in the bag with the clothes. Best place for it right now.
I watch a bit of TV on a tiny screen before sparking up my laptop and switching to YouTube. I have the wits about me to log onto the hospital wi-fi. I’ve also brought along the new series of Alan Partridge. It’s not as funny as I remember. This is probably a good thing as laughing, coughing and sneezing engage my cut stomach muscles which causes a streak of pain across my abdomen. For the most part, the pain killers are kept to common or garden Panadols. But after a big sneeze I ask if they can get something from the top shelf. I have to sign for it. Which is a pain. Nurses continue to come and go throughout the night checking vitals and the status of the overflow night bag – something that I am having no trouble in filling.
(T plus 1 day)
The next day, I’m freed from the drip and the ooze drain and encouraged to potter about the place. I break out my new crap slippers and ease slowly and painfully into my new crap pyjama bottoms. The ‘nil by mouth’ sign on the door is gone and I’m treated to a single 4” X 4” piece of toast. I ticked the ‘gluten free’ box on the way in and I’m getting a culinary history lesson – gluten-free catering circa 1989. If nutrition is part of the cure then I’m not going to get well eating this rubbish.
Shower time
I give the shower a go. It has a chair in it. I’m ready for a wash but I’m a few years away from sitting down in one. Showering is made trickier by the presence of the piss bag strapped to my leg. The nurse is in attendance to help. In fact, I’m under express instructions not to shower alone as I might faint. So, given the choice of fainting or dying of embarrassment, I opt for the latter. The nurse stoically does all that needs to be done to get me cleaned up, bagged and bandaged, and that’s that over for today.
As part of the operation, my stomach cavity was expanded with some kind of gas. This is standard practice and gives the surgeon extra room to manoeuvre. A good thing surely. The downside of this is that a good portion of that gas is still in there after they’ve sewn me up. The nurse had warned me about this. But I’d forgotten. Now I remember. This was easily the biggest cause of discomfort for me. Anything that causes pressure on the six newly minted gashes that I have strewn across my stomach is less than welcome. The nurses bring peppermint water and peppermint tea to help me pass the gas. But that isn’t happening. In fact, nothing is moving. It might if I really push hard. But that’s way too painful. I’m just going to have to sit this one out. For the next five days, as it turned out.
The day passes slowly. A nice lady comes in and ask me if I’d like to donate my prostate to medical research. Apparently, it still belongs to me. I know that body parts command a high price on the dark web, but I’ve never seen a prostate on the price list. Eyes, yes. Prostate, not so much. I sign it away. All yours. God’s speed.
More nearly-food arrives, the best of which was two dry rice crackers on a plate with a small tub of butter and a small tub of honey. My mouth is like the bottom of a budgie’s cage and they are giving me dry crackers to aid my recovery. Seriously. I’m saved by a care package of fresh fruit (including grapes) from the overpriced shop down the road.
(T plus 2 days)
I’m awoken with the arrival of breakfast. The room is rapidly filling up with plates of untouched crackers and bits and bobs of plastic-wrapped stuff. And now there’s a bit more to deal with. The tray includes a plate that has a cover on hiding the contents. Oooo. A cooked breakfast. Maybe I could eat. I lift the cover to reveal a solitary poached egg. Ta-dahh. I put the cover back. The Doctor swings in and gets straight to the point. How are we going? Good enough to go home today? That urine looks nice and clear. I call you with the results of the biopsy as soon as I have them. Gone.
The nurse checks in. What time am I planning to go? Like everywhere in the world, checkout is at 10. But before then, I’m going to need my goody bag. This consists of everything that I’ve used these last few days. Four types of tablets. Dressings and tape. Waterproof bandages. A couple of spare piss bags. Adhesive strips for the bags. Spare stockings. Special hospital-smell soap. The nurse runs through the entire contents so that I’m clear on what goes where and when to take what. She double-checks that I’ve got the doses right on the meds. I’m showered, dressed, drained and ready to roll. I walk gingerly to the carpark and fold myself carefully into the car. We’re going to take the most potholey, speedbumpy route home. It’s four days until the catheter is due to come out so I start counting down the days.
(T plus 5 days)
The days pass and nothing much happens. I’m staying indoors, mostly. I’ve raided the back of the wardrobe to find a pair of action slacks that I bought years earlier when I was chunkier. These are the only pants that I have that do a reasonable job of hiding the bag and tube strapped to my leg. By the time the weekend arrives, I’ve grown comfortable with the catheter and the daily and nightly rigmarole that goes with it. The weather is miserable and cold and my body is screaming out for a warming and wholesome roast dinner. We go to the supermarket. I’m secretly hoping that the store detective will spy my trouser bulge on the CCTV and will leap out from behind the cheese counter to frisk me. But it doesn’t happen. Just another boring trip to the shops. Do they even have store detectives any more? Mum pops around to say hello and stays for dinner. I’ve lost weight apparently. In the face. Not in the stomach. Which is still pronounced by the gas and strangely lumpy looking. Everyone has wine with their dinner. I have water. Grumpy.
