Awaiting Robotic Surgery!

Thank you for sharing your tips, thoughts and experience which I found reassuring.

You think I should be ok staying at a hotel for 1 night following my discharge before returning home but to ensure I have night bags, gloves and a jug in hand.

I've already started my pelvic floor exercises and take regular laxatives.

I chose University College Hospital because the Professor I saw privately for diagnostics has recommended his colleague to me.

Regards,

JC

I did opt for a local robotic op locally rather than open surgery 50 miles away, even though the surgeon proposing open surgery was suggesting he could spare the nerves on one side. Open surgery involves a bigger incision so did not fancy the journey. Personally and this is an opinion I would look to stay in hospital the second night let your OH have a good nights rest in the hotel and try to get an early discharge the next day and straight home,I think we all feel better in our own home. I opted for NHS treatment and was in a four bed bay, I think it would have been quieter in Piccadilly Circus ,I was given some ear plugs when I mentioned the noise. I also stopped the second night in hospital, it is major surgery and I finished up at A&E two nights later never really found out why but it was pain related to that first bowel movement. Once the bowells move it is a relief, no forcing ,you should have been told that you may leak between the catheter and penis when passing a motion. 10 days after op the catheter bag was still more red than rose, probably a couple more weeks before the urine was clear. I kept worrying the catheter was going to come out , just make a note of how much is hanging out, remember to keep it clean. Recovery is a personnel thing, as titanic says you will hobble around like a 90 year old at first. I was back at work within four weeks ,office based for a couple of weeks then could not wait to get out on the road up to 1000 miles a week visiting sites. One of the guys on here went to Austria on a motor bike not long after his op. Have a look at the posts " think it must be surgery for me" and "Da vinci surgery - my experience" lots of info and advice. Now 13 weeks post op and undetectable PSA life is almost back to normal, ED still an issue, not a problem. I am having a slow flow issue but a small procedure should sort this, would I do it all again, without doubt yes, Hope all goes well and keep us all up to date with progress.

Thanks Chris

Hello Jayce

I'm really sorry that you find yourself in the position that we have all had the misfortune to find ourselves in too. However it seems your condition has been found early enough for treatment to be successful, moreover and importantly, you have made an informed decision as to what form that treatment will take. My diagnosis was very similar to yours and if you read my previous posts you will see that my RRP has been successful and that my PSA is now unreadable. It has been three months since the op and I'm feeling well and getting fitter by swimming and walking. I hope that yours will be as successful and that in another three months we will be reading about the success of your own treatment.

As for your questions I'm not sure I can add very much to what has been said by the others. Like you I had to travel a long way for my op and my wife did the driving. Like you we stayed overnight near to the hospital the night before the op due to the early start but drove home on release. I didn't have a problem with the drive home in fact I was asleep for most of it. I had cushions under the seat belt and the passenger seat positioned so that I could lie back. I ensured the catheter bag was empty at the beginning of the journey but we had a strategy in case it needed to be emptied on the way back. It didn't and from my point of view the journey took no time at all but most importantly I was extremely grateful to be home.

The operation itself was a non-event in all honesty. The pain killing drugs worked very well and I felt virtually no pain. The couple of days in hospital afterwards was interesting. They will have you up out of bed very quickly and walking around to assist your recovery. As a motorcyclist I'm used to wearing ear plugs and I wore them at night; I would advise you to do the same unless noise is something that doesn't disturb your sleep. Drink plenty of water. I recorded everything I could remember in my earlier post and I hope this is of some help to you.

It is great when the catheter is removed. Another long journey back to the hospital for this to happen but so worth it. Just take it step by step after that when you are at home. Relax, get better, don't push yourself, just rest, take naps in the afternoon, watch rubbish daytime TV or read; and get better.

Good luck, I sincerely hope it all goes to plan. If there is anything else I can assist with please don't hesitate to get in touch,

Steve

Hi John,

Thank you for sharing your experiences and tips which I'll bear in mind.

How would you describe  your treatment and care at UCLH? My op will be performed by a different surgeon to yours.

Regards,

Jacey.

Hi Luther,

Thank you for your good wishes.

My wife treated me to a Ralph Lauren bottom nightwear yesterday. I wonder whether Mr Lauren cares how many men will wear his products following a prostatectomy!! 😜

Our return journey by car will take at least 3 hrs. We'll keep an eye on the bag. Thanks!

