almost 2 weeks post-RALP....update

[u/Mediocre-Yesterday74]

49 years old...almost 50

22 PSA, PI-RADS 3 lesion, Gleason 4+3

I had the surgery the 29th at 7:30am and was home by 1:30 p.m. Unfortunately, the catheter was not draining properly when we got home, so we had to go back to the ER the first night and get that taken care of. I had not drained at all for abourt 6 hours by that point, and I could really feel the pressure. They irrigated it and pulled out a clot and it was instant relief. Everything was back in a "flow state" from there.

I felt the most pain from the CO2 inflation on the first 3 days, in the shoulders especially. And the abdomen pain that feels a bit like someone hit you in the stomach with a baseball bat one time. But it does get a bit better every day. Still fairly sore in the perinuem area also.

I did do lots of walking, 5-6 times a day. Now that the catheter is out I was able to work a little around the house this week

I've been fortunate with the urinary incontinence issue, as I have not leaked one time since they removed the catheter four days ago. I did plenty of exercises before and had two sessions with a pelvic floor specialist before the surgery. I used the Squeezy app was hitting that thing like I was an Olympic athlete, and have been using it again now that the catheter is out. Having the catheter in does iritate the ureathra and has been causing some buring during urination.

I did get the report from pathology showing clean margins and no spread anywhere in the lymph nodes, that was great to hear. I was assigned Gleason Grade 3 pre-surgeryI and both surgerons thought I would get downgraded. The outcome was acatully more agressive then the Biopsy showed. They kept me at Gleason Grade 3, even found a small amount of Grade 5, and showed the cribform pattern. It had progressed showing significant cancer on 41% of the entire prostate, but no signs of it outside of the prostate. Looking forward to the hopefully near zero PSA test in five weeks, and every three months after that for a while.

One thing that I do not think is discussed enough here is the mental healing you may also go through in addtion to the physical healing. It is a mental backflip to know that the surgery will save your life, but you are also knowingly entering into a procedure that will forever take some things from you, as well as keep you without some functionalities for an unknown time. I was able to spend the first 4 days with just me and my wife without any distractions from work or other family, and that was very welcome as I found the need to really focus inward to process it all and I am still working on it. Those first few days felt very "delicate". I find there is a certain type bravery needed to make the decision to face surgery or radiation, I am proud of and I respect every man that is forced into having to make this choice.

[u/ChillWarrior801]

Welcome to the other side, brother! Sorry to hear about the bumpy takeoff, but things should improve steadily from here.

Here's a quote from Neil Gaiman that I found inspirational when I faced my own RALP almost three years ago:

"Being brave doesn’t mean you aren’t scared. Being brave means you are scared, really scared, badly scared, and you do the right thing anyway."

You're right that the mental side of things is underdiscussed here. Prostate cancer has turned me inside out emotionally, and almost completely for the better. My trip from stoic to weepy bastard was the last thing I was expecting. But the tears are almost all tears of gratitude. A win in my book

[u/Mediocre-Yesterday74 → u/ChillWarrior801]

Yes, I am expericing the same thing. Friends and coworkers would often describe me as "robotic" on the emotional side of things. I was very stoic also. Lots of crying since this proces began, and 100% on the tears of gratitude. I have a sense of awe and appreaction for things that I did not have before. As first it is a bit jarring after speding 50 years being a specifc kind of way. But I also agree it is for the better.

[u/Brief-Prune4246 → u/ChillWarrior801]

Stoics can be weepy, my friend. Much love

[u/sydeom]

Thank you so much for your update. I am also 49, soon to be 50, 4+4, highest PSA has been 10.2. I am staring at surgery within the next 6 months. We are here to support each other through this crap. Please keep us posted and feel free to DM me if you feel the need.

[u/GoNorth-Now]

All the best friend and thanks for sharing your story. Im scheduled for RALP in early November and one of my criteria for choosing a doctor and hospital was staying at least one night post op. There's a trend to do what is a major surgery in an ambulatory setting which I think is inhumane and driven by greed. There a few MDs and hospitals "pioneering" this trend and I'd stay away from them.

[u/Mediocre-Yesterday74 → u/GoNorth-Now]

yes 100% agree. I was absolutely forced out of the hospital by the discharge nurse, I assume to make a bed available or reduce the charges to insurance. I had a rough time waking up from the anethesia, lots of shaking and I was in a state of confusion untill my wife finallly came in. I did not feel like I was ready to leave yet but she kept pushing me saying that the guy who pushes your wheelchair was "ready for me". (shouldnt I be ready for him?)

I was also asking that same nurse lots of questions regaring the catheter bag and she said to me "sir you are not going to remember anything I am saying to you, so I am going to stop answering your questions" And of course we had an ussue with the bag and I did not fully understand the cadence of which you should expect to see it draining.

[u/ExcellentCookie6399]

Great news. Wishing you continued success and undetectable PSAs!

[u/DigginJazz]

Thanks for sharing. Glad to see you are on the road to recovery. I am 12 weeks post op with two undetectable PSA's under my belt. There have been some ups and downs but overall I feel fully recovered (minus ED issues). 73yo. Wishing the same for you.

[u/OkCrew8849]

Best of luck on your first post-RALP upcoming UPSA and continued healing.

[u/gg-3]

Will you be getting any somatic/genomic testing done on the surgical specimen? Decipher RP can be very informative.

[u/Happier_Tan-Man]

Congrats! Great news on your recovery so far.
I too was 49 at diagnosis and surgery.
You’re absolutely right about the mental aspect. It’s

[u/Glittering_Fact_411]

Great news on your recovery so far. My dear husband of 40 years had ralp on July 28. We’ve always had a robust sex life, even up to July 27. He has had an amazing attitude all of our lives together and fighting this has been no different. Lately though, I’ve noticed that he has taken a bit of a hit due to his ed. We get together and can both have “happy” endings but he is sad that he has no erection. I know it will take more time but honestly, I wasn’t aware that this part was going to hit him so hard. I wish I knew how to help him while also encouraging him to keep working on things too. Thank You for pointing out that this is very hard on all health areas, mental as well as physical.

[u/Mediocre-Yesterday74 → u/Glittering_Fact_411]

I am only a week without the catheter and my wife has been very supportive. We engage but nothing happens, it’s just too soon I have set my timer of expectations of anything happening in that department for months down the road. It is only mind A LOT but try not to be outwardly negative about it. My only advice is to I keep being as supportive and positive as you can

[u/Brief-Prune4246]

Indeed. Well done. I think it also takes a certain amount of courage to decline those treatments. A cancer diagnosis demands of us courage and resilience. I wish you a speedy recovery