(T plus 6 days)
Monday arrives. I’m back in hospital to get an x-ray and, if all goes well, have the tube removed from my bladder. I’m not sure what the etiquette is re catheter removal but I guess that showing up with a bag brim full of warm urine is generally frowned upon. I nip to the Gents and roll up my trouser leg to take a quick leak. I show the x-rays to the nurse. The news is that they look fine so I should pop up on the bed and take a deep breath.
Are you ready? Err. Dunno. Never done this before.
The nurse eases the tube out of my bladder whilst holding my gaze. It’s a slightly weird sensation. Not painful but nothing that you’d rush back for or write home about. With that done, I’m given a pad. A Tena pad. A Tena pad for Men. Size 3. The big one! We’re in unchartered territory. I need to put this pad down the front of my undies to absorb any leaks. The nurse asks if I’ve got tight-fitting pants on. I do so we’re good to go. I leave the nurse with my show bag which includes pads of various sizes and a script for Viagra. Apparently, the op causes distress to the nerves responsible for erections and the Viagra is prescribed to help put some daily lead in your pencil. I have it on good authority that if you don’t use it, you lose it. This was one of the few factoids that I remember from the initial consultation. The advice is to take a ¼ tablet each day and massage yourself in the shower. I’m not sure why it has to be in the shower. That’s just what they said.
Before I can leave the hospital, I need to drink a couple of litres of water and make sure that everything is working as it should be. When they remove the prostate, it leaves a gap which they fill by stretching the bladder down and stitching it into its new location. I think that’s what they said. Anyway, before I can go home, they want to be sure that all is well. If my bladder leaks, I’m not sure where it’s all going to go. But we’ll cross that bridge when we come to it. So, I’m hanging around the hospital for a couple of hours drinking litres of water and test-driving my remodelled bladder. The early signs are positive. The pee is pee coloured. Nothing is hurting. And I’m not pissing my pants and I don’t have urine coming out of my tear-ducts. I check back with the nurse and report the news. All good. We’re done. She’ll call me later in the day to check that I’m doing OK. And she’ll keep doing that for some days to come. These people are diamonds.
I leave the hospital, upbeat, and head to a nearby coffee shop. The physio told me that coffee, tea and alcohol are all irritants to the bladder and should be avoided. I think the nurse backed him up with the same advice. In fact, I’m pretty sure that I heard that same advice from a number of people, but perhaps didn’t fully register it because of the far-reaching consequences for the rest of my life. Buoyed by my recent performance in the hospital toilet I order a double espresso. I’m not doubting the advice. I just need to find where the edges are. The coffee tastes awesome. And radical. The car arrives as I’m finishing up and what-remains-of-my-time-on-this-earth starts.
(T plus 7 days)
While I was test-driving my bladder the day before, I bought a small box of generic Viagra from the hospital pharmacy. It’s quite expensive. On advice, I also bought a pill cutter which, theoretically, will slice each tablet into neat quarters. I’m told that I should have ¼ each day and wash the part vigorously in the shower to get the blood circulating. A number of people have told me that this is a necessary part of the rehabilitation without so much as a smirk. The pill cutter is more of a pill masher and the tablet is now a mix of big bits, small bits and powder. I dab a wet finger at the mess and have my first taste of copy-cat Viagra. Seven days after the op there’s not much movement downstairs so I’m keen to see if these tablets are going to help. Right away, they don’t. But after 40 minutes or so, we’re in business. Not 100% in business but enough to warrant an unscheduled shower. I wasn’t even dirty. As the doctor had warned in the scary preamble, orgasms will be possible but there won’t be any mess to clear up. As usual, he was right. Another box ticked.
The following days pass without note. The nurse had given me a selection box of incontinence pads which went from 3 (pretty big) to 0 (tiny). I’ve been working down the scale and settle on size 1, which is completely unobtrusive and providing me with all of the confidence I need to be normal. Normal is the goal now. I need to get back to normal as quickly as possible. Normal is drinking coffee, driving the car, walking to the shops, going to the pub, cleaning the house, going to work, eating out, socialising, pissing, shitting, fucking and generally carrying on like nothing has happened. So far, we’re making good progress.
I read somewhere that Korean Ginseng is supposed to help with erectile dysfunction. I don’t usually buy into the claims of the snake oil industry, but I needed an excuse for a walk so went and picked some up. I have been taking one or two a day. I can’t say for sure whether or not they have made any difference to anything, but my progress in this area has been, as they say, ahead of the curve so I’m still taking them. Please do not read this as an endorsement for Korean Ginseng. I, like everyone else in the world, has no idea if they have any effect. But hey, even placebos can have some effect.
