Pre-op is Like Foreplay

Pre-op is like surgery's foreplay. There, I've made it pretty easy for you to decide whether you want to keep reading or not. C'mon, my last post was about Viagra - is this really a surprise as a follow-up? Note: my blood pressure measures higher at Memorial Sloan-Kettering than any place in the universe. I keep telling them that I'm a boring 120/72 kind of guy everywhere else, and they always ask, "Are you nervous?" Now why would I be nervous ?

Running out of arms

Seriously, is there anything more entertaining than a day full of answering the same questions over and over again, and being poked, prodded, pricked, X-Rayed, MRI'd, etc.? I contend there is not. But do I really need an 8 hour day of this for a 3-5 hour surgery? Apparently, yes. Good thing they keep asking you your name and date of birth, because at one of my 4 appointments, I was greeted with, "Hi, Mr. Fernandez!" Oh crap. Me: "Um, nooooo, I would be Mr. Rose." Them, cheerily: "Well, it's a good thing I asked!" Why, yes indeedy, good for you. Note to self: write my name all over my abdomen. With a Sharpie. Maybe even the name of the procedure. And my date of birth. Possibly my wife's cell phone number if clarification is needed once I've been sent to la-la land. Maybe end with "remove prostate, not penis". Color me concerned, as this IS the #2 cancer hospital in the country.

Then there was the "consent" doctor, who signs off on everything to make sure I'm okay for surgery, even though all my tests are not yet completed at this time. He seemed genuinely perplexed at the number of surgeries/injuries I had, and wanted me to list them, complete with dates. I can't remember what I had for dinner last night, yet I'm supposed to remember ~20 surgeries, broken bones, dislocations, etc.. But the kicker was when he mentioned I still had my MRI to do (no surprise there), and that they would probably be doing the MRI with a rectal probe (BIG surprise there). Very, VERY long pause. Me: "I'm sorry, but did you say... RECTAL probe?!?!?" Him: "Yes, that's the best way for them to look at the prostate, I'm sure that's what they'll be doing. It's no big deal, after all the things you've been through." No big deal. Reassuring. I withheld the fact that there's been so many visits to my rectum by so many different people in the last couple of months, that it should soon appear as a tourist attraction on Yelp.

So, for those of you who stuck around long enough, how is Pre-op like foreplay? It lasts longer. No one tends to fall asleep during it (well, not if you're doing it right). It really does help you for what comes next. And, it tends NOT to involve scalpels. As for my blood pressure measuring higher at MSK than anywhere else? I'm thinking hearing the words "rectal probe" may have something to do with it. Peace.

Viagra - Yeah, I Went There

I was prescribed Viagra pre-surgery to increase blood flow to the area, which can aid in healing and reduce complications. At least that's my story and I'm sticking to it. That said, these things are friggin' expensive! I'm surprised there's not more 50+ year-old crime out there (excluding Wall St and Congress, of course). Ask your doctor if Viagra's right for you? Nah - ask your attorney if you can afford it. B&E becomes B&E&E - Breaking and Entering and Erect. Lovely. Should make for an interesting bus ride to the prison.

The stated side effects are interesting: dizziness, nausea, ringing in the ears, blurred vision combined with a raging erection. Sounds very much like college. And what an attractive specimen we may become, lurching about, falling over, zombie-like, all the while we're pitching a tent in our pants. Now it sounds like a typical Match.com first date.

My prescribed dosage is 25 mg, which wouldn't be a problem except for the fact that the pills are 100 mg oval pills. OVAL. Try cutting an oval pill into 4 equal parts with a knife (see pic) without winding up with a shard of Viagra embedded in your eye. That is not an emergency room visit you want to be involved in, my friend; those ER nurses will talk about THAT one for years. It will, however, not likely eclipse frozen rodents as the leader of foreign objects removed in an ER.

Redneck pill cutter

So, to the question you've been dying to ask...no, none of the side effects happened, not even the intended effect - at least not an urban legend-level effect. Maybe because it's just a quarter of the regular dosage, but I didn't feel anything different. Now you'll have to excuse me, I have walnuts to crack. Look Ma, no hands! Peace.

Catheter the Great

Cancer's one of those things that most people keep private. But when the majority of people are unaware of what's going on, no one wins. It's like Congress that way. But not me, and that's one of the reasons I blog about it - ignoring it doesn't make it go away, and blogging about it may help someone. It certainly helps me.

Ok, so back to being snarky about this whole cancer thing. So far we've covered ninjas, Kegel exercises, pelvic floors, erectile dysfunction and incontinence. Let's face it, that's a whole lot of fun right there. I mean, throw in an infection and we're talking PAR-TY. But what's a real party without a catheter?

Every guy reading this just shifted uncomfortably in their seat (psst, it doesn't go in your seat, guys). It's an interesting juxtaposition: minimally invasive surgery/maximally invasive bladder control. Like anything there's pros and cons. The pros? Pretty much limited to the one: the fact that you can relieve yourself at any time, without moving. Anytime. While eating, watching TV, having a conversation, even walking. I'm serious - you can simultaneously urinate while driving - no more rest stops!! Women won't understand this, but improving your door-to-door time for men is our holy grail. You know what I'm talking about. Try to do any of those without the use of a catheter and you'll likely be arrested, slapped, asked to leave the restaurant, lower your trade-in value, etc. It's basically stealth urination. They should give these things to spies. Maybe they do - how would we know?

