Day 30 - Surgeon #1

Heat up a mug of hot chocolate or a glass of glühwein, settle into your favorite comfy chair, and relax, because this will be a long one…

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Before you do, however, first this disclaimer: Graphic descriptions ahead.  Read at your own comfort level.

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So the surgeon (we’ll call him Dr. C in keeping with the "no-names-in-the-blog-to-protect-privacy" approach I’ve been using) walked into the exam room and introduced himself and said something along the lines of, “I’m sorry we have to have this discussion,” meaning “I’m sorry you have cancer.”

He was very easy-going yet very professional throughout the entire meeting.  We started by reviewing my biopsy results, with him showing me where the cancer was within the prostate and making sure that I understood what the results meant.

He pulled out some laminated cut-away drawings of the male anatomy and walked me through the layout of all the key players in the area of the prostate, and then took a black dry erase marker and began showing me exactly where he would be cutting.  He even brought in one of the robot arms with a miniature pair of scissors on the end to show me how large the instruments would be.  (You can watch video of an actual robotic prostatectomy on the two links that I've added to the right.  There's very little blood and it really is fascinating.)

Dr. C then addressed the risks of the surgery and the possible complications afterwards.  He showed me on the drawing where the bladder sphincter muscle was and how he would try to avoid getting too close to it to minimize the risk of incontinence after the surgery.

He also showed me the nerve bundles on either side of the prostate that control sexual function.  Dr. C said that because the tumor on my prostate was so close to the nerves on the right side, he would have to remove that nerve bundle to ensure that he gets all the cancer.  He said that very few guys with only one nerve bundle intact can “sport wood” (his words) on their own, without the assistance of a little blue pill.  The other thing that happens during the surgery is that I'll essentially have been given a vasectomy and will be "shooting blanks."

As Dr. C went through his explanation, he answered nearly three-quarters of the questions on my page.  Of course, I did ask those that weren’t answered in his discussion.  A few highlights:

On his qualifications:

Dr. C trained for a year on the da Vinci robot when it was first brought to his hospital in 2003, and did his first operation on a patient in 2004.  Since then, he’s operated on 700+ patients, with about 5% of them having post-surgery, long-term complications (mostly some form of incontinence or impotence). 

On the procedure:

I’ll have to go for biofeedback training about two weeks in advance of the surgery to teach me how to exercise my bladder sphincter so that I have better urine control after the catheter comes out. 

Dr. C will take some of the surrounding lymph nodes during the surgery to ensure that the cancer hasn’t spread to them. 

If all goes well and there’s no sign of infection, I can be released from the hospital the day after the surgery.  I’ll experience 3-5 days of a bloated feeling and pain, but it typically subsides to a tolerable level pretty quickly.

I’ll have a catheter for 5-8 days after the surgery.

On the recovery:

I should plan on 4 weeks off work to ensure a full and successful recovery.  It will probably be at least 2 weeks before I can drive again.

I should also be up and walking around soon after the surgery and should be able to shower the day after as well.

There would be regular monitoring after the surgery to see if there’s any cancer remaining, but there should be no need for radiation or other therapies unless something shows up.

We probably spent nearly 30-40 minutes together and, before I left, he had one last surprise for me.  He said, “I’m afraid I’m going to have to give you a Christmas greeting.  I need to feel what I’m dealing with, so bend over and put your elbows on the table.”  Ugh.  Not again!

All in all, I was very impressed by Dr. C and I would feel quite comfortable in his care.

On the drive home, I received a call from the father of a friend of mine at work.  Dr. C had removed his prostate five years earlier, and he was very pleased with Dr. C and the outcome of the surgery.  It’s always good to hear that from someone with first-hand experience.  It reinforced my thoughts about him.

So does all of this mean that I’m not going to see Dr. I in Indianapolis (get it?) on Monday?  Nope.  I’m still going to drive up there and check him out.  I guess I’m just wired to comparison shop.  J

Has the glühwein put you to sleep yet??

On to today…

It was a bit of a rough start this morning.  Even though everything was so positive with Dr. C, I had a whole lot rattling around in my head last night.  I did sleep better than the night before—but not the best—and that made me a bit of a grouch this morning.

Mid-morning, I received a call from Dr. C’s surgery scheduler and spoke with her about scheduling the actual procedure.  That was a bit unnerving.  I figured that I’d go ahead and get myself on the calendar, and if Dr. I is even more impressive, I can schedule the surgery with him and cancel the date with Dr. C.

I’ll keep the date to myself until I land on the actual surgeon and the final date.  That should be by mid-week next week.

So that’s it for this update.

Oh.  “What the hell is glühwein?” you ask…  Glühwein, or mulled wine, is a German holiday tradition—wine heated with spices like cinnamon, cloves, honey, and orange and is served warm.  (I’m sure there are a gazillion different versions out there.)