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Awaiting Robotic Surgery!

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User

Posted 05 Aug 2014 at 17:39

Hello Folks,

After reading some of the threads from this forum I felt that it will be an important source of support, advice, information and, indeed, inspiration for me as it has been, undoubtedly for countless others.

I am a very fit 64 yrs old who also (normally) enjoy excellent health until my diagnosis of cancer last June. This was never meant to be on my script but my DNA had decided otherwise!

The initial feelings of shock, surprise,anger and disbelief are behind me now. My sole focus is my determination to tackle the beast head on and beat it! All my deceased close male relatives lived until their eighties and (mostly) nineties. I want to be part of that exclusive club!!

Thankfully my cancer is localised but on both lobes: PSA 9.9, Gleason 7 at stage T2c with peri-neural invasion meaning cancer cells are surrounding and tracking along nerve fibres inside the gland. This, unfortunately, maybe an important indicator of possible or potential spread outside the prostatic capsule. We should know with more certainty following surgery. My hope is for the best clinical outcome possible : PSA undetectable plus negative margin.

I knew surgery would be best for me in agreement with the specialists. So I opted for a Davinci Radical Prostatectomy which is not available in Lincolnshire and asked to be referred to UCLH. For me the near probability of major complications such as incontinence and ED (though transient) is a small price to pay for longer survivability.

My op will be performed by a high volume robotic surgeon next month. We discussed the issue of nerve-sparing because of my peri-neural invasion. Though my wife and I enjoy an active sex life, I told him he has my blessing to remove all my nerve bundles if deemed clinically necessary. I'm sure he'll try and save some!

The single journey home is around 150 miles to the hospital. We are staying at a hotel which is about 10 mins walk from the H. It would be an overnight stay if all goes well. We are staying at the hotel on the day of my discharge and my wife to drive me home the next day.

Bearing in mind that I'll have a catheter attached to my leg, what would be the practical issues I need to bear in mind in terms of my staying at the hotel for 1 night following my discharge? Are there any other considerations?

I would be most appreciative of the thoughts of people who has undergone this type of surgery or any other comments.

My apology for the long narrative which may be of benefit to some people who has very similar clinical picture to mine although I, of course, appreciate that everyone has his unique set of circumstances.

Thank you for looking in and kind regards,

P.S. I'll be more than happy to respond to private messages if any member so wishes.

User

Posted 12 Aug 2014 at 17:16

JC

Again all down to individuals but the only nausea I had was from tramadol pain killers. If you stop awake for the op you could perhaps assist.

Thanks Chris

User

Posted 08 Aug 2014 at 18:23

As you read this reply from me, scan your eyes to the right ... just click on the little speech marks to reply with the whole response quoted.

Once your reply box appears with the quote at the top of the box, you can start your reply underneath the last 'quote' mark.

If you only want to quote part of the statement, you do as above and then use your cursor to highlight & delete what you don't want to include.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 08 Aug 2014 at 18:26

Originally Posted by: Online Community Member

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!

I wasn't sure whether you were fully aware that a man can have all nerves saved and still be left with permanent ED.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 09 Aug 2014 at 09:54

Jacey /Lyne

Its the old postcode lottery again, regarding the pads, 120 arrived a couple of weeks before the op.

Not sure if your comment about "taking it very easy" is right. Take advice from your team but they will no doubt want you out of bed on the same day as the op, not that I did, which is why I got the extra night in hospital. I was slow off the mark mobilising myself but recovery increased quicker once I did. I just felt I wanted to get the catheter out before doing too much. I think moving around helps the bowels to get working better, but remember no straining.

Thanks Chris

User

Posted 10 Aug 2014 at 13:57

JC

Port exactly same as Steve, my drain slight issue looked a bit red but was okay. Good shout from Rodders about tap, but also remember too close the tap when connecting and disconnecting the night bag. Lots of variations out there but my night time bags had a strange drain on them and were one time use, it had to be twisted or snapped off, that is where the gloves came in useful. Showering not an issue, when I came out of the shower I swapped to another set of Velcro straps and let the wet ones dry. Injections as said by others not an issue just vary where they are done in line with your teams instructions. Nurse OH did mine each night and also did my bag connections etc.

Thanks Chris

User

Posted 12 Aug 2014 at 20:10

Hi Jacey,

Theirs one thing about having a forum we can all help each other and try to put minds at rest, I don't think I would like to be awake during the OP I had GA. I went down for my OP at 0800 and didn't get back to the ward till 1800, no problems with sickness, but I do remember my tummy bigger than normal due to it being inflated for the OP so the Robot can do its job tummy it went down the next day. I had some pain killers first night but that was it, they want you up on your feet asap which was ok the sooner you move around the sooner get out of the hospital. Good to get home.

all the best

rodders

User

Posted 14 Aug 2014 at 19:43

Jacey you are not on your own it was my first time under GA, all I wanted was it to be over and get home you will be fine.

