Let's start with the fainting fits mentioned in the previous post. I had a CT scan of my head on 18th November and saw the neurologist about it and the faints yesterday. After a chat and a physical examination he told me he believed I had just been having faints rather than fainting fits. The impact of this is that he says I can now drive again and come off the medication over the next week. I do, however, have to advise the DVLA of the blackouts but can tell them he says I am fit to drive.
I had a Prostap injection last Monday and a PSA test. The results of the test were a raised PSA level of 30.1. As I suspected, the rise is almost certainly because the test was done too soon after the TURP procedure (only 32 days). I will make sure I have another PSA test before I see the Urologist in January.
Today I had my latest check up following my testicular cancer. Usual blood test, X-ray and physical examination. Progress is as expected and my next check up will be in six months instead of the four months it has been.
04 December, 2009
01 November, 2009
Good news and something to think about
Well the TURP operation on Thursday was completely successful. I was expecting it to be done under general anaesthetic, and could have insisted on doing so, but the anaesthetist preferred to go for an injection in my back to numb me from the waist done backed up with a tranquilliser to keep me calm. The latter worked so well that I was asleep within seconds of entering the theatre and don't remember much until being transferred from the trolley back to my hospital bed.
The catheter fitted after the operation was a special one that fed saline solution into my bladder as well as draining fluid from the bladder into a bag. The purpose of this was to flush any debris out. Towards the end of Friday fluid was flowing clear of blood and the flow rate of the saline solution was reduced. Then, in the evening, the saline feed was removed altogether. This meant that moving around was a lot easier because I only had to carry the bag with me and didn't need to push a drip stand around too.
On Saturday morning the catheter was removed altogether. Any peeing had to be into bottles so that the volume produced could be assessed. I found I could pee, with a good flow, and the volume was satisfactory. If it hadn't been for what else happened on the Friday afternoon I would have been free to go home Saturday evening.
So what did happen? I was sitting in the chair next to the bed doing a crossword puzzle when I first felt hot and then felt nauseous. I recognised these signs as being a precursor to fainting so I pressed the call button for a nurse and sat back. The next thing I new as I came to was that there were six or seven nurses and a doctor round the bed. I recognised the initial signs because they had occurred four or five times before over the last two or three years. I hadn't taken much notice of them because I had felt fine within half an hour or so.
The medics took a very different view. I was given various physical tests to confirm that I was in control of my facial muscles and had strength in my arms, legs, hands and feet. My reflexes were also checked including reaction to light shined into my eyes. I was given an ECG. Apart from the latter most of the tests were repeated by different doctors and nurses over the next couple of days. I was told by a doctor that one fainting fit might be a one-off. Two meant a 50% chance of more and three a 100% chance of more - I'd had more than three. I have been referred to the neurological out patients' clinic for assessment which will include a CT scan of my head. For the time being I must not drive.
The doctor wanted me to stay in hospital Sunday night with a view to having the scan on Monday. As there was no guarantee that there would be a slot on Monday and I was concerned about how well my wife would cope with me away for another night I insisted that I should go home. This was agreed to but not without a couple of hitches. First I had the oral agreement that I could go but the doctor had not documented this. Second, I had been given tablets to take to prevent a re-occurrence and a label needed to be put on the packet by the pharmacy. In the end I don't know if the doctor signed the discharge form or whatever and the box of pills hadn't returned from the pharmacy after a couple of hours so my son took me home with me agreeing that the tablets would be collected later. Well my son phoned the ward three times during the afternoon and the tablets never got back to the ward so I will not be taking one tonight. I'll call them mid morning tomorow to see when I can go and collect them.
The catheter fitted after the operation was a special one that fed saline solution into my bladder as well as draining fluid from the bladder into a bag. The purpose of this was to flush any debris out. Towards the end of Friday fluid was flowing clear of blood and the flow rate of the saline solution was reduced. Then, in the evening, the saline feed was removed altogether. This meant that moving around was a lot easier because I only had to carry the bag with me and didn't need to push a drip stand around too.
On Saturday morning the catheter was removed altogether. Any peeing had to be into bottles so that the volume produced could be assessed. I found I could pee, with a good flow, and the volume was satisfactory. If it hadn't been for what else happened on the Friday afternoon I would have been free to go home Saturday evening.
So what did happen? I was sitting in the chair next to the bed doing a crossword puzzle when I first felt hot and then felt nauseous. I recognised these signs as being a precursor to fainting so I pressed the call button for a nurse and sat back. The next thing I new as I came to was that there were six or seven nurses and a doctor round the bed. I recognised the initial signs because they had occurred four or five times before over the last two or three years. I hadn't taken much notice of them because I had felt fine within half an hour or so.
The medics took a very different view. I was given various physical tests to confirm that I was in control of my facial muscles and had strength in my arms, legs, hands and feet. My reflexes were also checked including reaction to light shined into my eyes. I was given an ECG. Apart from the latter most of the tests were repeated by different doctors and nurses over the next couple of days. I was told by a doctor that one fainting fit might be a one-off. Two meant a 50% chance of more and three a 100% chance of more - I'd had more than three. I have been referred to the neurological out patients' clinic for assessment which will include a CT scan of my head. For the time being I must not drive.
The doctor wanted me to stay in hospital Sunday night with a view to having the scan on Monday. As there was no guarantee that there would be a slot on Monday and I was concerned about how well my wife would cope with me away for another night I insisted that I should go home. This was agreed to but not without a couple of hitches. First I had the oral agreement that I could go but the doctor had not documented this. Second, I had been given tablets to take to prevent a re-occurrence and a label needed to be put on the packet by the pharmacy. In the end I don't know if the doctor signed the discharge form or whatever and the box of pills hadn't returned from the pharmacy after a couple of hours so my son took me home with me agreeing that the tablets would be collected later. Well my son phoned the ward three times during the afternoon and the tablets never got back to the ward so I will not be taking one tonight. I'll call them mid morning tomorow to see when I can go and collect them.
09 October, 2009
Re-bore planned
Last Monday I 'phoned the consultant's secretary to see if the results of the biopsy were available. The message on the answer phone listed the hours that she worked - just three days in the week. On Tuesday I got through and learnt that the biopsies were clear and the multidisciplinary team would be discussing them on the following Thursday. I asked about the catheter. She said she could book me into the consultant's clinic but he might prefer that I go to the day ward again. She'd check with him and send me a letter with appointment details.
On Thursday afternoon I had a call from the secretary asking if I could attend the consultant's clinic the following day. I said I could and I was booked in for 09:30. Friday morning I drove to the hospital to attend the clinic. I saw the consultant before 10:00. He told me that he reckoned that the best thing for me would be a TURP (Transurethral resection of the prostate) - a sort of re-bore of the passage the urethra takes through the prostate. I was half expecting this and had contemplated that it might become necessary even before the problems caused, or rather worsened, by the biopsy procedure because my flow was becoming rather thin. As I was happy to proceed he checked when the operation could be done (29th October), arranged for a sister to go through the consent procedure with me and then sent me to the pre-evaluation suite.
