Wednesday 17 July 2019

Bulletin Number 7 ~ From TURP to TWOC to TWERP (After the Operation)

Don't normally think about it ~ pee that is. Nature has a way of managing these things beneath the level of awareness. But what happens when you discover that not all the pee you void and see, is all that's being produced and got rid of? Some of it remains inside and you can't actually see how much.

Wish I could lift a flap or have an app to check my levels. Recently I've been measuring, so I know what's going in ~ coming out. But as I said, because you can't see inside, it's hard to know what's left over.

There's always something, but, if there's too much left in the bladder and it's hanging around, that's not good apparently ~ could back-up and damage the kidneys. An ultrasound scan would show me ~ I've had these ~ but you can't keep going to the hospital to do this test all the time.

If there's too much left over, you need to get rid of it somehow and that means a catheter. Over the past year, for this very reason, I've catheterised myself over a thousand times ~ ouch, not fun. I recently stopped doing this after the 'rebore' operation and I'm now a couple of weeks into a Trial Without Catheter or TWOC as they call it. 

It's great not using a catheter, and being the TWOC ~ that's what they call me ~ but it will take a while (several months) to recover and see if the operation has been a success. However, I'm gradually feeling better day by day and I've decided to revert to being what I've always been, (as several people would agree ~ I know who you are), a TWERP. 

Being a TWERP means that I can lead a life of Totally Wonderful Everyday Regular Pees. As nature intended I think. I don't mean to be reckless and kid myself, and I remain vigilant and mindful of the hazards of not being fully informed and aware of what's really going on inside my body. But until they develop a miniature scanner, an app or a flap, what more can you do?

Just like the pee, the urge and stress to check all the time comes and goes ~ I guess for the moment, I'll allow myself to accept the situation, move steadily from TURP to TWOC to TWERP, be mindful of it all and let it be. Here's hoping. 😉🤞

Tuesday 2 July 2019

Bulletin Number 6 ~ It's Peetiful and there are no Guaranpees (The Operation)

I go in to hospital for the 'rebore' TURP operation tomorrow to stop the retention of urine and ease the blockage caused by my prostate 'going LARGE '. It's under a general anaesthetic but I'll be home the same day. I will be sore and there will be an in-dwelling catheter for forty eight hours. I go back in two days to have it removed.Then it's down to peeing au natural (if I can) ~ naturally, I don't mean in the wilds or the street. 

It's been almost a year now of catheterising myself (every day 4 times a day ~ since August 2018 ~ over 1150 times.... ) I'm hopeful I won't have to do that any more, but ~ as I've been told several times ~ there are no guaranpees. The consultant doesn't say guaranpees of course ~ he's had the customary GSOH bypass operation (quite a high success rate in medics).
 

On the day before the operation, there is a good omen ~ or at least I think it is a good omen. I am cleaning windows at the back of the house when suddenly the Red Arrows ~ the whole airborne display team ~ fly very low in a sweeping curve right over me. I salute them! I'm sure there is something quite lovely about me standing there holding my limp-leaky hose, with all those macho-men@mach1 shooting by....

That evening (the one before D-day) I'm surfing the radio and happen to catch Derek Jarman's 'Blue'. I was transfixed. It's a kaleidoscopic multi-media experience largely performed by him exploring his approaching death (for real) sadly, he expired from complications due to HIV Aids. The drama was not perhaps the happiest and best of preludes to my looming operation.... but as in 'Warnography', we might say, I was hooked and totally drawn in. Who doesn't want to know what their death will be like?

To continue the metaphor, it's D-Day at the hospital and although I'm first on the operating list, (in my imagination, head-down, leaping off the landing craft ramp, fully-laden on to the cacophonous deathly beach below, getting shot at from all directions), amazingly, I don't die ~ not from the rebore operation anyway.  Boredom maybe? As a friend predicted, there was a lot of hanging around. But no of course I wasn't bored, there was so much to be mindful of.

