A Post-Surgical Update

 

Here is how Johns Hopkins describes the surgery I had on Thursday: “A transurethral resection of the prostate (TURP) is surgery to remove parts of the prostate gland through the penis.  The surgeon reaches the prostate by putting an instrument into the end of the penis and through the urethra. This instrument is…12 inches long and .5 inch in diameter. It contains a lighted camera and valves that control irrigating fluid. It also contains an electrical wire loop that cuts tissue and seals blood vessels. The wire loop is guided by the surgeon to remove the tissue blocking the urethra one piece at a time. The pieces of tissue are carried by the irrigating fluid into the bladder and flushed out at the end of the procedure.”*

Four days post-op, I’m seriously fatigued and bored out of my mind, but aside from the fact that it hurts to pee, my pain has been minor. I can slowly start working my way toward normal functioning in two weeks, at which time I’m supposed to let bleeding be my guide to what I can do.

 
I told the anesthesiologist (a delightful man named Albert Cho) that I wanted to stay awake for what was supposed to be a 90-minute surgery—but ended up taking two hours—and he readily agreed. There being a drape between us and the other five or so people in the room, we had an intimate conversation that I would enjoy sharing if I knew he would be okay with it. 

Surgical tables are hard, and the longer I lay there, the more my back hurt. When I asked for relief, he gave me Fentanyl. The pain didn’t go away until I hit 200 mcgs, an apparently large amount that I could only tolerate because I’ve taken narcotics every day for years. Fentanyl is awesome. I was wearing a Fentanyl patch when I crushed my thumb (after breaking my back) in 2014. When I realized that I had closed the bathroom door on my thumb, I said to myself, “That must hurt...” and then, By god, it does hurt!” and I opened the door.


When the surgeon visited me in recovery, I asked if there had been a problem, and he said no. I knew this couldn’t be altogether true both because of how long the surgery took, and because there had come a point at which the people on the far side of the drape had switched from talking to whispering. When he left, I asked my nurse (who hadn’t heard my conversation with the surgeon) what had happened, and she said I had bled more than expected, and the surgeon had thought it prudent to keep me in surgery a while longer. 


Recovery rooms are dismal places, what with people moaning, puking, and talking out of their heads—and that’s just the nurses—but I couldn’t go to a room because they were all occupied. I worried that I might have to spend the night in recovery (which has sometimes happened at Peggy’s former hospital), but my nurse predicted that I would be out of recovery in an hour or two, and she was right. My room being ready, off I went to meet my nurse, 27-year old Kristina, with whom I felt an instant rapport. I was so happy to have the surgery behind me that I babbled like a chimp. Before our time together ended, I was in envy of the man whose luck it is to be her father.


I left surgery with a double lumen urinary catheter, which consists of one tube carrying sterile water in, and another tube draining blood, clots, and urine out. Before entering my urethra, these tubes were joined together in a larger tube, which was taped to my thigh at one end and secured to my bladder with something resembling a balloon at the other. The balloon’s pressure made me imagine that I had to urinate, but there was nothing I could do about it. Nearly all of my post-op pain is due to the fact that it hurts to pee. My penis is black and blue, and my urethra feels sunburned, yet all of my post-op pain combined is minor compared to the back pain I’m in daily.


Most hospital nurses work twelve-hour shifts (hospitals appearing to be okay with the fact that consecutive twelve-hour shifts result in medical errors, job burnout, and car wrecks involving nurses who fall asleep at the wheel), so at 7:00 that evening, Kristina was replaced by Yani, whom I also liked and trusted. Before Kristina left, she said she would see me the next day. An hour before shift change the next morning, Yani said the same, so imagine my dismay when a gruff man with a loud voice—and a student nurse in tow—was introduced as my new nurse. I seek to avoid loud people, so his volume combined with my unhappiness over what I regarded as his hypermasculine persona, led to an unhappy relationship. On the other hand, he seemed competent and showed pride in his work, so my only real objection was that I didn’t care for him, and I didn’t think he cared for me. 

I tried to find out why Kristina had been replaced, but no one knew, although they admitted being surprised by it (I also learned that Kristina had spoken highly of me). I hate having to put up with things that make no sense to me, especially when I’m paying for them.


Before being sent home, I had to pass a two-part test. In part one, I had to pee into a urinal and show the result to my nurse. Part two was identical to part one. Had I flunked, I would have been sent home with a catheter that drained into a small bag during the day and a large bag at night. I easily passed, but my urine continues to be bloody, and I’m told that it might remain that way for quite some time. When I’m not peeing blood, I’m dribbling blood, but the nursing student who prepared me to go home offered nothing with which to catch the dribble. When I asked what she proposed, she gave me a stack of abdominal dressings, but I found that blood passed right through them, so I switched to stuffing my underwear with old washcloths, which cost nothing and are adequate for the task. Some men spend the rest of their lives dribbling, so I can but hope for the best.

 

*https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/transurethral-resection-of-the-prostate-turp

18 comments:

kylie said...

Oh gosh. I guess it's roughly comparable to the discomfort after a difficult birth. Bruised, stingy, not entirely continent.