I attended a meeting called 'Patient Surgical School" at UCHL aimed at those awaiting Robotic Prostatectomy specifically. There were representatives from various discipline present to answer questions. It covered all the important relevant issues before, during and after the op. We were even shown a (used) robotic arm with tiny scalpel(?) at its tip, which was passed around for us to play with! We were told it costs under £2,000 and discarded after 10 patients use. I just hope they'll use a brand new one when it's my turn!! lol ...mind you I use my Gillette razor more times than that!

Though I already know a good deal I found the meeting informative and beneficial.

The specialist nurse present suggested putting a soft pillow under the seatbelt when travelling.

Regards,

Jacey

Hi Steve,

Thank you for your kind thoughts and sharing your experiences.

It's somewhat uncanny (I, of course, don't mean it in an unkind way!) that we share similar clinical profile and other ideas!

Because of that the outcome of your treatment has made me feel even more optimistic and positive. Although my cancer is localised (T2c), I do harbour some concern about my peri-neural invasion which some researchers suggest is an important indicator of 'extra capsular extension' (i.e. presence of tumour beyond the confines of the prostate).

So, I'm really hoping for absence of cancer at the margins and undetectable PSA, no less, following the op.

But as you quite rightly said am taking it step by step. For sure, after my op I'll take it very easy, watch rubbish TV (fortunately, that's what available mostly!!) and gorge myself with antioxidant!

One last thought: I am bizarrely and perversely 'looking forward' to my surgery!!! Time to call men in white coat and cart me off! 😁

Like with other forum members, I'll certainly take your advice and suggestion on board.

Thanks again for your support.

Kind Regards

Thanks LynEyre,

Your comments and tips duly noted.

As I mentioned in my opening narrative, robotic RP is not available in Lincs. I've expressed the wish to have all my follow-ups (even including the regular PSA tests!) done at UCLH. I made that choice quite happily for 2 simple reasons: I've lived and worked just outside the capital for 35 years and nearly all my relatives and friends live in and around London. So it would be opportunistic of me to see or stay with them when I travel down there! Secondly, my local Trust was one of the 14 Trusts reviewed by Sir Bruce Keogh for their quality of care and treatment and was also lambasted by other organisations, including the Care Quality Commission, for their below average performance. Plus I had anecdotal evidence from some of my wife's relatives/friends about the poor care they received. One can appreciate my unfortunate reluctance not to be managed post-operatively for such a serious condition locally!!

I am under no illusion that there is a high probability that my nerve bundle will not be spared due to PNI, bilateral tumours, etc, though my surgeon stated that he'll try and save some! The best possible outcome for anyone undergoing RP is, of course, restoration of erectile function, urinary continence and eradication of the cancer (not necessarily in that order!). I'll very happily settle for the latter two even though we are currently sexually active! For me, the benefit of a significantly longer life far outweigh loss of normal erection, permanent or otherwise! I love life!  http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-cool.gif

BTW, Lyn, can you, please, guide me (step by step as I am not really tech-savvy!) on how to quote a specific phrase/paragraph of someone else  post and respond below it as you've done with mine. I like that! Thank you.

Regards,

JC

In our area you get one night bag to last as long as you have the catheter and pads are not provided on the NHS unless/until you have been incontinent for at least 3 months

Needle bins have to be purchased and are ridiculously expensive

Not all men need or get those post-op injections - depends on hospital policy and how healthy you are

There are only a few regions where the district nurse comes out post-RP and we certainly never saw the GP :-0

Lyne/Chris,

Indeed, postcode lottery and Hospital Trusts variations in terms of care pathways and policies. UCHL post-discharge care and provisions appear to be pretty good and adequate (incl. bags, assorted oral analgesia, laxatives, sharps plastic bin, etc).

We would also be supplied with 28 days of self-injected medication to minimise potential risk of DVT (deep vein thrombosis). Apparently, anyone who has any type of cancer surgery should be given these. The lead clinical nurse specialist  seemed to doubt its usefulness and stopped short of not recommending it. She, obviously, cannot as it is an NHS directive. Personally (this is purely and simply my choice), I probably shall not bother (or just do the first 5 days or so) because of my low risk of DVT: I enjoy excellent cardio-vascular health and will continue to wear my surgical stocking. There are other simple measures (such as early regular frequent mobilisation no matter how brief) one can take to combat DVT which I appreciate can be fatally rare!

