The operation
I reported into the hospital reception as requested on the afternoon of July 13 with the operation scheduled the following morning. I was taken up to the first floor and handed over to the ward staff. I was then shown to a private room not far from the nurses' station.
After a short time a nurse came in and said she was going to insert a IV line into my arm. An IV is a intravenous line or tube inserted directly into the vein to carry pain killers or medicine directly into the bloodstream. The nurse asked me to choose which arm I wanted the IV in, and having volunteered my left arm. She then turned my arm over and gave my wrist a couple of sharp taps to draw the vein and then inserted the needle. She then secured the iv line to my wrist for further use in the days to follow.
My wife stayed with me until early evening, leaving only to get something to eat downstairs at a coffee bar. I was fasting as ordered by the hospital. My wife left about 7pm, promising to return early the next. morning prior to the
I woke early on the day of the operation, shaved, and showered and then settled back on the bed to wait for the day's events to unfold. The nurses' station was just outside my room. I could hear the nurses greet each other as one shift arrived and the other shift prepared to leave after the ritual handover of the night's events. The next shift was greeted with the usual sounds of phones ringing and the never ending patient call bell alerts which had its own unmistakable loud buzz. which seem to echo down the corridor.
My wife arrived about 8am as promised bearing a few more personal items. We sat and chatted for about an hour before being interrupted by a nurse who announced she was going to take my blood pressure.
She wrapped the cuff around my outstretched arm, pumped the pressure up, and read the gauge, and noted the reading on the chart at the end of my bed. "Have you had anything to eat or drink this morning" she asked, and when told I was fasting ahead of an operation she said "Good" and promptly left.
My wife and I chatted off and on while we shared the morning newspaper. At about 10 am there was a flurry of activity as two nurses arrived in the room and announced they were going to take me down to the operating theatre. While one nurse busied herself with the bed the other produced something akin to a shower cap and placed it on my head. My wife and I said a hurried goodbye. The nurses exchange pleasantries with her, before manouvering the bed out of the room and I was on my way.
I was wheeled down a long corridor and into a lift and taken down to what appeared to be a holding area, somewhere it seemed near the operating theatre. The nursing activity here was more intense and concentrated. A nurse checked my identity wrist band, checked my name again, and scanned the chart at the end of my bed. Suddenly Dr Stapleton appeared, greeted me by name, and asked me if I was "ready to go?" In the meantime Computers were checked, charts read, and my blood pressure checked again. Another nurse checked my name and asked me what type of operation I was having.
I could feel the tension starting to rise within me as final checks were made. It was a little like being in a plane at the end of the tarmac awaiting clearance for takeoff. Your life was now in the hands of others.
Finally two nurses appeared and announced "ok here we go" and I was wheeled into the operating theatre. There were numerous people both men and women in the room. All were dressed in blue operating theatre coveralls with caps on their heads and busy with their respective responsibilities.
On one side of the room was a long table laden with stainless steel operating implements. A large bank of lights were above the operating bed. It looked very similar to what I had seen on television;
The nurses wheeled me over to the operating table in the middle of the room and asked me to manouver myself on the operating bed. I lay there trying to take in the atmosphere of a real live operating theatre, but barely had time to gather my thoughts before I was approached by the anaesthetist who I had previously met. He introduced himself to me again and announced he was going to put me to sleep. He then screwed something onto the IV line in my arm. I managed a quick look at the bank of lights above me and uttered a quick silent prayer for the Lord to watch over me. I remember no more. I was now at the hands of a skilled surgeon and his team for the next three hours.
Recovery
I woke from the effects of the anesthetic slowly. I was conscious enough to realize I was being moved from one location to another and was I was aware of the busy activity around me. I discovered later that I was being moved from the intensive care unit where they had taken me following the operation, back up to the ward.
Gradually the full impact of the operation dawned on me. I was laying on my back with a the intravenous tube attached to my wrist and trailing off somewhere above me. I was also linked up to a heart Monitor, where heart and blood pressure activity was Monitored. When I moved slightly I was conscious of other tubes trailing across my legs. I was also in some discomfort from the waist down. I was going nowhere. As I glanced around I could see my wife standing to one side of the room whilst the nurses busied themselves around me.
Dr Stapleton then appeared at the end of my bed. " Ian" he said, "Everything went well you are going to be fine" I muttered a quick " Thank you" and the surgeon left as quickly as he had arrived. I resumed my thoughts trying to get a handle on my physical condition.
My thoughts were interrupted when a nurse asked me if I would like a drink of water. I gratefully accepted but before I had time to put the cup down something erupted deep inside me. "I am going be sick" I gasped, and a quick thinking nurse grabbed a bowl and held it under my chin.
