3 Years Post Surgery

It's been nearly three years.  Time certainly flies.

Nothing has changed in the last year to year and a half.  The docs originally told me that it could take 2 years for things to reach equilibrium.  They were right.

Erectile Issues

I only used the injections for a few months.  They worked fine, but it wasn't long before nature took over and erectile functions were back to normal.  So, as far as I'm concerned, this is not an issue.

Pain

None.  Never really was an issue even shortly after surgery.

Continence

Still have urine leakage.  Nothing significant.  I wear a light pad mainly for peace of mind.  I had to quit using one brand because the deodorant they used smelled funny when there was any urine.  I'm using a thick pad now only because I could not find a thin pad.

The main issue with urine leakage is during sex.  I was expecting dry ejaculations, but, instead I get a gush of urine.  The amount depends on how full is my bladder.  Even if I have peed recently there will be some urine.  I find this rather disgusting.  I've talked to my doc and he says there is really not much that can be done - pee often and wear a condom.

Would I Make the Same Choice Again?

Yes.  Doing nothing was not a choice - my Gleason score was 7.  The choices for treatment were radiation (of various types) or removal.  With radiation I think I would always wonder if they got all of the cancer and would just be holding my breath waiting for something bad to show up in a future test.  As I stated in one of earlier posts, I feel that it was my prostate that had the cancer and now that it is gone, the cancer is gone.

I move on.
 

1 Year Post Surgery

It's been a year since surgery and my latest (June) PSA is below detectable limits.  That's great.  More confidence that there has been no metastasis, but still have to be vigilant.  Have a visit to City of Hope in early November.

Here is a summary of what is going on.

Erectile Issues

Erectile issue is slowly resolving itself.  While I still use injections to obtain "useable" erections, I find that I can get a partial erection without the injection.  Occasionally, I wake up in the night and find a fully erect penis (mine, of course).  So, it appears the nerve sparing efforts worked.  I'll just have to be patient.  Doc said it may take 2 or 3 years to regain full erectile function.

A little discussed related issue after prostate surgery is urine ejaculation.  I was told that after prostate removal, I would have dry ejaculations.  This makes sense as there is no prostate to produce the lubricating fluid and the tubes from the testicles have been cut.  But this is not the entire story.  I found that, on some occasions, I had a copious amount of ejaculatory fluid.  Searching the web, I found several discussions about this issue.  It turns out to be the obvious - the ejaculatory fluid is urine.  My testing with empty and full bladder showed the amount of ejaculatory fluid to be related to bladder fullness.  A surprise, but it can be dealt with - pee before sex and/or use a condom.

Continence

I still have minor urine leakage.  It is variable.  On rare occasions there will be enough sudden leakage to show through my pants.  Mostly it is just a tiny amount that shows up as yellow stains on my underwear.  

I am at fault.  I have not been doing my kegel exercises.  I do them for a while and then get lazy.  The result: yellow drawers.  I guess I have to develop a more consistent regime of kegeling.  I do not consider urine leakage to be any problem.  At worst I can wear a "man pad".

Urinary Tract Infection

On my first doctor visit after surgery, I mentioned to the doc that my urine smelled peculiar.  He said there was nothing in the surgery that affects urine odor.  I just went away thinking my nose had just gone awry.  

I looked on the web and could find little info on urine odor changes from prostate surgery.  The only urine odor changes were related to infections.  Since my doc had not mentioned the possibility of infection, I dismissed this as the cause.  Also, in April of this year I had my annual physical that included a urine test which showed no sign of infection.  But the odor persisted.

The odor seemed to get a little worse a few weeks ago, so I decided to try a regime of antibiotics just to see what happens (I bought some Amoxicillin for tropical fish on eBay).  Within two days the odor was mostly gone.  So I will continue the antibiotics for the full two weeks and see what is the outcome.  I may have to go to a more modern antibiotic if the odor returns, but at least I have confidence that I have had a UTI for nearly a year.  A little bothered that my doc had not been more on top of this.

