Surgery and Aftermath

 

This Wednesday will mark 2 weeks since my surgery to remove my prostate. I can't say that it's been a joy, but overall, I think things went well, and recovery is progressing, slowly!

A Mini-Vacation in Boston (Hardly)

We drove up to Boston on Tuesday 6/29, one day before the surgery. We booked a room at the nearby Inn at Longwood Medical hotel for 2 nights. The first night would be for 2 guests, the second for one. Steph would stay for 2 nights while my stay there was limited to just the one night. After that, I would "upgrade" to another "Inn" of sorts known as Brigham and Women's Hospital. Looking back, I would have much enjoyed staying with Steph and skipping this entire ordeal.

The Longwood Inn was actually quite nice with a nearby food court and restaurants. With the weight of surgery on both of us, we tried to enjoy the night before, knowing how much would change the following day. 

I was wearing my favorite "On the Water" tee-shirt that happened to have a picture of a big striped bass on the back. We rode down the slow and creaky elevator with a nice guy who looked to be about my age. He immediately saw the fish on my shirt and asked me if I enjoyed fishing. We chit-chatted about fishing all the way down, and then he casually mentioned that he was there for a blood disorder study. I could tell this was a home-away-from-home for him since he told me he lived in Maine. Our conversation turned a little sadder after he told me that he was already quite familiar with the area after having made the trip regularly with his wife who had stage 4 breast cancer. He was upbeat and matter-of-fact. We told each other to have a nice day. When we reached the street, Steph and I just stared at each other for a minute without much to say.

The following morning we enjoyed a leisurely cup of coffee and made our way over to the hospital for an 11 am check-in.

Pre-Surgery

We arrived at Brigham and Women's and were very fortunate that Steph was able to accompany me. They had just revised the covid visitor policy a couple of days earlier. I can't even imagine how people did this during Covid.

Once I arrived a the Pre-Operative Holding area, I was greeted by the kindest and most professional team of nurses and doctors I could imagine. Each medical professional that I came in contact with put me at ease and thoroughly explained every step. I met with two different anesthesiologists who explained that I would be getting an initial IV by which they would slowly start to introduce some "calming" drugs. 

I was also happy to see my surgeon who dropped by and casually mentioned that I would be patient number 2 of 3, having the same procedure that afternoon. In my slightly groggy state, I thought to myself, "You're gonna perform 3 of these, all this afternoon?". Here I was thinking that my surgeon was thinking about me, and only me, on this big day and for the lead-up over the last 6 months 😏. In reality, this was actually a good sign. For these types of complicated robotic surgeries, you're much better off with a surgeon in a major medical center who does a lot of these procedures vs some doctor doing his bi-annual prostatectomy muttering to himself, "hmmm, never come across that before". 

But in my slightly groggy outside voice I did say, "wow, you are a surgical superman" to which he chuckled. 

I signed a bunch of waivers and was wheeled off to the operating room. 

Surgery

Not much to say here. The only recollection I have is looking up at this round mega-light and hearing some words from the anesthesiologist. And then I was out.

When I read the anesthesia report days later, I would come to appreciate why anesthetists are so well compensated. And on that particular day in June, I would have voted for a pay raise for everyone in that room. 

My Anesthesia Cocktail: ceFAZolin (ANCEF), dexAMETHasone (DECADRON), dexmedeTOMIDine (PRECEDEX), ePHEDrine sulfate, fentaNYL, glycopyrrolate (ROBINUL), HYDROmorphone (PF) (DILAUDID), ketamine (KETALAR), lidocaine (XYLOCAINE), midazolam (PF) (VERSED), neostigmine methylsulfate (BLOXIVERZ), ondansetron (PF) (ZOFRAN), phenylephrine (NEO-SYNEPHRINE), propofol (DIPRIVAN), rocuronium (ZEMURON)

There was no way in hell I was waking up in the middle of the procedure with all that stuff running through my veins. 

The surgery lasted about 2 hours.

My surgeon would later call my wife and tell her that the surgery went well and that he was confident that he was able to get all the cancer. But we wouldn't know for certain until the pathology report came back in a week or so. 