I left the consultation with a leaflet about the TURP and my copy of the consent form and a package containing my notes. I handed the package to the receptionist at the pre-evaluation suite and was told they were booked up for the rest of the morning but I could be seen in the afternoon or early next week. I settled for Monday afternoon. I'll be in the hospital for two or three days for the TURP. I'll have a catheter again after the operation until my urine runs clear then I'll be allowed to go home without it. There is more information about TURP here http://hcd2.bupa.co.uk/fact_sheets/html/turp.html
A week or two back I had a letter from the consultants at the Christie Hospital who are monitoring me following my treatment for testicular cancer. The letter was to invite me to take part in a clinical study of potential genetic influences in testicular cancer. I've agreed to this as it only involves providing some blood and answering some questions. I've filled in the initial form and sent it to the research coordinator and now await the request for my blood sample. I suspect it will be taken at my next appointment at the Christie in early December.
Over the couple of weeks before the TURP I intend to be a bit more active despite the catheter. That probably means a couple of short to medium walks per day and maybe some resistance exercises at the gym. I may even try a cycle ride.
On Thursday afternoon I had a call from the secretary asking if I could attend the consultant's clinic the following day. I said I could and I was booked in for 09:30. Friday morning I drove to the hospital to attend the clinic. I saw the consultant before 10:00. He told me that he reckoned that the best thing for me would be a TURP (Transurethral resection of the prostate) - a sort of re-bore of the passage the urethra takes through the prostate. I was half expecting this and had contemplated that it might become necessary even before the problems caused, or rather worsened, by the biopsy procedure because my flow was becoming rather thin. As I was happy to proceed he checked when the operation could be done (29th October), arranged for a sister to go through the consent procedure with me and then sent me to the pre-evaluation suite.
I left the consultation with a leaflet about the TURP and my copy of the consent form and a package containing my notes. I handed the package to the receptionist at the pre-evaluation suite and was told they were booked up for the rest of the morning but I could be seen in the afternoon or early next week. I settled for Monday afternoon. I'll be in the hospital for two or three days for the TURP. I'll have a catheter again after the operation until my urine runs clear then I'll be allowed to go home without it. There is more information about TURP here http://hcd2.bupa.co.uk/fact_sheets/html/turp.html
A week or two back I had a letter from the consultants at the Christie Hospital who are monitoring me following my treatment for testicular cancer. The letter was to invite me to take part in a clinical study of potential genetic influences in testicular cancer. I've agreed to this as it only involves providing some blood and answering some questions. I've filled in the initial form and sent it to the research coordinator and now await the request for my blood sample. I suspect it will be taken at my next appointment at the Christie in early December.
Over the couple of weeks before the TURP I intend to be a bit more active despite the catheter. That probably means a couple of short to medium walks per day and maybe some resistance exercises at the gym. I may even try a cycle ride.
23 September, 2009
A blockage
I had passed a lot of blood during the day Monday but my water was clear in the evening and Tuesday morning. I'd not had much exercise these last two or three weeks so I walked into the village to do a bit of shopping and back again - about a two mile round trip. It was after this that when I opened the "flip flow" valve on the catheter that no real fluid was passed and what did do contained clotty blood. This happened twice. So I changed the "flip flow" valve for a leg bag so that my bladder could drain all the time even if the flow was nearly non existent. Added to this twice urine blood mixture was forced pass the catheter. So I called the urology nurse who advised me to go to see my GP (who would only be able to tell me how full my bladder was) or go to A&E.
So I spent a couple of hours of late afternoon / early evening in A&E. My catheter seemed to be blocked and there was plenty of blood in what had come through earlier. After taking blood samples and doing the usual blood pressure and temperature checks A doctor from the urology department came to see me. Wouldn't you just know it, the catheter bag had filled! We decided that, rather than replace the catheter, the one already in would be flushed. A clot of blood came out on the first flush but nothing more on the next two. All seems to be OK now - no more blood and bag filling nicely. I hope it stays that way.
Many thanks to my mate and his wife from down the road who drove me to and from the hospital and waited around with me whilst I was there.
Still OK today (Wednesday).
I think I know what caused the problem. I had strapped the catheter pipe to my thigh to keep it tidy but I think the walking pushed the pipe in and out a little. Probably just a couple of millimetres but enough to irritate my penis (walking was uncomfortable) and cause the catheter balloon to chaff my bladder. Needless to say the pipe is no longer strapped although it would probably be OK to do so provided that enough flexibility was allowed above it.
So I spent a couple of hours of late afternoon / early evening in A&E. My catheter seemed to be blocked and there was plenty of blood in what had come through earlier. After taking blood samples and doing the usual blood pressure and temperature checks A doctor from the urology department came to see me. Wouldn't you just know it, the catheter bag had filled! We decided that, rather than replace the catheter, the one already in would be flushed. A clot of blood came out on the first flush but nothing more on the next two. All seems to be OK now - no more blood and bag filling nicely. I hope it stays that way.
Many thanks to my mate and his wife from down the road who drove me to and from the hospital and waited around with me whilst I was there.
Still OK today (Wednesday).
I think I know what caused the problem. I had strapped the catheter pipe to my thigh to keep it tidy but I think the walking pushed the pipe in and out a little. Probably just a couple of millimetres but enough to irritate my penis (walking was uncomfortable) and cause the catheter balloon to chaff my bladder. Needless to say the pipe is no longer strapped although it would probably be OK to do so provided that enough flexibility was allowed above it.
19 September, 2009
A Disappointment
Yesterday, Friday, I went to the hospital to have the catheter removed. This was done with no problem and I just had to hang around and make sure I could pee before going home. So I was plied with tea and water to encourage the process. The first couple of attempts just produced a dribble with some blood. The next was a bit more encouraging - enough to slosh around in the measuring bottle - but still pretty pathetic. After lunch of a salad sandwich, more tea and water, the next attempts at peeing were more productive and were clear of blood but it was clear that I was taking in more liquid than I was passing out. The nurse said she'd give my bladder a scan after my next attempt to see how much fluid was being retained in my bladder. The scan showed that there was about 300ml still there.
It was decided to give it a bit longer before deciding what to do next. I had another cup of tea and went for a walk out of on hospital entrance around the block and back to the other entrance. The next pee was still less than 100ml.
Decision time. I could go home and hope it improves. The down side to this option was that if it didn't improve and I began to get discomfort due to the build up of urine in my bladder I'd have to go to A&E to get it sorted because the day case ward would be closed. So far there had been no discomfort despite more liquid intake that output. The second choice was intermittent self catheterisation. This would allow me to go home with some catheters and to use one maybe twice a day to stop my bladder getting over full. The third option was a permanent catheter like the one that had been removed that morning although I could have a "flip flow" valve (like a tap) instead of a leg bag.
I was very tempted just to go home and hope for the best but decided to give self catheterisation a try. The nurse explained what was involved gave me a catheter and left me to give it a go. Holding the tube (a normal sized one) in the proper way there was no way I could manage to even get it started. I discussed my failed attempt with the nurse. She told me that it would be all right to hold the tube near to the end to be inserted if that would help. She got me a smaller (narrower) sized catheter and offered to be around whilst I tried to insert it. This time I got it started and it was well in before it hit some sort of obstruction and refused to go further. The same thing had happened last week when two nurses failed to insert a catheter.