Low Testosterone

I have had a history of decreasing testosterone level which is normal with aging.  However, mine had gotten below 300 about a year and half ago.  Due to the diagnosis of prostate cancer, there was no consideration of starting testosterone replacement therapy and this subject was put on the back burner.

But, now that a year has passed, I want to revisit T replacement therapy.  I just don't have the get-up-and-go that I did a year or two ago.  I blame this on my low T.  I asked for a testosterone test in June and the results showed the level to be just above 200.  To me, this seems really low as the normal value is around 600 or 700.

My surgeon said he will not consider T therapy until at least a year after surgery and then only if the PSA level was below detection limits.  My local urologist has the same position.  I plan to discuss this with my surgeon during my upcoming November visit.  I have read many "learned" articles on the issue of T therapy after prostate cancer, and the recent ones all conclude that there is little basis for not starting testosterone therapy.  We'll see how this goes.  I may have to run down to Mexico and get some T.

The Bottom Line

While I don't like the idea that I had cancer, the outcome has been far better than I expected.  Permanent limp dick and diapers was my fear.  The reality has been easy to deal with.  To me, the only issue that bothers me is the lack of energy.  This may just be the normal result of getting older (I will be 70 in October).

Life is good.
 

On My Own - Penile Injection

Seemed simple enough in the doctor's office.  Now for my attempt.

Tuesday Evening

Loaded the syringe with 15 units (3x what the doc gave me), pressed the Inject-Erect against the side of my penis, pressed the button, and "Oh crap.  I didn't leave it long enough and the med just pumped out onto the floor".  Lesson learned - Hold it in place for several seconds after pressing the button.  In fact, just do as the doc said, "Make sure the yellow indicator is showing in the window before removing the device".  

Well, since I didn't know how much actually got injected, I decided to NOT try again until the next evening.  I practiced "dry runs" with water in the syringe just to see how long it takes to pump out the dose.  

Wednesday Evening

Ok, loaded her up again with 15 units.  Left it in place until the yellow indicator was visible in the window (4 or 5 seconds).  Removed unit.  No squirting of med.  So now we wait.

After about 10 minutes things started happening and by about 20 minutes there was a "full mast" erection.  Eureka!!!

Everything felt absolutely normal and performed absolutely normal except that the erection does not go away after orgasm.  

So now the concern becomes "Will it go down, or will I have to go to the emergency room?".  

More waiting.  

After about an hour more worry about emergency room visit.

After about an hour and a half things started to lighten up.  

By about two and a half hours everything was back to normal.  What a relief (kind of an odd thing to say).

Thursday

Interesting things have been going on "down there" during the day.  Whereas before yesterday's injection, there was nothing going on "down there".  Willy just kept himself tucked away like a scared turtle.  But today - lots of activity.  No true erections, but lots of moving about.  Have seen more of Willy today than I have for the last 4 months.  Don't quite know what this means, but find it interesting.

Will try reducing the dose to 10 units next time.

For those interested in cost for the injection.  The med, Trimix, costs me (insurance does not cover any of it) approximately $125 for 5ml (500 units).  So, assuming 15 units/injection, the per injection cost is about $4.  Cheap fun.  Of course, your mileage may vary.

Penile Injection Lesson - Nov 24

As planned at the last meeting with Dr. Kawachi, I returned with my injection kit for instructions on proper use.  

The prescribed drug is Trimix, a mixture of three drugs - PGE-1, Phentolamine, and Papaverine.  While the major active ingredient is PGE-1, researchers have found that adding the other two drugs (mainly vascodialators) reduce or eliminate pain some experience with PGE-1 alone.  The ratio of the three can be adjusted if a person still has problems, but most users are fine with the default mixture.

To help get over the fear of sticking a needle in my penis, an autoinjector was included with my supply kit.  It is called an Inject-Erect.  Here is a link to a YouTube video showing how to use the device:

https://www.youtube.com/watch?v=Lt1lFhN2UmY

And it is just as simple as the video shows.  There is absolutely no pain.  