I hope you have a full and fast recovery, my friend.

If the worst thing should happen and the dribble never stops, will you still have a worthwhile benefit from the surgery?

angela said...

Oh I hope you make a complete recovery
I think your brave staying awake. No way do I want to know what happens in surgery
I just want to go to sleep and wake up when it’s done. And if I don’t ever wake up well I guess I’ll not know the difference

Andrew said...

Similar to what my partner went through but the end result was good. It is nice when you have nurses who you connect with, but more important to have competent nurses.

Tom said...

I admit I skipped over some of the most graphic parts of your post (I'm squeamish and would certainly have opted to be fully anesthetized) but I'm glad it's now "behind" you and that you're on he road to recovery. I'm hoping -- and predicting -- that the dribbling will stop.

Strayer said...

You are funny, Snow. (description of the recovery room). That's unfortunate that you ended up with a high volume ultra masculline instead of Kristina or Yani. It sounds very post surgical painful having something half inch wide stuck up your urethra. I hope the bleeding eventually subsides, but that's a lot of trauma for a narrow tube, and the bladder, to take on. Might take a bit for all that to calm down.

kj said...

hi snow,
I'm glad you're home and doing well. I couldn't bring myself to read your first gorey-to-me paragraph but I know this surgical prep and recovery part all too well. I'm always afraid and it's always okay afterwards. I especially appreciate waking up!

Best wishes to you,
love
kj

ellen abbott said...

Damn. Sounds horrible.

Marion said...

My penis hurts just reading this. 🙈😬❤️‍🔥 Get well soon, Snow. You’re one tough son-of-a-bitch, for sure. 🌹 xo

Snowbrush said...

"If the worst thing should happen and the dribble never stops, will you still have a worthwhile benefit from the surgery?"

I was already dribbling, the only difference being that it's now bloody dribble, which is more of a mess. I'm optimistic that the problem will go away, but even if it doesn't, some of my other problems will. For instance, my enlarged prostate was pressing on my bladder, which made me feel that I had to pee, but when I tried to pee, very little came out, so I would be back in the bathroom few minutes later, trying to pee again. I was also finding it hard to start peeing, so I was spending  a great deal of time sitting on the pot (at home, I usually find it more convenient to sit than stand) waiting for pee that wouldn't come. I was told that all of these symptoms would probably get worse without the surgery.

"I think you're brave staying awake. No way do I want to know what happens in surgery."

I don't see it as bravery because I have no desire to grit my teeth and bear something scary, or to silently endure discomfort, or to see my own gore. When I first started having surgeries, I was simply curious about the experience, so I regarded staying awake as being entertaining and educational. Since then, I've developed severe sleep apnea, and intubation sometimes leaves my throat horribly, horribly sore. In fact, some of the worst pain in my life has come from waking up in recovery and having the Devil's own sore throat. I also have a vocal cord problem that is made worse by being intubated. Sometimes, though, I have had no choice but to be put to sleep because of what part of my body was being operated on. If you are ever tempted to stay awake for surgery, just remember that you can always change your mind even while the surgery is in progress, and that it will take no time at all for your anesthesiologist to switch gears.

"It is nice when you have nurses who you connect with, but more important to have competent nurses."

I'm lost as to what you're talking about, but I think you might be saying that technical expertise is a necessity but that connecting with patients on a human level is non-essential--kind of like the cherry on the top of a cake. I have very strong feelings about this because I've felt abandoned by callous caregivers. Especially where surgeons are concerned, many patients (in my experience, such patients are always men) talk as though they think that really good surgeons regard their patients as nothing more than an assemblage of parts, and that any patient who has a problem with this is a weakling who wants to be coddled like a baby. My experience with such caregivers is that as long as they don't get sued, they truly don't care about their patients' feelings or even if their patient has a positive outcome. I watch my caregivers closely, and I would never stick with a caregiver whom acted as though he didn't care about me as a human being. Connecting on a human level isn't an extra; it's the sine qua non of being a good doctor or nurse, and I think that when a caregiver lacks it, that caregiver is probably burned-out and should seek other employment.

cont.

Snowbrush said...

"that's a lot of trauma for a narrow tube, and the bladder, to take on. Might take a bit for all that to calm down."

I sometimes ponder how incredible it is that we allow surgeons to wound us--sometimes horribly--in the hope that the wound will eventually heal, and we'll be better for having endured it. Talk about a "leap of faith!"

"I'm hoping -- and predicting -- that the dribbling will stop."

Tom, I know you've been retired for a while, so I suspect you're in your sixties. An enlarged prostate being such a common problem, you might be undergoing the same surgery one of these days. It struck me as being sort of like a "rite of passage," in that while some men manage to detour around it, a hell of a lot don't.

"I couldn't bring myself to read your first gorey-to-me paragraph..."

Tom left a similar comment. I've had four major joint surgeries, and they were SO gruesome, left me in SO much pain, and took SO long to heal, that, in anticipating this surgery, I took comfort in the fact that, compared to them, it seemed nonthreatening--not minor, certainly, yet I should be up and running in two weeks rather than the year and a half that I once endured and the many months that I endured on other occasions.