Chris, were your port wounds sealed with surgical glue and dissolvable stitches with plastic dressing on so that you can shower?

Am, of course, hoping not to have an infection or serious catheter blockage! 😟

Regards,

J

Edited by member 10 Aug 2014 at 00:47  | Reason: Not specified

Hi Jacey,

            I am 64 and had D/Robotic surgery Nov2010 after bi/op results 4/3 gle scale 7 cancer which had extended outside the Prostate. The op went well op on monday and out on wednesday PM. I felt ok had no problems with cath you will need a night bag for cath dont forget to turn the tap open on night bag, You must remember this major surgery you will only see small dressings on your tummy and may be thinking you can carry on as normal. Take things easy by the way I was told the Cancer had spread to lymph nodes left/right was removed. I had cath removed 10 days after op used pads for about a week fully dry after 6/7 weeks. Can pee like a horse Ha Ha, ED nurse was very good tried pump worked for a while. Tried viagra tabs no good, I have been using Caverject injections which work for us for the past 3 1/2 years. You must remember to talk to each other and live life, they will want you to go on HT for a while. Hope all goes well.

rodders

I was prescribed 28 days of Clexane injections after discharge from Bristol Southmead Hospital....

Didn't find a problem self injecting .....not nearly as bad as it sounds....

As far as I'm aware this is standard policy at Bristol for RP procedures ... it may differ at other hospitals?

I had soluble sutures and no drain was needed....

No visit at home from a nurse was arranged or needed ......TWOC and follow up review with histology report was arranged at my local district hospital which saved me a 140 mile return journey..

Best Wishes

Luther

Thank you, Luther, for sharing your positive experience concerning AC injections.

Hoping there will be no issue with my wounds and catheter care!

Regards,

J

Hi Jacey,

            You are not alone about being worried that things going wrong and all these comments on DVT. Well as you stated you are 64 and fit, I was 61 when I had my op in good health apart from PC. I had stocking fitted before the OP and had to wear them for 2 days at home with no problems. Regarding the OP you will have a pre OP which is 2 or 3 days before the day, you may be given anti sickness tablets to take before the OP. Hope this helps regards

rodders

Lyne,

That's, precisely, the position I hope to be in when am strapped to the operating table in a few weeks time! 😀

Regards,

Jacey

Steve,

Gauging from your and others experience, the idea of returning home ASAP certainly appeal to me even though we live 150 miles away from the hospital.

It should be quite an interesting but, hopefully, not too eventful experience for me as I have never been hospitalised before!

Jacey

Jacey - I hope you're reassured by fellow-posters who've gone down the robotic LRP route. I had my encounter with the robot six weeks ago - see the Da Vinci thread on this forum - & this was my first GA since a childhood tonsillectomy. The weeks of waiting & psych-ing myself up for the op had me champing at the bit somewhat, but once in theatre I was immediately reassured by the friendly & laid-back approach of the anaesthetists at my local hospital. Apart from a slight sore throat I had no post-op pain, & only mild discomfort from the catheter when sitting. Bear this in mind on your long-ish car journey home & equip yourself with a variety of cushions. By the way, this discomfort will magically disappear when your catheter is removed. At home I found that leg & night-bags were no problem once I got used to them, but fear of infection kept me to a strict ritual of steri-swabbing the nozzles when changing & emptying bags.

Regarding anti-DVT compression stockings - do take extreme care when putting them on. I'm a stone-&-a-half over my ideal weight - I'm 61, by the way - & I ricked my back quite badly just before being trundled in to meet the robot, so was bizarrely grateful for the pre-op spinal injection ! Post-op I received Clexane and had a pneumatic massaging-machine attached to my calves for the first 24 hours or so, but wasn't offered any thinning shots for self-medication at home. Hospitals differ on their post-op routines, but make sure your discharge nurse gives you enough sterile swabs & dressings to manage the small port-wounds until the closures are removed, especially if you're not scheduled to have a visit from a district nurse. We were also given alcohol hand gel and surgical gloves, a staple-removal kit to take to our GP nurse, plus an informative incontinence & ED starter-pack from P Ca UK. Six weeks on & continence is slowly improving -  pelvic exercises adhered-to rigidly.

My GP obligingly prescribed Viagra, which RP patients are eligible to enjoy free on the NHS, regardless of age. I haven't used it yet, but live in hope...

Good luck & all the best for the op, & for a quick recovery !

Morris