The doc loaded the syringe with 0.05ml of Trimix solution.  He said this was probably not sufficient to get a "useable" erection but it should be enough to get a response.  All he wanted to do was demonstrate there was nothing to fear and that the Trimix would indeed work.  And it did.  After about 5 or 10 minutes I had achieved a partial erection (about "1/4 mast" erection).  He was happy with the response.  It was left with me to keep upping the dose over the next several days to achieve the erection I wanted.  Dr. Kawachi suggested I try the next injection in about 24 hours and to be fairly aggressive.  Don't do 0.05ml again, but move on to 0.15ml.

As for frequency, he said that the general guideline was to do no more than 3 injections per week; however, he said this was just a general guide and not to worry about frequency other than to wait at least 24 hours between injections.  Anyway, he said, "Your wife will be the limiting factor regarding frequency."  Kidding aside, he said that the purpose of the injections for the first year or so will be to rehabilitate the penis - not just for intercourse.  Urologists are of the opinion regarding erections that you "use it or loose it".  The longer you go without having an erection, the more difficult it will be to ever have an erection.  And, eventually, you will not be able to have an erection at all.

He did offer a stern warning about an erection that did not go down within about 2 hours.  If that happens I MUST call the hospital for instructions on how to relax the erection.  An erection that lasts more than 6 hours can (will?) cause irreversible damage to the penis.  An erection is the result of blood filing the copra cavernosa lying along both sides of the penis.  The blood is trapped inside during the erection and no new blood flows in or out.  Thus, if the blood stays in place too long, it will begin to clot.  A very bad thing.

I left with a smile and partial erection (and the hope that it would go down by the time I got home - about 2 hours).  Sure enough, it did.

I wait with anticipation for this evening's attempt.

4-Month Post-op Checkup

Went to COH yesterday for my post-op.  Most important issue was to get PSA measured since it is the indicator of any possible spread of the cancer.  The result was PSA less than 0.04, which is the same as zero.  So that was great news.  Just hope it stays that way.

Continence was discussed.  I am essentially down to zero pads.  I wear one sometimes just for peace of mind, but don't really need to.  Doc said continence will continue to improve for up to 3 years after surgery, so not to worry even if things were not going well.

Potency was a different issue.  No erections even with the Cialis.  Again he said not to worry - these were early days and things will improve.  COH believes in a proactive program of penile rehabilitation that includes pills such as Cialis, stimulation, and injections.  Here is a link to a YouTube video by John Mulhall of Memorial Sloan Kettering describing penile rehab.

 https://www.youtube.com/watch?v=ie8NkOu2VNA

My doc wants me to start injections in a couple of weeks.  He will order the meds from a compounding pharmacy in San Diego (something called Trimix).  The meds and auto-injector will be shipped to me.  When I get them I am to return to COH for instructions on how to properly use the device and to determine the correct dosage.  Kind of scary thinking about sticking needles in my penis.  

Been reading experiences on the net.  Here is one interesting article.

http://www.franktalk.org/phpBB3/viewtopic.php?f=5&t=2105 


Nothing else of significance.  I am happy with my progress.

Will report again after the injection visit.  Hmm... will there be a video?

Post-op 4week recheck - July 23

Wednesday
 
Blood test results showed PSA less than 0.04, which is the detection limit (before surgery my PSA was 7.0).  This means no cancer cells escaped from the prostate.  In other words - I AM CANCER FREE!  Hopefully, I can keep saying that for years to come.  Will return in November for another checkup.

On the continence level, all is progressing well.  I could do with just one light pad per day if I had to, but I change a couple of times to keep from smelling like pee.  I am not aware that I smell like a homeless person, I'm just a little paranoid.  Sneezing, farting and blowing my nose generally cause a small leak.  Walking, as long as I keep my core muscles firm, is no problem.  It's just when I stop and unconsciously let my muscles relax do I leak.  Doc said that my progress was great and that by the next visit, I should be virtually 100% dry - just wear a light pad as insurance.

On the Cialis level, no success as yet, but we will keep trying.  The doctor said keep at it on a regular basis.  "Use it or lose it", he said.

BM department is back to normal.  I stopped taking the stool softeners and then everything became normal again.  Stool softeners may be great, but they tend to gum up the works.