Young men with impossibly recent dates of birth. The constant backdrop of an eerie lift-shaft wind-noise like you get in 1930's Film Noire movies. Everyone sadly and separately immersed in their phones, magazines, music and leaflets (the silence occasionally punctuated, I observed, by reckless and inappropriate comments about Brexit and Women's football) ~ there was much to be amused and saddened by. Not trying to do anything, just being there, sitting, breathing and noticing it all as best I can. For example, putting compression stockings on to prevent a DVT was very funny. Every one of us donned them in a different way ~ I think the hole was meant to be underneath, but who knows? Certainly showed how individual we all are.

It's done! The operation is magically over and I'm in the recovery room where everyone's busy doing something again ~ pacing up and down, texting, listening to music, reading. I'm just sitting. I don't have my phone, a watch or anything and this evening is the first time I've not had to catheterise myself in ages and that's because there is already a 'standard practice' in-dwelling catheter in place following the operation. I can pee at will! Poor Will.

Hang on though chum, don't get too excited, as we said before, there are no guarantees that the operation will work and possibly you may have to self-catheterise for the rest of your life. Some people do have to do this or have to have a permanent catheter in place. Doesn't bear thinking about, but that's Life.... so I think about it.

During the operation, a catheter has been fitted to help drain the blood and to flush things through. The nurse tells me to drink 3 litres of water a day for the next few days and compliments me on the colour of my urine, which is already 'Rose' (Rosay, as in the wine). I'm also told that I'm a 'model' patient (because I'm not being sick, falling over or having worrying vital signs) I feel like a model actually ~ mostly an Airfix kit with no instructions and the wrong sort of glue ~ but I don't tell the nurse.

There is a sense of unreality about the whole thing, made even more surreal by reading the handout I'm given with instructions on such important topics as.... "It is advisable to wait until the catheter comes out before resuming intercourse", (of course) and.... "Most men experience dry orgasm where seminal fluid passes back into the bladder...." (really?) helpfully, the handout continues.... "This does not cause any harm, but does decrease the chance of fathering children." (useful to know). And.... "You may notice some blood and debris (debris?!) come out when you pass urine....again, this is common and can continue for up to 3 months." (Sheesh! Never taken a pee that's lasted that long before....)

Back to the hospital again tomorrow to have the catheter removed and to see if I can manage without one. We've become very attached, but it would be wonderful to pee normally again without leaking all over the place or not going at all and not having continuously to tote tons of catheters around with me. I'm making climate change worse here all by myself!
 

Joking and peeing aside, I do hope that my plumbing will return to some semblance of normality soon. I want to get on with the rest of my peetiful life ~ mindfully. No doubt you want to add.... "Urine good company there!?"

Friday 15 March 2019

Bulletin Number 5 ~ Walking Like John Wayne (Epididymo-Orchitis, another Curve Ball)

Saying how much he liked it, a friend sent me a quote from Pierre-Auguste Renoir who was responding to Matisse on why, in spite of his painful arthritis, he still painted….  Renoir said, "The pain passes but the beauty remains". I thought about this and replied:- "Thanks" I said, "I like it too…. but it’s not always beauty that remains after pain.... sometimes there's just more pain!"

I recently finished a two-week course of antibiotics for epididymitis or epididymo-orchitis to be precise (that's posh medical-speak for balls ache). It’s the condition where you have to wear your dancing trousers all the time ~ plenty of ballroom. Well actually no that wouldn't be advisable, because you really need close fitting tight underwear to offer proper support so I'm told. Either way this is another unexpected 'curve ball' (so to speak) and I'm feeling pretty sore and most uncomfortable. It was probably caused ~ we think ~ by having to catheterise myself all the time. Doesn't matter how careful, obsessive and hygienic you are (and I am), sticking a tube into your body four times a day to take a leak is bound to be hazardous and have consequences.

In actual fact, the antibiotics I've been taking have been more debilitating and stress-inducing than the bacterial infection they’re supposed to tackle ~ and believe me it is all very wearing on the tackle. Kill or cure. Tired, dizzy, sore eyes, diarrhoea, hyper-sensitivity to the sun, muscle ache, irritability, loss of memory…. Ioss of memory?…. The trouble is, I study the contra-indications and side-effects on the leaflet that comes with the tablets and I end up ticking all the boxes. But no, really, it is true that I did suffer most of these things and it was very hard to survive the cure. I have only recently stopped walking like John Wayne.