Now it was only the third option left. The nurse went off to get a normal catheter which she managed to insert with no trouble. A bag was attached initially so that my bladder could be drained then a "flip flow" valve was put in its place. The nurse had also brought along a bag containing some reusable night bags, a spare "flip flow" valve, a couple of leg bags, and a leg strap to keep the leg bag tube close to my thigh. She also contacted the company that supplies these items. They will contact my GP for a prescription, deliver extra spares on Tuesday and when ever I contact them for more (the one prescription is enough no repeats needed). She also put in a request for an urgent appointment with my Urology Consultant so that something can be done about the problem.
So, rather than being rid of the catheter as I had hoped, I'm lumbered with it indefinitely. There being no point in going along to the hospital each week, having the catheter removed, trying to pee, failing, and going home with another catheter. Especially if the problem has been brought on by various tools and tubes being poked into my bladder and something in the pipes, possibly the prostate, swelling up in protest and restricting the flow. I'm not inclined to allow any further internal investigations though. I'd rather stick to using the catheter for a couple of months whilst any potential inflammation settles down. I don't want any more prodding about causing more inflammation.
A curious thing with the catheter is that even though my bladder is emptied into a bag or via the "flip flow" valve, every now and again the system tries to pee normally and manages to squeeze a small amount of fluid out past the tube. Most of the time it is just a drop or two but occasionally it is enough to be potentially embarrassing. It is easier to manage with the "flip flow" valve because using the valve upon the warning signs usually pre-empts this happening. Even so, I'm using incontinence pads in case it happens whilst I'm out and about just in case.
It was decided to give it a bit longer before deciding what to do next. I had another cup of tea and went for a walk out of on hospital entrance around the block and back to the other entrance. The next pee was still less than 100ml.
Decision time. I could go home and hope it improves. The down side to this option was that if it didn't improve and I began to get discomfort due to the build up of urine in my bladder I'd have to go to A&E to get it sorted because the day case ward would be closed. So far there had been no discomfort despite more liquid intake that output. The second choice was intermittent self catheterisation. This would allow me to go home with some catheters and to use one maybe twice a day to stop my bladder getting over full. The third option was a permanent catheter like the one that had been removed that morning although I could have a "flip flow" valve (like a tap) instead of a leg bag.
I was very tempted just to go home and hope for the best but decided to give self catheterisation a try. The nurse explained what was involved gave me a catheter and left me to give it a go. Holding the tube (a normal sized one) in the proper way there was no way I could manage to even get it started. I discussed my failed attempt with the nurse. She told me that it would be all right to hold the tube near to the end to be inserted if that would help. She got me a smaller (narrower) sized catheter and offered to be around whilst I tried to insert it. This time I got it started and it was well in before it hit some sort of obstruction and refused to go further. The same thing had happened last week when two nurses failed to insert a catheter.
Now it was only the third option left. The nurse went off to get a normal catheter which she managed to insert with no trouble. A bag was attached initially so that my bladder could be drained then a "flip flow" valve was put in its place. The nurse had also brought along a bag containing some reusable night bags, a spare "flip flow" valve, a couple of leg bags, and a leg strap to keep the leg bag tube close to my thigh. She also contacted the company that supplies these items. They will contact my GP for a prescription, deliver extra spares on Tuesday and when ever I contact them for more (the one prescription is enough no repeats needed). She also put in a request for an urgent appointment with my Urology Consultant so that something can be done about the problem.
So, rather than being rid of the catheter as I had hoped, I'm lumbered with it indefinitely. There being no point in going along to the hospital each week, having the catheter removed, trying to pee, failing, and going home with another catheter. Especially if the problem has been brought on by various tools and tubes being poked into my bladder and something in the pipes, possibly the prostate, swelling up in protest and restricting the flow. I'm not inclined to allow any further internal investigations though. I'd rather stick to using the catheter for a couple of months whilst any potential inflammation settles down. I don't want any more prodding about causing more inflammation.
A curious thing with the catheter is that even though my bladder is emptied into a bag or via the "flip flow" valve, every now and again the system tries to pee normally and manages to squeeze a small amount of fluid out past the tube. Most of the time it is just a drop or two but occasionally it is enough to be potentially embarrassing. It is easier to manage with the "flip flow" valve because using the valve upon the warning signs usually pre-empts this happening. Even so, I'm using incontinence pads in case it happens whilst I'm out and about just in case.
11 September, 2009
What a nightmare
It should have been a straightforward procedure - Rigid cystoscopy and bladder biopsy. I understood it was to be done as a day case so didn't take any overnight things to the hospital at the appointed time of noon on Wednesday. The admittance notes had me down for overnight. Anyway I was taken to the ward and an allocated bed. All the admittance procedures went smoothly enough and I changed into a hospital gown.
At about 14:20 I was led downstairs to the surgery reception and fitted out with heart monitor and blood pressure cuff. A few minutes later wheeled into the anaesthesia room where a cannular was inserted into the back of my left hand. Pretty much the next thing I knew I was in the recovery room and ready to be taken back to the ward. The good news is that the surgeon could see nothing amiss in my bladder but took four random biopsies for testing anyway.
I had told the surgeon that I was keen to get back home the same day, and accordingly he had not fitted a catheter so that if I had no trouble peeing I'd be allowed home. Unfortunately I did have trouble peeing. This was almost certainly down to the damage done to the end of my penis by the cystoscope. Apparently I have the tightest entry the surgeon had come across and the skin on the inside of my penis had been torn and probably bruised too. After two or three hours of not being able to pee a catheter was inserted to allow my bladder to drain. So an overnight stay anyway.
The next morning the catheter was removed. I still couldn't pee though. After a couple of hours a short catheter was inserted on the basis that the obstruction to the flow seemed to be in the penis rather than the bladder. This was unsuccessful. So an attempt by a couple of nurses to insert a normal catheter was made - unsuccessfully. So a call was made for one of the doctors to come and do the job. An hour or two later a reminder call was put through. After about seven hours of desperately needing to pee and failing and getting pain in my penis with each attempt I was getting pretty distressed. The nurses, bless them, saw this and, I think made it pretty clear to the doctor that he was needed urgently.
Well, the doctor came, and not without some difficulty, managed to inset a catheter. What a relief - physically and emotionally. The down side was that I'd have to stay another night in the hospital, but all things being well I'd be able to go home the next day with the catheter still in place attached to a bag strapped to my leg.
I had a good night and the catheter worked well and this morning the doctor agreed that I could go home with the catheter fitted and keep it in place for a week. After the week I am to have it removed and to see if I can pee without it. Getting the OK to go and actually getting away are not the same thing. I pointed out that I had an appointment at the health centre this afternoon for my next Prostap injection and I really did not want to miss it. I think this concentrated their minds and by 14:00 the paper work was done, an appointment booked for next Friday to remove the catheter and a supply over overnight bags and a spare day bag provided with instructions on their use.
Matthew, my eldest son, picked me up from the hospital and took me home. He also agreed to drive me down to the health centre for my appointment. Just as we were about to leave I got a call from Smile about suspected fraudulent use of my credit card. We decided to sort that out on our return. I had the Prostap injection but didn't bother with the PSA test - the nurse confirmed my thoughts that all the mucking about around my prostate would produce artificially high readings. I'll get that done in a month or six weeks time.