Don't have any pain.  Strength seems normal.  Maybe a little down due to lack of regular exercise.  I walk around the resort each morning, but need to do more.

I don't know when I'll write next.  Hopefully, it will be to report Cialis success.

We plan to start our normal motor home journey on Monday.  It's 115 here today.  We will go to Oregon and Washington, where it will be cooler.

Happy, happy, happy.

End of Post-op Week 3 - July 12

No major happenings.

Continence continues to improve.  Just have to remember to empty the bladder before going off to one of the big-box stores.  Oh yes, always take along a spare pad.

Nothing up in the Cialis department.

Surgeon called me on Wednesday (must have been a slow clinic day).  I told him how I was doing and he said that everything sounded pretty normal.  I go to see him on July 23.

Still a bit surprised how slowly my bowel movements are to return to normal.  Not there yet, but close.  Am doing more walking first thing in the morning in hopes of getting things moving along.

Probably won't write anymore until after I visit the doc on July 23.

 

End of Post-op Week 2 - July 3

Writing day-to-day became somewhat of a bore.  Not any really different things going on - just improvements in the same things.  Improvement IS important!

I keep getting better in the no-pee department.  Today I got up with a dry pad, ate breakfast, had a large mug of coffee, took Max on a golf cart ride, and went on a long walk  around the resort (all by 8:30).  Had a wet pad after the walk.  Showered and changed pad.  It's now nearly 5 pm and pad is still dry.

BM department is moving a bit more slowly (pun intended).  Kind of crampy with inconsistent BM's.  It gets better each day, but not yet normal.  Maybe 80% normal.

Still have some abdominal pain.  After watching another detailed, fully narrated RALP on Youtube, I have better appreciation of why my guts might hurt.  It is better each day.

Nothing is up in the Cialis department.

I'm still happy, happy, happy with my progress.

I think I'll move to weekly writeups unless some great and wonderful thing happens one day.

Post-op Day 10 - Monday

Monday

Basically same report as yesterday - dry night, some issues standing.

Did go to Home Depot and walked up and down all the isles (nice indoor park when it's 110 outside).  Had a pretty soaked pad when I was done.  That was to be expected.  Hopefully, things will continue to improve.

In expectation of the future, I did a little Googling about male incontinence aids.  Here are some photos of possible candidates.

Fashionable Underwear

Squeezers

 Slip  on's

And, finally, the industrial strength cap.

 

Post-op Day 9 - Sunday

Sunday

Dry pad this morning.  Got up 2 or 3 times as the urge dictated, but did not try to test the limits of how long I could hold it.  I'll wait a week or so before testing such things.

Both sitting and lying down are no problem at all.  It's just when I first stand.  Actually, about 5 seconds after I stand up.  If I prepare myself, there is generally no pee burst.  So, encouraged I am.  I only used 3 pads today and none of those were really soaked - just a wet spot a couple of inches in diameter.

Feeling better in the abdomen department.  Not any gassy feeling today at all.  Incisions are starting to itch as they heal.  Baboon balls are deflating.  Still tender areas.

Ok, now for the Cialis story.  Sorry to disappoint, but nothing like the warnings on the TV ads.  Nor did I go biking, hiking, sitting in dual bath tubs, or any of the other exciting activities shown on the TV ads.

Tomorrow I will return to exercising (walking).  I expect wet pads.

 

Post-op Day 8 - Saturday

Saturday

The night was uneventful.  No giant wet spot in the morning.  Got up 3 times and peed with success.  Man pad only had a small wet spot.  From what I've read, few people have leakage when lying down.  Sitting is also pretty easy.

I find a short burst of pee is likely to occur when I first move to a standing position.  However, if I prepare myself, there is no problem.  Laughing, however, is a problem.

I keep practicing my kegel exercises.  I am convinced they are key to retaining bladder control.

Also, I think I have an advantage due to having had a TURP four years ago.  A TURP, conventional or green light laser as in my case, destroys the bladder neck sphincter forcing you to rely solely on the external sphincter.  I've had 4 years of practice, so I don't need to learn anew how to control the external sphincter.

