43. Second chances might only come around once – Part 2

walnut-shell

For those of you that enjoyed telling me how funny Dennis is, I am sad to announce that this is the final part of his story.

Boo hoo!

I told him of his new found fame and he quite enjoyed it. I walked away with him chuckling and smiling. Alas, he does not have a blog so there is nowhere I can direct you to. Not hating or anything. You are back with me again from next week. Hoorah! I hear and feel the chant. Well hopefully somewhere. Back to Dennis….

In years gone by, prostate treatment was carried out in a variety of hospitals, but it had become clear that those that treated the most cases seemed to have the best results, so the NHS decided to focus treatment in just a few places.  The consultant who gave me the news had said that I would be treated at University College Hospital London, and I would have what was known as a Robot Assisted Radical Prostatectomy.  Or in other words, I’d be on an operating table with a four-armed robot, while the surgeon sat over the other side of the room at a glorified Playstation.

I went in to meet one of the surgical team, and he went through the procedure.  It would take a couple of hours, he said.  I’d end up with six small scars, I was never going to be able to have children, and depending on how things went, I’d be incontinent for somewhere between a few months to a year.  Or if I was unlucky, for the rest of my life.  And I’d have erectile disfunction.

The scars I could live with, I didn’t want children, and given the choice between having to wear an incontinence pad or dying of cancer, I’ll take the Tena Lady every time.  As for ED, well we’ll cross that bridge when we come to it.

The surgeon asked if I had any questions.  I think I did – I can’t honestly remember – and then he asked if I was happy to proceed.  I was, and signed the proffered consent form.  This was early September.  How long would I wait for a date I asked, thinking it would be sometime in February or March, and wondering whether I’d be mobile for my birthday.

“Oh, about five weeks.” said the surgeon.  “Now, are you free this afternoon?  You should go to surgical school.”

My boss had said to take whatever time I needed, so yes, I was free.

Surgical school turned out to be a class of about twenty of us.  We had a wide range of ages and a variety of ethnic backgrounds.  The one thing we had in common was that we all had a small, walnut-sized gland that was trying to kill us.

A pair of very jolly specialist nurses spent two hours explaining everything.  What we needed to do before the operation.  What would happen during the operation.  What we’d feel like when we woke up.  What we’d need to do straight away.  What we’d need to do in the following weeks.  What we needed to eat.  Drink.  Wear.  And they introduced us to the catheter that we’d be wearing, post-op.  Every question we had, they answered.  They gave us exercises to do.  They gave us things to think about.  But mainly they gave us things to read.  Lots of things to read.

I came home and talked it over with my wife.  I knew they liked to get on with these things, but I wasn’t expecting it to be a matter of weeks.

I had explained to my boss, plus one or two close friends, what was going on, but other than that, kept quiet.  My team at work clearly knew something was up as I’d started taking days off at very short notice, but now I came clean and explained the situation.  I’d be taking a month off work, post-op, so they really ought to know why.

The other person I spoke to was a dear friend from work.  We’d known each other about 20 years, and she’d been though the female equivalent of what I was facing.  She gave me a lot of useful insight, particularly when it came to how your nearest and dearest might react.

“It’s frustrating for them,” she said, “because there’s nothing they can do.  You feel in control as things are explained to you.  You have all the information.  They just look on from the sidelines and can’t do much, and that can cause friction.”

It was true.  My wife and I sometimes didn’t see eye to eye.  I felt reasonably calm about the situation.  I was taking the view that this seemed to have been caught reasonably early, and I was fortunate that I was being treated by some of the best people in the country.  I couldn’t see the point of worrying too much.

My wife did worry though.  On reflection I probably didn’t deal with this very well, brushing off her concerns.  If I wasn’t worried, why was she?  Not my finest hour.

A couple of weeks later I was called back into UCLH.  I’d assumed this was for what the nurses had referred to as my ‘pre-op assessment’.  However it wasn’t.  There were a team of six surgeons at the hospital who carried out this particular procedure, and the surgeon who’d met me earlier had identified me a ‘a candidate for an alternative procedure’.  In other words, a guinea pig.  I now met the surgeon who was going to carry out my op, and he explained to me that as I was relatively young, and fairly fit and healthy, I was a suitable candidate for this ‘alternative’.

Normally, he said, we’d carry out the op that was explained to you.  However, a couple of Italians have come up with a variation.  It takes a bit longer and it’s a bit more complicated, but if it works, then the likelihood of you suffering incontinence is much reduced.

Sounded good.  Was there a downside?

“Well,” he said.  “I’m the only one of the six in this hospital trained to carry out this variation.  I’ve carried out the regular operation about 950 times…”

“And how many times have you done the new way?”

“Eight.”

I mulled it over for a few minutes and eventually came to a decision.  Doctors learn by doing.  Clearly not everyone was suitable for this procedure, so his opportunities for doing were much reduced.

“Sign me up.” I said.