So for the next week I'll be living with a catheter and bag. I don't think I'll go to the gym next week nor doing any cycling. Walking is OK but a bit strange at the moment. It is good to be home and more or less back to normal though.
A call back to Smile confirmed that someone had been using my card on an on-line betting site. So the card is stopped until they send me a new one. They told me not to worry about the fraudulent transactions (about £700 worth), they will be removed from my account as the fraud department handles the matter. Just an inconvenience but an unwelcome one.
Ain't life fun?
At about 14:20 I was led downstairs to the surgery reception and fitted out with heart monitor and blood pressure cuff. A few minutes later wheeled into the anaesthesia room where a cannular was inserted into the back of my left hand. Pretty much the next thing I knew I was in the recovery room and ready to be taken back to the ward. The good news is that the surgeon could see nothing amiss in my bladder but took four random biopsies for testing anyway.
I had told the surgeon that I was keen to get back home the same day, and accordingly he had not fitted a catheter so that if I had no trouble peeing I'd be allowed home. Unfortunately I did have trouble peeing. This was almost certainly down to the damage done to the end of my penis by the cystoscope. Apparently I have the tightest entry the surgeon had come across and the skin on the inside of my penis had been torn and probably bruised too. After two or three hours of not being able to pee a catheter was inserted to allow my bladder to drain. So an overnight stay anyway.
The next morning the catheter was removed. I still couldn't pee though. After a couple of hours a short catheter was inserted on the basis that the obstruction to the flow seemed to be in the penis rather than the bladder. This was unsuccessful. So an attempt by a couple of nurses to insert a normal catheter was made - unsuccessfully. So a call was made for one of the doctors to come and do the job. An hour or two later a reminder call was put through. After about seven hours of desperately needing to pee and failing and getting pain in my penis with each attempt I was getting pretty distressed. The nurses, bless them, saw this and, I think made it pretty clear to the doctor that he was needed urgently.
Well, the doctor came, and not without some difficulty, managed to inset a catheter. What a relief - physically and emotionally. The down side was that I'd have to stay another night in the hospital, but all things being well I'd be able to go home the next day with the catheter still in place attached to a bag strapped to my leg.
I had a good night and the catheter worked well and this morning the doctor agreed that I could go home with the catheter fitted and keep it in place for a week. After the week I am to have it removed and to see if I can pee without it. Getting the OK to go and actually getting away are not the same thing. I pointed out that I had an appointment at the health centre this afternoon for my next Prostap injection and I really did not want to miss it. I think this concentrated their minds and by 14:00 the paper work was done, an appointment booked for next Friday to remove the catheter and a supply over overnight bags and a spare day bag provided with instructions on their use.
Matthew, my eldest son, picked me up from the hospital and took me home. He also agreed to drive me down to the health centre for my appointment. Just as we were about to leave I got a call from Smile about suspected fraudulent use of my credit card. We decided to sort that out on our return. I had the Prostap injection but didn't bother with the PSA test - the nurse confirmed my thoughts that all the mucking about around my prostate would produce artificially high readings. I'll get that done in a month or six weeks time.
So for the next week I'll be living with a catheter and bag. I don't think I'll go to the gym next week nor doing any cycling. Walking is OK but a bit strange at the moment. It is good to be home and more or less back to normal though.
A call back to Smile confirmed that someone had been using my card on an on-line betting site. So the card is stopped until they send me a new one. They told me not to worry about the fraudulent transactions (about £700 worth), they will be removed from my account as the fraud department handles the matter. Just an inconvenience but an unwelcome one.
Ain't life fun?
01 August, 2009
Wonky bladder?
At each of my check ups at the Urology Clinic for my prostate problem I have given a sample of urine and each time the cytology has found suspicious cells unconnected with the prostate. After the second such sample I underwent a flexible cystoscopy examination and a CT Urogram neither found anything untoward. Now that the latest cytology has found suspicious cells, the Urologist wants me to have a rigid cystoscopy examination and bladder biopsy. Thankfully these will be done under general anaesthetic as a day case at the hospital – a rigid cystoscope up the water works sound most uncomfortable. I should get an appointment letter sometime in the next week or so.
The situation is then that the testicular cancer is in remission (next check-up early December), the advanced prostate cancer is under control (next check-up January) and bladder cancer (I presume) is under investigation. If the series continues, I suppose it will be the kidneys next. :)) As is to be expected this has my wife back in worry mode and to be honest, it has me a bit disconcerted too. Life's too short to let it get me down though.
The situation is then that the testicular cancer is in remission (next check-up early December), the advanced prostate cancer is under control (next check-up January) and bladder cancer (I presume) is under investigation. If the series continues, I suppose it will be the kidneys next. :))
24 July, 2009
Check-up
I saw one of the registrars this morning. They are basically happy with the way the treatment is going and are happy that the PSA count is down to 1.1 – in the normal range. I asked about bone density checks (the hormone treatment I am on thins the bones) and was told that they don't do such tests until there are symptoms such as bone pain and that won't happen until I've been on the treatment for many years. The same applies to bone strengthening treatments (such as Zometa). I asked about their policy regarding stage three clinical trials. The multi disciplinary team discusses the patients suitability for such trials and offer them at the start of treatment. I said I was interested in the Stampede trial and the Alpharadin trial if I fit the criteria. I do understand why I might not fit the trial protocols – Stampede because of recent testicular cancer and Alpharadin because of spread to lymph nodes – but I want them to know that I am interested. Finally I asked that I be copied with any correspondence with my GP.
I had to provide a urine sample for cytology tests. The samples given on previous visits had suspicious cells in them but further investigations had found nothing. The suspicious cells are unrelated to the prostate cancer but could point to problems with my bladder or kidneys. If anything suspicious is found in the sample this time, I will be called in for another cystoscopy examination (camera poked through the tubes), this time under general anaesthetic as a day case patient. I should know within a fortnight whether this will be necessary. Otherwise my next appointment will be in six months time.
I had to provide a urine sample for cytology tests. The samples given on previous visits had suspicious cells in them but further investigations had found nothing. The suspicious cells are unrelated to the prostate cancer but could point to problems with my bladder or kidneys. If anything suspicious is found in the sample this time, I will be called in for another cystoscopy examination (camera poked through the tubes), this time under general anaesthetic as a day case patient. I should know within a fortnight whether this will be necessary. Otherwise my next appointment will be in six months time.
19 June, 2009
Out of limbo
On the 17th June, just before my second prostap injection I had another PSA test. This afternoon I 'phoned the health centre to get the results. The PSA count is down to 1.1. I am relieved that the PSA count is low. Reason said it would be but there was always a nagging doubt. Now looking forward to the count to go sub-zero. I'm putting some questions together for when I next see the Urologist at the end of July. I hope he is not pushed for time!
