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PROSTATE CANCER SUPPORT SITE

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Todd Merritt and Anjie live in Jacksonville, FL. U.S.A.. He was 45 when he was diagnosed on March 17, 2010. His initial PSA was 5.6 ng/ml, his Gleason Score was 7 and he was staged T1c. His choice of treatment was RALP (Robotic Assisted Laparoscopic Surgery).

As a city employee working as a public servant, I am fortunate to be provided a yearly thorough physical exam. It consists of stress tests, blood work, and ultrasound of vital organs and blood vessels. Its quite a good deal for free. Although some doctors poo poo it when you go see them with a potential problem. ( More on that later ).

Around mid November of last year I had my physical through the city. I cannot remember of the exact number, but my PSA was 3 point something. Additionally, on the sonogram scan the technician advised she saw what looked like a protrusion of the prostate into the bladder. I remember getting a little down and concerned about this development only because this runs in my family. My uncle now recently deceased from Mesothelioma, had prostate cancer and my dad had it when he was 63. My dad had the open manual surgery and is still going today at 80. I had no symptoms other than urinating about twice during sleeping hours which I chalked up to drinking water before bedtime.

Went to my primary care doctor on January the 29th. He did the DRE (Digital Rectal Examination) and said he felt like it was enlarged on one side and you know the next step, a referral. I was sent to a urologist at Shands hospital. He looked at the picture of my ultrasound and my results from the initial blood work in November and said, "Why are you here"? I thought that was a strange thing to say, however I was kind of relieved thinking maybe this is nothing. He also conducted a DRE. He believed it was slightly enlarged as well and ordered a free and clear PSA. That came back as 5.6. The next step that this doctor who asked why was I there was to order a biopsy.

I had some mental anguish about the biopsy, but that was the worst part of it the anticipation. It was not as bad as I imagined. The doctor and his assistant, were very good. He numbed up the organ before taking the samples. I watched the procedure on the screen. The only time I felt any pain was about an hour after when I got home the anesthesia wore off and my prostate was sore for about 30 minutes or so. And yes, I had the blood in my semen but nowhere else. The first time I had sex after that procedure was a little painful, but went away in time.

A week later the Doctor left a message on our answering machine, but it cut off do to some type of malfunction so all I got was this is Doctor so and so and....click. Wonderful, I thought the Doctor calling the house personally was not good. Was not able to get a hold of him that day, so I had to wait until the next day. He finally got a hold of me at work the next morning. I remember him saying, We took twelve samples and unfortunately one came back as cancerous. He said something about making another appointment with him and his partner to discuss treatment options but much of that all sounded like Charlie Brown's teachers, Blah blub, blah blah blub......! I was a little stunned but not shocked and thought I took it very well. I had co-workers around me who I shared the news with which made it easier I believe.

Now to get into the news most people including me are most interested in, what treatment and why. At this point I knew that many advancements had been made since my dad had the open surgery seventeen years ago. In the back of my mind I figured I would go and get that new proton therapy radiation and be done with it. We have one here in our own back yard at the very hospital I was referred to. No worries. This was going to be cake.

I then met with a physician's assistant at Shands during my follow up appointment. I know P.A.s are just about a doctor, but thought it odd that I was not talking directly to a doctor about such a serious matter. She coolly went over six different options and at the end recommended surgery. Then said, "Would you like to speak to the surgeon himself"? I said, sure why not. I was numb at this point thinking this didn't sound good. The surgeon came in and basically made some good points about surgery. I asked how much experience he had in the robotic LAP. He said he had done about eighty. That sounded like a lot to me at that time.

