Prostate Cancer – A Treatment Story

The day of the surgery in the hospital with the Foley catheter there was obviously some blood in the urine.  Not a lot but some, red, some clotting.  There was a little sometimes with the catheter and a little after it was removed, but nothing significant.

Then, last night after 17 days, around 11pm, the urine turned dark brown.  Almost like a Pepsi/Coke/tea urine color and it continued through the night.  I called the urologist first thing in the morning – I had no fever, no pain, was going successfully and it was not bright red, so did not call during the night.  The nurse said that it was most likely “old blood” meaning blood from the trauma of surgery that, like the external wounds, was shedding the clots and almost like the internal “scabs” (only by way of analogy).  She said if I got a fever, it became uncontrolled, painful, or red, to call back today (Friday, of course) or the Mayo main number and talk to the on-call urologist if it happened over the weekend.

They advised:

1. Drink a lot – I had been drinking a lot of water, but am drinking more to “flush” it.

2. Call them if there were changes as above.

3. There may be visible clots passing too. [Update: They were right it seems!]

4. If it hasn’t resolved by Monday, they’d want me to come in and get it checked.

5. That blood may continue 4-8 weeks after surgery even.

I had known that blood was a possibility, but the possibility of the dark color of it wasn’t clear to me.  Given the explanation above, I am taking it as a positive that internal healing is progressing just as external.  Externally, one of the scars just looks like a small scratch already.  The largest one is not as good (I think that is where they pulled it out so it had to be bigger), but scars were at the bottom of my list of priorities – perfect pathology being number 1, followed by continence, followed by E.D. not being an issue, followed by scars.

On a better note, while ED and incontinence are possibilities after radical prostatectomy, in this case, both have been resolving pretty quickly – it helps being early 40s vs 80s as they said.  It isn’t 100% yet, but even less than 2 weeks after surgery they were doing okay and usually seeing improvements.  Hopefully no steps backwards on either.

After my 5am vital sign wake-up, I fell back asleep until around 6:45am when a friend got there.  The Doctor showed up around 8am and said things had looked good (fingers crossed there!) and that he would see me in a week to follow-up, get the catheter out (hopefully, they’ll do an x-ray to check how things have healed).

After looking at my abdomen, I saw 8 holes – one drain hole, 6 for Da Vinci and I’m not really sure what the other one was.  I hope to ask him in a week exactly what each was for if I think of it.

He said I was cleared to eat regular food, so I got pancakes, sausage, and orange juice.  Normally I eat much healthier but it had been nearly 48 hours since I’d had food by then and I was quite hungry.  So, ate breakfast and just a bit later they gave me 2 lortabs and about thirty minutes after that they said it was time to sit for an hour and then go for a walk.

After sitting, wasn’t too bad, I got the “podium walker” and walked around the whole floor.  They gave me a second gown so I didn’t moon anyone.  I think the podium walker was a good idea although at the time I asked if I really needed it.  Then I got back in bed for a bit.

Mid-afternoon, I got up again and walked around the room and stood in the room for about 30 minutes, then they had me do another lap around the floor.  I could’ve done it without the walker this time, but was still a little unsteady so we decided not to chance it.

By dinner time, I was a little hungry and had some fish and veggies.  Pretty good.  Finally at about 6:45pm, they said, “We can discharge you shortly if you wish.”  Now all afternoon the nurses had thought it was a “no way today” situation since I hadn’t gotten done with surgery and back to the room until after 7pm.  But the Doctor said it was okay.  Knowing the speed of things, I asked if I “could we wait until morning?” and they said fine.  It was not an issue since it was so late and I could get out “first thing.”

Given that it was 7pm, I had no pain meds (so had to get them filled) and didn’t want to chance the pharmacy not having it at 8:30pm or 9pm when I got out of there, the nurse and I thought it was fine and the Doctor agreed.  The other concern was only having swapped the catheter from the leg bag to the night bag once.  I wanted another shot or two for experience with supervision because I knew I’d be doing it on my own a fair amount.

So, I got another lortab a bit later and fell asleep.  I woke at midnight having knocked the IV port out of the back of my left hand and so blood was dripping everywhere.  The nurse came in, took it out, cleaned it up and we heard another “Code Blue” on floor 4.  There was a tapping/hammering from somewhere in the hospital, probably above us, and I was going to call the nurse thinking perhaps someone was calling for help, but before I did I heard them talking about it and were sending someone up to figure out what was going on.  I was in room 555, which was right across from the main nurses station.  It was kind of nice to be able to hear human voices talking right there.

I fell asleep pretty quickly after that and woke up at 5am for the vitals check.

All in all, the day after surgery was not as bad as I feared.  It was relatively easy, the hospital staff were great and I was kept occupied or was sleeping.

The anxiety from the day after the 10 needle biopsies until the surgery was terrible, waiting and waiting.  The only thing close is waiting to get pathology to confirm what the surgeons and other experts are saying.