Post-Surgery

I was not shy with the nurse call button. It wasn't lost on me that the icon looked a little like the IronMan MDOT logo (man that seems far away now! Someday!)

For all the good things I had to say about the Pre-Op process, the Post-Op/Recovery process left a little to be desired. As my faculties gradually started coming back to me, I remember first feeling somewhat complacent and even thinking to myself "this wasn't so bad". But as the drugs started to wear off the whole thing turned into a less-than-satisfying experience. 

I wasn't in the actual recovery area that long before they wheeled me off to another section down the hall called "Extended Recovery". At one point I had heard someone say that, due to a large number of surgeries, the usual recovery rooms were full and I would be spending the night in this "Extended Recovery" area. This is just conjecture, but I would not have been surprised if the operating rooms were overly busy because they were making up for lost time resulting from delayed surgeries due to Covid. 

Regardless of the reason, the area they had me in looked a bit like a convention hall with curtained partitions masquerading as hospital rooms. In reality, my tiny curtained area was right next to another guy, who I surmised was either patient number 1 or patient number 3 in the prostatectomy stack that afternoon. 

I recall being extremely thirsty and experiencing very strange pains that were increasing in intensity by the hour. My requests for something to drink would result in a little Dixie cup half-filled with ice chips and water and a tiny apple juice cup intended for a 6-year-old. I'm pretty sure I had been cut off of the IV fluids for quite a while at this point. These little water and juice cups weren't cutting it. It would be like finishing a half-marathon in 90-degree heat and being offered a single Dixie cup of water at the end. I asked for one jug of water and one jug of ice, which they begrudgingly brought me.

Then there was the pain. The pain started hitting me from different places. First, there was the catheter itself which was most unpleasant (and would stay with me for 10 days at home). When I asked for something to ease that pain, I was told "sure there's an ointment that will help a lot with that". Great!  "But first you much watch a 7-minute video followed by a 3-minute video on how to change and care for a catheter". Not great. It must have been around midnight at that point. I pleaded with the nurse to see if I could skip the video and just get some help with ointment. Instead, I was tossed a bunch of packets of soapy wipes, the magical ointment, alcohol wipes and, QTip thingies and told to watch the videos to figure out how to do my own mini surgical procedure. I wondered why I couldn't just watch these videos later or at home, but it turns out, they were like first-run movies that were only available in the theater, I mean hospital. Lesson #1 in this situation, don't use the alcohol wipes for anything around your skin. Turns out they were for wiping the tubing and plastic catheter connections when you switch from the large bag to the small "travel" bag, which the videos explained in great detail and which I never used the entire time. 😏

Then, general stomach pain started rolling in. It felt like I had done 100 sit-ups and 50 leg-raises the day before. I couldn't tell if this was muscle pain (after all, they did have to poke 6 holes into my stomach area for the procedure) or gas pain, or a combination of both. But this wasn't the half of it. 

A Pain in the Neck Shoulder!

Ok, so I had just had a bodily organ yanked out through my belly button. That would explain the overall discomfort in my abdomen area. I got that.

But what was up with the intense shoulder pain I was feeling? I had been warned about the after-effects of the carbon dioxide gas that is pumped into the abdomen area as part of the surgical process to expand the field of vision for the surgeon as he worked the robotic controls.

But I hadn't considered that what goes in must come out. This isn't the typical kind of burpee, farty gas you think of either. No. This gas gets pumped straight into the abdomen cavity and must find a way out on its own. Gas tends to travel upward, so the egress point for all this gas is, you guessed it, the shoulders. To say that it felt like I overdid it on the shoulder press machine at the gym wouldn't do it justice. It felt like my shoulders were slowly being pried off my body. 

Time to hit the nurse button again, more pain medicine please. 

Speaking of Pain Medicine 

We had recently watched a great documentary called Crime of the Century (on HBO), a searing indictment of Big Pharma and the political operatives and government regulations that enable over-production, reckless distribution, and mass abuse of synthetic opiates. 