I’m out of size 1 pads so I pick some up at the supermarket. Potatoes, check. Milk, check, Chicken, check. Pissy-pants pads, check. The new normal. The girl at the checkout doesn’t care as she scans the boxes. She’s not judging me. Me neither. It’s the new normal. Who gives a shit?
(T plus 11 days)
It’s Saturday. As part of project ‘get back to normal as quick as possible’ we’re going for a walk through the city. In preparation, I download one of those step-counter apps. I’ve been told not to overdo it – no heavy lifting – nothing too strenuous – so knowing how far we’ve walked is (for the first time) going to be quite useful. We head off to drink coffee, fill up on fish and chips, stroll through the park, mill about the market, go window shopping, sip a glass or two of wine, enjoy the sun and revel in the normalness of it all.
Back at the ranch, the app tells me that I did 19,326 steps – 12km. Is that over-doing it? Tomorrow will tell.
(T plus 12 days)
It’s Sunday. The sun is out again lighting up a lovely crisp and clear morning. On doctor’s orders, I’ve spent the week experimenting with Viagra doses and have concluded that ½ a tab produces a workable result but ¾ of a tab is better still. Or put another way, ½ a tab is fine if you’re in the shower. But in company, ¾ is a better bet. I pull out a number of mangled bits of pill from the cutter which I estimate to be in the region of ¾ of a tab. Tick tock. Cup of tea. Tick tock. OK, that worked. That worked 100%. Thank God for that. The long and short of it is that the doctors don’t really know how your equipment is going to respond to the treatment. Everyone is different. They are going to do everything humanly possible to keep everything working but there’s always the chance that things won’t end well. And there are stats to prove it. A small percentage of patients will never get a full (read usable) erection again. It may be 12 to 24 months before things are back to normal. And so on. Stats like these are shared in the early consultations and, whilst many things go in one ear and out the other, anything penis-related tends to stick. So, to get early affirmation that Project Normal is on track is good news.
The rest of the day is given over to another walk through the city. We get coffee and stop by a couple of pubs for a restorative glass of wine. Normally it would be beer. But I’m giving this wine stuff a go as it feels significantly less bulky. An hour into the walk and I’m feeling noticeably more tired than yesterday. Maybe there is something in that ‘don’t overdo it’ advice I keep hearing. We decide to get the bus back. The step-o-meter says 10774 steps – 7k. Good enough. Normal enough.
(T plus 16 days)
Things are getting more and more normal at the days pass. The morning routine is much the same except that I stuff a size 1 down the front of my undies. Some of the smaller scabs on my stomach are starting to drop off, though the 2” gash north of my belly button is standing fast. I’m in with the physio for session #3. We spend a bit of time going over what’s been happening. Have you been doing your exercises? Yes. Have you been weighing your pads? Nope. The scales in the fruit and veg aisle aren’t that sensitive. Can you do squats without leaking? Yep. And erectile dysfunction… how’s that going? Great. I need the tablets but that’s behaving like nothing’s happened. I’m actually feeling extremely fortunate. And grateful. When can I get back in the water? I lift my top up to show the scars. He’s seen it all before. Yep, they look good. Don’t get in the water until the scabs have gone. The water will soften them (good point) and swimming is going to put a strain on your core. The surgeon has made multiple incisions in your stomach muscles and they need time to properly mend. OK. Got it.
We finish up with a new program of more intensive pelvic floor exercises. The goal is to get rid of the pads. OK. They’re only a temporary measure? That is good to know.
(T plus 18 days)
It’s Saturday and we’re going out for lunch. We grab a coffee and start walking into the City. It’s a beautiful clear day and cold enough for soup. It’s perfect soup weather. I’m having soup. Just a normal bowl of soup. We continue the stroll through the City and settle down outside one of the better pubs in the area. The seats outside are bathed in sun and it feels like the right time to have my first beer in three weeks. My normal swigging cadence has been replaced by the more gentile sip of a wine drinker. I’m now sipping the beer. It tastes OK. It’s fine. I’m sure it used to be better. Eventually I get through it and get another. I definitely feel a bit different. A slight pain in the lower abdomen. Is this the bladder irritant that I was warned about? I don’t get it with wine. But maybe it’s the volume and carbonation that is making beer harder to deal with than wine. I’m going to monitor this closely. This is important work.
We stop for a mulled wine at the ice rink and head home. The step-o-meter says we’ve done 9k.