The vomiting reflex caused every muscle and the newly sown stitch wound my lower abdomen to scream out in pain and discomfort. I thought I had ripped my stomach open again, and visualised another trip back to surgery. I managed a quick glanced at the result in the bowl and was horrified. A dark brown and red liquid presented itself. I slumped back on to the pillow. "What is that" I asked painfully. The nurses explained it was normal after this type of operation and that there was some blood present. A second wave of vomiting then occurred, with the same painful and ugly result. One of the nurses then returned with a small Tablet. "This will help with the vomiting" she said. I accepted the Tablet and lay down again exhausted and hurting internally. At this point my wife left obviously realising that talking had to be abandoned for another day. Thankfully the vomiting settled down and never returned. Day one was almost over and I was glad just to rest and try and get some sleep.
I was stirred from my light slumbering in the early hours of day two with a nurse moving very quietly around my room. Occasionally the light from her torch would come on as she checked the Monitors and intravenous drips in my room. The nurse was barely audible as she moved from side to side and back again with an occasional flash of her torch. Finally I could bear the quietness no longer and I spoke.
"Oh" she said in a soft Asian accent "You are awake. This is good because I can give you a sponge bath before it gets too busy" Her voice was barely audible. I muttered an "ok" and left her to her nursing duties.
The nurse returned carrying a bowl and a towel, and somehow maintained her almost silent disposition.
In the silence she bathed my neck, arms and face, with warm water before drying me with a towel. I ascertained from her that it was 5am. With her shift finishing at 7am she probably had a lot to do and was glad to be able to commence this work early. Having completed her responsibilities with me she collected her sponge bath towels and quietly departed I imagined a spirit couldn't move more quietly than this nurse, and looked forward to daylight and a normal chat.
I didn't have to wait long. By 7.30 am the next shift of nurses appeared on the scene. One of them was a high spirited young woman who bounced into my room full of the joys of life and announced her name as Jenny. Jenny was the opposite of the Asian lady who was in my room earlier and for a moment her highs spirits and rapid movement around my room irritated me. After she had departed I decided to investigate what was happening under the sheets. I was horrified. I wasn't feeling in high spirits and my attitude took a dive when I peered under the sheets.
Besides being tethered by a intravenous drip to my arm, I was also tethered by a catheter, a tube which drains blood and urine from the bladder through the top of my penis and branching off to two bags which hang on the side of my bed.
One of the bags was an overnight bag bag where urine is drained from the bladder. This bag fills automatically as the bladder drains and the nursing staff replace it when needed. The other bag can be detached from the overnight bag and is carried around with you, however for the time being I was going nowhere.
However it was the state of my genitals which alarmed me..They were black and grotesquely swollen. They looked like I had been in a fire and been burnt badly. It was about then I started to feel sorry for myself. Every movement was met with resistance from the lines I was attached to. The catheter was the most painful. It was in one of the tenderest parts of the body, and it wasn't too long before I called to a nurse for help.
My spirits were dashed even further when Jenny the "Joys of life" nurse who I had now nicknamed, burst in to the room. I announced my discomfort to her.
Jenny peered under the sheets, winced and exclaimed "Ooh wow!" She had seen the black and swollen private parts of my anatomy and was genuinely in sympathy. " Ooh!" she said " Would you like a massage" and laughed. I told her she was cruel and to come and repeat that in 12 months time.
Jenny turned out to be a sympathetic nurse who responded quickly to my complaint and often applied a numbing gel to ease my discomfort. I missed her when her shift finished and another shift came on.
So concerned was Jenny that I heard her ring Dr Stapleton that night and describe the sight she had seen.
I felt relieved that someone was concerned enough to ring and follow up her concerns. My hopes of any sympathy from the surgeon were short lived the next morning when Dr Stapleton called in. Having been told of the discomfort I was in decided to look for himself. "Oh that's fine," he said " That's coming on nicely" was his only comment before he disappeared out of the room. Having operated on hundreds of men he had summed up his handy work quickly. I don't remember saying thank you as he left.
Visits from family members and work colleagues were part of the daily routine. A Physiotherapist also called in to make sure my breathing and lungs were OK following the anaesthetic. He left a plastic device with two table tennis balls inside it. The aim was to blow into the mouthpiece and get the balls to the top of the devise thus assuring my lung capacity was in good working order. I was glad I didn't smoke.
Because of the earlier vomiting I was permitted only a broth for the first couple of days. The offering was awful. It tasted like it had been drained of any nourishment and tasted like warmed water. I started to crave hot vegetables and something substantial to eat.
The nurses' station was located just outside my room and the daily routines of hospital life could be heard from my room. Tea and food trolleys had their own familiar sound. One morning about two days after my operation I could hear someone pushing a trolley very early one morning. The woman would start at one end of the long corridor and make her way along to each room where she would knock on the doors and announce her presence with a loud "Tea, coffee, cordial."
