Wednesday, 7 September 2011

The 'If' Game

Today, we went to see the Oncology nurse to talk about the operation, side effects, the date of the op and for Ady to learn about pelvic floor exercises.

I've got lots to say, so bare (or is it bear...I never know) with me...
They have decided to keep the operation date as 14th Sept, so that is next Wednesday !
The surgeon who does the laproscopic  surgery is going to do it. He says that he will try and do it laprascopically (keyhole) and if it all goes wrong, then he will open him up and chop it out that way.
She explained that the reason patients who have had previous surgery can't usually have keyhole is because they need to pump air into the pelvis and abdomen so they can see what they are doing and move everything out of the way. If you have had surgery before, your organs tend to stick together and don't move so easily and they cant get enough air in to see what they are doing, and frankly, with the way this whole saga is going, we dont want them chopping out the wrong bit !!
Our onco nurse thinks that there is a high chance he will have to open him up in the end, but we wont know until after surgery.

Here are a load of 'ifs'..

If it is keyhole surgery and that all goes to plan, then Ady is out of hospital possibly the next day, recovery is quick and he will be back to work in a couple of months.

If it is open surgery, then Ady will be in for about 5 or 6 days and recovery will be for months. He will have staples sealing the wound and he has to be extra careful of hernias because of the weakened scar tissue from the previous surgery.

If the cancer is contained, then all is brilliant and he is deemed to be cured. There is a 30-40% chance of this happening.
If the cancer has spread, Ady will be offered some hormone therapy to start with, possibly, depends on the oncologist, but definitely radiation therapy. This will be for 5 days a week for 7 weeks. That is 20 miles to the hospital and 20 miles back every day ....I work that out to be about 1400 miles?, plus the time I will have to take off work to ferry him around...I will probably have to give up some of my work actually. The implications of radiation therapy happening are pretty grim. The nurse said that it will leave him very tired and feeling quite poorly...great !
There is a 60-70% chance of this happening.
We have to wait two weeks for the histology results on the prostate. If the outer edge of the prostate has cancer cells, then spread is likely, if there are none,then spread is unlikely.
We have to wait for 6 weeks to do a PSA test, which should come back under 1...anything over that, means they have left some cancer behind.

When they take the prostate out, they also cut part of the wee wee tube...what's it called......oh yes, the urethra, and then pull the rest of it up and attach it to the bladder. By the time they have hacked about with his prostate and bladder, they then put a catheter in for a couple of weeks to let it all  heal, and when that is removed, he will be incontinent. 5% of patients will be incontinent, or have problems for ever, but with Ady being young, he should regain his, but in the mean time, I suppose I will have to put up with him pissing everywhere as long as it isn't on my new sofa of course.
The hospital will supply us with incontinence pads, but only about 28 of them. I have to phone the district nurses for the rest, and they have to assess him to see what pads he needs. They cant do the assessment for six weeks after I phone, so I need to plead and beg for them to dip in to the emergency supply while we wait. The nurse and I agreed that it shouldn't be this way, but that's the way it is so I think I will add Tena for men to my weekly shopping list.

The other side effect from this operation is impotence. I have chortled to myself at other peoples responses to this problem.
Most of the women that I talk to about it, respond with things like 'ooohh, you lucky thing' and ' wow, that must be a relief' and ' cor, what a bonus, every cloud' and 'I bet your headaches improve' !!
Most of the men, however, respond with things like ' Bloody hell, the poor bloke' and 'can they give him viagra?' and 'I bet the wife's cheered up' !

I wont make a comment on my response... Ady doesn't care as long as they take the cancer away.

There is a few risks involved with the op. There are the usual ones like infection, bleeding, clots, death and so on, and with this one, there is a risk of perforating the colon wall, so I hope the surgeon doesn't trip over something as he is going in with the knife !....Can you imagine it? "Bugger, I've got him straight in the arse"...Poor Ady and his back passage !!

Then we got to talking about pelvic floors, and our nurse was trying to say to Ady in a polite way about lifting his muscles up inside him to strengthen them and holding for a count of five. He had to do this without rising off the seat in a buttock clench.
She asked him to have a try, and he was saying nah, nope, cant feel a I told him to imagine sucking a poo back up his bum.....he completely understood that and did them perfectly. I told the nurse that it is better to talk in a basic way to him while she was wiping the tears of laughter from her eyes. She says she has never met anyone like us before...cant imagine why miself...

So, the day of the operation, we need to be at Maidstone for 7am. We are not sure if I should take him there and we get someone else to take the girls to school, or we get someone else to take him and I take the girls to school, bearing in mind that Ady will leave at 6.15 and the girls leave at 7.30. Or the other option is to see if the bed is free the night before, and take Ady in then.
I think we are going to hope the bed is free and go in the evening before and have friends on standby to take him in the morning.
He will be out and recovering by 3pm, just in time for me to pick the girls up from school and visit about 3.45.
We need to talk to the girls and have a family meeting to see what is best for everyone.I will just go with the flow, as I usually do.

So, old mans disease?...One of the better cancers to get?....nah, I don't think so.

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