It took surprisingly little time, considering that this is the NHS we’re talking about, for things to start moving once I had chosen a radical prostatectomy as my preferred course of action. After a little over a week, an appointment arrived for us to meet with the surgeon on 21st September. Yet another chance to marvel at the inadequate parking facilities at our hospitals.
Along with the various prostate cancer solutions with which I had originally been presented, came a leaflet on each. Actually, only the surgical option really seemed like a potential solution; the others being more like containment/management. The leaflets explained each treatment and, of course, gave a balance sheet of their expected benefits and potential detrimental effects. The meeting with the surgeon put a little more detail on the summary leaflet for surgery and provided us with a chance to ask questions. Doubtless, it was also designed for him to assess me as a case [Ed: and let’s face it, I am a case.] and ensure I wasn’t about to have a sudden change of heart over his slice-and-dice skills.
Radical prostatectomy procedures come in a few different flavours. If there can be said to be a traditional approach to this kind of surgery, I think it’s been the cut-one-large-hole approach. Even this, it seems, had some subcategories based upon exactly where the surgeon chose to cut said large hole. A more modern approach is laparoscopic surgery [Ed: good grief, I spelt that right first time – scary!] or the cut-several-smaller-holes approach. The appeal of several smaller holes is that they heal faster than one large hole. I think four holes are used, one for a camera and three others for assorted sterilized screwdrivers, pliers and chisels, etc. An even more modern version of laparoscopic surgery exists which is robotic laparoscopic, the fly-by-wire approach in which the surgeon drives a robot to manipulate the tools. This is relatively new and has restricted availability in the UK.
I’d be getting the hands-on personal approach to laparoscopic surgery. That’s fine, I programmed computers professionally for 30+ years and the thought of a prostate-extracting robot going into an infinite loop and having to be rebooted in the middle of operating theatre doesn’t appeal. Laparoscopic would be the surgeon’s initial approach; it apparently can become necessary to revert to the cut-one-big-hole approach but let’s hope in my case. So far, so good – I’d heard nothing that was about to dissuade me from my chosen course of action.
Our main question was:
How do you get a relatively large prostate gland out through five relatively small holes? We assume you don’t want to slice up an organ containing cancer cells to extract it piece by piece?
Good question, Carol! No, no, rest assured, once disconnected, the offending organ is put into a purse-like bag, one of the plethora of holes is made large enough to stretch over the bag, et voila!
Mr Surgeon expected this to happen in about a month. I mentally stretched that estimate expecting it to be one NHS month which did, in fact, turn out to be equivalent to two calendar months. Still not bad. The interesting thing here is that, in the intervening time until hospital admission, Mr. Surgeon encouraged me to do pelvic floor exercises. Yikes! I’ve heard of those; girls do them but I’d no idea how. Mr Surgeon explained the technique and suggested 10 reps 10 times a day. Darwin, it’s like being back at the gym again! These exercises potentially help the post-operative recovery of, shall we say, “urinary control”.
My initial condition had already made me become a stage 1 girlie by causing me not to pass a loo willingly without using it. Now I was being regaled to become a stage 2 girlie by indulging in pelvic floor exercises. I’m hoping not to go to stage 3 by talking about naff-all for hours on the phone. Should the worse happen and I arrive at stage 4 which I define as regarding shopping as entertainment or as an Olympic sport, I shall be seeking further medical attention in the form of a frontal lobotomy. [Ed: crumbs – spelt that right first time, too!]
Right, back to my daily gym regime of pelvic floor exercises …