Regards Rodders

User

Posted 18 Aug 2014 at 09:46

I might be dry, but a bloody site more miserable!!!!

Or even a sight more miserable!!!!!!!! (Post made in a hurry, hence the silly error.)

Edited by member 18 Aug 2014 at 15:41 | Reason: Not specified

Stay Calm And Carry On.

User

Posted 20 Aug 2014 at 23:41

Originally Posted by: Online Community Member

And who knows 6f2, if you hadn't rushed back to the golf so quickly you might even be dry now!

Life is for living......

Steve

User

Posted 14 Apr 2023 at 16:12

New blog post on robotic surgery https://personalizemymedicine.com/2023/04/14/surgical-robotics-the-future-of-surgery/

User

Posted 16 Apr 2023 at 10:22

Ah thanks for that Chris I hadn’t realised it was a resurrected conversation I had been reading the recent conversation links,
🤭🫢
Jeff

Show Most Thanked Posts

User

Posted 05 Aug 2014 at 21:39

Jacey
Age 62 Diagnosed with prostate December 2013. Had Da Vinci surgery April 28th 2014. PSA undetectable 12th June 2014 and 30th July Incontinent for only 4 days after catheter removed, others here have done even better.

I was diagnosed in Dec 2013 and went on a roller coaster of shall I, shan't I right up to the time I was in the anaesthetic room. Eight weeks post op and back at work after four weeks, I wonder why I even considered not having it done. 10 out 12 samples positive, Gleeson 4+3 PSA 7.7 Dec 2013 rising to 10 just before the op 28th April 2014. I think I am very fortunate to have cracked the incontinence so quickly, do the pelvic floor exercises. I had the Da Vinci surgery and the nerves were not spared (too much disease) The experience has strengthened our relationship and although I have ED but we already have a VERY fulfilling love life. Histology showed positive margins, but research into positive margins showed they do not always mean spread. Two post op PSA tests have been undetectable.

I left hospital with a supply of night bags,one per night and a spare day bay to change after one week. The night bag may have a stand or a frame that sits under the mattress. The incontinence nurse suggested a washing up bowl to stand the night bag in just in case of accidents. Some surgical gloves for the OH when attaching and removing the night bag and a plastic jug too empty the day bag into, this saves sticking the pipe near the loo. I wore loose jogging bottoms in the day and pyjamas at night just to save snagging the pipes. The bag etc will feel a bit awkward at first but you soon get used to it.

My surgeon said I would be out the next day, the nursing staff said " don't be rushed into leaving too early".

Just consider your seat belt position on such a long journey home.

The first time you pass a motion will be a relief and remember no straining.

Probably to late to change things but Nottingham city hospital urology now have the latest Da Vinci kit.

Thanks Chris

User

Posted 05 Aug 2014 at 22:17

Hi Chris,

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

User

Posted 06 Aug 2014 at 13:46

Hi Jacey

I met the robot at UCLH in May 2014, Althought the op is in and out the next day dont think its a piece of cake, it take's time to recover many weeks if not months, I only had to travel on the london underground for and hour along with my wife, get in the car the other end for 5 minutes, I shuffled around like a 90 year old changing platforms and walking upstairs etc. I was cream crackered, and went streight to bed when I got home...but maybe I'm a wimp !

I would recommend that you travel in something like tracksuit bottom, something baggy and comfortable, the catherter isnt painful but can be uncomfortable and youll find yourself moving around to find a better position, at night you can use a bucket to rest the night bag which is bigger , along with extention tubing, sleep on your back for a week or so until you can gradually sleep on you side, maybe ask someone to check the bag in the night as it can fill to overfull, it can be a bit of a pain in the butt learning to use and get used to the bag and tubing etc...you even get use to the smell of pi** after a few months...

good luck and dont worry to much about the op, they do it day in day out no big deal

User

Posted 06 Aug 2014 at 21:04

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

User

Posted 07 Aug 2014 at 11:12

Hi Jacey,

I opted for Robotic Assisted surgery in June 2014........ I had no hesitation in taking that route after I had gone through all the other options available to me and also taking the advice of my very experienced consultant....
( Check out my profile for details )

I agree with the others regarding clothing...... I wore loose fitting track bottoms and a loose T shirt when I was discharged after 24 hours..