However, the prostatectomy has done two things that adversely affect my external sphincter - possibly damaged some of the nerves controlling this sphincter, and allowed me to become lazy about sphincter control because of the catheter.  I don't know how significant has been the damage to any nerves, so can't really quantify the extent of that factor.  Maybe there is no damage.  However, I'm convinced that not having to think (even subconsciously) about maintaining bladder control for an entire week has been a bad thing.  My experience has been that if you goof off for X amount of time, it takes several times X amount of time to get back on track.

But, so far, I am encouraged.

Sitting is much easier without the catheter.

Still a little gassy, but only slightly.

I will start my Cialis tonight.  Tomorrow's post may have to be censored.

Post-op Day 7 - Friday - Catheter Removal Day

Friday

Drove over to COH this morning.  Got there an hour and half earlier than my appointment, but they took me right in and removed my catheter and performed a flow test.  The nurse practioner gave me a bottom line on the pathology report.  Also, got meds for interesting drug test.

The nurse removed the urine bag and syringed about 100cc of water into my bladder.  She asked me to tell her when I felt a strong need to urinate.  She then removed the catheter - no pain, just a kind of eerie sensation.  I stood up and peed.  Was even able to stop and restart stream.  Bladder emptied just fine.  I proudly put on my "man pad" held in place by my briefs and pulled up my trousers.  Now I just have to learn how to NOT pee.  A catheter makes you very lazy in this regard.  I think it would be better if they removed it after only a couple of days.  Maybe not even use one at all.

The bottom line on the pathology report is no evidence of cancer spread outside the prostate.  The prostate margins were clear and the removed lymph nodes showed no sign of disease.  Not absolutely conclusive, but pretty close.  The PSA test in a month will be more definitive.  The PSA value should be below detectable limits if there has been no spread of cancer.

Now for the really weird part.  When we went in for the initial consultations with the docs, we were told that they (COH) have been trying a new post-op protocol using Viagra.  Their thinking is that since Viagra (and other similar ED drugs) increases blood flow to the areas just recently messed with, then maybe that would improve rate and quality of recovery.  So, I now take a Viagra (actually Cialis) every day for the next 9 to 12 months.  I can't tell if Gayle is excited or not.

Home now practicing not peeing.

Post-op Day 6 - Thursday

Thursday

Got up feeling crappy.  Painful lower abdomen.  Kind of like I had been doing a bunch of situps.  Guess I did too much walking yesterday.

Took my Levofloxacin antibiotic in preparation for tomorrow's catheter removal.

Later in the morning I felt dizzy and foggy.  Looked up side effects of the antibiotic - sure enough, dizziness.  I was expecting an antibiotic to give you gut problems, not make you dizzy.

Speaking of gut, I still am not back to normal in that department.  Still have gas and just out-of-wack digestive track.  I think I drank too many fizzy soft drinks too early.  I was warned not to.

It's about 8:30 pm now and my dizziness seems mostly gone.  Still have gassy gut, but not a big problem (I hope).

Will drive over to COH in the morning  for 11:30 appointment.  The catheter was kind of fun for a while, but it has worn out its welcome.  What follows; however, may be worse.  They told me to bring some "man pads" for after the catheter.

Post-op Day 5 - Wednesday

Wednesday

Nothing of much interest to report.  Feeling better with regards to the surgery each day.  However, the one thing I have noticed is the effect of increased exercise.  I'm feeling it in my hips and legs.  My usual exercise has been water aerobics, so, with all the walking, my hip joints and legs are getting a lot more workout than before. 

Last night I slept on my stomach for the first time (I don't know why - when I woke up, I was on my stomach).  I noticed there was a wet spot on the sheet about where the drain had been removed.  A bit of a surprise.  I do know that I was still having quite a bit of drainage (at least in my opinion) prior to removal of the drain on Saturday.  They tested the fluid and concluded it was not urine, so, assuming the lab results were correct, there should be no problem.  Remember, I was discharged on a Saturday and it took 9 hours for them to get the lab results for the drainage sample.  I remain cautious.  When I have the catheter removed on Friday, I will quiz them (whoever the "them" is that I get to see) about drainage.