The trolley she was pushing was laden with the morning offering and the noise of the combined cups saucers and plates crashing against each other set up a din that echoed down the corridor.
She would repeat the ritual at every door. After what seemed like a thousand calls she announced herself at my room and walked in. I waved her away impatiently. I am not sure,but I think I called her a terrorist. I hope she understood. I wasn't feeling myself..
The nursing staff were eager to get me mobile as soon as possible. After the first week I was encouraged to start walking again. The daily routine of struggling with two bags attached to my left leg just above the knee now began. Before I could move freely the overnight bag had to be detached from my leg and then reattached before going to sleep that night.
Walking was very tentative at first. Painful slow shuffles along the ward corridors became routine.
A highlight was the day I was allowed to eat a normal meal. I eagerly scanned the menu and was instantly attracted to a meal of carrots, potatoes,broccoli, patties and gravy. I have rarely enjoyed an offering so wonderful. It lifted my spirits just to be able to eat normally again and I reordered it again for the evening meal. Another milestone was achieved when I was allowed to have a shower. With eager anticipation I managed to free myself from the night bag. I still had the catheter bag attached to me and that was to stay.. I shuffled my way into the shower area. I was now beginning to manage the catheter bag well.
I unstrapped it from my leg and let it dangle away from the direct force of the shower.
I turned the hot water on and adjusted the cold water until all felt right and I stepped under. It was wonderful. I stood there allowing the warm soothing water to wash over me. I could feel my spirits lifting. I washed myself and reluctantly emerged feeling like a new man. It was great therapy.
I was now starting to appreciate visitors. My wife's employer had generously granted her as much time off as she wanted and she spent everyday with me. My sons and family were constant visitors. My work colleagues also came on a regular basis. There was always encouragement to get well and never any hint of frustration at my being away from the work situation. This continued during the next 8 weeks of recuperation. I felt grateful.
The catheter continued to be a source of discomfort. Nurses would be called day and night and asked to apply the numbing gel. Because of the catheter bag attached to my leg I couldn't sleep on my side, and I yearned for the day when I could roll over and sleep on my side.
Mobility was slow. Daily walks along the corridors on the ward were painful. I felt like I had been hit by a bus and shuffled along gingerly trying to extend the daily walking routines each day.
Home
After six days in hospital I was allowed to go home. One of my sons called for me and I gingerly made my way out of the hospital. I was greeted by fresh air and sunshine. I thought of the many who enter hospital never to leave. Again I was thankful.
Gradually my strength returned and the day came when I was booked into have the catheter removed. I returned to the hospital and was taken to a room on the ground floor. My feelings of apprehension of having the catheter removed were offset somewhat with the thought that I would be free from having this tethered to my leg.
I was shown into a room and asked to put on a hospital gown and lie on the bed. I was told that a registered nurse would come and remove the catheter. After a nerve racking wait the nurse finally appeared and prepared to remove the catheter. I prepared myself for a painful experience.The nurse then asked me to take a deep breath and while I was distracted quickly removed the catheter. It was all over. A long thin plastic tube emerged from within me. I was thankful she did it quickly.
I was about to get off the bed when she told me to relax as that was just the start of the day's events. ' I have to be sure you can urinate satisfactorily before I let you go" she said. It was something that I hadn't thought about. My bladder had been traumatised and had to learn to operate on its own again.
The nurse went away and returned with a large jug of water. ' I want you to drink as much as you can" she said and I will measure it and see how you go" I was to press the buzzer next to the bed when I had finished. With that she left and I began drinking. After about the third glass nothing seemed to be happening to my bladder,and the situation was made worse when my wife told me I would have to have the catheter put back in if I couldn't go. It wasn't the news I wanted to hear.
I continued to take on water. The amount in the jug was getting lower all the time and my spirits were following.
I was getting very despondent when I gradually felt an urge. I couldn't believe my luck as the feeling of an increasingly slow filling bladder increased. With a bottle in hand to urinate in I headed into the toilet with feelings of anticipation.
Gradually my bladder began to work. I emerged with a small offering and a smile on my face eager to drink some more and be released at the next appearance of the registered nurse. In the meantime I had rang the bell as instructed.
More drinking followed more visits to the toilet and the smile on my face was getting bigger as the bottle started to fill up. After about an hour there was still no sign of the nurse and it crossed my mind to do a runner from the hospital.
Drink followed drink and the visits to the toilet increased as did the amount in the bottle. I could feel the smile on my face getting bigger. I was almost free. At last the nurse reappeared and I gleefully held up the bottle with some satisfaction,but the smile quickly evaporated when she announced it wasn't what she wanted.