I had to take a taxi for the 70 mile trip home and got stuck in traffic on the motorway! .... during that time my catheter leg bag was almost full so had to stop on the hard shoulder to empty it!
I have to say that wearing a seat belt was uncomfortable and I was pretty shattered by the time I got home...

I didn't find too many problems managing the catheter, but I did have some 'bypassing' which I was told was nothing to worry about as long as my bag was still filling up...
Hope all goes well for your future op....

Best Wishes

Luther

User

Posted 07 Aug 2014 at 21:13

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

User

Posted 07 Aug 2014 at 23:15

Jacey, add pants to your shopping list - proper ones not boxers and in a size larger than you usually wear. You will have the equivalent of a vasectomy as part of the operation so your penis and scrotum may be very swollen afterwards and you will be glad of the additional support :-o

Also, when buying joggers or pyjama bottoms, try to get a dark colour with a drawstring waist rather than elasticated, this will be more comfortable if your tummy is very blown up afterwards and less likely to rub on the dressings.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 08 Aug 2014 at 00:31

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.

User

Posted 08 Aug 2014 at 00:42

Thanks again, Chris, for your comments.

Your tip about catheter and bowel movement is useful as I suffer from constipation. I've started taking 'Laxido', a 'gentle' laxative!

I find your remarks that you'll "undoubtedly do it all over again if needed" very reassuring.

Kind Regards,

Jacey

User

Posted 08 Aug 2014 at 01:19

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

User

Posted 08 Aug 2014 at 01:32

Hi Lyn,

Thank you for your useful input.

I bought 2 briefs (medium), sometimes small size can fit me, yesterday just for that purpose!

You think I should get a large size? No problem!

Yes, my pant is elasticated and has a drawstring. Thank heavens for pragmatic wives! 😉

Kind Regards,

Jacey

User

Posted 08 Aug 2014 at 02:28

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

User

Posted 08 Aug 2014 at 06:59

Originally Posted by: Online Community Member

You think I should get a large size?
Kind Regards,
Jacey

Stick with the medium ones and treat yourself to an empty plastic bottle for the 3 hour journey. If you get stuck in a traffic jam on the motorway the last thing you will feel like doing is to stand on the hard shoulder changing a leg bag with an audience of fascinated holidaymakers.

Beats me why anyone would travel 3 hours for treatment though. Will all your follow up appointments also be at that hospital or will you be transferred back to the local urology team afterwards? 10 years or more of going backwards and forwards for check ups might become rather wearying.

By the way, at age 64 with PNI it may be a little over-optimistic to think that ED will be transient!

Edited by member 08 Aug 2014 at 07:06 | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 08 Aug 2014 at 17:09

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,

User

Posted 08 Aug 2014 at 18:23

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 08 Aug 2014 at 18:26

Originally Posted by: Online Community Member

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!

I wasn't sure whether you were fully aware that a man can have all nerves saved and still be left with permanent ED.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 09 Aug 2014 at 00:17

Jacey

Just some other issues to consider. No doubt you will have a drain and cannula fitted, when the nurse removed these and dressed them the dressings were not applied very well and I leaked blood onto the bed, the hospital PJs and the floor. So make sure they are okay before you leave.
Are UCLH providing all your post op needs, I came out with , spare leg bag, 10 night bags and frame , I had to get another bag from the hospital because my catheter removal was put back a day, twenty eight days of anti clotting injections( another job for the OH ? ) I should have had a box for the empty injections but collected one our from local medical centre . Spare dressings for drain wound ( 4 times to big , only size they had) . 100ml morphine, pain killers that I had said make me sick, do you use a pain killer that works, but be careful of pain killers that cause constipation. I did not need regular painkillers no regular pains, only the one that put me in A&E. Have arrangements been made for the district nurse to visit and check wounds ? Will your GP do post op Health check. Have you already had catheter care training and got a post op incontinence nurse appointment, have you got a post op ED appointment. Who will arrange your first post op PSA blood test. All the above just happened because it was all with the same health trust.

A bit there to think about, but less to worry about if sorted pre op.

You will need to drink plenty of fluids, but after a while water looses it's appeal, I added cordial and mixers to plain water to give it a better taste. Appetite may not be as good post op so have some of your favourite food with you if you can.

Hope we are not overloading you too much.

Thanks Chris

User

Posted 09 Aug 2014 at 01:09

Whoah, just shows how much variation there is from hospital to hospital.

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

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 09 Aug 2014 at 09:54

Jacey /Lyne

Its the old postcode lottery again, regarding the pads, 120 arrived a couple of weeks before the op.