My wife is the more logical one of the two of us and she immediately thought surgery was the way to go. For me, it took about two weeks to figure this out. My reasoning : I visited the proton therapy institute one day and researched it as well. I even read Robert Marckini's book given to me by my dad. I did not like the options after proton treatment if the cancer came back. Nor was I enthused about the short term data as it is relatively new. [Not really - PBT (Proton Beam Therapy) has been used for prostate cancer for at least 15 years] Most of the clients were older folks that wanted to avoid surgery which is certainly understandable. [Not so - the sample of men who chose this treatment who shared their experiences show ages ranging from 42 to 72 - and that's not old!! I used to think it was, but now I know better.] I thought about waiting and or going to the natural remedy route but that entails one to fully commit to life of constantly battling something with a lifestyle change. I do believe that its beatable this way, but I'm not sure if I have the intelligence or the fortitude to tackle PC this way. To me, and this is just me, I don't want to have to dance with a disease or skirt around it with diet and so forth especially at my age.

I want to kick its butt, get it out and get on with living. However, I have the utmost respect for those that take on this disease in this manner. I think they are brave and courageous to do so. My decision was based on living without constantly worrying about PC. The success rates with the robotic LAP and my age and good shape. The long term effects of this procedure for the most part seem minimal. I'm an good with things not returning to "normal" for awhile as long as I can live and work and be with family. I'll deal with short term stuff all day long.

I finally came to the realization that the robotic Laparoscopic surgery was the way to go. This is getting way to wordy so I'm going to start to get to the point. I knew I had to shop around though from all the terrific information on this very site. I was referred to the McIver Clinic here in Jacksonville by a number of people. We met with Dr. Vashi. Spoke to him for about fifteen minutes and was sold. He was confident, but not arrogant and very thorough. This particular Doctor has been doing these procedures for six years which I belive is a good amount of experience. I'm scheduled for June the 10th to meet the robot. Two days from now. Yes, I'm a little nervous and anxious. Heck, I've never broken a bone and now this. I am at peace and have asked the Lord to see me through which is my strength. I could nor bear this weight alone, I have placed the burden on Jesus.

I have contacted a couple of men on this site who have responded to my questions which has been a tremendous help and therapy. If I can be of help to anyone, I would welcome it. I shall update my progress in my recovery as soon as I'm able.

Later: Well, Im laying on the couch a laptop in my lap. Its about two and a half days after my robotic lap surgery. Baptist Hospital in Jacksonville was outstanding. The entire staff and surgeons were so professional and took great care of me.

The surgery was easy; the recovery, well, thats a little tougher. I told myself I was not going to get nervous prior to the surgery, but when you change into that gown and put that hair net on you know its go time and my blood pressure started to rise. Just couldnt help it. I was given something to relax me just before being rolled into the O.R. It helped cause I remember speaking to all the people around me and shooting the bull with them. Saw the Da Vinci in the room breathed into the mask a few times and that was it. Eazzzyy.

As soon as I awoke in recovery, I asked how long it took. I was advised two hours and forty five minutes. Not too bad I guess. The surgeon spoke to my wife telling her everything went well. He gave her a picture of where my prostate used to be. Both nerve bundles on each side were clearly visible and were intact! Whew that was comforting and a relief. Now, just to get them to work in the future will be a blessing. But that is not a major concern right now. I did not have any of the gas / air pains that some of the men have described so I guess I'm fortunate. The next day I was voiding gas so I guess that was a good thing. The drain tube was removed the next day and the Dr. said it was up to me if I wanted to stay another night. I figured I could do the same thing at home as I was doing in the hospital so I left. Took a walk down the hall of the hospital before leaving which was a good sign. It was a little tough sitting on the pot for that first watery bowel movement though. Squating was tough due to the staples and catheter.

Ok, this is all short term stuff I know and much has been said before. But all in all its rather unremarkable or "routine". This is all I can report on now. I'm home moving some not not wanting to cause I hate this catheter. Its freaking me out, I just havent gotten used to it yet as some explain in their respective accounts. The incision sites are real sore and I can't bend over or cough or it hurts. Maybe I'm just a sissy. I do have some control of my penis as I can squeeze it and feel the catheter inside. Not pleasant. Maybe thats a good thing. I will be going back to the doctor in about a week to get this tube out of me and will report more as I know more. Thanks to all who have written me with well wishes. The Lord has answered my prayers and I feel this was the correct route for me to pursue. I feel its not a treatment but a good chance for a cure. Again, please contact me if I can help in any way.

