Mets Day 50 - 1 Month Post-Surgery Status Report

One month after my bladder, prostate, and 61 lymph nodes were removed, and a neobladder created, here is a status report on how I am doing in my physical recovery.  I will use this report as a benchmark of sorts to gauge my progression.  It may also be useful to other readers who are facing or may have the same surgery.

1.  The primary incision is almost completely closed.  There is a half-inch opening at the bottom of the incision that has not has skin form over it yet; it is still granulating and forming a scab.  There is almost no pain associated with the primary incision.

2.  The site of my JP drain is completely closed and healed.

3.  My SP tube site (removed 3 days ago) is still closing.  It is improving each day; the amount of yellowish discharge is decreasing.  There is still pain associated with it, but far less than when the SPT was in.  Jennifer dresses the site with hydrogen peroxide, cleans it with saline, then we put a 4x4 gauze over it, or a large band-aid. 

4.  My abdominal strength is still weak, but is slowly improving.  I can get up from chairs or exit from cars without assistance and usually without pain.  I must use my elbows to roll out of bed.  Rolling over in bed is probably the most problematic due to the SP tube site trying to close. 

5.  Voiding the neobladder can be done only while seated.  Not having had any guidance from a physical therapist, I am trying to squeeze a number of different muscle combinations. Usually, urine flow is weak to moderate, and lasts only a few seconds.  Complete voiding takes several minutes of trying different muscle combinations.  Putting external pressure on the areas of the neobladder occasionally helps.  There usually is mucus from the neobladder each time I void.  I have had no problems with blockage and have not had to self-catheterize. 

6.  Continence during the day is pretty good, as long as I void every two hours or so.  If I do not, then I may have a brief squirt of incontinence if I cough or move suddenly.  Today, for example, I am trying to go through the day for the first time without a Depends or a urine pad.  So far, so good. 

7.  Nighttime continence is more difficult.  I need to get up every 90 minutes or so (as short as every hour, usually no longer than every two hours) to void, or else I will leak into the Depends and/or urine pad.  I tried setting the alarm to wake me up, but found that I would wake up without it when I was on the edge of incontinence.  This means that I usually have not been in deep REM sleep, and not getting the physical rest to which I have been accustomed prior to surgery.  When I get up for the day each morning, I feel grey and foggy.  I find it more difficult to concentrate, and reading long and complex books or documents is far more difficult than before. This lack of good sleep, more than anything else, has impaired my mind and inhibited my desire and ability to return to work.  I am told that, eventually, the frequency of getting up each night will decrease to perhaps once or twice a night. 

8.  The overall level of pain that I feel each day is relatively low, although at times I still feel a moderate burning pain across my right side, from just past the SPT incision site to the right hip -- the same area where I felt the intense pain in the hospital.  I find that, on those times that I feel that burning pain, wearing a Thermacare heat wrap over the area substantially diminishes the pain.  So far, there is no pain associated with the cancer. 

9.  My voice has changed due to apparent scarring of my vocal cords during the intubation during surgery.  It sounds more hoarse than before surgery.  I also am unable to project as much power through my vocal cords as before.  I don't know if that is permanent. 

10.  Coughing, sneezing, and laughing are slowly getting less painful, as my abdomen heals.  I can now generate a deeper cough than I could a week or so ago, although it comes with a twinge of pain. 

11.  While not directly related to the surgery, my hair is different due to the chemotherapy.  It is thinner and has a bit of a curl to it - as opposed to my straight hair of before.  It also grows far slower than before. 

12.  I have lost about 20 pounds since May 1.  My appetite ebbs and flows - sometimes I'm ravenous, but usually I'm either less hungry, or not hungry at all.  I typically have a protein shake for breakfast.  I also make sure to drink lots of fluids during that day - usually Propel Zero or ice water.  Shockingly, I have little desire for Diet Coke (with or without lime).  This news may cause Coke to lose substantial market value.  Whether I eat lunch is entirely dependent upon how a feel.  It may be nothing, or it may be some fruit, or it my be more substantial.  Dinner is also dependent upon how I feel, although when I do eat, the portions are smaller than before.  I also find myself snacking less than before.  I can walk by a box of Girl Scout thin mints, or Entermanns, or cake, and feel zero desire -- far different than before.  All this is probably a good thing in the big picture, since I could stand to lose even more weight.  But I do not recommend this diet to anyone.

13,  Impotence is an unknown, as sexual activity has taken a back seat to physical healing.  I have noted that the days of morning wood appear to be over.