A Month Downstream

prostate_logo The month in question is the month following the removal of my catheter, which is, of course, when my stream started. 😀 As I was being packed off home with my initial supply of continence pads to deal with my constant stream when upright, my urology nurse told me she’d see me in four weeks time at Stoke Mandeville hospital and, “trust me, your leaking will have improved by then”. This constituted two pieces of good news: not only did they expect my situation to improve but poor Carol would not have to drag me all the way over to High Wycombe hospital next time.

My appointment was last Friday and I certainly felt that I’d made progress. I had gone from an almost constant stream, leaking whenever I wasn’t sitting or lying down, to having some rudimentary control over my stream and being able to move for short distances around the house remaining largely dry. I’d progressed from two large pads a day and now, helped by knowing my limitations and choosing tasks accordingly, I was able to make a single intermediate pad last a whole day. Improved though I was, however, I still felt as though my improvement was mostly down to short-term PC muscle control, courtesy of good ol’ pelvic floor exercises, and had a few questions for nursie.

3:30 PM on a weekday is pretty much the worst possible time for an outpatient appointment at Stoke Mandeville. It’s probably the worst time for an appointment at any British hospital given their universally inadequate parking arrangements. Not only have the afternoon’s patients all pitched up but it’s visiting time, too, so all the inmates’ visitors are also driving around searching for non-existent parking spots.

Given the need to park about 1,000 cars in 750 official parking spaces (numbers are a complete guess but you get my point), many vehicles are forced to park on yellow lines, roundabout islands, grass verges, etc. – anywhere there is space, albeit illegal. I should say, “erstwhile grass verges”, really. There had been a lot of heavy rain recently and, as we drove into the hospital grounds, I saw all manner of vehicles that, having slithered to a halt, were now arranged at rakish angles on what once had been grass but which had now been churned into a boggy quagmire by too many car tyres. The vehicles were reminiscent of abandoned military hardware and, together with the mud, made the place look more like a Somme battlefield than a hospital. All that was needed to complete the illusion was a few strategically positioned shell craters. Ah, there they are! Oh, no, my mistake, that’s just part of the regular building activity. Good substitute, though.

Carol dropped me at the outpatients entrance to minimize my leakage distance – I didn’t want to add to the already saturated boggy ground, after all 😀 – and went off in search of somewhere illegal to abandon our car. She returned about 15 minutes later having had to leave the hospital grounds following a fruitless search, eventually having parked in a residential street, legally it seemed, across the main road. Those residents must get really hacked off with the hospital overspill.

We wandered down a corridor or two to the nurse’s waiting area. I felt quite buoyant ‘cos I didn’t think I’d leaked. Yeah! Running a mere 30 minutes late at Stoke Mandeville is good going so we were happy to be seen at 4:00 PM when my progress summary got me a that-sounds-normal kind of thumbs up.

The question uppermost in my mind stemmed from my feeling that much of my improvement seemed due to muscle control. Since I had already misinterpreted what they meant by incontinence (I’d expected stress incontinence but had something more like total incontinence), I wanted to know what their idea of getting my continence back meant.

Do you expect sphincter control to return since I’m clearly never going to be able to do a 5-mile walk with clenched pubococcygeus muscles.

After explaining that pubococcygeus muscles were pelvic floor, a.k.a. Kegel, muscles, with some relief, I heard that they did, indeed, expect sphincter control to return eventually, though cases vary greatly and it can take quite a while for some. The majority get it back within three months but for a small percentage of men, continence does not return. Naturally, I’m hoping that I’ll stick with the majority. After all, one of my reasons for going in for the surgical option as soon as possible was to be as young and fit as I could be, giving myself the greatest chance of a full recovery.

The nurse quizzed me about my drinking habits and did suggest that I might like to avoid caffeine since that can be a bladder irritant. [Strike One!] Of course, though the nurse didn’t mention it, alcohol is a muscle relaxant so it might be advisable to avoid that, as well. [Strike Two!] It’s a long time since I attended a baseball game but I think that means, one more strike and I’m out.

Still, at least sitting on the bench arrests my stream. 😉

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