Thanks Chris

User

Posted 09 Aug 2014 at 22:24

Originally Posted by: Online Community Member

Whoah, just shows how much variation there is from hospital to hospital. 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,

User

Posted 09 Aug 2014 at 23:21

Jacey,

Like you I'm reasonably fit. I was encouraged to wear my surgical stockings for a month after being released from hospital and to use the self injections too and did so, more to please my wife if I'm being honest, but nevertheless the surgeon who performed my operation was quite clear that he thought both were necessary. Also, when I mentioned to him that I was about to embark on a long motorcycle ride to Austria a few weeks later he also asked me to wear the surgical stockings whilst on the bike.

So probably worth doing. As an old friend used to say 'you won't lose by it'.

Steve

Edit

My port wounds were sealed with some kind of surgical glue but no other dressing and I was told that I could shower with no ill effects to them. The only issue I had was with the drain tube hole in my left side that took a little longer to heal over than the surgical ports and I know of another who's drain tube hole was problematic too. Just something to be aware of although I'm sure yours will be fine.

Edited by member 09 Aug 2014 at 23:27 | Reason: Not specified

User

Posted 10 Aug 2014 at 00:45

Jacey, it isn't an NHS directive for everyone having cancer surgery. John didn't get the injections because he didn't need them, not all hospitals issue them routinely. Our hospital only prescribes anti-coagulant meds to patients deemed to be at real risk of DVT. Nor was John given stockings to wear at home - maybe the difference was because he was quite a bit younger, maybe there is less risk of DVT after open surgery or it might simply have been because his bloods were good.

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

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 10 Aug 2014 at 12:38

Thanks again, Steve, for your input.

I'll raise the issue of anticoagulant therapy with my surgeon prior to the surgery. It might be a case of overtreatment/overkill in my case!

I have not yet ruled out those darn injections!!

I shall certainly pay particular attention to any wound dressing. Thanks!

Regards,

User

Posted 10 Aug 2014 at 12:49

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

User

Posted 10 Aug 2014 at 12:52

Lyne,

I was quoting what we were told regarding anticoagulant therapy for all patients following cancer surgery. It's, obviously, standard practice at UCLH based on their own research evidence.

Nonetheless, I am still intrigued by it. DVT has always been a potential complication of hospitalisation with or without surgery. Why the big fuss now?

Anyway, this debate has little relevance to subject matter of this forum IMO!

Regards,

User

Posted 10 Aug 2014 at 13:05

Hi again Jacey

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

User

Posted 10 Aug 2014 at 13:56

Originally Posted by: Online Community Member

Lyne,
I was quoting what we were told regarding anticoagulant therapy for all patients following cancer surgery. It's, obviously, standard practice at UCLH based on their own research evidence.
Nonetheless, I am still intrigued by it. DVT has always been a potential complication of hospitalisation with or without surgery. Why the big fuss now?
Anyway, this debate has little relevance to subject matter of this forum IMO!
Regards,
J

It may not seem particularly important to you but this is an open forum and we all have a responsibility to ensure the information we post is as correct as possible and doesn't create undue panic. You stated that all men get these things and that the injections are mandatory, neither of which are right. Any new members who don't know better could read this and have unnecessary worry & stress about the fact that they didn't have the injections or haven't had a visit from the nurse. What is true for you may not always apply to every case or every hospital or every CCG and trying to second guess what others will do with the information you post is a skill in itself. You are very new here so it may be hard to imagine but there have been times when members have demanded certain treatment routes or services simply because someone on here posted that it 'always happens' and then been terribly upset and frightened when their own medical team have refused or pooh-pooed the idea.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 10 Aug 2014 at 13:57

User

Posted 10 Aug 2014 at 14:09

Hi Rodders,

Thank you for your input and good wishes.

Although I am well prepared and informed about my pending op, I very much value members sharing their own personal experiences. I feel a lot can be learnt despite our own individual circumstances. There is always the possibility of something unexpected going wrong!

I read with interest your experience about tackling ED. Very useful to know! 👍

Regards,

User

Posted 10 Aug 2014 at 14:16

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

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

Regards,

User

Posted 10 Aug 2014 at 15:02

Originally Posted by: Online Community Member

Lyn,

My apology to anyone if I have caused any confusion, panic or otherwise. It is certainly not my intention to misinform or mislead members on such a serious matter!

I have read the forum T & C and do not believe I breached any of them.

You are right that we all have a responsibility to others as well as to ourselves may I add.

I take that responsibility very seriously indeed and expect others to do the same.

I acknowledged and recognised, as shown by my previous posts, that our circumstances are unique to ourselves and, therefore, may not be applicable to others.

