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