23 April, 2009
Limbo and a welcome visit
I'm halfway through the period from my first Prostap injection to the next one in mid June. I'm really impatient to find out if the treatment is working but won't really know until I get the results of the next PSA test which will be taken at the same session that I get the next Prostap injection. It is frustrating because I don't see much change in my symptoms. At least not as much as I would have hoped. I still need to get up three times a night and often need two attempts to empty my bladder. I also get the same, low level, discomfort in my lower back.
Just after Easter my parents, brother, other brother's widow and her son came up to visit. This took a bit of organising and increased my wife's stress levels somewhat. She coped with the stress by taking charge of what would happen here. I'd not noticed this coping strategy before, but I'm sure it is not new to her. In the past I would have matched her assertiveness with assertiveness of my own but the treatment had an effect and I just didn't have the energy to put my own case forward. On the Easter Monday, things came to a head with me feeling bullied [this is the nearest I can get to describing my feelings at the time but it is not absolutely accurate]. My wife could tell I was not my usual self and insisted I tell what was wrong. This was difficult because I didn't really have the right words and I knew that if I actually started talking about it I was going to be tearful. She insisted and I told her, between sobs, that I felt bullied. That I knew that she was not bullying me but that this was the best I could describe the feelings. This occurred mid morning and it was not until late evening that I began to feel better.
In the event things went very well. My parents travelled up bu coach to join my brother, nephew and sister in law in Milton Keynes where they had been staying with my niece and her family over Easter and they drove up here Tuesday afternoon. They had an evening meal with my youngest son and his fiancée and stayed in the Travel Lodge over night. On Wednesday morning they came over and, once my youngest son arrived we went into the village for a coffee (to give my wife some quiet time to herself). My elder son was to join us there but he turned up late and missed us. Then back home for a light lunch. Youngest son skipped this but elder son joined us. We had a pleasant time together and, I hope, my parents left less worried about me than when they arrived.
They all left late afternoon to drive the 280 or so miles back to Ramsgate and they were home by 22:30 despite an incident in Leek where a van shot out from the oncoming traffic, clipped their wing mirror and smashed into the following car. The incident involved police, ambulance, fire brigade and an air ambulance. This added about a half an hour to their journey time.
Just after Easter my parents, brother, other brother's widow and her son came up to visit. This took a bit of organising and increased my wife's stress levels somewhat. She coped with the stress by taking charge of what would happen here. I'd not noticed this coping strategy before, but I'm sure it is not new to her. In the past I would have matched her assertiveness with assertiveness of my own but the treatment had an effect and I just didn't have the energy to put my own case forward. On the Easter Monday, things came to a head with me feeling bullied [this is the nearest I can get to describing my feelings at the time but it is not absolutely accurate]. My wife could tell I was not my usual self and insisted I tell what was wrong. This was difficult because I didn't really have the right words and I knew that if I actually started talking about it I was going to be tearful. She insisted and I told her, between sobs, that I felt bullied. That I knew that she was not bullying me but that this was the best I could describe the feelings. This occurred mid morning and it was not until late evening that I began to feel better.
In the event things went very well. My parents travelled up bu coach to join my brother, nephew and sister in law in Milton Keynes where they had been staying with my niece and her family over Easter and they drove up here Tuesday afternoon. They had an evening meal with my youngest son and his fiancée and stayed in the Travel Lodge over night. On Wednesday morning they came over and, once my youngest son arrived we went into the village for a coffee (to give my wife some quiet time to herself). My elder son was to join us there but he turned up late and missed us. Then back home for a light lunch. Youngest son skipped this but elder son joined us. We had a pleasant time together and, I hope, my parents left less worried about me than when they arrived.
They all left late afternoon to drive the 280 or so miles back to Ramsgate and they were home by 22:30 despite an incident in Leek where a van shot out from the oncoming traffic, clipped their wing mirror and smashed into the following car. The incident involved police, ambulance, fire brigade and an air ambulance. This added about a half an hour to their journey time.
08 April, 2009
A small milestone
Monday I finished the course of Cyproterone Acetate tablets so now my treatment is just the Prostap. The only side effect I noticed from the tablets was some breathlessness. Hopefully, now they are finished, this will cease. There is also some potential for side effects from the Prostap. There are a couple that appear to be affecting me. The first is loss of sex drive and erectile dysfunction. This is not a big deal for me or my wife, fortunately. The other side effect is diarrhoea but this may be down more to my changed diet rather than to the treatment. Again, it is not a problem because it is not the sort of diarrhoea associated with food poisoning or a stomach bug where one dares not stray far from a lavatory. Rather it is just that when I move my bowels the stools are very loose.
Also on Monday I finished reading Professor Jane Plant's book Prostate Cancer: Understand, Prevent and Overcome. This is where the change of diet comes in. Mostly I am very sceptical of diets that claim to prevent disease or give one big health benefits. I've been of the opinion that a balanced diet is enough along with not consuming more calories than are burnt off. However, Jane Plant appears to have researched the subject of her book very thoroughly and has references to peer reviewed scientific research to back up her reasoning and conclusions. This is enough to persuade me that it is worth following her advice, even though, for me, it is too late to prevent prostate cancer.
I have also been perusing another of her books written jointly with Gill Tidey: The Plant Programme; recipes for fighting breast and prostate cancer. The diet is based largely on Chinese diets because in China (except in some cities where western diets are becoming more popular) prostate and breast cancer is practically non-existent. Dairy products are not used in China and animal protein is a very small amount of the total diet. The authors propose a scoring system for types of food ranging from 0 to 10. Those with active cancer (like me) should have a score of no more than 4 for any meal and no more than 15-20 for a day, averaged out over a week to allow for treats. Those on a prevention or maintenance programme should have only one meal a day scoring more than 5 and a total score per day of 30-35 averaged out over a week. The scores are as follows:
The Plant Programme has a large number of recipe suggestions organised under meal types, breakfast, snacks, main meals. There is also advice about eating away from home. So far I am finding it quite easy to 15 points per day, especially averaged over the week.
Both books are well worth a read and should be readily available for purchase from the usual sources as well as for loan from your local library.
Also on Monday I finished reading Professor Jane Plant's book Prostate Cancer: Understand, Prevent and Overcome. This is where the change of diet comes in. Mostly I am very sceptical of diets that claim to prevent disease or give one big health benefits. I've been of the opinion that a balanced diet is enough along with not consuming more calories than are burnt off. However, Jane Plant appears to have researched the subject of her book very thoroughly and has references to peer reviewed scientific research to back up her reasoning and conclusions. This is enough to persuade me that it is worth following her advice, even though, for me, it is too late to prevent prostate cancer.