 

UPDATED

June 2010

 

 

June 29th - On June 17th seven days out of surgery, I returned for a follow up / post op. appointment at the McIver Clinic. The night before my appointment I went to empty my catheter box and to my surprise and shock, the large see-through tube was pure red! I felt fine. Upon further inspection and investigation, I realized I had eaten a red popsicle. So those of you that go through this don't be alarmed if something similar happens to you if you down some red juice or red popsicles.

The staples were replaced by the steri strips and the catheter was removed as well. I was not sure they were going to remove the catheter as they initially told me ten days, but I was deemed good to go so out it came. That was a very below average 1.2 seconds of my life, but it was quick and not too painful. I placed a mini dry pad as soon as the cath. came out. I did not see any leaking initially. So on I went to the grocery store after the appointment to fill prescriptions of Cialis and antibiotics. Still no pathology report at this time which is a little concerning. I was walking around the store wondering if I was leaking. I figured one would not be able to feel it at this point so it was a great unknown. I went home and drank water. When the urge arrived I checked the pad and it appeared dry. I urinated for the first time which felt odd. I felt and heard like some air bubbles came out at the end. Weird sensation. The wonderful part was that I had total control. Only near the end when the bladder is almost empty is when I could be prone to leak a few drops if I do not concentrate. Urinating is more frequent now and it seems to be a stronger stream for me. Still sometimes burns a touch at the end. I imagine this is all part of the healing process.

One of the few downsides I have experienced is a yeast infection. I understand this can be caused by moisture and the antibiotics. Using Cortizone10 which seems to be slowly doing the trick. I did not begin the Cialis right away. I do have blood flow and ED does not seem to be a problem. Conjured up some "happy" thoughts just for the exercise and it responded satisfactorily. Have to concentrate though or quickly it goes down like a deflated balloon. I'm now on the Cialis for the blood flow. I'm not sure if it is needed but it was prescribed so I'll go with it.[There is a piece on this aspect at "Use It Or Lose It".] Did a quick experiment with just me the other day and it works fine. Virtually the same feeling, but nothing is produced.

I'm very pleased at this rate of recovery, but I'm going to take things real slow and not push the issue. I just was curious if things worked at this point. The urology clinic called today and advised the pathology report revealed the cancer was contained to only one core of the prostate and nothing else was detected. I cannot report on any updated Gleason scores as I did not ask or care at this point. I will check back in near the end of July when I go in for my first blood test. I have truly been blessed and taken care of during this process by God's mercy and grace.

Thank you Terry for a great resource to turn to during this time I really appreciate it, it has been a tremendous aid in learning so much about this issue. The guys on here are terrific.

 

UPDATED

July 2010

 

 

Today, July 20th, 2010, I had my second follow up post op. doctor appointment. This is the first one with the PSA check. I know this is where a lot of guys start to sweat, an rightly so, but I was confident and knew I was fortunate and blessed that it had been contained.

It has been about six weeks since my surgery. I learned my Gleason score was downgraded from the original 7 to a 6. My PSA level is 0.08. I am feeling well. Only some minor soreness or pain near the abdomen when I stretch or strain a little too much.

Still no leaking with the only exception after emptying my bladder and there is a very small amount of urine left. If I strain or lose concentration, that can get away from me and a few drops will come out. I believe this too shall improve with time.

I would say I have no ED issues. I ran out of the trial Cialis which was to get the blood flow going, but there seems to be no decrease in activity. Still getting used to being dry, but there is no mess! Ha!

That's all for now. I'll report back in four months on the next PSA check.

 

UPDATED

March 2011

 

 

I've had two blood work ups since my last update. Both showing negligible results warranting no attention. I am already on the every six month program for checking the psa.

I am fortunate enough to have no major sexual side effects and have not needed the assistance of medication.

No incontinence except for the rare occasion I lift and twist a certain way.

Not doing too bad from nine months out from the procedure. Thanks for your attention.

Todd.

Todd's e-mail address is: jaxk9@bellsouth.net