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Wednesday 1 November 2017

Prostate cancer and me.

With Movember beginning again I thought I'd give you an insight to what happened to me, with all the gory details! In fairness there's not much in the way of gore so you'll be OK! This is bit of a diatribe but stick with it!
My brush with 'The big c' ( I always spell the big c with a small c to show my contempt for it) began with me feeling abit under the weather, abit flu-y, I even had time off work unusual for me as I'm normally pretty healthy. About a week into this virus thing I got a urine infection, oh joy! Trip to the Doc's led to a course of antibiotics however one course didn't work so back I went & saw the Doc again who gave me another course, but she also said it was probably a good idea to have my, to use her phase, 'pipework' checked out as I shouldn't really be getting urine infection at all. So within about a fortnight I was in front of a Consultant Urologist, who was an exceptionally nice chap who made me feel at ease and was very easy to talk to. This would have been late November 2013, after being poked and prodded in terrible places ( he did introduce himself first but there was no dinner or flowers!) he felt two 'dots' on my prostate that were worthy of further investigation.  From the word go we talked about the possibility of it being cancer ( see- small c again!) but it was just one option at this stage. My PSA (Protein Specific Antigen) blood test was slightly higher than he'd like but the fact that I'd been unwell anyway would lead to that so I was down to have another test in a couple of weeks. The urine infection had no bearing on things at all, it was just my bad luck!
Well, an ultrasound scan, an MRI scan and a biopsy later it was confirmed as prostate cancer. Bugger!
 However it was only just big enough to respectably call itself a cancer, there's a scale to which these cancers are measured against, its called the Gleason scale  and is two numbers added together.
There may be more than one grade of cancer in the biopsy samples.The first is the most common grade in all the samples. The second is the highest grade of what’s left. When these two grades are added together, the total is called the Gleason score. Mine was 3 +3 so 6, pretty low & most importantly more likely to be slow growing.
So how did I feel  when my consultant confirmed it was the big c? Not unduly worried to be honest. I know that sounds very blasé but it wasn't like being told we need to operate now or its three more clean shirts and that's your lot! Untreated this cancer would kill me there was no doubt, but it could take anything between 12, 15 or even 20 twenty years to do so. Also I believe my loved ones did all the worrying for me even though I  made it all very clear to them and they knew as much as I did every step of the way. Basically I said only worry if I worry, not sure they listened though!
So, treatment. I had options to a degree anyway. My consultant suggested I see a colleague of his who is an oncologist who specialised in radio therapy etc. He flagged up that zapping the tumours with radio therapy could cause 'collateral' damage to the area around the prostate and you don't want any collateral damage around that area at all! Then there was brachytherapy. This entails inserting tiny beads of radioactivity into the prostate that work to eliminate the tumour over a period of time. Doesn't always work and  again the radioactivity could effect other bits. His thoughts really were that surgery was probably the best way to go. For a while my Consultant thought about putting me on what's called 'watchful waiting.' You have regular tests to make sure its not getting any worse and when it does they whip you in and take out your prostate. That's not a bad idea but you are quite literally sitting on a time bomb! My Consultants conclusion, after talking with his colleagues was that as I was very young for prostate cancer anyway (far more cases over 65 years) the best bet would be to take it out. As with any operation, the younger you are the better and the quicker you get back to normal, it was highly likely it would have to come out sometime anyway.
Got to say having thought about it, discussed with Tara, looked on line etc I thought surgery was the only way to go, lets get rid of the problem and get on with life.  The whole way along my consultant had told me this was a very fixable problem, I was going to be around for a good few years yet! Of course I hung on his every word!
So the date was set for me to go in for a RALP, a Robotically Assisted Laparoscopic Prostatectomy. This is the fascinating bit! Put simply I would have 5 small incisions made across my stomach and five 'arms' would be put in. The surgeon would be sitting at a computer monitor with little hand held gismos. These gismos would be used to direct the arms inside me, they mimicked the movements made by the surgeons hands.  I considered this keyhole surgery, which it is really, but the Staff Nurse who did my pre -op  checks a week before I went in told me that it was still major surgery I was going to have & to take things easy post op. ( check out YouTube for videos of this op they are well worth a watch)https://www.youtube.com/watch?v=xyu4lVr5koU
Six weeks before going under the knife I had to see a physio and we talked pelvic floors...........I didn't even know I had one and wasn't sure exactly where it was. I mean I've heard of the Sargasso Sea but I couldn't find it on a map!  It was vitality important that my pelvic floor was tight as a drum once as I'd had the op I could potentially be leaking like a sieve! One of the two 'valves' from my bladder would be taken out with the prostate so the exercises were very important. She gave me exercises that I worked like buggery on and pleased to say that post op once the catheter was taken out (you have one in for a week post op) I was in the top 5% with little leakage! This improves all the time post op but its good to keep up the exercises!
48 hours before the off I had to go on a very bland diet. Plain as plain can be and & on the day I went in (the night before the op) I had no food at all, only this lemon tasting jollop that I was really looking forward to but unfortunately was pretty horrible!
Now I had the good fortune to be covered by private health via the company I work for but rather ironically my op would have to be carried out at an NHS hospital, the Lister in Stevenage. I was assured by my consultant I was not queue jumping anyone who was in greater need than me. Infact he maintained that if it wasn't for private health paying the NHS to use this wonderful machine it would have been mothballed long ago.
Tara took me in  and our first greeting was from a nurse who said they don't get paid for taking private patients! Great! I get the old leftie nurse. I really didn't want to fall out with her as she was having to do terrible things to me later but I did tell her that BUPA pay the NHS for using all of their toys and facilities, she did perk up at this and was fine from then on.