Just to be on the safe side, the GP recommends that I have another ultra sound scan at the hospital, this time not to admire my impressively large coconut-sized prostate, but to make sure my balls are intact, the swelling and infection has abated and to investigate why my testicles (there's nothing ticklish about them) were attempting to 'go large' like my prostate.

A nurse ushers me in to the ultra sound scanning room and introduces me to the white-coated pale faced operator, who says, "We're here today to scan your testes ~ is that right?"


She said 'We', so I'm thinking ~ "What, both of you?!" I don’t suppose I actually said that out loud (not sure) but anyway I'm invited to lower my trousers and pants and I slide on to the paper-lined examination couch. While I'm still sitting up, I confide in her all about the epididymitis infection and the two week course of antibiotics I’ve just finished and the fact that I'm still catheterising myself four times a day and the various discomforts I’m experiencing.... you see, I don't know what she knows and I should really stop prattling on and just ask her.

I scan her face for clues, but she's very blank and then I remember, Oh yeah, I'm the one that's being scanned here, not her.  I'm stalling for time, but eventually I have to recline on my back and I'm told casually in passing.... to, "Hold your penis up to your abdomen". What does that mean?! My mind creates all sorts of visually impossible variations, but before I can drift further into these musings or ask questions, a napkin is placed decorously over the upper part of my privates and we get on with the procedure ~ one ball at a ponderous time.

Very cold gel is applied, together with an even colder probing instrument. It is/she is delicately touching me ~ you know ~ there, but it's not exactly arousing. Out of the corner of my eye I can see her staring at the screen and at short intervals she clicks a device which beeps like the ones they use at the Optician. I've no idea what she can see on the screen ~ for all I know, she could be watching 'Casualty' on TV. Gradually I become aware that maybe I should have positioned myself a little bit further up the couch, because now, the circulation to my calves is definitely cut off and I can't feel my feet.  


"That's the right one done, moving on to the left....", Is that my feet or my balls she's talking about? I've lost track now, and in a daydream I suddenly notice a small red and blue dot stuck on the ceiling directly above my head on either side of a vent. "Let's take a look at the Kidneys”. Yes let's! Very thorough this lady and I’m most grateful.

After a few days, the results are in and I appear to have been lucky yet again ~ everything is given the all clear, 'nothing sinister', just residual stuff as I recover from the infection. 'Resolving' I think they said. I would give it a loud Yayyy!! if I felt properly well myself right now, but I suppose a whimpish 'mehh' has got to be better than nothing. Soon I will start to assist my recovery again by returning to the gym and I will get back in the saddle..... I'm determined.

But a couple of days after finishing the antibiotics, I'm no better in the nethers, so “ding#ding…. round two!” Just to finish me off, the doctor prescribes further antibiotics to try to improve things and because of the silly side-effects of the last lot, he prescribes another type. Reading the leaflet that came with the tablets, it looks like more of the same, but hopefully it will be worth it... (fingers, eyes and legs crossed). I trust him ~ his speciality or sideline is the health and well-being of air crew. If he gets it right with me, this time next week I could be jetting off into the sunset. Let's hope so.

PS Then I had the news that the operation I was due to have around April/May to help me pee properly again, has now been put back to June/July. Apparently, although in the beginning I was told to expect a wait of around 8 weeks for the operation, they are within their standards in the NHS for completion of treatment, even if it drags on until 50 or 52 weeks. I'm only at week 27 so there's some way to go yet.... Deep joy!

Bulletin Number 4 ~ BPH Yayyy! (The Biopsy Result)

"Let me put you out of your misery right away", she said almost before we sat down. This is the specialist nurse we're seeing to review the results of the prostate biopsy operation I had 36 days ago. "There is no cancer!" 

Stunned silence .... Resting in disbelief, my head slips back slowly against the wall behind me.... I'm in a world of questions mostly formed around....

"What the #%<*?!"

Since August last year I've had numerous invasive investigations to discover why I can't pee properly. (I can, but afterwards there's too much urine left in my bladder). This is not good, because over time it could damage my kidneys ~ or I might explode. 