Urine is nice and urine colored (looks like apple juice), so apparently have no bleeding issues.  I make a lot urine. 

I seem to be aware of the catheter more today.  Kind of like a hard object rubbing inside my urethra.  Feels more on the bottom side of the urethra.  Feels better if I lay down or stand up. 

Bumped into someone this morning on my walk who had just yesterday learned of my prostate cancer.  He stood very close and whispered.  "How was I doing?", etc...  It took me by a bit of a surprise as I still cannot get too excited about this cancer thing.  It does not even occur to me that I have cancer.  My prostate gland had cancer and now it is gone, so I don't have cancer.  Of course, this may not be true.  Certainly won't have any data in this regard until after my first PSA blood test on July 23.  I will keep my fingers crossed.

 

Background and the First 4 Days After Surgery

I just felt like I needed to write down what goes on in the process of dealing with a cancer diagnosis and the events that follow.  This is my story.  I have no idea how it will end.

Background

On May 12, 2014 my urologist informed me that my biopsy results were positive for prostate cancer with a Gleason score of (3+4)=7.  This meant that most of the cancer cells were slower growing (grade 3), but there were some more aggressive cancer cells (grade 4).  Because of the presence of the more aggressive cells, he recommended that I needed to take some form of action - I was not a candidate for any of the "watch and wait" protocols.

Since the first hint that there was a problem on the prostate front (an abnormal DRE on March 27), I had begun studying prostate cancer.  My background as an engineer and research scientist made this a most logical approach.  The Internet provides a vast amount of information that helped clearly explain the disease and its treatment options.  I was well prepared when meeting with my doc.  Based on the information gleaned off the Internet and listening to my doc's advice, I quickly decided on removal of the prostate.

Being 68 years old and in good health, left all the treatment options open.  There were three: surgical removal, radiation therapy (many choices), and cryotherapy.  In cryotherapy they freeze the entire gland, not just the region containing the tumor.  This seemed rather "coarse" and would not be amenable to sparing the nerve bundles running along the outside of the prostate, so I quickly ruled it out.  Radiation therapy comes in a range of techniques.  However, in all of them, the target is the detected tumor.  What about some very small, yet undetected tumor that might come to light a few years down the road?  Nope, not willing to chance it.  Get rid of the whole thing once and for all.  

For some reason, the cancer diagnosis was no big thing.  I found the people around me were much more upset than I was.  I kept asking myself was I just in denial, but I didn't think so.  In fact, at no point have I been really upset except when they were getting ready to wheel me into the operating room.  I had cancer.  There were treatment options.  I studied them carefully.  I understood what I read.  I knew what the risks were and was willing to accept them.  My wife and I openly discussed the options and possible side effects.  She was completely supportive and agreed with my "get rid of it once and for all" attitude.  Choice made, let's get on with it.
 
My doc recommended going over to Loma Linda or City of Hope (or any other place of my choice) for surgery.  Both are reasonably close to the Palm Springs area (70 miles to LL and 120 to COH). So, back to the Internet to study both hospitals and their staff.

It was a tough choice.  Both are apparently great hospitals.  However, COH had more experience (number of procedures) with robot prostate surgery.  But, as my doc pointed out, once you do a few thousand of these, it doesn't really matter if your experience base is 3000 or 10000, you will have seen most every thing several times.  Anyway, I chose COH.  One thing I found annoying about LL was it's constant waving of the "Proton Therapy" banner.  Just do a Google search on LL and you will see what I mean.  I really didn't want them waving that banner at me when I was trying to make decisions.

My doc made me an appointment with COH and I went over on June 4 to meet with the docs.  They appeared confident and spent time with me and my wife answering all questions and clearly explaining what was to be done and the possible outcomes.  We both came away satisfied that COH was a good choice.  My surgery was scheduled for Friday, June 20, 2014 by Dr. Yamzon.  (Note to self: NEVER schedule surgery on a Friday).