The cons? There are many, starting foremost with: eww. Secondly, they insert a 115 foot tube into your manhood! Okay, it's not 115 feet long, but if that's the part that concerned you, then I submit you are not a male. It will be (or at least SHOULD be), the first time something has gone INTO that particular part of your anatomy. That's just wrong. Anywhere. Anytime.

I've had this pleasant experience a few times in conjunction with surgeries. Sometimes they do it while you're still under, other times after you've woken up. Do yourself a favor and request it be done while you're in a semi-coma; this is not something you want to be a cognizant party to. It's much better to wake up and wonder, "Hmm, I wonder where that tube goes?". Don't worry, the nurses are used to the anguished screams of discovery. It lets them know you're awake and also that you have, indeed, discovered you've been catheterized.

It's really the removal you need to be concerned with, and, more importantly, the current state of emotion of the nurse who will be removing it. Catch them at a good time, i.e., they've just been told they're getting a raise and shorter shifts, and they will gently and tenderly remove it, telling you what a big, brave boy you are while they do so. Catch one that has just learned her husband has been sleeping with her sister, and she will likely pretend she is starting a 27", gas-powered, 6 forward gear snow thrower. If you were the one above who focused on the length of the tube instead of it's entry point, I'll spell it out for you: You're the snow thrower. Ouch. Peace.

Cancer's a "Curve Ball" - Really?

This one won't be humorous; this post is a needed venting.

It's okay if I decide to make light of my cancer and joke about it; it's okay if my close friends and family do as well (double standards are one of my top pet peeves, so if I'm going to dish it out, I have to take it, too.) It's even better when people tell me I'll be fine, I'll beat it, or some variation of that, because it's obvious it's meant to be positive, uplifting and to wish me well.

What's not okay is when someone callously dismisses your cancer as a "curve ball in your life", acting as if it's no big deal. That is taking insensitivity to a whole new level, in my opinion. There wasn't a hint of compassion or concern, it was meant as dismissively as it sounds. The utter lack of empathy shouldn't come as a surprise to me, since it has always been totally lacking in this person, yet I still stared at the written words (yes, she actually put that in writing), shocked by their coldness.

I'm not sure, knowing that, why I expect better from this person, but there you have it; when you're optimistic, you get disappointed. It comes with the territory. Sorry, but I just needed to get that out. I promise I'll be back to sarcastic and snarky in my next post. Peace.

Kegel All the Way Home

Radical Retropubic Prostatectomy (RRP) is a very large term for removing a very small organ. Like any surgery, there can be unwanted side effects, but this one includes, among others, incontinence (oh joy) and erectile dysfunction (oh joy joy). These are usually temporary, but could be longer lasting, even permanent. Yikes. The good news is that I can help my recovery immensely and reduce the risk of these nasty complications by doing Kegel exercises.

Women are probably more familiar with Kegel exercises than men. This is understandable, because for men to exercise something, it better be able to grow larger and be tattooed, otherwise it's not worth the effort. This also explains our reluctance to exercise our brains, good judgement and, of course, caution. Yes, doing so would reduce ER visits nearly by half, which would be good for our gender, but bad for the economy. So, you're welcome, glad we can do our part in the recovery.

The Kegel muscles are a part of the "pelvic floor", two words most men would never think to combine, let alone exercise. I checked my Bowflex manual; no mention of Kegel muscles (or pelvic floor, for that matter). No such free weight exercise, either; at this point, I'm still not convinced Kegel exercises exist. Enter Google. Google tells me I can "find" my Kegel muscles while urinating, by "shutting off" the stream. This was obviously written by a woman, since for a guy, once we start, we have absolutely no desire to stop. In many ways this is very similar to our behavior towards sex, including the length of time it takes us to do either. They are also supposedly the muscles you use to hold in a fart; again, something no real man would ever willingly or knowingly do, so no point of reference here, either.

But I'm a "good" patient, so I've been doing these exercises since I read about them. My pelvic floor muscles are now capable of crushing my own prostate (kind of a do-it-yourself RRP). It also strengthens your sphincter - so I'm ready for my next DRE (digital rectal exam). And I promise you - someone's gonna lose a digit. Peace.

Ninja Cancer post #2

MSKCC (Memorial Sloan-Kettering Cancer Center) visit was interesting; the surgeon upped my Gleason score from 7 to 7.5 (who knew they used fractions?) and recommended a Radical Retropubic Prostatectomy, which is a minimally invasive robotic surgery that will remove my ninja cancer-ridden prostate as well as the surrounding lymph nodes. Still getting my head around the removal of an organ being considered "minimally invasive"...

Even though the bone and CAT scans were negative for the ninjas metastasizing, they are recommending a pelvic MRI to both verify those results and aid in the surgery. Which brings up an interesting question: can I have an MRI without the implant in my right leg (and rod in one of the fingers on my right hand) being forcibly removed by the magnetic pulses? Because I'm guessing that would probably sting.

I showed them this picture on my phone, and suddenly everyone there forgot about my cancer and wanted to take a look at it. I guess when your day has you looking at nothing but prostates, genitalia and anuses, an implant that looks like it's from the front end of a '58 Chevy becomes something of a novelty. And yes, I said anuses, because even though they are urologists, apparently a DRE (that's Digital Rectal Exam) MUST be performed on each visit, and yes, it IS as pleasant as it sounds. I can hardly wait for the next one, but they could at least buy me dinner first.

The good news is both implants are what are considered "MRI-compatible", so there's no threat of them flying out of my body. I'm scheduled for the surgery the first week of October, so it's a waiting game for now. Time to get into surgery shape and prepare for ninja removal. Peace.