The next few weeks seemed to fly by.  Within two weeks I’d been sent a date for mid-October.  I made arrangements for people to pick up my workload.  I bought a baggy pair of track suit bottoms that would be comfortable to wear and would have room for my catheter.  I’d been doing my pelvic floor exercises for weeks, and at the request of my surgeon, I’d tried to lose as much weight as I could in five weeks ‘So he wouldn’t have so much to cut through.’

We caught a taxi up to the hospital.  Because my surgeon carried out a list there once a week, I’d been moved to the Princess Grace hospital in Marylebone which was posher than most hotels I’ve ever stayed it.  I was shown up to a private room, and then we sat.  And waited.

I can’t remember how long we sat there.  Somewhere between two and four hours I think.  And then a nurse came to walk me down to the theatre.  We walked into the prep room, I hopped up on the trolley and the anaesthetist introduced himself.  I was quite looking forward to this bit.  I’d never had an operation before and lots of people had described the deliciously woozy feeling you get when they give you the pre-med.  You try and count back from ten and it all goes a bit swimmy and you fade out.

I don’t know what they gave me, but they put a cannula in the back of my hand, and a split second later I was back in my room being shifted from the trolley to my bed.  No hallucinogenic trip for me.  It was like someone flicked a switch and I lost about five hours.

Must be what those Texans who get abducted by aliens feel like.

Recovery was slower than expected.  They’d been hoping to throw me out the next morning, but for a while my blood pressure was low enough to cause concern, but by early afternoon I’d improved enough to make the Senior Registrar happy.  A nurse had shown me how to use the catheter that had been fitted while I was unconscious, I’d been given some tablets and some anti-clotting injections and before I knew it we were on our way home in a taxi.

The next few weeks passed by quite quickly.  For a week I didn’t move much, sitting propped up in bed reading.  Then I was getting up and moving about.  Soon I could go out for short walks.  In less than two weeks I’d been called back to have my catheter removed.  While it was a relief in some ways, I’d quite got used to thinking ‘I need a pee.  Oh right!  No need to get up!’  The worst bit were the anti-clotting jabs.  I had 28 needles with the correct dose of anti-clotting agent.  You had to squeeze your thigh between your thumb and finger, stick the needle in, inject the fluid and that was that.  After a fortnight I felt like a pincushion.

After three weeks I was beginning to think that I ought to be going back to work, but while I might have looked alright on the outside, I wanted to give my insides as much chance of healing properly as possible, so bravely stayed at home and watched daytime TV.

One thing I had noticed though, and reported to the nurse when she phoned for a progress update, was that while I’d worn an incontinence pad for a couple of days, I’d found that I didn’t need it.  I’d kept up my pelvic exercises, and that, combined with the skill of my surgeon and those two unnamed Italians, seemed to have given me the best possible result.  Thank you, Mr Prasanna Sooriakumaran.  And thank you, unknown Italians.

That was nearly eighteen months ago.  Since then I’ve had blood tests every three months, which have, thankfully, been clear.  Those tests will carry on for ten years, with decreasing regularity (as long as they stay clear).  I do have to take a variety of tablets every day for the ED, the cholesterol and the diabetes, but I’m working on losing weight.  It’s been suggested that I was borderline with the diabetes, so shift a stone or five, and I could be off the tablets.

Having been so fortunate with the cancer, so lucky that it was picked up and treated so fast, it seems foolish not to give my health the best possible chance.  I still have a bit of chocolate now and then, but not as much as I used to.  I hardly touch fizzy drinks these days.  And I get a bit more exercise than I used to.  I’m not going to be troubling the GB Olympic team any time soon, but I’m gradually getting into shape.

I was given a second chance that my Dad never had.

I’m not going to throw it away.

 

Postscript

After reading this, Peter asked me what I wanted other people to take away from it. I’ve been thinking about that for a few days.

First off, take care of yourself. Whatever your age, and whatever your lifestyle, there are bound to be some simple choices you can make to tip the odds just a little further in your favour.  Just make some changes to your diet.  Lose a bit of weight.  Get a bit more exercise.  It might not prevent you, or your loved one, from getting prostate cancer, but then again, it can’t do any harm.

Second, if you’re in a group that are prone to prostate cancer, be that race, weight, age or any combination of those factors – and Peter’s blog can give you plenty of information about that – then get checked.  You might have to push a bit.  You might have to be a bit awkward, a bit forward, make a bit of a nuisance of yourself with your GP.  But this is your health we’re talking about.  You don’t have to be rude.  Just firm.

And lastly.  If you do find yourself sitting down with a doctor who gives you the serious look followed by the news that you didn’t want to hear, remember : you’re not alone.  There will always be someone.  A wife.  A partner.  A friend.  Maybe a colleague.  Someone who will help.  Maybe they’ll give you advice.  Maybe support.  Maybe they’ll just be someone who’ll listen when you’re worrying.  Don’t take that help for granted.  Most of the time you’ll – unsurprisingly –  be focused on yourself.  But if they care about you, they’ll be worrying too.  They won’t want to put that burden on you, but they’re going through it with you, every step of the way.  Be grateful.

And if you are currently in a battle with that killer walnut – I wish you the very best.

Dennis

 

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