What she wanted,she went on to explain,was to see how much I could pass in one effort not a cumulative effort that now confronted her. ' I have been buzzing you" I cried, "but no one came this is the result of a dozen trips to the toilet " I could feel my temperature rising.
The nurse could see I was getting agitated and asked me to return to the toilet and return with what I could pass. The intake of water had made this easy and I returned with the mandatory 20ml she was apparently required to have. " OK that's looks good" she said " I think you can go". I wasted no time getting dressed and leaving the hospital, however there was to be one last twist to this story.
One of the side effects of the nerve sparing prostatectomy is that for a time urinary incontinence is the normal side effect of the operation. Men are supplied with pads to wear while this is occurring but with pelvic floor exercises this is all but eradicated in most Cases.
Back to hospital
Before I had left hospital the surgeon had given me some Tablets to help with this drying up process but it was to have painful results.
A week after leaving hospital, my daily routine had been to walk around the reserve directly outside my home. As I slowly returned home one day about a week after being discharged it occurred to me that I hadn't urinated at all since lunch time and it was now 5pm.
I thought it may have been a lack of water so I started to drink some more. I then felt the need to pass water so went to the toilet but as much as I tried nothing happened.
The pain in my lower stomach was now starting to reach alarming proportions. Then it suddenly dawned on me that I couldn't urinate at all. I made my way out to my wife who was watching television and announced that there was something wrong. I couldn't urinate. " Quick ring the hospital" I said. The urgency of my tone caused my wife to spring into action. " You have the hospital number in your room" she said. With that I headed towards the bedroom half doubled over with pain. I reached the bedroom but the pain was beginning to take hold so much so that I couldn't concentrate on where I had put the hospital phone number.
I called to my wife and she could see I was in acute discomfort. She hurriedly rang the hospital and was put through to the ward where she explained the growing crisis.
The hospital then rang the surgeon who urged me to get under a warm shower in the hope of easing the pain and restarting the bladder. My wife got me into the shower but the pain was increasing. Another call was made to the hospital and they told my wife to "Bring him in."
By this stage I was doubled up in pain and beside myself. I urged my wife to explain to the cab company that it was urgent but because my wife used the cab company often to get to work only a code was used. The call is registered and passes automatically to a cab. "They won't know its urgent" I lamented. We proceeded to the front gate with the pain now excruciating. It suddenly dawned on me too that the Royal Show was on and that Saturday nights was probably the busiest night of the week on the roads. It could be an hour before a cab arrived I thought to myself and stood face down with my head on the fence.
I was about to suggest calling an ambulance when my wife said " Here it is" I have never been so glad to see a taxi I told the driver where I wanted to go and we set off. I tried not to show I was in pain but the discomfort must have been obvious. I nearly wrenched the handle off the cab door in agony and tried to breathe deeply and think of other things.
As expected the drive along Goodwood Road and past the show crowds was very slow. I couldn't blame the taxi driver. As we approached West terrace the prospect of getting through at least 12 sets of traffic lights alarmed me. I uttered another urgent prayer of distress and closed my eyes anticipating a stop start journey through the Western end of town.
With my eyes closes I mentally prepared to count the stops. We seem to have a good run initially but then the cab slowed and stopped. One, I thought to myself. The cab resumed but the pain seemed to be increasing. I glance up momentarily but we were still on West Terrace and a lot of intersections loomed. I closed my eyes again and waited for the next stop but we kept going. We are having a good run I thought to myself. My wife said something from the back seat but the pain shut it out. Suddenly we turned right and I remembered it was a quicker way through that part of town. We stopped at lights again but then had a clear run all the way to the hospital. I uttered another quick prayer of thanks e before paying the driver and thanking him profusely.
We hurried onto the ward where we were met by a nurse and shown to a room with a bed. " I was contemplating having to suffer another catheter when I suddenly felt as if I could urinate. I made my way to the toilet nearby and to my immense relief managed to pass a little urine. It wasn't much but the relief was wonderful. The decision was made to keep me in overnight. The decision on my part was met with enthusiasm. At least I was near help.
As the night wore on I found I could urinate more and more and things had started to settle down.
By morning I was passing water as if nothing had happened, but I was still eager to talk with Dr Stapleton who I was told would call in on his normal rounds that morning.
I lay on the bed feeling the tension draining out of me. I was about to drift off to sleep when Dr Stapleton walked into the room and greeted me in his usual pleasant tones.
I told him of the events that had unfolded and the drama that had occurred. I wasn't quite ready for his reply. " Oh that's normal" he said laconically " These Tablets we give folk to dry them up sometimes have that effect...you should be fine now" With that he left and I was left contemplating his reply.
Six months on and I am feeling fine with the mandatory PSA checks not even registering on the prostate Richter scale. My cancer has gone.
The nerve sparing operation which spares those erectile nerves have yet to be proven. But it is still early days.
The end.
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