Mets Day 111 - 3 month post-surgery report

Ninety days after my bladder, prostate, and 61 lymph nodes were removed, here's how things stand:

1.  The oncologists tell me that it is almost certain that I have microscopic urothelial cancer floating around in my body, most likely my lymphatic system, but the first post-surgery scans (bone scan and full-body CT scans) showed no evidence of metastatic activity.  Having failed GemCis chemotherapy, there is no proven second-line treatment for someone in my position.  The standard of care is watch at wait.  Statistically, there is a very high likelihood that the cancer will recur in a distant location -- most likely the liver, lungs, or bone -- but sometimes it doesn't.  And in the meantime, I go on with life, with a renewed appreciation of how precious each day is. 

2.  The primary incision is healed, and is becoming smoother to the touch.  No problems. The SPT scar is completely healed, and I have had very little pain associated with it in the past month.  Every now and then, I'll get a twinge of nerve pain across the right side of my pelvis, which I attribute to lingering scar tissue.  Maybe I should have another massage by Mike Taylor to break up the last of that scar tissue.

3.  I am slowly regaining abdominal strength, although I have assiduously avoided anything resembling an organized exercise program.  After the big windstorm, I started using my chain saw to cut up some of the fallen trees, although I eventually I got some sense and turned it over to my son and son-in-law. 

4.  As detailed in recently blog posts, voiding the neobladder for most of the past month has been very difficult.  Last Friday the urologist figured out that scar tissue had nearly completely closed off the exit point from the neobladder into the ureter.  That problem seemed to be the source of many of my urinary issues.  The doctor punched through the scar tissue using a series of catheters and succeeded in reopening the hole, at least for now.  There is a chance that it will begin to close again; I am to closely monitor my urine flow to see if it changes.  Two days ago the Foley catheter was removed, and since then I have been able to pee normally. 

5.  Nighttime continence remains a work in progress.  My leakage at night has dramatically decreased, although I am not ready to give up the Depends just yet. I am hopeful that enlarging the opening will enable me to completely empty my neobladder before going to bed.  Combined with modifying my diet to avoid drinking anything after dinner, perhaps I can stay dry at night.  I'm still trying to figure out what works best for me.

6.  My pain level has dropped through the month.  I find that I rarely need to take the prescription-strength Naproxin, or any other pain medications.  With the lack of sleep, my stamina has still been weak, but for the past couple of nights I've slept for four hours straight, and feel like a new man.  I know everything is relative, and hopefully as I get more sleep, my stamina and energy level will continue to increase.

7.  My vocal cords seem to have mostly recovered from the scarring during the intubation during surgery.

8.  My hair remains thinner and grows slower.  Last weekend I got my first hair cut since leaving the hospital.

9.  My appetite is near normal.  I made chocolate chip cookies last night and ate raw cookie dough while watching the Olympics, so life is good. 

10.  No change yet with regard to impotence, although the pelvic floor nurse at GW wants me to get a vacuum device that pulls blood into the penis.  She explained that, like any other muscle, the penis needs to be in an erect state several times a day or else it will atrophy.  (Sounds like a great pick-up line to me.)  She was trying to tell me that I should use this thing five times a day.  I think I'll bring Jennifer in to the next appointment and see if she's, er, up for it.