Alittle later a bloke came in ( I presume a phlebotomist) to put a cannula into my left hand. First attempt the vein collapsed so he had another go, same thing happened, made my toes curl abit when he tried to stab the vein again! Another go this time in my arm, still no good. At this point I said he could have one more go, which luckily was a success. This was in my right hand, though strangely enough once I woke up from the op it was back in my left hand!
Said goodnight to Tara, she was staying in the Premier Inn next door as it was about 30 miles home & she wanted to be near me. I read for a while, had the first of my two prescribed showers read a bit longer and got some shut eye. Up at 6am I think, another shower then wait for the off. A porter and a nurse came in and I was wheeled in the bed for what seemed like about six miles. Up lifts, down lifts, along dark long corridors & eventually into a holding area for patients under the knife. I was asked my name and age etc for the umpteenth time & left there. A chap on my left got wheeled off & I was on my own. Next thing my consultant pops in dressed in his scrubs and looking very cheerful. I asked him whether he had good steady hands this morning and he held them out to show me! Interestingly enough he also told me that it wouldn't matter whether his hands were steady as this incredibly clever machine he uses would compensate for it anyway!
A little later I was wheeled into an anteroom and the anaesthetist said he'd give me something to relax me. I remember thinking so this is to relax me and then I'll be given something else to put me under......That's all I remember until I woke up! The op lasted about two and a half hours I think. My consultant had my prostate checked by a pathologist as soon as it was out (its actually put in a small bag and popped out through your belly button!) to ensure there was just a small amount of cancer in it, which there was. A technique not used everywhere.
I remember coming round and having a very dry throat, I coughed causing a great deal of pain in my right side. This was where the largest incision was made & was the only wound to be stitched, the others being clipped together. The arm that was used in this incision is moved about alot, I think it has a light on it and also pumps in the carbon dioxide used to inflate the abdomen to give the surgeon abit of room to work. Apparently when I came round I had a conversation with my consultant  that I remember absolutely nothing about, he also kindly phoned Tara to say I was out of theatre & had done well. The boys of course all kept in touch with Tara, I'm deeply touched & very moved that they all there for their old Dad.
 I recall being wheeled into a room in the Urology Department & Tara was there though I was still quite groggy. Tara had bought me some grapes, my consultant came in for (another!) chat told me that I could have the grapes if I chewed them thoroughly, which I did. They tasted like nectar.
I had a pain in my right shoulder, this is expected as from where they are operating the underside of the diaphragm is touched and bizarrely you get referred pain in your shoulder. I must say I felt like I'd been run over by a bus, albeit a small one.
I think I slept alot and next morning was wheeled into a small 4 bed ward. There was an old chap there who was chatting and he then held up a small tube of something telling us he'd meant to get denture fixative but got condom lubricant by mistake.......well the ward just erupted with laughter, I can honestly say I was in so much pain laughing I couldn't be sure whether the tears running down my face were of laughter or pain I thought I'd ruptured my stitches! Maybe it was because I still had anaesthetic in my system but I thought this was bloody hilarious. I stupidly told one of the nurses later on and started myself laughing all over again!
It's generally just one night in hospital but my temperature was up slightly, so as a precaution I was kept in an extra night. A fella arrived in the next bed who was to have a  kidney out & like me was an old headbanger, so we were able to talk music for a while which was good.
Next morning a nurse suggested I go for a short walk, so with her help I did. On my walk I caught sight through a window of some poor old sod in a dressing gown on the arm of a nurse holding a bag of his own pee. Then it dawned on me, it wasn't a window, it was a glass door and was a reflection of me!!
All good today so I was discharged. I should state here that the care I received in the Urology Department at the Lister hospital was second to none. They are a brilliant team and I felt well looked after. I even got a kiss from one of the nurses, you don't get that with BUPA!
Home then, felt very tired and abit strange with this catheter in situ. You don't want to see tubes coming out of you anywhere but particularly there! I was required to inject myself every day for the first month, this is to ensure I didn't get a DVT. At the hospital they took me through how to do it & I had a go, they also said this if I really couldn't do myself they'd arrange a district nurse to call to do it. I didn't want to waste the resource of a district nurse calling on me when I'm sure there's others she'd be better employed seeing so I bit the bullet and did it myself. Laura popped over with her brothers ( just little fellas at the time) & they wanted to watch me inject my stomach. 'Ok then' I said, count to 3 and I'll do it, they got to 3, I nearly did it but said 'count to 3 again'...........I think  we got up to about 38 before I did it! The rest of the month, with exception of the last couple of days strangely, was fine.
A week later I was back at the hospital to have the catheter taken out, I wasn't looking forward to this but is actually painless. The nurse say's breath in & before you've even taken that breath the catheter is out. I was then sent back to the waiting room and instructed to drink water, lots of it, until I couldn't hold on any longer. The results were weighted in a medicine bottle to see whether your bladder is emptying as it should. All Ok, so that was it really, back home to recuperate.  A couple of weeks post op I went for a walk to the post box which was downhill. Walking back felt like the north face of the Eiger, I was knackered! Slowly got back to something like normal, think I was off work about nine weeks in total.  Things take while to get back to normality but they do eventually. The following link is about the Lister Hospital reaching the milestone of 1000 RALP ops!
http://www.enherts-tr.nhs.uk/blog/17975/news/1000th-robotic-prostate-cancer-surgery-procedure-performed-at-the-lister-2/
I'm now three and a half year post op and completely cancer free. I'll have PSA blood tests twice a year for another two years then it drops to one test a year for a further five years then that's it, your bloody cured mate!
If this was my brush with cancer then I got off pretty lightly to be honest. There's many others that don't, hence Movember. Please follow this link to donate :https://mobro.co/markmorgan106





































































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