I have also been perusing another of her books written jointly with Gill Tidey: The Plant Programme; recipes for fighting breast and prostate cancer. The diet is based largely on Chinese diets because in China (except in some cities where western diets are becoming more popular) prostate and breast cancer is practically non-existent. Dairy products are not used in China and animal protein is a very small amount of the total diet. The authors propose a scoring system for types of food ranging from 0 to 10. Those with active cancer (like me) should have a score of no more than 4 for any meal and no more than 15-20 for a day, averaged out over a week to allow for treats. Those on a prevention or maintenance programme should have only one meal a day scoring more than 5 and a total score per day of 30-35 averaged out over a week. The scores are as follows:
| Fresh fruit and vegetable juices and salads | 0 |
| Soya "milk" and "yoghurt", nuts, dried fruits, uncooked grains and bean curd (tofu) | 1 |
| Mixed cooked and raw vegatables and fruit | 2 |
| Cooked vegatables, fruit, grains and cooked dried pulses | 3 |
| Canned beans, vegatables, Soya "cream" | 4 |
| Dominantly vegatables with eggs | 5 |
| Dominantly vegetables, with chicken, duck, fish, and seafood | 6 |
| Dominantly vegetables, with lamb, pork, rabbit, venison | 7 |
| Dominantly egg | 8 |
| Dominantly chicken, duck, fish, and seafood | 9 |
| Dominantly lamb, pork, rabbit, venison | 10 |
The Plant Programme has a large number of recipe suggestions organised under meal types, breakfast, snacks, main meals. There is also advice about eating away from home. So far I am finding it quite easy to 15 points per day, especially averaged over the week.
Both books are well worth a read and should be readily available for purchase from the usual sources as well as for loan from your local library.
27 March, 2009
Some good news
It's been an interesting eight days. Last Friday I had a CT Urogram at Stepping Hill Hospital, a CT scan of my urinary tract. The appointment letter said I should drink water one hour before the appointment. I did this but emptied my bladder just before I cycled to the hospital. Once there I was asked to change into one of those split-back gowns and presented with about a litre of water to drink. Before the scan I was injected with stuff to highlight the area of interest and some other stuff to make my kidneys work faster. After the scan, I'd barely got dressed when my bladder demanded to be emptied. A few minutes later and the same demand. I cycled home with my bladder demanding to be emptied again. This continued with, thankfully, longer periods between the demands for the next couple of hours.
Last Tuesday I had the first of my hormone injections (prostap) at the local health centre. Next one due 16th June and I'll get my PSA checked at the same time.
This morning was the appointment for the Flexible Cystoscopy at Stepping Hill Hospital Urology clinic. I'm getting blasé about strangers fiddling about with my private parts now. The procedure was painless but not without some discomfort. It is quite fascinating to see the inside of ones plumbing. The camera was not attached all of the time though because the doctor could see better and manipulate the gubbings better without it. There was nothing obviously wrong with my bladder. Good oh! The CT Urogram did not show up anything either. At least, not concerning the bladder. It did show that the prostate cancer has spread to some abdominal lymph nodes as well as my bones. I don't think this is a big deal because there will be no change in treatment and the treatment will be just as effective against the cancer in the lymph nodes as in the bones and prostate itself. My next check up will be in four months and my urine will be checked out again then.
Following the procedure I was advised to drink plenty of water to help prevent any chance of an infection and to expect some blood in my urine for a couple of days. If I suspect I have an infection (temperature, feverishness) I'm to see my GP. The first few times I emptied my bladder there was some discomfort and plenty of blood. By late afternoon the discomfort has gone but there are still some traces of blood.
This afternoon it was over to the Christie Hospital for my regular check up regarding the testicular cancer which is [in remission] cured. Usual procedure: provide some blood for tests, physical examination and chest X-ray. I took the opportunity to tell the doctor about the prostate cancer. Next check up in four months.
So, hopefully, there will be nothing to report on the cancer front until I get my next PSA results at the end of June.
Last Tuesday I had the first of my hormone injections (prostap) at the local health centre. Next one due 16th June and I'll get my PSA checked at the same time.
This morning was the appointment for the Flexible Cystoscopy at Stepping Hill Hospital Urology clinic. I'm getting blasé about strangers fiddling about with my private parts now. The procedure was painless but not without some discomfort. It is quite fascinating to see the inside of ones plumbing. The camera was not attached all of the time though because the doctor could see better and manipulate the gubbings better without it. There was nothing obviously wrong with my bladder. Good oh! The CT Urogram did not show up anything either. At least, not concerning the bladder. It did show that the prostate cancer has spread to some abdominal lymph nodes as well as my bones. I don't think this is a big deal because there will be no change in treatment and the treatment will be just as effective against the cancer in the lymph nodes as in the bones and prostate itself. My next check up will be in four months and my urine will be checked out again then.
Following the procedure I was advised to drink plenty of water to help prevent any chance of an infection and to expect some blood in my urine for a couple of days. If I suspect I have an infection (temperature, feverishness) I'm to see my GP. The first few times I emptied my bladder there was some discomfort and plenty of blood. By late afternoon the discomfort has gone but there are still some traces of blood.
This afternoon it was over to the Christie Hospital for my regular check up regarding the testicular cancer which is [in remission] cured. Usual procedure: provide some blood for tests, physical examination and chest X-ray. I took the opportunity to tell the doctor about the prostate cancer. Next check up in four months.
So, hopefully, there will be nothing to report on the cancer front until I get my next PSA results at the end of June.
14 March, 2009
Taking stock
As can be expected I have needed to have a bit a rethink about what is important. Feedback on the forums on the Prostate Cancer Charity suggest that it is important too. First off I wanted to be informed. I want to know what I can expect from prostate cancer and the treatment of it. The Prostate Cancer Charity website has been invaluable. It has what it calls The Toolkit which contains fact sheets covering Diagnosis, Treatment and Lifestyle. A couple of these were given to me in the information pack provided by the hospital and I've printed off several more and have started to read through them.
The other important aspect of the Prostate Cancer Charity web site is the Message Board. There are many long term members of this forum who have been living with protate cancer for years. What stands out about them is their cheerfulness, optimism, determination not to give in to their condition and their encouragement to new members most of whom will be newly diagnosed. These fellows have taken control of their lives. I don't know whether there is any scientific evidence to back this up, but it seems to me that being positive and taking control makes a big difference to ones prognosis, even when the initial clinical signs are not at all encouraging. This has given me a big fillip.
I'm a born optimist and am generally cheerful so what I am working on is taking control. Firstly with regards to diet. The general concensus seems to be that a dairy free diet that avoids red meats and is low in fat and sugar is the way to go. The dairy free part is going to be the hardest aspect for me. I love cheese and butter but I'm sure I can adapt. Replacing meat with fish will be no hardship.
Exercise is also important especially keeping the bones strong because the hormone therapy can lead to osteoporosis. I will be walking in the fresh air as often as possible. This will load the skeleton and be good for vitamin D. On sunny and bright days anyway. I'll also get some resistance exercises in the gym and do a bit of cycling.
From a practical point of view I am sorting things out so that, some distant time in the future, my wife will be able to get on with things with the least hassel possible. This will be an ongoing project.
The cytology tests of the second urine sample I gave proved suspicious so I will be having an internal examination of my urinary tract later this month. I will also be having a CT scan of the urinary tract. The CT scan is OK but I can't say I'm looking forward to the other.
The other important aspect of the Prostate Cancer Charity web site is the Message Board. There are many long term members of this forum who have been living with protate cancer for years. What stands out about them is their cheerfulness, optimism, determination not to give in to their condition and their encouragement to new members most of whom will be newly diagnosed. These fellows have taken control of their lives. I don't know whether there is any scientific evidence to back this up, but it seems to me that being positive and taking control makes a big difference to ones prognosis, even when the initial clinical signs are not at all encouraging. This has given me a big fillip.