As you pointed out this is an open forum. Unfortunately, as such, posters comments can be interpreted to suit whoever reads them. I cannot take responsibility for that as we are all adults.

If my comments are deemed to be inappropriate, malicious or rude, I would expect the forum moderators to censor me or take whatever action they feel they need to take.

Regards,

User

Posted 11 Aug 2014 at 20:18

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

User

Posted 11 Aug 2014 at 22:07

Hi Rodders,

Thank you for your continued support and advice.

Yes, I'll be fitted, pre-operatively, with anti blood clotting stockings and given an injection to stop me getting blood clots during the op.

There was no mention, so far, of any other pre-op taking place a few days before. I expect there would be procedural variations, be it clinical or organisational, between hospitals as long as patients gain the best and safest of outcomes!

One thing I do dread above anything else, post-operatively, is the possibility of nausea and vomiting (quite common following GA, general anaesthesia) which I hate! So, anti emetics would be very handy! I wonder whether I can choose to have an epidural instead.... I wouldn't mind staying awake and chatting to the Robot!! 😜

Regards,

Jacey

User

Posted 12 Aug 2014 at 00:05

I suspect your wit and repartee would be challenged by having your head tipped down and your feet up in the air!

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 12 Aug 2014 at 10:27

Originally Posted by: Online Community Member

Hi Rodders,

.... I wouldn't mind staying awake and chatting to the Robot!! 😜

Regards,

Jacey

From what I can remember the robot at Bristol wasn't very talkative......http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-smile.gif

User

Posted 12 Aug 2014 at 12:53

Originally Posted by: Online Community Member

I suspect your wit and repartee would be challenged by having your head tipped down and your feet up in the air!

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

User

Posted 12 Aug 2014 at 13:05

Originally Posted by: Online Community Member

From what I can remember the robot at Bristol wasn't very talkative......http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-smile.gif

Expect it'll do more chopping than talking!! 😎

User

Posted 12 Aug 2014 at 17:16

JC

Again all down to individuals but the only nausea I had was from tramadol pain killers. If you stop awake for the op you could perhaps assist.

Thanks Chris

User

Posted 12 Aug 2014 at 17:28

No, I was very happy to be in the land of nod when it was all happening thank you very much. Anyway, it was so nice to meet the lovely anaesthetist lady at Addenbrookes, she was a gem.

User

Posted 12 Aug 2014 at 20:10

Hi Jacey,

all the best

rodders

User

Posted 12 Aug 2014 at 22:04

That was what I was trying to say Rodders.....it's great to get home. I wouldn't have wanted another night away in a hotel after nights in the hospital.

User

Posted 13 Aug 2014 at 18:39

Originally Posted by: Online Community Member

That was what I was trying to say Rodders.....it's great to get home. I wouldn't have wanted another night away in a hotel after nights in the hospital.

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

User

Posted 14 Aug 2014 at 19:43

Jacey you are not on your own it was my first time under GA, all I wanted was it to be over and get home you will be fine.

Regards Rodders

User

Posted 17 Aug 2014 at 14:10

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

User

Posted 17 Aug 2014 at 15:59

Hi Jacey,
As you already know, my husband had his op at UCH and I can confirm tbat when we attended the pre-op patient surgical school we were informed tbat ALL men undergoing robotic surgery would be sent home with a supply of injections.. In my husbands case this consisted of 26 injections (one per day ) starting the day after the op.
Jane

User

Posted 17 Aug 2014 at 16:01

Tbat ??? Lol sorry but this blooming i.pad has a mind of it's own ;)

User

Posted 17 Aug 2014 at 23:28

When I woke up, the wind was amazing. To the nurse, it must have looked as though I was simulating love making due to the discomfort. As soon as that died down with the peppermint tea, I had virtually no discomfort. I certainly didn't feel as though I had had a major operation. I was playing golf again 6 weeks post op.

Make sure you are sorted re post-op referrals for incontinence and ED. Pads should be on prescription - I must have spent over £150 before my referral - and what tablets , ciallis, viagra, vacuum pumps etc to get things moving. Remember it can take a year or even much longer to have natural erections even with nerve sparing surgery.

I had my blood thinning injections for 28 days, during which time I also wore the stockings. Travelling home was far worse after catheter removal than after the op! I was leaking like mad, but over 15 weeks post catheter removal, I have much more control and hope to be dry by the end of the year.

Paul

Stay Calm And Carry On.

User

Posted 17 Aug 2014 at 23:35

And who knows 6f2, if you hadn't rushed back to the golf so quickly you might even be dry now!

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 18 Aug 2014 at 08:11

I think you've done really well Paul, hope you're enjoying your golf :)

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