I'm not sure if this was some type of pendulum reaction to the opioid crisis, but I found that my nurses were very hesitant to give me pain meds other than Tylenol. Believe me, I hate pain pills as much as anyone. But to go from 100mph on the drugs they loaded me up with during surgery to 2mph on Tylenol seemed a bit, abrupt. Reluctantly, they would give me one teeny, tiny oxycodone tablet when I asked and would eventually send me home with enough for a couple of days. My wife with no medical experience whatsoever would do a much better job managing my pain meds and ramping me down from his stuff than they did at the hospital. 

Home Sweet Home

Bourne Bridge Cape Cod

We're lucky to live on Cape Cod. Even though it's home, the excitement of driving over the Bourne Bridge when we return to the cape never gets old. One of us will typically mutter "we're on cape time now!". The feeling was particularly strong on Thursday, July 1st when we returned from Boston.

When we stepped into the house, there were a few guys putting the finishing touches on our bathroom remodel project that we had started a few months earlier. They left early and then it was just the 2 of us. It felt great to back home.

I was able to pretty quickly wean off of the pain meds. I started taking 1/2 Oxy pills, then just Tylenol, then nothing.

The toughest part of the recuperation was the catheter. That was rough. Though they sent me home with a smaller "travel" bag, I never used it. I just stuck with the large bag and got pretty good at concealing it in my Tear Away Basketball Pants. Kind of ironic, me, wearing old-styled basketball pants, when I've never been much of a fan of the game. But these pants were a game-changer in dealing with the catheter. 

I started increasing my walking distance after a couple of days. I finally graduated from laps around the kitchen and living room to short walks up and down the street. But this is when I started getting carried away. Quarter mile walks turned into 1/2 mile walks and I was feeling cocky. It was when I increased my walks to a full mile with some hills thrown in that the wheels started coming off the bus. I returned home to a catheter bag full of cherry-Kool-Aid-colored liquid. "This is bad" I thought to myself. "This is real bad". I frantically called the emergency number for my doctor. The nurse I spoke to asked me a bunch of questions and told me it should resolve on its own if I just cut out all the [crazy] walking. I toned down the walking back to a quarter mile and everything cleared up. Phew! Later someone would remind me that people with catheters typically don't walk a mile at a time. Another useless lesson learned. 

When the catheter finally came out on day 10, it was one of the best days of my life. Really. Top 10, maybe top 5 even. I had freedom, mobility, and the prospect of longer walks. Walking would have to take the place of running, biking, and weight-lifting for at least 6-8 weeks so I was anxious to get on with it. 

Walking - Time to Smell the Roses

I used to hate walking with a passion. Even though I felt that I could run forever as a kid, I despised walking. When my mother would take me to the mall with her, even the short walk between stores felt like a marathon.

But this time it was different. When I got up in the morning, I'd thrown on my sneaks and just walk out the door. No running shoes, shorts, shirts and HR straps. No Strava segments to shoot for. Just out the door and down the street. It sounds corny, but I felt acutely aware of the scents and sites along the way. From flowers to bunnies. I was loving it. 

It occurred to me that walking might not just be a running alternative for me after all this is done. I think there's a continuum of how much ground you can cover and how much of the small details you appreciate as you increase the speed of your locomotion. 

For example on the one extreme, you have walking. You're going slow. You can really take the time to appreciate small details and scents as you walk. Heck, you can even stop and talk to a neighbor if you feel like it. As you start moving a little faster with running, you cover a lot more ground, but start to lose the opportunity to appreciate little details along the way. The same thing happens as you move up to biking and even driving a car on the extreme end. Yes, you cover a lot of ground, which is great in its own right. But things start to go by so fast, you can't possibly appreciate the little details. Blink and it's gone. 

So yes, I will attempt to increase my walking time up to 1+ hours and maybe do it twice a day. This should get me to a similar calorie-burning mode as my daily runs (and rides). But even after I am able to get back to running I will make an effort to carve out a place for a daily walk!

So at this point, almost 2 weeks out from surgery, I am feeling better each day while anxiously awaiting my post-surgical meeting with my doctor to understand the actual results of the surgery, as confirmed in the pathology report. 

Till then, it's time to hit the roads - walking, that is. 

ps - Feedback is welcome. Feel free to leave a comment at the bottom or send me an email at Email Spike