To cut a long and complicated story short, we've gone from an initial theory of 'Benign Prostatic Hyperplasia' (BPH), "Your prostate is enlarged, which is perfectly normal for your age and it's squeezing your urethra and causing retention", to "We'd better make sure it's not some form of cancer, so you'd best have an MRI and a biopsy operation". So I did and thankfully nothing abnormal was detected. No cancer; "BPH, Yayyy!"

However, it is true that I do have a rather impressive prostate gland. Normally they are walnut-sized. Evidently, mine's more the size of a coconut ~ well somewhat shy of that really. 

The upshot of this fact, is that I do need an operation as soon as possible for a 'rebore', to get everything working as normal again. There are no guarantees that there won't be complications afterwards and it could be more unpleasant than the biopsy I had before, and longer and even more eye-watering to recover from. But.... when you think about the unthinkable alternative of what might have been.... well, I consider myself a very lucky man!

Just to finish, picture this.... I'm settling back now with a small glass of celebratory Port🍷....


"Ahhh.... so good!"  

'Cockburns' of course. (I mean Co-burns)

Bulletin Number 3 ~ Panda Eyes (The Biopsy)

Well, the result of the MRI wasn’t great. There are 'tissue abnormalities in the prostate' and they want to carry out a biopsy under general anaesthetic. Strange kind of ‘floaty' feeling right now. As ever, plenty to be mindful of, and after the biopsy, we’ll see what’s next….
Two black eyes, surgical compression stockings, many and various unpleasantnesses while thankfully I was unconscious…. later, I realise the biopsy operation is done. "Take a look at yourself in the lake and you'll see!" my wife joshingly says. She's not wrong. I'm not a swan.... I'm a panda!

Very early start yesterday at the Hospital, arriving and leaving in total darkness and when staff weren't calling me Mr Ever (as in never) lee, they resorted to calling me Mr. Colin. Got seen and questioned by everyone from the theatre admissions clerk to the consultant surgeon. Also interviewed by an anaesthetist ~ (well two actually, because of a mix up! A profusion of confusion). And then finally I was left to sit it out in a waiting area consisting of a circle of sleepy men in various stages of scruffy undress and overnight bags, to watch the shopping channel on tv with no subtitles. No wonder they were all dozing! I thought I’d do the same.

And then.... coming weirdly from behind a thin screen, there was lots ~ and I do mean lots ~ of very raucous laughter. At first I thought it must be staff, but it turned out to be women patients who, like us, were all there to have an operation of one sort or another. I don't know if they had been given their pre-op medication already but they were definitely having a great party! At one point I heard one of them exclaim, "Let's go round and get them talking", referring to us men. The men squirmed and groaned in dismay and the women ~ some of whom were peeking through a gap in the screen ~ fell about laughing uproariously! You can't beat a good old Pompey laugh!!

Finally after a two and a half hour wait from 7-9.30am it was my turn for the theatrics. The surgeon had promised to show me the MRI scan which I had not seen yet (nor had he) and he started to go over this with me while I was being wired up and pinned down by the anaesthetist and theatre nurse. The surgeon with the registrar was situated virtually behind me, so lying on the operating table, I had to lift myself up on my elbows and crane my neck around to see. At which point the nurse would shove me back down! Anyway, I did see the two shadows that he said they would be aiming for and we had a chat (or rather a shout across the room) about sizes of prostates and bladders….  The anaesthetist then asked me what operation I thought I was going to have…. bit of an odd question.  "Who knows?" I replied with a smile... I didn't really care at this point, and let them get on with it.
In recovery, I was chillin' ~ I mean I was cold ~ and the semi-detached nurse from Spain very kindly got me a hot blanket and the anaesthetist dropped by and said, "Back to normal then?!” “Err, what's normal?!" I replied, equally cheerily. He seemed happy, so I was rapidly whisked away along endless corridors of speeding light…. like in 2001 the movie.