I'm a born optimist and am generally cheerful so what I am working on is taking control. Firstly with regards to diet. The general concensus seems to be that a dairy free diet that avoids red meats and is low in fat and sugar is the way to go. The dairy free part is going to be the hardest aspect for me. I love cheese and butter but I'm sure I can adapt. Replacing meat with fish will be no hardship.
Exercise is also important especially keeping the bones strong because the hormone therapy can lead to osteoporosis. I will be walking in the fresh air as often as possible. This will load the skeleton and be good for vitamin D. On sunny and bright days anyway. I'll also get some resistance exercises in the gym and do a bit of cycling.
From a practical point of view I am sorting things out so that, some distant time in the future, my wife will be able to get on with things with the least hassel possible. This will be an ongoing project.
The cytology tests of the second urine sample I gave proved suspicious so I will be having an internal examination of my urinary tract later this month. I will also be having a CT scan of the urinary tract. The CT scan is OK but I can't say I'm looking forward to the other.
09 March, 2009
Test results
Just back from the urology clinic at the hospital and the news is not good. Prostate cancer is confirmed and what is more it has started to spread to my bones. This means that it can't be cured just controlled for a period. For those that like numbers, the PSA test from my first hospital visit was 79.9 (up from the 57) and the Gleesen number 9, with 80% of the prostate affected both sides.
My treatment starts today with hormone therapy by pills. This will last 28 days. A week or two into this treatment I will start the long term hormone treatment delivered by injections each 12 weeks. The purpose of the treatment is to knock back the testosterone produced by my body which feeds the cancer. The treatment should be effective for one or two years until the cancer adapts to lack of testosterone and starts growing and spreading again. The doctor said that there are further treatments available once this happens but didn't say what they were.
There are likely to be side effects from the hormone treatment. My libido will be reduced; I'll probably put on weight around my belly; I may get hot flushes; I may develop breasts; I'll likely easily tire.
To add to that lot there were traces of blood in the urine sample I provided at the first hospital visit. This was unexpected and may indicate problems with my bladder or kidneys but there was no evidence of this in the MRI scan. So I provided another sample today as a double check. If there is evidence of blood in my urine again I'll need to undergo an internal examination of my urinary tract including bladder and kidneys.
So what happens next? I'll peruse the various booklets provided by the nurse and see if there are any changes to my diet and life style that will help to control the cancer. I'll have a good clear out. My wife has been urging me to do that for years and it will be one less worry for her. I'll complete my "what to do when I'm dead (or very ill)" file so that my sons can support her when I'm gone. Not that I have any intention of going any time soon. I'll see if I can persuade her to learn how to use a computer - it will be of great benefit for her. Apart from these things I'll just get on with life.
My treatment starts today with hormone therapy by pills. This will last 28 days. A week or two into this treatment I will start the long term hormone treatment delivered by injections each 12 weeks. The purpose of the treatment is to knock back the testosterone produced by my body which feeds the cancer. The treatment should be effective for one or two years until the cancer adapts to lack of testosterone and starts growing and spreading again. The doctor said that there are further treatments available once this happens but didn't say what they were.
There are likely to be side effects from the hormone treatment. My libido will be reduced; I'll probably put on weight around my belly; I may get hot flushes; I may develop breasts; I'll likely easily tire.
To add to that lot there were traces of blood in the urine sample I provided at the first hospital visit. This was unexpected and may indicate problems with my bladder or kidneys but there was no evidence of this in the MRI scan. So I provided another sample today as a double check. If there is evidence of blood in my urine again I'll need to undergo an internal examination of my urinary tract including bladder and kidneys.
So what happens next? I'll peruse the various booklets provided by the nurse and see if there are any changes to my diet and life style that will help to control the cancer. I'll have a good clear out. My wife has been urging me to do that for years and it will be one less worry for her. I'll complete my "what to do when I'm dead (or very ill)" file so that my sons can support her when I'm gone. Not that I have any intention of going any time soon. I'll see if I can persuade her to learn how to use a computer - it will be of great benefit for her. Apart from these things I'll just get on with life.
02 March, 2009
MRI Scan
I had a bit of a panic this morning. The letter advising me of my MRI scan appointment asked me to confirm the appointment as soon as possible and I'd forgotten to do so. Thus, ten minutes before I had planned to leave for the appointment I was hanging on the 'phone listening to a message thanking me for calling and telling me I'd be put through to someone as soon as they were available. I was getting twitchier by the minute. At last I did get through and the appointment was confirmed. Whew! So off I set on my bike.
When I got to the scanning department, a BUPA facility set up in the hospital that provides services to the NHS as well as private patients, I was asked to fill in a questionnaire designed to check whether I have any metal in my body or had any recent medical procedures that need to be taken into account. I was able to reply "No" to all of them.
When they were ready for me I had to strip to underwear and socks and put on a disposable gown, again to ensure no stray metal. The radiologist went through the questionnaire with me again and then we were off. I'd been told these scanners are noisy but I was not quite expecting the intensity of the noise. This despite wearing headphones playing a local radio station. The radio was in audible whilst the scanner was active. Probably a bit like being in a thick walled metal box with demented smiths hammering on the outside with the sound of miss-tuned radios added for good measure. Fortunately the procedure only lasted about 25 minutes with the longest spell being about 15 minutes.
I'm looking forward to seeing the consultant again to get the results of the various tests. I'll be disappointed if it is later than next week.
When I got to the scanning department, a BUPA facility set up in the hospital that provides services to the NHS as well as private patients, I was asked to fill in a questionnaire designed to check whether I have any metal in my body or had any recent medical procedures that need to be taken into account. I was able to reply "No" to all of them.
When they were ready for me I had to strip to underwear and socks and put on a disposable gown, again to ensure no stray metal. The radiologist went through the questionnaire with me again and then we were off. I'd been told these scanners are noisy but I was not quite expecting the intensity of the noise. This despite wearing headphones playing a local radio station. The radio was in audible whilst the scanner was active. Probably a bit like being in a thick walled metal box with demented smiths hammering on the outside with the sound of miss-tuned radios added for good measure. Fortunately the procedure only lasted about 25 minutes with the longest spell being about 15 minutes.
I'm looking forward to seeing the consultant again to get the results of the various tests. I'll be disappointed if it is later than next week.
23 February, 2009
Prostate Cancer Awareness Month
March 2009 is Prostate Cancer Awareness Month. Learn more about it at prostate -cancer.org.uk
Prostate ultrasound scan and biopsy
Well that is another check out of the way. It didn't hurt though there was some discomfort. This is how it went.
First Emma one of the nurses explained what was to be done and who would be there whilst it was done. She explained the potential risks, what would be done to mitigate them and what to do if I suspect I have an infection. She also checked whether I had various conditions that they'd need to take account of. I am to expect some blood in my urine and stools for up to a few weeks but probably only for a day or two.
The main risk is that infection could get into my blood stream through the site of the biopsy. The symptoms to look out for are those akin to flu - feverishness, aches, feeling unwell - if I do get these I'm to go straight to A&E because I'll need intravenous antibiotics. The mitigating actions are preemptive antibiotics, the first of which she gave me. She also gave me tablets to take tonight and tomorrow. I then had an hour to spend whilst the antibiotics took effect before the actual treatment. I went off to have a black coffee and a scone.
