THERE WAS NO RESPONSE TO AN UPDATE REMINDER IN 2016 SO THERE IS NO UPDATE.
First - these are my initial thoughts following the diagnosis and a decision making process. I am scheduled to undergo Robot Assisted Laparoscopic Prostatectomy (RALP) June 6 2012. I work as a physician (anesthesiologist) and hope that my ducumentation here will serve to:
1: Help me to stay focused and busy
2: May provide others with some insightful feedback regarding this journey" as it unfolds...
This is an update to my preliminary introduction. I have been schedule to have a Robot Assisted Laparoscopic Prostatectomy (RALP) on June 6 2012 at New York Presbyterian Hospital with Dr Ash Tewari. I hope that my comments in these posts are helpful in that they are from the perspective of a physician (Anesthesiologist) and I shall try to address areas that I have found either particularly challenging and/or insightful. Since this illness is never going to one of those things that I can "just put it behind and move on"- as so many well intentioned people suggest, I think it is most helpful to be very practical and not merely give accounts of how well or how badly things are going- we all have those experiences and that approach would merely be "preaching to the choir".My reasons for selecting this option are as follows:
- I am otherwise healthy with a relatively early stage diagnosis - therefore a good surgical candidate.
- In my case,this allows the best opportunity for a definitive "cure"
- I will get back to work with the shortest downtime ( anticipate 2-3 weeks)
- I am not "burning my bridges" with a surgical approach - whereas with radiation therapy, the risks and difficulties of subsequent "salvage surgery" is very much increased.
- Psychologically - surgery is the quickest and most definitive method of "getting rid of it". That is crucial to my well- being.
- Psychologically, the possibility of adverse effects such as erectile dysfunction and temporary urinary incontinence - are a lesser concern than the issues I've mentioned.
I am scheduled to have a Robotic Assisted Laparoscopic Prostatectomy (RALP) on June 6 2012. Being in "waiting mode" is very very frightening and lonely. I am of the opinion that despite it's well-intentioned mission, "You are not alone " is only minimally effective in helping me because ultimately those who suffer illness of any kind are alone! That the members of this forum are reachable only through cyberspace serves to emphasize that sense of isolation - not relieve it!
Underwent robot assisted laparoscopic prostatectony (RALP) as scheduled June 6 2012 and discharged the following day. Now Postop day 3, minimal pain, walking about 3 miles per day as per protocol. Suprapubic and urethral catheters in place but more awkward than painful. Pain easily controlled with ibuprofen. Eating a soft diet. Doc says that all frozen sections showed clear (i.e.,- ve) margins and was able to achieve "nerve sparing". Follow-up appointment June 13 for removal of catheters.
Six weeks post operative PSA reported as < 0.13 ng/ml. When pressed for details lab says value measured at 0.02 ng/ml (but not a definitive measurement). In effect this means that PSA is undetectable. Very minor degree urinary incontinence (about 2 pads/ day).
Erectile dysfunction: responds to intracorporeal papaverine injections - tried 2x weekly to "exercise" erectile function while awaiting nerve recovery.
Also using "Osbon" Erecaid vacuum pump to encourage erectile function. http://www.timmmedical.com/
No further treatments anticipated.
5 months postoperative. Minimal if any urinary incontinence. Erectile dysfunction responds to papaverine injection. PSA undetectable.
8 months after robotic assisted laparoscopic prostatectomy. Zero incontinence. Persistent erectile dysfunction but some improvement. No ongoing treatment. PSA below level of detection.
Over a year postoperative. No urinary incontinence. Some ED which is gradually improving.
Only residual symptom is erectile dysfunction. This is responsive to stimulation. No medications prescribed or needed. Satisfied with long term results. Still seeing urologist for long term PSA testing.
T's e-mail address is: todesbiwak AT yahoo.com (replace "AT" with "@")
NOTE: T has not updated his story for more than 15 months, so you may not receive any response from him.