On the ward, where I thought I was going to get something to eat (I hadn't had anything for 16 hours and was feeling a bit peckish)  I was offered a cup of tea and a biscuit. Actually, as a matter of fact it was all kicking off at this point, and the staff were very busy attending to people whose recovery wasn't quite as 'normal' as mine ~ they were flaking out all around me and there weren't even any laughing women to lighten the mood. It was a bit of a carry on, and when a nurse held a digital thermometer up to a man’s head and about the reading said, “This can’t be right, can it?!” Sister replied wearily, “I think that’s room temperature!” It was surreal.

To get my discharge I had to, yes, you guessed it.... wait. I was a bit confused when a nurse asked me, "What's your lift called?" "What lift, I haven't got a lift!” I said stupidly. She meant my wife, who was coming to collect me. She came and yes you guessed it, we waited.... This time it was for the medication to be made up in the pharmacy. We waited and waited. We even offered to go and get the stuff, but procedure had to be followed. In the end, it turned out that although the computer said the meds were  'in preparation', in fact they had been prepared and waiting for collection a long time ago.

Much later, slowly recovering at home the following day (today) I read the small print and a medical research paper about one of the tablets I was due to start taking. Lucky I did, because I could have ended up with a floppy iris. No really! Who wants a floppy iris? This tablet is contra-indicated for anyone ~ like me ~ with a cataract or other ophthalmic conditions. So I won't take these, unless.... hang on.... let's have a read.... maybe they can cure panda eyes!
 

Despite all the hilarity, the NHS is doing its very best to sort me out and I’m really grateful for all their fine care. There is still a shadow (or two) of doubt hanging over me, as it were, to be understood and discussed and hopefully I will find out more in the next few days. Finally, as each moment unfolds and Father Christmas packs his presents and plots a course on his santanav.... be kind to yourself and one another. 

Here’s to ‘Not Yet’ and 'Happy Continuation Day'!! 

Bulletin Number 2 ~ Come Fly With Me (The MRI Scan)


At the hospital MRI department early this morning, after calling out the name of what I thought must be someone else, the young nurse in purple goes through my safety form with me. This is to make sure that I don't have anything contained within my person that will be magnetically attracted to the scanner, causing me to be ripped apart from the inside. Luckily, I don't have piercings, replacement joints or any suspicious metallic history.

So all clear with the form then, except.... the very last question ~ do I have urinary retention? Well yes! That's why I'm here. My prostate is enlarged and it's preventing my bladder from emptying fully.

I'm invited to go for a pee. And I do try, but I can't pee.... because, guess what... I have urinary retention. I explain this to her and she looks perplexed, concerned and anxious.

Never mind, I offer to catheterise myself instead, if it would help (luckily, I have brought some portable catheters with me). An empty bladder means that a better image can be obtained. Maybe it would have been helpful if the pre-scan instruction leaflet I was given had made this point. Had I not said yes to the question about urinary retention, the nurse was going to give me an injection of radioactive dye as a part of the procedure. It’s a good job I said yes. On returning from my bathroom break, and reporting my success, she was much relieved ~ as was I.

Before I knew it, two other nurses, a woman and a man, hustled me in to the 'breezy' MRI room containing a big white open-ended tunnel that looked very suitable for testing the aerodynamic qualities of jets. I was impressed and keen to get on with it ~ especially as it was a bit drafty around the rear of the fetching pink gown I was half-wearing.

Getting me in, was all too rushed, confusing and uncomfortable. Not much room for elbows and knees and many things they tried to put into place got trapped. I was the only one aware of these bits and pieces, so naturally I had to shift them. This self-help was not appreciated ~ I should have known better. Then from behind, they suddenly clamped huge headphones on me that felt as if they would crush my head flat ~ ear to ear. And finally, before they left, as they guided me in feet-first on the electric platform, I was partially strangled by the headphones cable around my neck.

I remembered reading that I had to wear these headphones because, according to the instructions, the machine would make a 'loud buzzing/tapping noise and produce some vibration'. In reality, this quaint description proved to be somewhat inaccurate, and would have been better written as:- 'Keith Moon the drummer from The Who, going berserk on a demented solo; an impatient plumber struggling with a jammed pipe, desperate to get on with his next job; prisoners in jail banging tin mugs on their bars in protest; a scene from a World War Two submarine movie with echo-location pinging all over me, depth-charges exploding, about to send me to the bottom; and 'Mayday' being repeatedly and frantically tapped out in Morse; or being caught in a car in a hail storm'. But hey, what do I know!?

