ramses (imported) wrote: Wed Sep 10, 2008 12:42 pm
For the guys here who have had prostate problems, what were the first clues that something wrong was going on?
Ramses, you don't want any clues, other than something being off in the PSA counts.
Sixty years ago, the first signs were bone pain when the prostate cancer had metastasized.
The proper description of those cancer victims was "dead men walking".
Now, with regular digital prostate exams (yes, the finger up the butt), those problems can often be discovered much earlier. Sometimes it can be discovered early enough to save the patient's life. Of course, the surgery is necessarily extensive, and does a lot of damage. Invest in diaper companies.
With an annual PSA test, most patients get a huge jump on the problems. Almost too much of a jump.
The earlier it is treated, the better the final prognosis. Caught early, the odds of survival are excellent. With good modern treatment, your chances of surviving are better than 95%, pretty much no matter which treatment choice you make.
I still champion the Free PSA in conjunction with the PSA.
If your PSA is high, a high Free PSA (more than 20%) might save you the pain of a biopsy. (It stings at the time, but not as much as a vaccination. The next day it hurts.)
Also, a low PSA is not a free pass. I had a very low PSA. A very low PSA plus a very very low Free PSA is a virtual guarantee of Prostate Cancer.
To re-re-repeat - Go to a clinic. There will be somebody there watching if the nice doctor makes grab for your wallet.
Do not settle for procedures that are ten years old. They will do much more damage and cause you significantly more problems. My first Urologist tried to persuade me to do that, and some of the protocol he wanted to follow was simply witless. He managed to forget to mention the newer techniques.
The more surgeries your surgeon performs, the less likely adverse conscequences will happen (infections, collateral damage to the intestines, incontinence, and all the other nasties they will warn you about), and more likely you will be, if not happy with the results, at least not feeling as if you are a cripple. The relationship is statistically strong, and direct - more surgeries per year equals fewer bad results per surgery.
I am now well past the intial recovery stages. I am up to performing every physical task I could do before. Run up a flight of stairs, carry heavy loads for hours, jump, stand, or sit. No problems.
No incontinence, almost. If I wait too long to head for the toilet, I sometimes spend a small penny when I sit up too fast. Otherwise, no problems in that area, whatsoever. I no longer have a problem with flow. No enlarged prostate. After about four weeks, I pitched the Depends and never looked back.
Still not much wood. Something strange going on there. A couple of morning woodies, but mostly nothing.
Orgasm is different. Better in some ways. I had to learn to let it run on. It lasts a lot longer and sort of tapers off. Very nice. Overall motivation is still extremely low.
I will say a lot of good things about the "Da Vinci" procedure - robotic orthoscopic surgery. It is not outpatient. It is serious abdominal surgery. It was a month before the pain at sitting up pretty much went away. All-in-all it is probably much cheaper than the older traditional stomach incision, because so little time is spent in the hospital. My insurance company fell all over themselves approving the somewhat experimental surgery.
All but one of the incision scars has healed nicely (the tape came off after they removed the staples. I could have replaced it, but did not. The wound spread apart, a little.) Now I am wiser.) The longest incision is more pronounced, but I expect in a year that all of them will be nearly invisible.
Upsides - I arrived at the hospital about 4:30 AM on a Thursday, and my wife was driving me home on Friday at 1:30 PM. I had three days off, then worked from the couch in the living room for two or three weeks. I work from home right now. If you do not, then plan on two weeks off, have another week available if necessary, and it probably will be necessary.
The older style abdominal surgery will cause more nerve damage, will take longer in the hospital to recover (hospitals are extremely dangerous places these days), the incision will be much bigger, and will take much longer to heal even after you are out of the hospital.
Actual, real pain - not much. I had to take pain killers a number of times in the days after the surgery, maybe four in the first three days. Seemed like I needed one to go to sleep for the first week - aches and pains were keeping me awake. None since them. Your mileage will vary.
You learn very quickly the difference between the right way and the wrong way to sit up. Now, any way that does not involve me landing on my head is fine.
Even the Depends were not too much of an inconvenience. I knew that they were part of the consequences of the treatment, and that I would soon not need them. I went four days in a row where I only put a new one on because it was fresh, and decided to quit using them entirely.
So don't be afraid of the pain, it is minimal, and what is not minimal is soothed with pain killers.
One of John's biggest concernes is that it will not improve your sex life. I promise you, it will not improve your sex life. Know yourself and how you feel about decisions. If you think you will regret it forever, think very carefully before going ahead, especially if your Gleason score is 5.