Friday - Surgery Day

While I didn't feel scared or even too anxious, my blood pressure was 174.  It's normally 125.  Clearly my insides were bothered.

The anesthesiologist gave me a shot just before they wheeled me into the OR at about 9:15 am.  I remember nothing until about 5 or 6 pm when I was in my room.  About 8 pm my wife said I was doing fine, but was mostly incoherent and not a lot of fun to be around, so she went back to the motel to get a good night's sleep.

Mat was the nurse on duty who took great care of me (I guess, I was mostly loopy).  It was a really long night.  I would go to sleep and sleep soundly, but for only a few minutes to half and hour.  Which was ok, because Mat was always in and out checking on me.  Anyway, the night seemed to take forever.  No pain or particular discomfort.  Mostly felt like I had done about 500 situps.  I think Mat gave me some happy juice a couple of times.

Saturday

About 5am, Mat made me get up and walk around.  I was very tentative in moving, fearing that something would break loose causing great amounts of pain.  No such thing happened.  Walking was great.  I mostly sat in a chair or walked around from then on until I was released later in the day.

When the wife came in about 8am, I told her I didn't think I would be able to go home today as I felt quite "beat up".  Also, noticed I had a case of "Baboon balls".  Ever noticed on the nature shows how massive Baboon balls are?  Well, I now had a set.  I had read somewhere that this was a side effect for a day or so.   Penis was hidden away like a scared turtle.

About the middle of the morning Mat gave me a new happy pill, and things began to feel much better.  Each trip up and down the hall was easier and I began to feel pretty good.  My noon, I was chomping at the bit to go home.

The catheter was not a problem at all.  I had previous experiences with a catheter, so there were no surprises.  It's really quite nice in that you can sleep all night without having to get up to go pee.  Plus you get to see in real time how much urine you generate.  And how your intake of fluids affect the urine production.  It's really quite interesting.  You make a lot of pee really fast, especially if you are hooked to an IV and are drinking lots of fluids.

I was discharged about 3pm.  I was a little concerned about my comfort level during the upcoming 2 hour drive back to the Palm Springs area, but it turned out to be no problem at all.  We stopped about half-way and I walked around a bit.

Went by the kennel and picked up the dog and headed home.

Sat down in front of my computer to check emails and such.  Went to bed at my normal time.  No particular pain or any other issues.  Slept well.

Sunday

Today I have a lot of gas pain in my guts from the CO2 they pumped into me.  I was warned about this and told to walk and fart as much as possible.  This I did.

Hung around watching TV, computer, dog, wife, ...  Rather boring.  Meaning everything was normal.  If it was not boring, then something must be wrong.  I took a pain pill (oxycodone) just to see if things would move along a little faster.  Took a nap.

Monday

Felt even better, but still gassy.  Also, had not yet had a BM, so that added to gas pain.  More walking with farting.  About noon, BM success.  Gas pain all gone.  

Continued the day with normal "do nothing because it is 108 degrees outside".  Worked on learning how to write a Java Android app for my Nexus tablet.  I want to monitor the engine and transmission of our motorhome.  Just engineer geekiness.

Keep feeling better.  Another long walk in the evening.

Oh, there was a terrible part of the day.  That was trying to schedule my post-op visits to COH.  They may be a great hospital, but their scheduling service SUCKS.  It took some 3 hours and conversations with 7 people to get my return appointments confirmed.  I believe all the problem goes back to the fact that I was discharged on a Saturday (remember my note about not having surgery on a Friday).  While the hospital might like you to believe they are a 24/7 operation, this ain't true.  There were several screw ups in trying to get discharged and the discharge instructions regarding scheduling my post-op visits was wrong.  Anyway, after more pain and agony than the surgery, my visits got scheduled correctly (I hope).

Another good night's sleep.

Tuesday

Feeling even better.  Went a nice long walk before it got hot.  Just sitting here writing, I feel perfectly normal.  Well, I guess the catheter does pull a little when I wiggle around.

The wife had bought me all kind of nice sweet things to eat, so I just finished the last pudding cup.  And the jello cups went yesterday.  Back to bread and water, I guess.