Surreally superimposed on all this clatter and cacophony, were the dulcet tones of Frank Sinatra crooning in my ears.... "Come fly with me, come fly, let's fly away...."  Lasting nearly an hour, the whole thing was hilarious and distressing at the same time. I kept wondering to myself, is this what it's supposed to be like, or is the machine about to blow up with me in it?

To be fair, they did give me a little rubber ball to squeeze to alert them if I was worried about anything or needed to stop. But breathing, laying back and being mindful of the whole wondrous experience was the only realistic option. Escape and resistance was futile.

Afterwards.... curious about how the scan imagery would eventually turn out, and slowly recovering over breakfast in the hospital restaurant, I notice an inscription on my stainless steel knife blade ~ it says 'Utopia'.

Perfect!!

Bulletin Number 1 ~ Prostate Cancer.... What Me? (I Only Wanted A New Bed!)

"Small scratch!" the nurse says dully, automatically on script as she syringes my blood. "Keep this on for an hour", she mumbles as she sticks the cotton wad to the crook of my arm. 

Surprisingly ~ too quickly ~ the following day, my breathless doctor calls to inform me that he is putting me on the fast-track for prostate investigations! This is all happening so fast. "Your PSA level is high". "Have a good weekend," he says, "I'll be around on Monday if you want to ask any questions". (I only went to see him because we wanted to get a new bed....).

For some time I'd had what I took to be 'normal' waterworks problems for a man in his late sixties. This man.  A bit of 'urgency' (almost getting taken short) and 'frequency' (going a bit too often) and the occasional minor 'accident' (really getting taken short). You don't want to get a new bed if there's a risk of leakage, so I thought I'd better give the doctor a call, after all I hadn't seen him for years. I'm just getting over a bad back and now this. 


We've gone to meet an old friend in Brighton. The weather is fine and we're having a lovely time. I'm feeling kind of floaty and numb and waves of emotion are sweeping around, over and through me. Apart from my wife, she is the first person I've mentioned all this to, and from the look on her face it appears that I might actually be in serious trouble. I feel somewhat detached from reality. 

On top of that, in two days ~ September 4th ~ it's the anniversary of the death of our daughter Annabel; always a difficult and heart-rending time. In three days ~ September 5th ~ it's my birthday. Never been a great fan of birthdays! In eight days ~ September 10th ~ I will have a whole battery of tests in Portsmouth. This will tell us If I have stage one, two or three of prostate cancer or that there's something else going on and the results will present me with a number of options. 'Watch and wait', medication, radiotherapy, an operation or an as yet to be decided approach involving a whole collection of things.... or m
aybe it's a false alarm? I'm told to keep the next two months free!

It's alright I suppose ~ I mean, nothing's happening yet ~ right now ~ and I will take each day as mindfully as I can, and as best I can, directly experience it all. Except it's not quite what I had in mind for the foreseeable future! Just got a new bike ~ treated myself to an electric one ~ been meaning to for years.... perfect timing!

Let's see what happens eh? What else can I do? I don't want this to define or change me and my life forever, but who knows? My plan is to carry on being strong, keeping up with all connections, and involvements with family, friends and everyone, and work at staying as fit as I can while I can, whenever I can. And see what unfolds....
Wish me luck!

Health Bulletins ~ Are You Well?

In the spirit of mindful sharing ~ please don't feel you have to read this stuff ~ here is an ongoing record of all the experiences I've had since discovering a few months ago in August 2018 that I'm blessed with an impressively large prostate gland and consequently as a result, I have urinary retention. 

Doesn't sound like a fun read, but I like to be mindful in everyday life and say it how it is ~ the good, the bad, the funny and sad.  

So whether you are male or female, you have health issues and are actively availing yourself of a Health Care Service, or you are in your prime, never give it a second thought or perhaps might reflect on your future health one day.... this is definitely a mindful experience to be aware of. 

Read on to the Bulletins above, if you'd like to be amused and know more.... and you're not easily upset or offended!