(T plus 19 days)
It’s another fine day and we’re up for another walk. Today we’ll leave the city and head to the coast. A boring bus ride gets us there. The easy flatness of the city is replaced by a coastal walk that includes uneven surfaces, sharp inclines, some light rock-hoping and quite a few flights of stairs. It’s been a while and by the end my legs are tight, tired and in need of a deep stretch out. They’ll be a bit tight the day after too. But it’s all part of what needs to be done. We eat fish and chips outside and I give cider a try. Seems fine. We get the bus back to roast a chicken. It is a winter’s Sunday after all. The step-o-meter says 23,705 steps. That’s 16k. 16k without me pissing myself even a little bit.
(T plus 1 month)
I get a call from the nurse checking in. How’s it going? Great. Any leakage? No. Nothing. Are you still wearing the pads? Yes, as a precaution. OK, let’s stop with the pads and see how you go. OK. It’s 4 weeks to the day since the op and I’m going commando. It’s a bit nerve-racking at first. But the pads have been clean for mostly ever so it shouldn’t be a problem. And it isn’t. Soon, I’ll be getting dressed and not even thinking about padding up.
The days and weeks are rolling by and everything is getting back to normal. I’ve started to put weight on so it’s time to get back into exercising properly. I might even design a fitness routine. Or at least keep a log of it. I wonder if there’s a website for that.
We had a weekend break to somewhere a bit warmer which required me to jump on a plane. It was only a short hop but I wasn’t sure if the pressure in the cabin was going to have an effect on the bladder. Fat ankles can happen after a long flight, so anything could happen, right? I popped in a precautionary pad on the morning of the flight. I needn’t have bothered. We were only in the air for 60 minutes but nothing leaked. Good to know.
Beer, cider and wine without a prostate. What’s for the best?
I’ve been experimenting with beer, cider and wine to see which ones are going to be a problem for me. The advice has been to avoid all alcohol but that’s the medical profession for you. They say don’t smoke and look how that’s going. So I’m keen to understand how irritating alcohol actually is for me with my newly reshaped bladder. And after one month the results are in. Wine doesn’t seem to bother me at all i.e. drinking it doesn’t have any noticeable effects. It doesn’t cause any discomfort in the pelvic region nor weakness in the bladder department. Cider seems equally benign. But lager does seem to cause some discomfort downstairs. Not leakage, but a slight bloating feeling. It’s not painful but there’s definitely something going on. Before the op, I was warned off all alcohol altogether, but my forming view is that some types might be worse than others. This is an entirely unscientific conclusion, but I’m going with it. My lager swilling days are over. And my wine sipping days have arrived. I’ll keep cider in the back pocket as a nice alternative when I need something big, cold and wet. Also, alcohol-free lager seems fine but that might be because it is impossible to drink more than two bottles without losing the will to live.
A quick chat with the GP
I drop by the surgery to give blood for the PSA test and the doctor is keen to have a chat. I’ve not booked in an appointment, but she makes time for me on the spot. How’s it all going? We haven’t spoken since the op. I remember you were a bit low when we last met. Shit. Yes, I was. I’d forgotten. But she hadn’t. Anyway, I reported that things were going well. And that my hypertension had gone away. I keep a log on my phone. I scroll through the readings. You can see when in time the op was by looking at the numbers. Before the op – high. Immediately after the op – normal. It goes off a cliff edge on the day of the op – 180 over 100 and something on the way into the theatre. 120 over 80 on the way out. We check the blood pressure there and then. It is always high in the surgery… the walk there… the white coats. It’s usually 180 over 100-and-something. It was last time. The screen said so. But not anymore. Today, it’s 112 over 85. Actually, a bit on the low side, but that’s fine. I get a repeat script but for a lower dose. The meds seem to be working now that I don’t have a life-threatening prostate onboard.
The 6-week check-in
At the 6-week mark, I’ve done another blood test and I’m heading back to hospital to get the results. It’s standard practice for them to check the PSA reading after the op. Too soon and they may get a false reading. So the 6 week mark is deemed to be the right time. The P in PSA stands for Prostate so given that I don’t have one any more I’m wondering what this test is going to tell anyone. Before the op the PSA was 9-ish. Right now, the test confirms, it is less than 0.05. Everyone seems happy with that, so I am too. There will be another test in 3 months. If it goes up, then we might be looking at resurgent cancer and radiotherapy. I suppose I’ve got that hanging over me for the rest of my days. We take a quick look at a print-out of the biopsy results. This is the biopsy that they did on the removed prostate. I’ve not seen this write-up before. The surgeon rang through the result the minute that it hit his desk but they have pictures here. The prostate looks pretty angry. The cancer was rated as a Gleason 5 in the middle. That’s pretty bad. The scale only goes to 5. The total score was a Gleason 9 at its worst. Again, that’s not good. If this cancer had gone untreated for another 12 months, you could be reading a very different account of events. If any at all. I have my naturally curious GP to thank for that. In other news, the surgeon wanted to know about pads and erections, so I tell him. I’m making great progress he cheerily reported. Yep. I agree. I just need to work on getting my fitness back and I’ll be happy.