The hospital is testing out new machines to do the ultrasound scan and biopsy because the existing ones, though serviceable, are getting a bit old. I was asked if I minded being treated with the machine under test. I was happy to agree, not least because the machine is a better one. It did mean that there was a representative of the machines makers present, but what ho, if there was going to be two doctors and two nurses another woman would make little difference.
The ultra sound scan and biopsy is actually a single procedure - the scan helps the doctor position the tool to take the samples. I had to get changed into one of those daft gowns that are open at the back. Makes sense for this procedure though. The doctor explained the procedure again and gave me another chance to ask any questions. Then I had to lie on the bed on my left side with my knees up to my chest. A pillow supported my head. The two nurses were on the other side of the bed, the way I faced, their main purpose seemed to be to engage me in conversation to take my mind off of what was happening in my back passage. They did it well.
The doctor first examined my prostate with a finger before inserting the tool and injecting a local anaesthetic. I felt the tool being inserted but not the injection. I think that the lubricating gel they use has some anaesthetic properties itself. There was some discomfort as the tool was moved about inside me and some of the biopsy snips made me jump a bit but there was no pain. Then the tool was withdrawn and I was allowed to lie on my back for a while whilst the information about expecting blood and what to do if I suspect an infection were repeated. It was also emphasised that if I have any worries over the next few days I can ring the clinic, or if out of working hours, the urology ward. Then it was get dressed an go home. I was given some tissues to put in my underwear to soak up any potential bleeding.
The results should be available to the consultant in a week or so. I'll get a call from the clinic to make an appointment to see the consultant when he has the results. My friend, who has recently been through all this, gave me a lift home and suggested some questions to ask when I next see the consultant about the results. When I got home I found that the postman had delivered a letter from the hospital detailing my appointment for the MRI scan which will be next Monday morning. It is pleasing to see the urgency being applied to get things sorted. Actions are happening in days rather than weeks.
First Emma one of the nurses explained what was to be done and who would be there whilst it was done. She explained the potential risks, what would be done to mitigate them and what to do if I suspect I have an infection. She also checked whether I had various conditions that they'd need to take account of. I am to expect some blood in my urine and stools for up to a few weeks but probably only for a day or two.
The main risk is that infection could get into my blood stream through the site of the biopsy. The symptoms to look out for are those akin to flu - feverishness, aches, feeling unwell - if I do get these I'm to go straight to A&E because I'll need intravenous antibiotics. The mitigating actions are preemptive antibiotics, the first of which she gave me. She also gave me tablets to take tonight and tomorrow. I then had an hour to spend whilst the antibiotics took effect before the actual treatment. I went off to have a black coffee and a scone.
The hospital is testing out new machines to do the ultrasound scan and biopsy because the existing ones, though serviceable, are getting a bit old. I was asked if I minded being treated with the machine under test. I was happy to agree, not least because the machine is a better one. It did mean that there was a representative of the machines makers present, but what ho, if there was going to be two doctors and two nurses another woman would make little difference.
The ultra sound scan and biopsy is actually a single procedure - the scan helps the doctor position the tool to take the samples. I had to get changed into one of those daft gowns that are open at the back. Makes sense for this procedure though. The doctor explained the procedure again and gave me another chance to ask any questions. Then I had to lie on the bed on my left side with my knees up to my chest. A pillow supported my head. The two nurses were on the other side of the bed, the way I faced, their main purpose seemed to be to engage me in conversation to take my mind off of what was happening in my back passage. They did it well.
The doctor first examined my prostate with a finger before inserting the tool and injecting a local anaesthetic. I felt the tool being inserted but not the injection. I think that the lubricating gel they use has some anaesthetic properties itself. There was some discomfort as the tool was moved about inside me and some of the biopsy snips made me jump a bit but there was no pain. Then the tool was withdrawn and I was allowed to lie on my back for a while whilst the information about expecting blood and what to do if I suspect an infection were repeated. It was also emphasised that if I have any worries over the next few days I can ring the clinic, or if out of working hours, the urology ward. Then it was get dressed an go home. I was given some tissues to put in my underwear to soak up any potential bleeding.
The results should be available to the consultant in a week or so. I'll get a call from the clinic to make an appointment to see the consultant when he has the results. My friend, who has recently been through all this, gave me a lift home and suggested some questions to ask when I next see the consultant about the results. When I got home I found that the postman had delivered a letter from the hospital detailing my appointment for the MRI scan which will be next Monday morning. It is pleasing to see the urgency being applied to get things sorted. Actions are happening in days rather than weeks.
20 February, 2009
What's it all about?
It looks like things are going to get interesting for me and I want my friends and family to have an easily accessible way to find out how things are going.
Two years ago I had worries about one of my testicles but I didn't take immediate action. I was lucky. I had testicular cancer (seminoma) and it had spread to two or three lymph nodes. An operation removed the offending article and chemotherapy sorted out the lymph nodes. Since November 2007 I have been clear.
A few weeks ago I noticed changes to the way and the frequency I was passing urine. No waiting around this time. My GP examined my prostate and arrange for a PSA test. When I saw him again to get the results he told me that the count was high (57) and that he had referred me to the Urology Department at the local hospital.
My appointment at the hospital was yesterday. The consultant there examined me again and confirmed that it looks very much like prostrate cancer. He put things in train for me to have an ultrasound scan and biopsy of my prostrate gland, a bone scan and an MRI scan. I also provided more blood for another PSA test and checks of my kidney function and blood calcium.
No hanging around. The ultrasound scan and biopsy is scheduled for Monday morning. I've just got back from the bone scan and the MRI scan will be done within a few weeks. I'll have another meeting with the consultant once he has the results of the biopsy in a week or ten days from Monday.
I reckon this is a fine example of the NHS working well, just as it did two years ago. I'm optimistic that the problem has been found early this time and that the prognosis is good.
Two years ago I had worries about one of my testicles but I didn't take immediate action. I was lucky. I had testicular cancer (seminoma) and it had spread to two or three lymph nodes. An operation removed the offending article and chemotherapy sorted out the lymph nodes. Since November 2007 I have been clear.
A few weeks ago I noticed changes to the way and the frequency I was passing urine. No waiting around this time. My GP examined my prostate and arrange for a PSA test. When I saw him again to get the results he told me that the count was high (57) and that he had referred me to the Urology Department at the local hospital.
My appointment at the hospital was yesterday. The consultant there examined me again and confirmed that it looks very much like prostrate cancer. He put things in train for me to have an ultrasound scan and biopsy of my prostrate gland, a bone scan and an MRI scan. I also provided more blood for another PSA test and checks of my kidney function and blood calcium.
No hanging around. The ultrasound scan and biopsy is scheduled for Monday morning. I've just got back from the bone scan and the MRI scan will be done within a few weeks. I'll have another meeting with the consultant once he has the results of the biopsy in a week or ten days from Monday.
I reckon this is a fine example of the NHS working well, just as it did two years ago. I'm optimistic that the problem has been found early this time and that the prognosis is good.
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