"Damn. Sounds horrible."

Hi, Ellen, you might want to read my last response--the one to KJ.

PhilipH said...

Bloody good account of your TURPS procedure. I'm so glad that you came through the opening procedure so very well. It seems the surgeon encountered some problem along the way which caused a longer session on the operating table but you came through OK.

Really great that you've won the opening game and now have to stoically press on with the longer middle game and look forward to a masterful and well-deserved end game; i.e. Checkmate!

Well done Snowy. Sleep well. Philip

Sue in Italia/In the Land Of Cancer said...

Glad you got through this procedure with your humor intact. My father decided to ignore his ever growing prostate until he had total blockage and needed to be admitted for near kidney failure. He eventually recovered from the TURP. As for how common prostate problems are, you take your age and that correlates directly with your chances of prostate enlargement. Peeing is taking longer and longer for my husband…,,

Snowbrush said...

"Well done Snowy. Sleep well. Philip"

Thank you, dear. I just worked my way through "Fawlty Towers" again, and wondered if you like it. I had what might be called a religious experience while watching it, and I knew you would want to be the first to know. What came to me was that Basil Fawlty is like the God of the Bible in that he's petty, angry, humorless, violent, narcissistic, threatening, two-faced, selfish, intolerant, judgmental, vengeful, dishonest, thinks others' actions are directed at him, and is incapable of seeing the world through the eyes of anyone but himself.

"My father decided to ignore his ever growing prostate until he had total blockage and needed to be admitted for near kidney failure."

I did a web search into how this could occur. It's pretty obvious really, but no one had told me that a total blockage was possible--perhaps most people die before it gets that bad.

"He eventually recovered from the TURP."

One reason I was given for having the surgery now was that I'm still "young enough" (73) to easily recover from it, yet I'm now six days out and still exhausted. I've had some serious surgeries in the past, but they didn't leave me this tired, but then I wasn't this old.

"As for how common prostate problems are, you take your age and that correlates directly with your chances of prostate enlargement. Peeing is taking longer and longer for my husband…"

Yes, of course, but I don't know the % of men who have the problem at various ages or how fast it typically develops. My father lived with me his last two years--he died at 85--yet I'm unaware that he had it--which was good because he wouldn't have been as tractable a patient as I.

Far Side of Fifty said...

Well you survived! That is the important part and after your bladder is done being angry you may feel better! You are correct it all takes longer when you are older! Get better soon!

Snowbrush said...

"My penis hurts just reading this."

Marion, dearest, the Deep South isn't the best place for transgender people, you know. Perhaps you should consider a move to the Willamette Valley where Oregonians are so accepting of people like yourself that we're helping puppies and kittens transition into their proper gender. Then too, if you came here, you would be away from hurricanes and tornadoes. Something else you would enjoy here is the absence of cockroaches. I have NO idea why they don't live here, but I've never seen a single one in my 33-years here (maybe they vote Republican, so don't feel comfortable among all the God-hating Commies). You could even grow moonflowers! I'm trying elephant's ears this year, but I put them into a planter three weeks ago (March was warm, so everyone was hoping that April would be the same), and it's been in the thirties almost every night since so I really know how they're going to do.

"Get well soon, Snow."

Thank you. I have missed you. Over the past 15 years or so, you have grown on me like a.... well, I'm not sure--not like lemon pie and pussy cats, certainly, but not like ringworms and mange either (my Yankee spell checker doesn't recognize the word mange).

You’re one tough son-of-a-bitch, for sure.

"I'm not! I'm not!" he said while sobbing and beating the floor with his fists.

"You are correct it all takes longer when you are older!"

I had a tonsillectomy when I was twenty, and a six year old boy had his out the same morning. By afternoon, he was enjoying ice cream, whereas I couldn't even swallow spit until the next day. I can only account for this in terms of age. When I had a knee replacement five years ago, I was assigned to a group of joint replacement patients (we were a day or two post-surgical). There was a woman in her eighties in that group, and she had had both hips replaced. She seemed to be doing fine, but I've sometimes wonder what the thinking of her surgeon was.

"Get better soon!"

Thank you. The well wishes of my readers mean a lot to me.

CreekHiker / HollysFolly said...

I'm glad you have this behind you and I'm hoping the bleeding and pain cease soon. Take care Snow!

Anonymous said...

My husband had this procedure. It was successful and made a huge difference in his quality of life. Kris

Snowbrush said...

An update: I'm continuing to recover nicely as far as the bleeding goes, but I remain awfully tired. Two days ago, I went on automatic and picked up a loaded cooler and carried it twenty feet through two narrow doors. Only when I reached my destination did I remember that I'm not supposed to lift more than ten pounds. I warily checked my pee the rest of that day and the next, but there was no apparent blood.

"I'm glad you have this behind you and I'm hoping the bleeding and pain cease soon."

Thank you, Creekhiker.

"My husband had this procedure. It was successful and made a huge difference in his quality of life. Kris"

Kris, you're back! I had been worried about you because I can't find your email address and you've never gone this long without commenting. I'm so glad you're here.